Skip to main content
SpringerLink
Log in

Progression of brain atrophy in multiple system atrophy

A longitudinal VBM study

  • ORIGINAL COMMUNICATION
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

In this study, we aimed to determine the progression of brain atrophy in the parkinson variant of multiple system atrophy (MSA-P). Voxel-based morphometry was applied to two consecutive high resolution MR images of 14 patients with probable MSA-P in comparison to 14 patients with Parkinson’s disease (PD). The time interval between baseline and follow-up investigations (1.0 ± 0.5 SD years in MSA-P and 1.4 ± 0.6 SD years in PD patients) was introduced as covariate in the statistical analysis. Additionally, correlation analyses were performed between the progression maps and clinical data. We observed marked progression of brain atrophy in the MSA-P cohort, the regions including striatum, mesencephalon, thalamus and cerebellum, but also cortical regions such as the primary sensorimotor cortex, supplementary motor area, lateral premotor cortex, medial frontal gyrus, middle frontal gyrus, orbito-frontal cortex, insula, posterior parietal cortex and hippocampus. Short disease duration was correlated with progression of atrophy in the striatum whereas longer disease duration was correlated with increasing atrophy in the cortical areas and cerebellar hemispheres. The UPDRS-III score was not significantly correlated with any brain region. Our data suggest that cortical atrophy is prominent in MSA-P and early degeneration of the basal ganglia drives late onset cortical atrophy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Reference

  1. Brenneis C, Boesch SM, Egger KE, Seppi K, Scherfler C, Schocke M, Wenning GK, Poewe W (2-2006) Cortical atrophy in the cerebellar variant of multiple system atrophy: A voxel-based morphometry study. Mov Disord 21(2):159–165

    Article  Google Scholar 

  2. Brenneis C, Seppi K, Schocke MF, Muller J, Luginger E, Bosch S, Loscher WN, Buchel C, Poewe W, Wenning GK (2003) Voxel-based morphometry detects cortical atrophy in the Parkinson variant of multiple system atrophy. Mov Disord 18:1132–1138

    Article  PubMed  Google Scholar 

  3. Gilman S, Low PA, Quinn N, Albanese A, Ben Shlomo Y, Fowler CJ, Kaufmann H, Klockgether T, Lang AE, Lantos PL, Litvan I, Mathias CJ, Oliver E, Robertson D, Schatz I, Wenning GK (1-2-1999) Consensus statement on the diagnosis of multiple system atrophy. J Neurol Sci 163:94–98

    Article  Google Scholar 

  4. Good CD, Johnsrude IS, Ashburner J, Henson RN, Friston KJ, Frackowiak RS (2001) A voxel-based morphometric study of ageing in 465 normal adult human brains. Neuroimage 14:21–36

    Article  PubMed  CAS  Google Scholar 

  5. Horimoto Y, Aiba I, Yasuda T, Ohkawa Y, Katayama T, Yokokawa Y, Goto A, Ito Y (2002) Longitudinal MRI study of multiple system atrophy - when do the findings appear, and what is the course? J Neurol 249:847–854

    Article  PubMed  Google Scholar 

  6. Hughes AJ, Daniel SE, Kilford L, Lees AJ (1992) Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 55:181–184

    PubMed  CAS  Google Scholar 

  7. Klockgether T, Faiss J, Poremba M, Dichgans J (1990) The development of infratentorial atrophy in patients with idiopathic cerebellar ataxia of late onset: a CT study. J Neurol 237:420–423

    Article  PubMed  CAS  Google Scholar 

  8. Konagaya M, Konagaya Y, Sakai M, Matsuoka Y, Hashizume Y (30–3-2002) Progressive cerebral atrophy in multiple system atrophy. J Neurol Sci 195:123–127

    Article  Google Scholar 

  9. Konagaya M, Sakai M, Matsuoka Y, Konagaya Y, Hashizume Y (1999) Multiple system atrophy with remarkable frontal lobe atrophy. Acta Neuropathol (Berl) 97:423–428

    Article  CAS  Google Scholar 

  10. Lantos PL (1998) The definition of multiple system atrophy: a review of recent developments. J Neuropathol Exp Neurol 57:1099–1111

    PubMed  CAS  Google Scholar 

  11. Ozawa T, Paviour D, Quinn NP, Josephs KA, Sangha H, Kilford L, Healy DG, Wood NW, Lees AJ, Holton JL, Revesz T (2004) The spectrum of pathological involvement of the striatonigral and olivopontocerebellar systems in multiple system atrophy: clinicopathological correlations. Brain 127:2657–2671

