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Previous studies have shown that spinal cord atrophy is also a key aspect of SCA1 neuropathology. Magnetic resonance imaging (MRI)\u2010based spinal cord measurements could, therefore, serve as staging or monitoring biomarkers. However, previous findings were limited to cross\u2010sectional analyses, and longitudinal changes remain unexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study investigates both cross\u2010sectional and longitudinal cervical spinal cord alterations in SCA1 mutation carriers compared to healthy controls, evaluating the utility of this biomarker.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Baseline and 1\u2010year MRI changes were assessed in 40 controls, 16 preataxic and 58 symptomatic SCA1 mutation carriers. T1\u2010weighed images were processed with FreeSurfer and the Spinal Cord Toolbox. We related Z\u2010scores to disease duration, calculated standardized response means, and analyzed clinico\u2010genetic associations using a linear mixed model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The three groups differed significantly in cross\u2010sectional area (CSA) at all levels at baseline. Over time, CSA at levels C1 and C2 decreased in the preataxic and symptomatic groups compared to controls. Preataxic carriers already showed pronounced spinal cord atrophy, whereas pontine changes emerged later in the disease course. Standardized response means were highest for CSA at C2 in preataxic stage, whereas this was pontine volume at symptomatic stage, indicating region\u2010specific biomarkers across disease stages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Cervical spinal cord atrophy is an early and progressive feature of SCA1, detectable before clinical onset, providing a promising imaging biomarker for early disease stages. Our findings suggest a caudal to rostral progression of atrophy in SCA1. \u00a9 2026 The Author(s).\n                      <jats:italic>Movement Disorders<\/jats:italic>\n                      published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mds.70294","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T07:10:47Z","timestamp":1775718647000},"page":"1836-1846","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early and Progressive Spinal Cord Atrophy in Spinocerebellar Ataxia Type 1"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3231-7984","authenticated-orcid":false,"given":"Colette J.M.","family":"Reniers","sequence":"first","affiliation":[{"name":"Department of Neurology, Donders Institute for Brain, Cognition, and Behavior Radboud University Medical Center  Nijmegen The Netherlands"},{"name":"Department of Medical Imaging Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6372-0801","authenticated-orcid":false,"given":"Teije H.","family":"van Prooije","sequence":"additional","affiliation":[{"name":"Department of Neurology, Donders Institute for Brain, Cognition, and Behavior Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5735-1934","authenticated-orcid":false,"given":"Kirsten C.J.","family":"Kapteijns","sequence":"additional","affiliation":[{"name":"Department of Neurology, Donders Institute for Brain, Cognition, and Behavior Radboud University Medical Center  Nijmegen The Netherlands"},{"name":"Department of Medical Imaging Radboud University Medical Center  Nijmegen The 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