title: Cortical atrophy in the cerebellar variant of multiple system atrophy: a voxel-based morphometry study.
abstract: This study aimed to determine in vivo the atrophy patterns in clinically established cerebellar variant of multiple-system atrophy (MSA-C) using voxel-based morphometry (VBM). Thirteen patients with MSA-C (12 probable, 1 possible) and 13 healthy controls matched for age and sex were included. High-resolution MR images were acquired with a 1.5 T scanner. Images were normalized onto a study-specific template, segmented into the tissue compartments, modulated with the Jacobian determinants, and finally smoothed with a Gaussian kernel filter of 10 mm. The general linear model was used to assess statistical differences in gray and white matter. Infratentorial atrophy was observed in the cerebellar hemispheres, vermis, mesencephalon, and pons of MSA-C patients. Supratentorial volume loss was found in orbitofrontal and mid-frontal regions as well as in temporomesial and insular areas of both hemispheres. A negative correlation was observed between a cerebellar ataxia score and the volume of cerebellar hemispheres, peduncles, and pons. To compare this atrophy pattern to that of spinocerebellar ataxia (SCA2), which was previously reported by our group, a conjunction analysis was assessed. We observed a volume loss shared by both disorders comprising the cerebellum, vermis, pons, mesencephalon, orbitofrontal, mid-frontal, and temporomesial cortex of both hemispheres as well as the left insular cortex.
authors.affiliation: Clinical Department of Neurology, Innsbruck Medical University, Innsbruck, Austria. christian.brenneis@uibk.ac.at
authors.forename: Christian
authors.initials: C
authors.lastname: Brenneis
authors.forename: Sylvia M
authors.initials: SM
authors.lastname: Boesch
authors.forename: Karl E
authors.initials: KE
authors.lastname: Egger
authors.forename: Klaus
authors.initials: K
authors.lastname: Seppi
authors.forename: Christoph
authors.initials: C
authors.lastname: Scherfler
authors.forename: Michael
authors.initials: M
authors.lastname: Schocke
authors.forename: Gregor K
authors.initials: GK
authors.lastname: Wenning
authors.forename: Werner
authors.initials: W
authors.lastname: Poewe
mesh_terms: D000328:Adult; D000368:Aged; D001284:Atrophy; D002524:Cerebellar Ataxia / Q000175:diagnosis*; D002531:Cerebellum / Q000473:pathology*; D002540:Cerebral Cortex / Q000473:pathology*; D003937:Diagnosis, Differential; D004292:Dominance, Cerebral / Q000502:physiology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008432:Mathematical Computing; D008636:Mesencephalon / Q000473:pathology; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000175:diagnosis*; D011149:Pons / Q000473:pathology; D020754:Spinocerebellar Ataxias / Q000175:diagnosis*