title: Diffusion-weighted imaging in multiple system atrophy: a comparison between clinical subtypes.
abstract: Multiple system atrophy can be classified into two main types, a Parkinsonian (MSA-P) and a cerebellar (MSA-C) variant based on clinical presentation. We obtained diffusion-weighted magnetic resonance imaging (DWI) in 9 MSA-P and 12 MSA-C patients and 11 controls, and correlated DWI changes with disease duration and severity. We found that Trace (D) values in the entire and anterior putamen were significantly higher in MSA-P than in MSA-C patients and controls, whereas Trace (D) values in the cerebellum and middle cerebellar peduncle (MCP) were significantly higher in MSA-C than in MSA-P patients and controls. Increased disease duration was significantly correlated with increased Trace (D) values in pons of MSA-P patients, and in cerebellum and MCP of MSA-C patients. Both UMSARS and UPDRS motor scores positively correlated with entire and posterior putaminal Trace (D) values in MSA-P patients. The diffusivity changes parallel phenotypical and pathologic differences between MSA-P and MSA-C patients, suggesting that DWI is a feasible tool for in vivo evaluation of neurodegeneration in MSA. Based on our findings, Trace (D) measurements in the putamen and pons in MSA-P patients and in the cerebellum and MCP in MSA-C patients could serve as quantitative markers for microstructural damage in the course of disease.
authors.affiliation: Department of Neurological Sciences, University Federico II, Naples, Italy.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Pellecchia
authors.forename: Paolo
authors.initials: P
authors.lastname: Barone
authors.forename: Carmine
authors.initials: C
authors.lastname: Mollica
authors.forename: Elena
authors.initials: E
authors.lastname: Salvatore
authors.forename: Marta
authors.initials: M
authors.lastname: Ianniciello
authors.forename: Katia
authors.initials: K
authors.lastname: Longo
authors.forename: Andrea
authors.initials: A
authors.lastname: Varrone
authors.forename: Caterina
authors.initials: C
authors.lastname: Vicidomini
authors.forename: Marina
authors.initials: M
authors.lastname: Picillo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Michele
authors.forename: Alessandro
authors.initials: A
authors.lastname: Filla
authors.forename: Marco
authors.initials: M
authors.lastname: Salvatore
authors.forename: Sabina
authors.initials: S
authors.lastname: Pappatà
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001931:Brain Mapping; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000145:classification* / Q000473:pathology*; D012720:Severity of Illness Index