Cerebellar Atrophy in Multiple System Atrophy (Cerebellar Type) and Its Implication for Network Connectivity
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ORIGINAL ARTICLE
Cerebellar Atrophy in Multiple System Atrophy (Cerebellar Type) and Its Implication for Network Connectivity Hao Zhang 1 & Shaozhen Ji 2 & Shan Ren 3 & Ming Liu 1 & Weizheng Ran 4 & Xinning Zhang 4 & Wenyang Tian 4 & Zhigang Chen 3 & Zhiqun Wang 1,5
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract We sought to assess structural and functional patterns of cerebellum in multiple system atrophy (cerebellar type), and investigate the associations of structural and functional cerebellar gray matter abnormalities. We collected magnetic resonance imaging data of 18 patients with multiple system atrophy (cerebellar type) and 18 health control subjects. The gray matter loss across the motor and cognitive cerebellar territories in patients was assessed using voxel-based morphometry. And change in the connectivity between the cerebellum and large-scale cortical networks was assessed using resting-state functional MRI analysis. Furthermore, we assessed the relationship between the extent of cerebellar atrophy and reduced-activation in the cerebellar-cortical and subthalamo-cerebellar functional connectivities. We confirmed the gray matter loss across the motor and cognitive cerebellar territories in patients and found that the extent of cerebellar atrophy was correlated with decreased connectivity between the cerebellum and large-scale cortical networks, including the default, frontal parietal, and sensorimotor networks. The volume reduction in the motor cerebellum was closely associated with the clinical motor severity. A post hoc analysis showed reducedactivation in the subthalamo-cerebellar functional connectivity without the subthalamic nucleus atrophy. These results emphasized significant atrophy in the cerebellar subsystem and its association with the large-scale cortical networks in multiple system atrophy (cerebellar type), which may improve our understanding of the neural pathophysiology mechanisms of disease. Keywords Multiple system atrophy . Cerebellar atrophy . Magnetic resonance imaging . Functional connectivity . Voxel-based morphometry
Introduction
Hao Zhang, Shaozhen Ji and Shan Ren contributed equally to this work. * Zhigang Chen [email protected] * Zhiqun Wang [email protected] 1
Department of Radiology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China
2
Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
3
Department of Neurology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China
4
Beijing University of Chinese Medicine, Beijing 100029, China
5
Department of Radiology, Aerospace Center Hospital, Beijing 100049, China
Multiple system atrophy (MSA) is a progressive neurodegenerative disease pathologically characterized by alpha synuclein-positive glial cytoplasmic inclusions (GCIs), which lead to the degeneration and death of neuron mainly in the striatum, cerebellum, and olivopontine structures [1]. Currently, MSA is mainly classified into
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