A STUDY OF PARKINSONISM IN MULTIPLE SYSTEM ATROPHY - CLINICAL AND MRICORRELATION

We investigated clinical and MRI correlation in 18 patients with clini cally-diagnosed multiple system atrophy (MSA) and 16 age-matched contr ols, using 1.5 T magnetic resonance imaging (MRI). We evaluated the se verity of parkinsonism in each MSA patient. In assessing the MRI findi ngs, we examined three parameters quantitatively: width of the pars co mpacta of the substantia nigra (SNc); putaminal hypointensity on T-2-w eighted images; and putaminal atrophy. As in previous studies, SNc wid th was narrowed and the putaminal signal intensity was decreased in pa tients with MSA compared with controls. The clinical severity of parki nsonism did not correlate significantly with the SNc width or the scor e of putaminal hypointensity in MSA. However, not only did putaminal a trophy occur, but correlated well with the severity of parkinsonism in MSA. A significant correlation could not be established between narro wing of SNc and shrinkage of the putamen. These findings suggest that putaminal atrophy is associated with the clinical manifestations of pa rkinsonism and do not support the hypothesis that transsynaptic degene ration occurs in MSA.