    Article  PubMed  Google Scholar 

  12. Robbins TW, James M, Lange KW, Owen AM, Quinn NP, Marsden CD (1992) Cognitive performance in multiple system atrophy. Brain 115(Pt 1):271–291

    Article  PubMed  Google Scholar 

  13. Robbins TW, James M, Owen AM, Lange KW, Lees AJ, Leigh PN, Marsden CD, Quinn NP, Summers BA (1994) Cognitive deficits in progressive supranuclear palsy, Parkinson’s disease, and multiple system atrophy in tests sensitive to frontal lobe dysfunction. J Neurol Neurosurg Psychiatry 57:79–88

    Article  PubMed  CAS  Google Scholar 

  14. Seppi K, Yekhlef F, Diem A, Luginger, Wolf E, Mueller J, Tison F, Quinn NP, Poewe W, Wenning GK (2005) Progression of parkinsonism in multiple system atrophy. J Neurol 252:91–96

    Article  PubMed  Google Scholar 

  15. Su M, Yoshida Y, Hirata Y, Watahiki Y, Nagata K (2001) Primary involvement of the motor area in association with the nigrostriatal pathway in multiple system atrophy: neuropathological and morphometric evaluations. Acta Neuropathol (Berl) 101:57–64

    CAS  Google Scholar 

  16. Tison F, Yekhlef F, Chrysostome V, Balestre E, Quinn NP, Poewe W, Wenning GK (2002) Parkinsonism in multiple system atrophy: natural history, severity (UPDRS-III), and disability assessment compared with Parkinson’s disease. Mov Disord 17:701–709

    Article  PubMed  Google Scholar 

  17. Tsuchiya K, Ozawa E, Haga C, Watabiki S, Ikeda M, Sano M, Ooe K, Taki K, Ikeda K (2000) Constant involvement of the Betz cells and pyramidal tract in multiple system atrophy: a clinicopathological study of seven autopsy cases. Acta Neuropathol (Berl) 99:628–636

    Article  CAS  Google Scholar 

  18. Watanabe H, Saito Y, Terao S, Ando T, Kachi T, Mukai E, Aiba I, Abe Y, Tamakoshi A, Doyu M, Hirayama M, Sobue G (2002) Progression and prognosis in multiple system atrophy: An analysis of 230 Japanese patients. Brain 125:1070–1083

    Article  PubMed  Google Scholar 

  19. Wenning GK, Ben Shlomo Y, Magalhaes M, Daniel SE, Quinn NP (1994) Clinical features and natural history of multiple system atrophy. An analysis of 100 cases. Brain 117(Pt 4):835–845

    Google Scholar 

  20. Wenning GK, Kraft E, Beck R, Fowler CJ, Mathias CJ, Quinn NP, Harding AE (1997) Cerebellar presentation of multiple system atrophy. Mov Disord 12:115–117

    Article  PubMed  CAS  Google Scholar 

  21. Wenning GK, Seppi K, Tison F, Jellinger K (2002) A novel grading scale for striatonigral degeneration (multiple system atrophy). J Neural Transm 109:307–320

    Article  PubMed  CAS  Google Scholar 

  22. Wenning GK, Ben-Shlomo V, Magalhäes M, Daniel SE, Quinn NP (1994) Clinical features and natural history of multiple system atrophy. Brain 117:835–845

    Article  PubMed  Google Scholar 

  23. Wenning GK, Tison F, Ben-Shlomo Y, Daniel SE, Quinn NP (1997) Multiple system atrophy: a review of 203 pathologically proven cases. Mov Disord 12:133–147

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Clinical Dept. of Neurology, Innsbruck Medical University, Anichstr. 35, 6020, Innsbruck, Austria

    Christian Brenneis, Christoph Scherfler, Klaus Seppi, Werner Poewe & Gregor K. Wenning

  2. Dept. of Radiology, Innsbruck Medical University, Innsbruck, Austria

    Karl Egger & Michael Schocke

Authors
  1. Christian Brenneis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Karl Egger
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christoph Scherfler
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Klaus Seppi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michael Schocke
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Werner Poewe
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Gregor K. Wenning
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christian Brenneis.

Additional information

Received in revised form: 7 June 2006

Rights and permissions

Reprints and permissions

About this article

Cite this article

Brenneis, C., Egger, K., Scherfler, C. et al. Progression of brain atrophy in multiple system atrophy. J Neurol 254, 191–196 (2007). https://doi.org/10.1007/s00415-006-0325-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00415-006-0325-6

Keywords

Search

Navigation