Abstract：
OBJECTIVE: To investigate hypothalamic atrophy and its clinical correlates in multiple system atrophy (MSA) in-vivo.
BACKGROUND: MSA is characterized by autonomic dysfunction and parkinsonian/cerebellar manifestations. The hypothalamus regulates autonomic and homeostatic functions and is also involved in memory and learning processes.
METHODS: 11 MSA, 18 Parkinson\'s Disease (PD) and 18 Healthy Controls (HC) were included in this study. A validated and automated hypothalamic segmentation tool was applied to 3D-T1-weighted images acquired on a 3T MRI scanner. MSA hypothalamic volumes were compared to those of PD and HC. Furthermore, the association between hypothalamic volumes and scores of autonomic, depressive, sleep and cognitive manifestations were investigated.
RESULTS: Posterior hypothalamus volume was reduced in MSA compared to controls (t = 2.105, p = 0.041) and PD (t = 2.055, p = 0.046). Total hypothalamus showed a trend towards a reduction in MSA vs controls (t = 1.676, p = 0.101). Reduced posterior hypothalamus volume correlated with worse MoCA scores in the parkinsonian (MSA + PD) group and in each group separately, but not with autonomic, sleep, or depression scores.
CONCLUSIONS: In-vivo structural hypothalamic involvement may be present in MSA. Reduced posterior hypothalamus volume, which includes the mammillary bodies and lateral hypothalamus, is associated with worse cognitive functioning. Larger studies on hypothalamic involvement in MSA and its clinical correlates are needed.
BACKGROUND: MSA is characterized by autonomic dysfunction and parkinsonian/cerebellar manifestations. The hypothalamus regulates autonomic and homeostatic functions and is also involved in memory and learning processes.
METHODS: 11 MSA, 18 Parkinson\'s Disease (PD) and 18 Healthy Controls (HC) were included in this study. A validated and automated hypothalamic segmentation tool was applied to 3D-T1-weighted images acquired on a 3T MRI scanner. MSA hypothalamic volumes were compared to those of PD and HC. Furthermore, the association between hypothalamic volumes and scores of autonomic, depressive, sleep and cognitive manifestations were investigated.
RESULTS: Posterior hypothalamus volume was reduced in MSA compared to controls (t = 2.105, p = 0.041) and PD (t = 2.055, p = 0.046). Total hypothalamus showed a trend towards a reduction in MSA vs controls (t = 1.676, p = 0.101). Reduced posterior hypothalamus volume correlated with worse MoCA scores in the parkinsonian (MSA + PD) group and in each group separately, but not with autonomic, sleep, or depression scores.
CONCLUSIONS: In-vivo structural hypothalamic involvement may be present in MSA. Reduced posterior hypothalamus volume, which includes the mammillary bodies and lateral hypothalamus, is associated with worse cognitive functioning. Larger studies on hypothalamic involvement in MSA and its clinical correlates are needed.
摘要：
目的：研究下丘脑萎缩及其与多系统萎缩（MSA）的临床相关性。
背景：MSA的特征是自主神经功能障碍和帕金森病/小脑表现。下丘脑调节自主神经和体内平衡功能，也参与记忆和学习过程。
方法：11MSA，本研究包括18名帕金森病(PD)和18名健康对照(HC)。将经过验证和自动化的下丘脑分割工具应用于在3TMRI扫描仪上获取的3D-T1加权图像。将MSA下丘脑体积与PD和HC的体积进行比较。此外，下丘脑体积和自主神经评分之间的关联，抑郁,研究了睡眠和认知表现。
结果：与对照组（t=2.105，p=0.041）和PD（t=2.055，p=0.046）相比，MSA下丘脑后体积减少。与对照组相比，下丘脑整体显示出MSA降低的趋势（t=1.676，p=0.101）。下丘脑后体积减少与帕金森病（MSA+PD）组和每组的MoCA评分较差相关，但不是自主神经，睡眠,或抑郁得分。
结论：MSA可能存在体内下丘脑结构受累。下丘脑后体积减少，包括乳头体和下丘脑外侧，与更差的认知功能有关。需要对下丘脑参与MSA及其临床相关性进行更大规模的研究。
背景：MSA的特征是自主神经功能障碍和帕金森病/小脑表现。下丘脑调节自主神经和体内平衡功能，也参与记忆和学习过程。
方法：11MSA，本研究包括18名帕金森病(PD)和18名健康对照(HC)。将经过验证和自动化的下丘脑分割工具应用于在3TMRI扫描仪上获取的3D-T1加权图像。将MSA下丘脑体积与PD和HC的体积进行比较。此外，下丘脑体积和自主神经评分之间的关联，抑郁,研究了睡眠和认知表现。
结果：与对照组（t=2.105，p=0.041）和PD（t=2.055，p=0.046）相比，MSA下丘脑后体积减少。与对照组相比，下丘脑整体显示出MSA降低的趋势（t=1.676，p=0.101）。下丘脑后体积减少与帕金森病（MSA+PD）组和每组的MoCA评分较差相关，但不是自主神经，睡眠,或抑郁得分。
结论：MSA可能存在体内下丘脑结构受累。下丘脑后体积减少，包括乳头体和下丘脑外侧，与更差的认知功能有关。需要对下丘脑参与MSA及其临床相关性进行更大规模的研究。
