Diffusion-weighted imaging in multiple system atrophy: A comparison between clinical subtypes

Maria Teresa Pellecchia, Paolo Barone Barone, Carmine Mollica, Elena Salvatore, Marta Ianniciello, Katia Longo, Andrea Varrone, Caterina Vicidomini, Marina Picillo, Giuseppe De Michele, Allessandro Filla, Marco Salvatore, Sabina Pappatà

Research output: Contribution to journalArticlepeer-review


Multiple system atrophy can be classi.ed into two main types, a Parkinsonian (MSA-P) and a cerebellar (MSA-C) variant based on clinical presentation. We obtained diffusion-weighted magnetic resonance imaging (DWI) in 9 MSAP and 12 MSA-C patients and 11 controls, and correlated DWI changes with disease duration and severity. We found that Trace (D) values in the entire and anterior putamen were significantly higher in MSA-P than in MSA-C patients and controls, whereas Trace (D) values in the cerebellum and middle cerebellar peduncle (MCP) were significantly higher in MSA-C than in MSA-P patients and controls. Increased disease duration was significantly correlated with increased Trace (D) values in pons of MSA-P patients, and in cerebellum and MCP of MSA-C patients. Both UMSARS and UPDRS motor scores positively correlated with entire and posterior putaminal Trace (D) values in MSA-P patients. The diffusivity changes parallel phenotypical and pathologic differences between MSA-P and MSA-C patients, suggesting that DWI is a feasible tool for in vivo evaluation of neurodegeneration in MSA. Based on our findings, Trace (D) measurements in the putamen and pons in MSA-P patients and in the cerebellum and MCP in MSA-C patients could serve as quantitative markers for microstructural damage in the course of disease.

Original languageEnglish
Pages (from-to)689-696
Number of pages8
JournalMovement Disorders
Issue number5
Publication statusPublished - Apr 15 2009


  • Diffusion-weighted imaging
  • Magnetic resonance imaging
  • MSA subtypes

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Medicine(all)


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