Objective: Using multimodal MRI, the aim of the study was to evaluate brain changes due to disease progression in multiple system atrophy (MSA) patients.

Background: Multimodal MRI approach is based on combination of MRI parameters sensitive to different tissue characteristics (e.g. volume atrophy, iron deposition, and microstructural damage). The combination of different MR biomarkers could help to discriminate different pathologies with parkinsonian syndrome (Péran et al. Mov Disord.; 2018).

Methods: 19 MSA patients underwent 3-T MRI exam twice at time of inclusion and after one year of follow-up. This MRI comprised: T2*-weighted, T1-weighted and diffusion tensor imaging scans. We used the same method as in the previous work (Péran et al., Brain, 2010) to extract MRI markers (grey density, R2* value, mean diffusity (MD) and fractional anisotropy). The GD, R2*, MD, and FA maps were compared using non-parametric paired t-tests. Statistical significance threshold was set to p<.05 corrected for family wise error.

Results: [figure1] shows changes due to disease progression from voxel-based analysis in R2*, MD and FA maps. The main results showed significant increase of MD in brainstem and in cerebellum in MSA patients. After one year, MSA patients showed also lower FA mainly in left inferior longitudinal fasciculus. Additionally, MSA patients showed a decrease of R2* mainly in cerebellum and in fusiform gyrus. We did not find significant modifications for grey density maps. (Figure1: Significant differences in R2* (red); MD (green) and FA (blue) maps.)

Conclusions: This study demonstrates that multimodal MRI is able to detect longitudinal modifications after one year of MSA progression. Further analyses are on-going to determine the relationships between clinical and MRI markers.

References: 1: Péran P, Barbagallo G, Nemmi F, Sierra M, Galitzky M, Traon AP, Payoux P, Meissner WG, Rascol O. MRI supervised and unsupervised classification of Parkinson’s disease and multiple system atrophy. Mov Disord. 2018 Feb 23. doi: 10.1002/mds.27307. [Epub ahead of print] PubMed PMID: 29473662. 2: Péran P, Cherubini A, Assogna F, Piras F, Quattrocchi C, Peppe A, Celsis P, Rascol O, Démonet JF, Stefani A, Pierantozzi M, Pontieri FE, Caltagirone C, Spalletta G, Sabatini U. Magnetic resonance imaging markers of Parkinson’s disease nigrostriatal signature. Brain. 2010 Nov;133(11):3423-33. doi:10.1093/brain/awq212.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/multimodal-mri-markers-modifications-in-multiple-system-atrophy-a-longitudinal-study/