Jiri Keller MD, Presenter: Nothing to Disclose

Aaron M. Rulseh MD, Abstract Co-Author: Nothing to Disclose

Robert Rusina PhD, Abstract Co-Author: Nothing to Disclose

Katerina Zarubova, Abstract Co-Author: Nothing to Disclose

Hana Brožová, Abstract Co-Author: Nothing to Disclose

Petra Havránková, Abstract Co-Author: Nothing to Disclose

Josef Vymazal MD, PhD, Abstract Co-Author: Consultant, EPIX Pharmaceuticals, Inc, Boston, MA Consultant, NovoCure Ltd, Haifa, Israel

The aim of our study was to evaluate diffusion changes in main subtypes of Multiple System Atrophy (MSA): MSA-P (Parkinsonian) and MSA-C (cerebellar). We compared MSA patients to healthy subjects as well as MSA-C to MSA-P using TBSS.

Patients with probable MSA-P (n=7, 1 Male, 6 Female, 58.8Y±5SD), MSA-C (n=10, 6 male, 4 female, 59.0Y±4SD; for MSA-C/MSA-P n=8, 5 male, 3 female, 58.6Y±5SD) and healthy volunteers (n=10, 5 male, 5 female, 58.6Y±5SD) were included. DWI was performed at 1.5T in 12 non-collinear gradient directions with an SS-EPI sequence. Eddy-current and motion correction, and tensor estimation was done in FSL and FA, MD, axial (AD) and radial (RD) diffusivity were calculated for each voxel and analyzed using TBSS (FA>0.3, 2500 permutations).

In both MSA-P and MSA-C widespread reduction of FA and increased MD/RD were observed. In the MSA-P group, both FA and RD were decreased in cerebellar peduncles, while MD/AD remained normal. RD was lower in corticospinal tract, commistural fibres and many subcortical regions. FA changes followed RD in left internal capsule, but not on the right nor in the exteral capsule. Increased MD followed RD, but in fewer voxels. AD and RD/MD was higher in the EC and along the superior margin of the putamen bilaterally, where FA changes were absent. In MSA-C, FA was reduced and RD/MD increased in all cerebellar peduncles. A small volume of higher AD was observed in the MCP bilaterally. RD was increased throughout the CR and commissural fibers bilaterally. RD was increased in the internal/external capsules bilaterally (except left posterior limb of IC), the bilateral CST and diffusely in many subcortical regions. Changes in FA/MD followed RD but in fewer voxels. Comparison of MSA-C and MSA-P groups revealed only very subtle changes in the right internal capsule.

White matter changes in both MSA-P and MSA-C are widespread, changes in RD with nearly unaltered AD support the hypotesis that oligodendrocytes are primarily affected in MSA. Supported from grants IGA MZ CR, NS9654-4/2008, NT11328-4/2010, MŠM 0021620849 and MŠM 0021620816.

Changes of diffusion properties could help to set a clinical diagnosis of MSA, confirmation on large cohort of patients is needed.

Keller, J, Rulseh, A, Rusina, R, Zarubova, K, Brožová, H, Havránková, P, Vymazal, J, Visualisation of Global White Matter Changes in MSA-P and MSA-C Using TBSS.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11016514.html