Callosal Tissue Loss in Multiple System Atrophy-A One-Year Follow-Up Study

Department for Clinical Engineering, Haukeland University Hospital, Bergen, Norway
Movement Disorders (Impact Factor: 5.68). 11/2010; 25(15):2613 - 2620. DOI: 10.1002/mds.23318
Source: PubMed


Multiple system atrophy (MSA) is a neurodegenerative disease not only affecting the basal ganglia, brainstem, cerebellum, and intermediolateral cell columns of the spinal cord but also the cerebral cortex. Clinically, cerebellar (MSA-C) and parkinsonian variants of MSA (MSA-P) are distinguished. We investigated 14 MSA patients (10 MSA-C, 4 MSA-P, men: 7, women: 7; age: 61.1 ± 3.3 years) and 14 matched controls (men: 7, women: 7; age: 58.6 ± 5.1 years) with voxel-based morphometry (VBM) to analyze gray and white matter differences both at baseline and at follow-up, 1 year later. Baseline comparisons between patients and controls confirmed significantly less gray matter in MSA in the cerebellum and cerebral cortex, and significantly less white matter in the cerebellar peduncles and brainstem. Comparisons of tissue-loss profiles (i.e., baseline versus follow-up) between patients and controls, revealed white matter reduction in MSA along the middle cerebellar peduncles, reflecting degeneration of the ponto-cerebellar tract as a particularly prominent and progressive morphological alteration in MSA. Comparisons between baseline and follow-up, separately performed in patients and controls, revealed additional white matter reduction in MSA along the corpus callosum at follow-up. This was replicated through additional shape-based analyses indicating a reduced callosal thickness in the anterior and posterior midbody, extending posteriorly into the isthmus. Callosal atrophy may possibly reflect a disease-specific pattern of neurodegeneration and cortical atrophy, fitting well with the predominant impairment of motor functions in the MSA patients. © 2010 Movement Disorder Society

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    • "However, it was difficult to select data only for pathologically confirmed patients, and the diagnosis in this study was clinically evaluated by an experienced neurologist based on consensus criteria. Third, we failed to detect the gray matter volume loss of the substantia nigra as well as in previous VBM studies, although the neuronal loss of substantia nigra is a hallmark of MSA-P (Mamata et al., 2002; Minnerop et al., 2010; Tir et al., 2009). Even though the software used for the analysis and the evaluation of spatial resolution have greatly improved, the segmentation of MRIs of nuclei located in brainstem remains a weakness. "
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