Journal of Neurology

, Volume 262, Issue 8, pp 1876–1882 | Cite as

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

  • Jae-Hyeok LeeEmail author
  • Tae-Hyung Kim
  • Chi-Woong Mun
  • Tae-Hyoung Kim
  • Yong-Hee Han
Original Communication


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.


Multiple system atrophy Subtypes Longitudinal MRI Iron Volume Putamen 



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.

Conflicts of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Jae-Hyeok Lee
    • 1
    • 2
    Email author
  • Tae-Hyung Kim
    • 3
  • Chi-Woong Mun
    • 3
  • Tae-Hyoung Kim
    • 4
  • Yong-Hee Han
    • 5
  1. 1.Department of Neurology, Research Institute for Convergence of Biomedical Science and TechnologyPusan National University Yangsan HospitalYangsanSouth Korea
  2. 2.Medical Research InstitutePusan National University School of MedicineYangsanSouth Korea
  3. 3.Department of Biomedical EngineeringInje UniversityGimhaeSouth Korea
  4. 4.Department of NeurologyDong-Eui HospitalBusanSouth Korea
  5. 5.Center for Molecular and Cellular Imaging, Samsung Biomedical Research InstituteSeoulSouth Korea

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