Establishing the biomarker of multiple system atrophy

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To assess the progression of brain degeneration in patients with multiple system atrophy (MSA), we conducted prospective analyses using voxel-based morphometry (VBM), mean diffusivity (MD), and fractional anisotropy (FA) of magnetic resonance imaging. We evaluated VBM, MD and FA in 17 probable MSA patients every 6 months from registration for 2 years, and compared their findings to those of 17 healthy controls using a voxel-based analysis technique. VBM, MD and FA showed the progressive spread of cerebral degeneration mainly in the frontal lobe, especially the prefrontal cortex, subsequently spreading to the temporal and parietal lobes, and finally to the occipital lobe after 2 years. VBM, FA, and MD showed the distinct progression pattern of cerebral involvement in MSA. The simultaneous evaluation of VBM, FA, andMD can provide an insight into the features of cerebral abnormalities in MSA and potential quantitative biomarkers of disease progression.