Category: Parkinsonism, Atypical: MSA
Objective: We aimed to develop new multimodal biomarkers allowing objective monitoring of early MSA progression to improve outcome definition for future neuroprotective trials.
Background: MSA is a rare neurodegenerative condition characterized by a rapid gait deterioration with severe prognosis. Currently, no treatment is available to slow down disease progression.
Method: This analysis focuses on 19 MSA patients, enrolled in the Gait’N’Park multicentric cohort (NCT04653688). Longitudinal data, including clinical scales (UMSARS), unsupervised gait analysis (at home using smart insoles), and multimodal MRI data (volumetric, R2*, QSM for iron load, and DTI for microstructural alterations), were collected at baseline (W0) and 24 weeks (W24).
Results: At W24, there was a significant increase of mean diffusivity in cerebellar white matter (pFDR=0.029) and in fiber bundles between: Substantia Nigra and Dentate Nuclei (pFDR=0.0013); and Dentate Nuclei and Thalamus (pFDR=0.0013). No significant worsening was observed at W24 for other parameters, such as UMSARS, gait speed (95th centile) or stride length (mean), putamen, cerebellum or pons volume, or putamen R2* and QSM values.
Conclusion: Our data confirm the low sensitivity to early change of UMSARS, currently use as the gold standard to monitor disease progression. Whereas diffusion imaging of white matter appears to be sensitive to change as early as 6 months of follow-up, with high statistical significance, supporting early involvement of oligodendrocytes. This kind of biomarker should be considered to enhance outcome definition for future neuroprotection trials.
This abstract was already submitted for the European Academy Neurology (EAN) 2024 congress (Helsinki, 29/06/2024-02/07/2024) and was not published before.
Mean diffusivity analysis at W24 vs W0
Mean diffusivity evolution along time
Tractography: A=Whole brain B=SN-DN C=DN-Thalamus
To cite this abstract in AMA style:
F. Marchand, R. Viard, D. Devos, L. Defebvre, T. Ollivier, D. Guehl, G. Kuchcinski, C. Moreau. Prospective Study of Gait and Multimodal MRI Biomarkers for Multiple System Atrophy [abstract]. Mov Disord. 2024; 39 (suppl 1). https://www.mdsabstracts.org/abstract/prospective-study-of-gait-and-multimodal-mri-biomarkers-for-multiple-system-atrophy/. Accessed June 15, 2025.« Back to 2024 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/prospective-study-of-gait-and-multimodal-mri-biomarkers-for-multiple-system-atrophy/