MRI in autonomic failure.

Abstract

SUMMARY A significant rank correlation between rigidity and putaminal signal dropout on magnetic resonance imaging (MRI) in patients with multiple system atrophy suggests that putaminal degeneration may cause this clinical finding. Absence of putaminal abnormalities on MRI in patients with pure autonomic failure may prove useful in differentiating these two autonomic disorders.Autonomic failure may occur alone (pure autonomic failure) or in association with central neurological disorders, including Parkinsonism, ataxia and pyramidal findings (multiple system atrophy).' Multiple system atrophy includes both striatonigral degeneration and olivopontocerebellar atrophy, since there is frequently overlap of patients in these two categories, and the clinical and pathological findings in multiple system atrophy encompass those described for both striatonigral degeneration and olivopontocerebellar atrophy.2 The pathology of pure autonomic failure, however, has not yet been clearly defined.Biochemical and pharmacological differences between multiple system atrophy and pure autonomic failure have increased our understanding of these diseases.1 Unfortunately, these differences cannot be exploited as diagnostic tests in individual cases. The development of magnetic resonance imaging (MRI) has made it possible to examine structural details within the brain not visualised by computed tomography (CT) scans. We recently described putaminal atrophy on T1 weighted axial scans of three of eight multiple system atrophy patients, and decreased signal intensity in the posterolateral putamen on T2 weighted scans of seven of these patients by MRI,3 in

Grey matter differences associated with age and sex hormone levels between premenopausal and perimenopausal women: A voxel‐based morphometry study

“…The function of the putamen has been recognised for many years . It was found to be engaged in autonomic nervous system activity and related to multiple system function . The shrinkage in the volume of the putamen nuclei with advancing age has been reported by several independent groups .…”

“…20 It was found to be engaged in autonomic nervous system activity and related to multiple system function. 20,21 The shrinkage in the volume of the putamen nuclei with advancing age has been reported by several independent groups. 22,23 In accordance with the previous studies, the negative correlation between the left putamen and age may be caused by age-related volume reduction in perimenopausal women compared to premenopausal women.…”

“…22,23 In accordance with the previous studies, the negative correlation between the left putamen and age may be caused by age-related volume reduction in perimenopausal women compared to premenopausal women. In addition, Brown et al 21 revealed that the signal reduction in the putamen could be a symptom for multiple system atrophy and pure autonomic failure. Moreover, the putamen volume alteration was found in postural tachycardia, syndrome obstructive sleep apneoa and depression patients during a DARTEL-VBM study, 24,25 and a relationship between increased volume in the putamen and autonomic hyperactivity was confirmed.…”

Structural brain abnormalities in postural tachycardia syndrome: A VBM-DARTEL study

“…The functional contribution of the striatum to autonomic control has been recognized for some decades, and is an important consideration in the understanding of the autonomic failure and dysautonomia associated with multiple system atrophy and related Lewy body diseases (Pastakia et al, 1986 ). Previous studies suggests that MRI signal reduction in putamen could be an early measure for differentiating multiple system atrophy from pure autonomic failure (Brown et al, 1987 ). Similar findings also come from radioisotope (PET) studies (Brooks et al, 1990 ).…”