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Progression of subcortical atrophy and iron deposition in multiple system atrophy: a comparison between clinical subtypes

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Abstract

Magnetic resonance imaging (MRI) can be useful not only for the diagnosis of multiple system atrophy (MSA) itself, but also to distinguish between different clinical subtypes. This study aimed to investigate whether there are differences in the progression of subcortical atrophy and iron deposition between two variants of MSA. Two serial MRIs at baseline and follow-up were analyzed in eight patients with the parkinsonian variant MSA (MSA-P), nine patients with cerebellar variant MSA (MSA-C), and fifteen patients with Parkinson’s disease (PD). The R2* values and volumes were calculated for the selected subcortical structures (caudate nucleus, putamen, globus pallidus, and thalamus) using an automated region-based analysis. In both volume and R2*, a higher rate of progression was identified in MSA-P patients. Volumetric analysis showed significantly more rapid progression of putamen and caudate nucleus in MSA-P than in MSA-C. With regard to R2* changes, a significant increase at follow-up and a higher rate of progression were identified in the putamen of MSA-P group compared to MSA-C and PD groups. This longitudinal study revealed different progression rates of MRI markers between MSA-P and MSA-C. Iron-related degeneration in the putamen may be more specific for MSA-P.

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Acknowledgments

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2014R1A1A2059252). The sponsor’s role was confined to financial support. The sponsor was not involved in the design, methods, subject recruitment, data collections, analysis, and preparation of reports.

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The authors declare that they have no conflict of interest.

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    Authors and Affiliations

    1. Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomo-ri, Mulgum-eup, Yangsan, Gyeongsangnam-do, 626-770, South Korea

      Jae-Hyeok Lee

    2. Medical Research Institute, Pusan National University School of Medicine, Yangsan, South Korea

      Jae-Hyeok Lee

    3. Department of Biomedical Engineering, Inje University, Gimhae, South Korea

      Tae-Hyung Kim & Chi-Woong Mun

    4. Department of Neurology, Dong-Eui Hospital, Busan, South Korea

      Tae-Hyoung Kim

    5. Center for Molecular and Cellular Imaging, Samsung Biomedical Research Institute, Seoul, South Korea

      Yong-Hee Han

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    1. Jae-Hyeok Lee
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    2. Tae-Hyung Kim
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    3. Chi-Woong Mun
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    Correspondence to Jae-Hyeok Lee.

    Additional information

    Jae-Hyeok Lee and Tae-Hyung Kim contributed equally to this study as first authors.

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    Lee, JH., Kim, TH., Mun, CW. et al. Progression of subcortical atrophy and iron deposition in multiple system atrophy: a comparison between clinical subtypes. J Neurol 262, 1876–1882 (2015). https://doi.org/10.1007/s00415-015-7785-5

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    • DOI: https://doi.org/10.1007/s00415-015-7785-5

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