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Visualization and quantification of disease progression in multiple system atrophy

Authors

  • Till-Karsten Hauser MD,

    1. Department of General Neurology, Center of Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
    2. Department of Neuroradiology, University of Tübingen, Tübingen, Germany
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  • Andreas Luft MD,

    1. Department of General Neurology, Center of Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
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  • Martin Skalej MD,

    1. Department of Neuroradiology, University of Tübingen, Tübingen, Germany
    2. Department of Neuroradiology, University of Magdeburg, Magdeburg, Germany
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  • Thomas Nägele MD,

    1. Department of Neuroradiology, University of Tübingen, Tübingen, Germany
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  • Tilo T.J. Kircher MD,

    1. Department of Psychiatry and Psychotherapy, RWTH Aachen University, Aachen, Germany
    2. Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
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  • Dirk T. Leube MD,

    1. Department of Psychiatry and Psychotherapy, RWTH Aachen University, Aachen, Germany
    2. Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
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  • Jörg B. Schulz MD

    Corresponding author
    1. Department of General Neurology, Center of Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
    2. Department of Neurodegeneration and Restorative Research, Center of Molecular Physiology of the Brain and Center of Neurological Medicine, University of Göttingen, Göttingen, Germany
    • Department of Neurodegeneration and Restorative Research, DGF Research Center “Molecular Physiology of the Brain,” Center of Neurological Medicine, University of Göttingen, Waldweg 33, D-37073 Göttingen, Germany
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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. © 2006 Movement Disorder Society

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