Trajectories of Pontine Volume in Patients with Multiple System Atrophy

IF 7.6 1区医学 Q1 CLINICAL NEUROLOGY Movement Disorders Pub Date : 2025-04-02 DOI:10.1002/mds.30182

Kazuya Kawabata PhD, Florian Krismer PhD, Mizuki Ito PhD, Kazuhiro Hara PhD, Epifanio Bagarinao PhD, Vincent Beliveau PhD, Patrice Péran PhD, Germain Arribarat PhD, Anne Pavy-Le Traon PhD, Wassilios G. Meissner PhD, Alexandra Foubert-Samier PhD, Margherita Fabbri PhD, Mark Forrest Gordon MD, Aya Ogura PhD, Masahisa Katsuno PhD, Olivier Rascol PhD, Christoph Scherfler MD, Klaus Seppi MD, Hirohisa Watanabe PhD, Werner Poewe MD

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Abstract

Objectives

To investigate trajectories of regional brain volume changes in multiple system atrophy (MSA) and their potential utility as surrogate markers of disease progression in the cerebellar subtype (MSA-C).

Background

Reliable biomarkers for tracking disease progression in MSA are urgently needed. Although several studies have explored neuroimaging markers, imaging measures that are reliable and reproducible at the individual-level are lacking.

Methods

Longitudinal three-dimensional (3D)-T1 images from multiple cohorts of 21 subjects with probable MSA-C, 19 with probable MSA-parkinsonian subtype (MSA-P), 113 with Parkinson's disease, and 227 healthy controls were processed using the FreeSurfer longitudinal pipeline. Extracted volumes were assessed for individual longitudinal trajectories, intra-individual variability, and pontine regional volume decline.

Results

Pontine volumes showed lower intra-individual variability in measurements compared with other infratentorial brain regions. All probable MSA-C patients exhibited a decline in pontine volume, ranging from −3.6% to −16.8% per year (mean: −9.1%), falling more than two standard deviations below the mean of healthy controls. In MSA-C, the temporal dynamics of pontine volumes exhibited nonlinear changes, characterized by progressive atrophy in the earlier period of the disease, followed by a pre-plateau phase associated with advanced disability in the later period. Predictive modeling suggests that pontine atrophy may begin before symptom onset of MSA-C.

Conclusions

Pontine volume is a sensitive marker of disease progression, exhibiting a nonlinear decline with low intra-individual variability in measurements and greater volume loss in the earlier stages, reaching a pre-plateau phase in the later stages with advanced disability. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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多系统萎缩患者脑桥体积的变化轨迹。

目的：研究多系统萎缩（MSA）的区域脑容量变化轨迹及其作为小脑亚型（MSA- c）疾病进展的替代标记物的潜在用途。背景：迫切需要可靠的生物标志物来跟踪MSA的疾病进展。虽然有几项研究探索了神经成像标记，但在个体水平上缺乏可靠和可重复的成像测量。方法：采用FreeSurfer纵向管道对21名疑似MSA-C患者、19名疑似msa -帕金森亚型（MSA-P）患者、113名帕金森病患者和227名健康对照者的纵向三维(3D)-T1图像进行处理。提取的体积评估了个体纵向轨迹、个体内部变异和桥体区域体积下降。结果：与其他脑幕下区域相比，脑桥体积在测量中显示出较低的个体内变异性。所有可能的MSA-C患者都表现出脑桥体积的下降，每年下降幅度为-3.6%至-16.8%（平均：-9.1%），比健康对照组的平均值低两个标准差以上。在MSA-C中，脑桥体积的时间动态表现出非线性变化，其特征是疾病早期进行性萎缩，随后是与晚期残疾相关的平台期前阶段。预测模型提示脑桥萎缩可能在MSA-C症状出现之前就开始了。结论：脑桥体积是疾病进展的敏感标志，在早期表现出非线性下降，个体间测量变异性较低，在晚期残疾时体积损失较大，在晚期达到平台前阶段。©2025作者。Wiley期刊有限责任公司代表国际帕金森和运动障碍学会出版的《运动障碍》。

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来源期刊

Movement Disorders 医学-临床神经学

CiteScore

13.30

自引率

8.10%

发文量

371

审稿时长

12 months

期刊介绍： Movement Disorders publishes a variety of content types including Reviews, Viewpoints, Full Length Articles, Historical Reports, Brief Reports, and Letters. The journal considers original manuscripts on topics related to the diagnosis, therapeutics, pharmacology, biochemistry, physiology, etiology, genetics, and epidemiology of movement disorders. Appropriate topics include Parkinsonism, Chorea, Tremors, Dystonia, Myoclonus, Tics, Tardive Dyskinesia, Spasticity, and Ataxia.