Department of Neurology, Medical University Innsbruck, Innsbruck, Austria.
Neuroimaging Research Core Facility, Medical University Innsbruck, Innsbruck, Austria.
Mov Disord. 2024 Jan;39(1):119-129. doi: 10.1002/mds.29633. Epub 2023 Nov 7.
To determine the rates of brain atrophy progression in vivo in patients with multiple system atrophy (MSA).
Surrogate biomarkers of disease progression are a major unmet need in MSA. Small-scale longitudinal studies in patients with MSA using magnetic resonance imaging (MRI) to assess progression of brain atrophy have produced inconsistent results. In recent years, novel MRI post-processing methods have been developed enabling reliable quantification of brain atrophy in an automated fashion.
Serial 3D-T1-weighted MRI assessments (baseline and after 1 year of follow-up) of 43 patients with MSA were analyzed and compared to a cohort of early-stage Parkinson's disease (PD) patients and healthy controls (HC). FreeSurfer's longitudinal analysis stream was used to determine the brain atrophy rates in an observer-independent fashion.
Mean ages at baseline were 64.4 ± 8.3, 60.0 ± 7.5, and 59.8 ± 9.2 years in MSA, PD patients and HC, respectively. A mean disease duration at baseline of 4.1 ± 2.5 years in MSA patients and 2.3 ± 1.4 years in PD patients was observed. Brain regions chiefly affected by MSA pathology showed progressive atrophy with annual rates of atrophy for the cerebellar cortex, cerebellar white matter, pons, and putamen of -4.24 ± 6.8%, -8.22 ± 8.8%, -4.67 ± 4.9%, and - 4.25 ± 4.9%, respectively. Similar to HC, atrophy rates in PD patients were minimal with values of -0.41% ± 1.8%, -1.47% ± 4.1%, -0.04% ± 1.8%, and -1.54% ± 2.2% for cerebellar cortex, cerebellar white matter, pons, and putamen, respectively.
Patients with MSA show significant brain volume loss over 12 months, and cerebellar, pontine, and putaminal volumes were the most sensitive to change in mid-stage disease. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
确定多系统萎缩（MSA）患者体内脑萎缩的进展速度。
疾病进展的替代生物标志物是 MSA 的一个主要未满足需求。使用磁共振成像（MRI）评估脑萎缩进展的 MSA 患者的小规模纵向研究得出的结果不一致。近年来，开发了新的 MRI 后处理方法，可以可靠地自动量化脑萎缩。
对 43 例 MSA 患者进行了连续 3D-T1 加权 MRI 评估（基线和随访 1 年后），并与早期帕金森病（PD）患者和健康对照组（HC）进行了比较。使用 FreeSurfer 的纵向分析流以观察者独立的方式确定脑萎缩率。
MSA、PD 患者和 HC 患者的基线平均年龄分别为 64.4±8.3、60.0±7.5 和 59.8±9.2 岁。MSA 患者的基线平均疾病持续时间为 4.1±2.5 年，PD 患者为 2.3±1.4 年。MSA 病理主要受累的脑区表现出进行性萎缩，小脑皮质、小脑白质、脑桥和壳核的年萎缩率分别为-4.24±6.8%、-8.22±8.8%、-4.67±4.9%和-4.25±4.9%。与 HC 相似，PD 患者的萎缩率最小，分别为小脑皮质-0.41%±1.8%、小脑白质-1.47%±4.1%、脑桥-0.04%±1.8%和壳核-1.54%±2.2%。
MSA 患者在 12 个月内出现明显的脑容量损失，小脑、脑桥和壳核体积在疾病中期最敏感。
