Multiple system atrophy parkinsonian type (MSA-P)
Citation, DOI & article data
It is important to note that the current belief that olivopontocerebellar degeneration, Shy-Drager syndrome, and striatonigral degeneration are different manifestations of the same underlying disease, namely multiple systemic atrophy (MSA), is recent, and as such many older publications will describe these as separate entities 1,2.
For a discussion of epidemiology and pathology, please refer to multiple systemic atrophy (MSA).
Striatonigral degeneration presents predominantly with parkinsonism with mild cerebellar and pyramidal and signs. As such it is classified within the MSA-P subtype of MSA.
Putaminal findings in MSA-P 3:
- reduced volume
- reduced GRE and T2 signal relative to globus pallidus
- reduced GRE and T2 signal relative to the red nucleus
putaminal rim sign: abnormal high T2 linear rim surrounding the putamen is seen at 1.5 T 3
- importantly this is a normal finding at 3 T and thus should not be relied upon at a higher field strength 4
- 1. Kornienko VN, Pronin IN. Diagnostic Neuroradiology. Springer Verlag. (2008) ISBN:3540756523. Read it at Google Books - Find it at Amazon
- 2. Matsusue E, Fujii S, Kanasaki Y et-al. Cerebellar lesions in multiple system atrophy: postmortem MR imaging-pathologic correlations. AJNR Am J Neuroradiol. 2009;30 (9): 1725-30. doi:10.3174/ajnr.A1662 - Pubmed citation
- 3. Lee JY, Yun JY, Shin CW et-al. Putaminal abnormality on 3-T magnetic resonance imaging in early parkinsonism-predominant multiple system atrophy. J. Neurol. 2010;257 (12): 2065-70. doi:10.1007/s00415-010-5661-x - Pubmed citation
- 4. Lee WH, Lee CC, Shyu WC et-al. Hyperintense putaminal rim sign is not a hallmark of multiple system atrophy at 3T. AJNR Am J Neuroradiol. 2005;26 (9): 2238-42. AJNR Am J Neuroradiol (full text) - Pubmed citation