Imaging Markers of Disease Progression in Multiple System Atrophy

Abstract

Different neuroimaging modalities hold potential as surrogate markers of underlying neurodegeneration in multiple system atrophy (MSA) and may reflect cell loss, altered glucose metabolism, microglial proliferation, astroglial activation, and nigrostriatal denervation. Multiple studies have demonstrated that serial structural and functional imaging studies are capable of demonstrating neurodegeneration in MSA patients quantitatively, which allows sample size estimates based on rates of progression of these neuroimaging markers. This review summarizes recent research findings as a tool to assess longitudinal changes of serial neuroimaging-derived parameters in MSA.

Keywords::

• dopamine transporter single-photon emission computed tomography (DAT-SPECT)
• MRI
• multiple system atrophy (MSA)
• neuroimaging
• positron emission tomography (PET)
• progression

Authors' contributions

K Seppi reviewed conception, organization and execution, contributed to the drafting the manuscript, critical revision of the manuscript and literature search. B Heim contributed to the organization and execution, drafting the manuscript, critical revision of the manuscript and literature search. F Krismer contributed to the organization and execution, critical revision of the manuscript and literature search. W Poewe reviewed conception and organization and contributed to the critical revision of the manuscript.

Financial & competing interests disclosure

K Seppi reports personal fees from Teva, UCB, Lundbeck, AOP Orphan Pharmaceuticals AG, Roche, Grünenthal and Abbvie, honoraria from the International Parkinson and Movement Disorders Society, research grants from FWF Austrian Science Fund, Michael J Fox Foundation and International Parkinson and Movement Disorder Society, outside the submitted work. W Poewe received personal fees from Abbvie, Allergan, AstraZeneca, BIAL, Boehringer‐Ingelheim, Boston Scientific, GlaxoSmithKline, Ipsen, Lundbeck, Medtronic, MSD, Merck‐Serono, Merz, Novartis, Orion Pharma, Teva, UCB and Zambon and received royalties from Wiley Blackwell, Oxford University Press and Cambridge University Press. This work was supported by MSA Coalition (FK JAP GKW HK KS; https://www.multiplesystematrophy.org). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

K Seppi reports personal fees from Teva, UCB, Lundbeck, AOP Orphan Pharmaceuticals AG, Roche, Grünenthal and Abbvie, honoraria from the International Parkinson and Movement Disorders Society, research grants from FWF Austrian Science Fund, Michael J Fox Foundation and International Parkinson and Movement Disorder Society, outside the submitted work. W Poewe received personal fees from Abbvie, Allergan, AstraZeneca, BIAL, Boehringer‐Ingelheim, Boston Scientific, GlaxoSmithKline, Ipsen, Lundbeck, Medtronic, MSD, Merck‐Serono, Merz, Novartis, Orion Pharma, Teva, UCB and Zambon and received royalties from Wiley Blackwell, Oxford University Press and Cambridge University Press. This work was supported by MSA Coalition (FK JAP GKW HK KS; https://www.multiplesystematrophy.org). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.