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Title: Pyramidal tract degeneration in multiple system atrophy: the relevance of magnetization transfer imaging
Authors: Rocha, Antonio Jose da
Martins Maia, Antonio Carlos
Silva, Carlos Jorge da
Braga, Flavio Tulio
Diniz Fortes Ferreira, Nelson Paes
Barsottini, Orlando Graziani Povoas [UNIFESP]
Ferraz, Henrique Ballalai
Ctr Med Diagnost Fleury
Medimagem Hosp Beneficiencia Portuguesa
Universidade Federal de São Paulo (UNIFESP)
Keywords: Parkinsonism
magnetization transfer imaging
cortico-spinal tract
Issue Date: 15-Jan-2007
Publisher: Wiley-Blackwell
Citation: Movement Disorders. Hoboken: Wiley-liss, v. 22, n. 2, p. 238-244, 2007.
Abstract: The clinical features of multiple system atrophy (MSA) include four domains: autonomic failure/urinary dysfunction, Parkinsonism, cerebellar ataxia, and corticospinal tract dysfunction. Although the diagnosis of definite MSA requires pathological confirmation, magnetic resonance imaging (MRI) studies have been shown to contribute to the diagnosis of MSA. Although pyramidal tract dysfunction is frequent in MSA patients, signs of pyramidal tract involvement are controversially demonstrated by MRI. We evaluated the pyramidal involvement in 10 patients (7 women) with clinically probable MSA, detecting the presence of spasticity, hyperreflexia, and Babinski sign, as well as demonstrating degeneration of the pyramidal tract and primary motor cortex by MRI in all of them. Our article also discusses key radiological features of this syndrome. in MSA, pyramidal tract involvement seems to be more frequent than previously thought, and the clinicoradiological correlation between pyramidal tract dysfunction and degeneration may contribute to the understanding of the clinical hallmarks of MSA. MRI may also add information regarding the differential diagnosis of this syndrome. (C) 2006 Movement Disorder Society.
ISSN: 0885-3185
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