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However, functional connectivity (FC) changes of the CAN in patients with multiple system atrophy (MSA) remain unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate FC alterations of CAN in MSA patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Prospective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Eighty\u2010two subjects (47 patients with MSA [44.7% female, 60.5\u2009\u00b1\u20096.9 years], 35 age\u2010 and sex\u2010matched healthy controls [HC] [57.1% female, 62.5\u2009\u00b1\u20096.6\u2009years]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>3\u2010T, resting\u2010state functional magnetic resonance imaging (rs\u2010fMRI) using gradient echo\u2010planar imaging (EPI), T1\u2010weighted three\u2010dimensional magnetization\u2010prepared rapid gradient echo (3D MPRAGE) structural MRI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>FC alterations were explored by using core modulatory regions of CAN as seeds, including midcingulate cortex, insula, amygdala, and ventromedial prefrontal cortex. Bartlett factor score (BFS) derived from a factor analysis of clinical assessments on disease severity was used as a grouping factor for moderate MSA (mMSA: BFS\u2009&lt;\u20090) and severe MSA (sMSA: BFS\u2009&gt;\u20090).<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>For FC analysis, the one\u2010way ANCOVA with cluster\u2010level family\u2010wise error correction (statistical significance level of <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.025), and post hoc <jats:italic>t<\/jats:italic>\u2010testing with Bonferroni correction or Tamhane's T2 correction (statistical significance level of adjusted\u2010<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05) were adopted. Correlation was assessed using Pearson correlation or Spearman correlation (statistical significance level of <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with HC, patients with MSA exhibited significant FC aberrances between the CAN and brain areas of sensorimotor control, limbic network, putamen, and cerebellum. For MSA patients, most FC alterations of CAN, especially concerning FC between the right anterior insula and right primary sensorimotor cortices, were found to be significantly correlated with disease severity. FC changes were found to be more significant in sMSA group than in mMSA group when compared with HCs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>MSA shows widespread FC changes of CAN, suggesting that abnormal functional integration of CAN may be involved in disease pathogenesis of MSA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2<\/jats:p><\/jats:sec><jats:sec><jats:title>Technical Efficacy<\/jats:title><jats:p>Stage 3<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.28693","type":"journal-article","created":{"date-parts":[[2023,3,29]],"date-time":"2023-03-29T14:54:16Z","timestamp":1680101656000},"page":"1472-1487","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Alterations in Resting\u2010State <scp>MR<\/scp> Functional Connectivity of the Central Autonomic Network in Multiple System Atrophy and Relationship with Disease Severity"],"prefix":"10.1002","volume":"58","author":[{"given":"Haiying","family":"Lyu","sequence":"first","affiliation":[{"name":"Department of Radiology, Ruijin Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Neurology and Institute of Neurology, Ruijin Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naying","family":"He","sequence":"additional","affiliation":[{"name":"Department of Radiology, Ruijin Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Li","sequence":"additional","affiliation":[{"name":"MR Collaborations Siemens Healthineers Ltd.  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