Radiological hints for differentiation of cerebellar multiple system atrophy from spinocerebellar ataxia
Abstract Differentiation cerebellar multiple systemic atrophy (MSA-C) from spinocerebellar ataxia (SCA) is important. The “hot cross bun” sign (HCBS) at pons and magnetic resonance spectroscopy (MRS) are helpful. However, the prevalence of HCBS and the alteration of cerebellar MRS parameters are evo...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2022-06-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-14531-0 |
| _version_ | 1811227205617844224 |
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| author | Hung-Chieh Chen Li-Hua Lee Jiing-Feng Lirng Bing-wen Soong |
| author_facet | Hung-Chieh Chen Li-Hua Lee Jiing-Feng Lirng Bing-wen Soong |
| author_sort | Hung-Chieh Chen |
| collection | DOAJ |
| description | Abstract Differentiation cerebellar multiple systemic atrophy (MSA-C) from spinocerebellar ataxia (SCA) is important. The “hot cross bun” sign (HCBS) at pons and magnetic resonance spectroscopy (MRS) are helpful. However, the prevalence of HCBS and the alteration of cerebellar MRS parameters are evolving with disease progression. We hypothesized that since the HCBS and MRS are evolving with time, different parameters for differentiation of MSA-C and SCA are required at different disease stages. The aim of this study was to evaluate the HCBS and MRS changes in patients with MSA-C and SCA at different disease stages. A total of 398 patients with molecularly confirmed SCA (SCA1, 2, 3, 6, 17) and 286 patients diagnosed with probable MSA-C (without mutations in SCA1, 2, 3, 6, 17 genes), who had received brain magnetic resonance imaging (MRI) and MRS from January 2000 to January 2020, were recruited. Twenty-five patients were molecularly identified as having SCA1, 68 as SCA2, 253 as SCA3, 34 as SCA6, and 18 as SCA17. We compared their clinical parameters and neuroimaging features at different disease stages. The presence of HCBS was assessed using an axial T2 fast spin-echo or FLAIR sequence. Proton MRS was recorded with voxel of interest focusing on cerebellar hemispheres and cerebellar vermis and avoiding cerebrospinal fluid spaces space using a single-voxel stimulated echo acquisition mode sequence. We found that patients with MSA-C tend to have a higher prevalence of pontine HCBS, worse Scale for the Assessment and Rating of Ataxia scores, lower cerebellar N-acetyl aspartate (NAA)/creatinine (Cr), and choline (Cho)/Cr, compared to patients with SCA at corresponding disease stages. In MSA-C patients with a disease duration < 1 year and without pontine HCBS, a cerebellar NAA/Cr ≤ 0.79 is a good indicator of the possibility of MSA-C. By using the pontine HCBS and cerebellar MRS, discerning MSA-C from SCA became possible. This study provides cutoff values of MRS to serve as clues in differentiating MSA-C from SCAs. |
| first_indexed | 2024-04-12T09:37:41Z |
| format | Article |
| id | doaj.art-24cfc9af7f554d7f8172ec6cb66c9160 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-12T09:37:41Z |
| publishDate | 2022-06-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-24cfc9af7f554d7f8172ec6cb66c91602022-12-22T03:38:10ZengNature PortfolioScientific Reports2045-23222022-06-011211810.1038/s41598-022-14531-0Radiological hints for differentiation of cerebellar multiple system atrophy from spinocerebellar ataxiaHung-Chieh Chen0Li-Hua Lee1Jiing-Feng Lirng2Bing-wen Soong3School of Medicine, National Yang Ming Chiao Tung UniversityDepartment of Neurology, Cardinal Tien HospitalSchool of Medicine, National Yang Ming Chiao Tung UniversityTaipei Neuroscience Institute, Taipei Medical UniversityAbstract Differentiation cerebellar multiple systemic atrophy (MSA-C) from spinocerebellar ataxia (SCA) is important. The “hot cross bun” sign (HCBS) at pons and magnetic resonance spectroscopy (MRS) are helpful. However, the prevalence of HCBS and the alteration of cerebellar MRS parameters are evolving with disease progression. We hypothesized that since the HCBS and MRS are evolving with time, different parameters for differentiation of MSA-C and SCA are required at different disease stages. The aim of this study was to evaluate the HCBS and MRS changes in patients with MSA-C and SCA at different disease stages. A total of 398 patients with molecularly confirmed SCA (SCA1, 2, 3, 6, 17) and 286 patients diagnosed with probable MSA-C (without mutations in SCA1, 2, 3, 6, 17 genes), who had received brain magnetic resonance imaging (MRI) and MRS from January 2000 to January 2020, were recruited. Twenty-five patients were molecularly identified as having SCA1, 68 as SCA2, 253 as SCA3, 34 as SCA6, and 18 as SCA17. We compared their clinical parameters and neuroimaging features at different disease stages. The presence of HCBS was assessed using an axial T2 fast spin-echo or FLAIR sequence. Proton MRS was recorded with voxel of interest focusing on cerebellar hemispheres and cerebellar vermis and avoiding cerebrospinal fluid spaces space using a single-voxel stimulated echo acquisition mode sequence. We found that patients with MSA-C tend to have a higher prevalence of pontine HCBS, worse Scale for the Assessment and Rating of Ataxia scores, lower cerebellar N-acetyl aspartate (NAA)/creatinine (Cr), and choline (Cho)/Cr, compared to patients with SCA at corresponding disease stages. In MSA-C patients with a disease duration < 1 year and without pontine HCBS, a cerebellar NAA/Cr ≤ 0.79 is a good indicator of the possibility of MSA-C. By using the pontine HCBS and cerebellar MRS, discerning MSA-C from SCA became possible. This study provides cutoff values of MRS to serve as clues in differentiating MSA-C from SCAs.https://doi.org/10.1038/s41598-022-14531-0 |
| spellingShingle | Hung-Chieh Chen Li-Hua Lee Jiing-Feng Lirng Bing-wen Soong Radiological hints for differentiation of cerebellar multiple system atrophy from spinocerebellar ataxia Scientific Reports |
| title | Radiological hints for differentiation of cerebellar multiple system atrophy from spinocerebellar ataxia |
| title_full | Radiological hints for differentiation of cerebellar multiple system atrophy from spinocerebellar ataxia |
| title_fullStr | Radiological hints for differentiation of cerebellar multiple system atrophy from spinocerebellar ataxia |
| title_full_unstemmed | Radiological hints for differentiation of cerebellar multiple system atrophy from spinocerebellar ataxia |
| title_short | Radiological hints for differentiation of cerebellar multiple system atrophy from spinocerebellar ataxia |
| title_sort | radiological hints for differentiation of cerebellar multiple system atrophy from spinocerebellar ataxia |
| url | https://doi.org/10.1038/s41598-022-14531-0 |
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