title: Visualization and quantification of disease progression in multiple system atrophy.
abstract: To visualize and quantify disease progression in multiple system atrophy (MSA) from cerebellar type (MSA-C), we combined two magnetic resonance imaging (MRI) techniques, voxel-based morphometry (VBM) and 3D-based volumetry. Patients suffering from MSA-C (n = 14) were imaged twice with an interval of 2.0 +/- 0.2 years. We first applied VBM to map brain morphology changes between MSA patients and controls and to identify brain areas that showed a significant amount of atrophy. Using 3D-based volumetry, we confirmed that in MSA-C patients, the brainstem including medulla and pons, vermis and cerebellar hemispheres, caudate nucleus and putamen showed significant atrophy compared with controls. Next, we used 3D-based volumetry to analyze the atrophy rates. Atrophy rates in patients with MSA were significantly different from controls for putamen (-11.4% +/- 2.6%/year), vermis (-12.3% +/- 2.9%/year), and cerebellar hemispheres (-6.6% +/- 1.1%/year). The results show that 3D-based MRI volumetry is a tool that allows the disease progression of MSA to be followed over a time period of 2 years and suggest that it may serve as a surrogate marker in clinical trials to measure disease progression.
authors.affiliation: Department of General Neurology, Center of Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.
authors.forename: Till-Karsten
authors.initials: TK
authors.lastname: Hauser
authors.forename: Andreas
authors.initials: A
authors.lastname: Luft
authors.forename: Martin
authors.initials: M
authors.lastname: Skalej
authors.forename: Thomas
authors.initials: T
authors.lastname: Nägele
authors.forename: Tilo T J
authors.initials: TT
authors.lastname: Kircher
authors.forename: Dirk T
authors.initials: DT
authors.lastname: Leube
authors.forename: Jörg B
authors.initials: JB
authors.lastname: Schulz
mesh_terms: D000368:Aged; D001921:Brain / Q000473:pathology*; D001933:Brain Stem / Q000473:pathology; D002421:Caudate Nucleus / Q000473:pathology; D002531:Cerebellum / Q000473:pathology; D018450:Disease Progression; D004292:Dominance, Cerebral / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008432:Mathematical Computing; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000175:diagnosis*; D011699:Putamen / Q000473:pathology