Volume 90, Issue 4 pp. 225-231
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A study of parkinsonism in multiple system atrophy: clinical and MRI correlation

M. Wakai

Corresponding Author

M. Wakai

Departments of Neurology Nagoya University School of Medicine

M. Wakai, Department of Neurology, Nagoya University School of Medicine, 65 Tsurumai-cno, Shouwaku, Nagoya 466, JapanSearch for more papers by this author
A. Kume

A. Kume

Departments of Neurology Nagoya University School of Medicine

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A. Takahashi

A. Takahashi

Departments of Neurology Nagoya University School of Medicine

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T. Ando

T. Ando

Nagoya Daini Red Cross Hospital

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Y. Hashizume

Y. Hashizume

Institute for Medical Science of Aging, Aichi Medical University, Japan

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First published: October 1994
Citations: 23

Abstract

We investigated clinical and MRI correlation in 18 patients with clinically-diagnosed multiple system atrophy (MSA) and 16 age-matched controls, using 1.5 T magnetic resonance imaging (MRI). We evaluated the severity of parkinsonism in each MSA patient. In assessing the MRI findings, we examined three parameters quantitatively: width of the pars compacta of the substantia nigra (SNc); putaminal hypointensity on T2-weighted images; and putaminal atrophy. As in previous studies, SNc width was narrowed and the putaminal signal intensity was decreased in patients with MSA compared with controls. The clinical severity of parkinsonism did not correlate significantly with the SNc width or the score of putaminal hypointensity in MSA. However, not only did putaminal atrophy occur, but correlated well with the severity of parkinsonism in MSA. A significant correlation could not be established between narrowing of SNc and shrinkage of the putamen. These findings suggest that putaminal atrophy is associated with the clinical manifestations of parkinsonism and do not support the hypothesis that transsynaptic degeneration occurs in MSA.

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