{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T11:44:31Z","timestamp":1792755871624,"version":"4.5.0"},"reference-count":32,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T00:00:00Z","timestamp":1743552000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate trajectories of regional brain volume changes in multiple system atrophy (MSA) and their potential utility as surrogate markers of disease progression in the cerebellar subtype (MSA\u2010C).<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Reliable biomarkers for tracking disease progression in MSA are urgently needed. Although several studies have explored neuroimaging markers, imaging measures that are reliable and reproducible at the individual\u2010level are lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Longitudinal three\u2010dimensional (3D)\u2010T1 images from multiple cohorts of 21 subjects with probable MSA\u2010C, 19 with probable MSA\u2010parkinsonian subtype (MSA\u2010P), 113 with Parkinson's disease, and 227 healthy controls were processed using the FreeSurfer longitudinal pipeline. Extracted volumes were assessed for individual longitudinal trajectories, intra\u2010individual variability, and pontine regional volume decline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Pontine volumes showed lower intra\u2010individual variability in measurements compared with other infratentorial brain regions. All probable MSA\u2010C patients exhibited a decline in pontine volume, ranging from \u22123.6% to \u221216.8% per year (mean: \u22129.1%), falling more than two standard deviations below the mean of healthy controls. In MSA\u2010C, the temporal dynamics of pontine volumes exhibited nonlinear changes, characterized by progressive atrophy in the earlier period of the disease, followed by a pre\u2010plateau phase associated with advanced disability in the later period. Predictive modeling suggests that pontine atrophy may begin before symptom onset of MSA\u2010C.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pontine volume is a sensitive marker of disease progression, exhibiting a nonlinear decline with low intra\u2010individual variability in measurements and greater volume loss in the earlier stages, reaching a pre\u2010plateau phase in the later stages with advanced disability. \u00a9 2025 The Author(s). <jats:italic>Movement Disorders<\/jats:italic> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mds.30182","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T05:45:39Z","timestamp":1743745539000},"page":"1369-1378","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Trajectories of Pontine Volume in Patients with Multiple System Atrophy"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8851-4377","authenticated-orcid":false,"given":"Kazuya","family":"Kawabata","sequence":"first","affiliation":[{"name":"Department of Neurology Medical University Innsbruck  Innsbruck Austria"},{"name":"Department of Neurology Fujita Health University School of Medicine  Toyoake Japan"},{"name":"Division of BrainTheraInformatics International Center for Brain Science, Fujita Health University  Toyoake Japan"},{"name":"Department of Neurology Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4493-5073","authenticated-orcid":false,"given":"Florian","family":"Krismer","sequence":"additional","affiliation":[{"name":"Department of Neurology Medical University Innsbruck  Innsbruck Austria"},{"name":"Neuroimaging Research Core Facility Medical University Innsbruck  Innsbruck 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Center Nagoya University  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7805-279X","authenticated-orcid":false,"given":"Vincent","family":"Beliveau","sequence":"additional","affiliation":[{"name":"Department of Neurology Medical University Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7200-0139","authenticated-orcid":false,"given":"Patrice","family":"P\u00e9ran","sequence":"additional","affiliation":[{"name":"ToNIC, Toulouse NeuroImaging Center Universit\u00e9 de Toulouse, INSERM, UPS  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8754-8110","authenticated-orcid":false,"given":"Germain","family":"Arribarat","sequence":"additional","affiliation":[{"name":"ToNIC, Toulouse NeuroImaging Center Universit\u00e9 de Toulouse, INSERM, UPS  Toulouse 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