{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T03:41:27Z","timestamp":1792467687769,"version":"4.5.0"},"reference-count":40,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recent studies have reported longitudinal brain atrophy in multiple system atrophy (MSA) in relatively small patient cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare longitudinal regional brain volume and clinical changes as endpoint measures for MSA clinical trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>MSA patients with 1\u2010year longitudinal brain magnetic resonance imaging (MRI) were selected from the placebo arm of the M\u2010STAR Study (NCT03952806) and stratified into MSA\u2010cerebellar (MSA\u2010C) and MSA\u2010parkinsonism (MSA\u2010P) subtypes. A multisite healthy control (HC) cohort from international datasets was included for comparison. Baseline and longitudinal atrophy were assessed through automated MRI volumetry. Standardized longitudinal effect size values with 95% confidence intervals (CIs) and sample sizes required to detect treatment effect were estimated for 42 individual regional brain volumes, four combined volumetric indexes, nine clinical scales, and serum neurofilament light chain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The final study cohort included 129 MSA patients (76 MSA\u2010C, 53 MSA\u2010P) and 184 HC. The most atrophic structures at baseline were infratentorial regions in MSA\u2010C and putamen in MSA\u2010P. In both subtypes, infratentorial structures showed the largest longitudinal volume loss compared with HC. The annualized change of a cerebellum\u2010pons\u2010putamen volumetric index was the most powerful progression biomarker in MSA patients (effect size: \u22121.81 [95% CI: \u22122.14, \u22121.55]) and in both subtypes (MSA\u2010C: \u22122.04 [95% CI: \u22122.58, \u22121.68], MSA\u2010P: \u22121.55 [95% CI: \u22122.08, \u22121.22]), requiring the lowest sample size per arm (MSA, N\u2009=\u200955 to detect 30% treatment effect), and outperforming clinical measures (\u221259.6% patients required per arm).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      These findings support longitudinal MRI\u2010derived regional atrophy rates as sensitive imaging endpoints to assess treatment efficacy in MSA clinical trials. \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.70585","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T03:23:56Z","timestamp":1792466636000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Automated Magnetic Resonance Volumetry to Measure Multiple System Atrophy Disease Progression in Clinical Trials"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2071-2083","authenticated-orcid":false,"given":"Andrea","family":"Quattrone","sequence":"first","affiliation":[{"name":"Department of Neurology University Hospital, LMU Munich  Munich Germany"},{"name":"Department of Medical and Surgical Sciences, Institute of Neurology Magna Graecia University  Catanzaro Italy"},{"name":"Neuroscience Research Centre, Magna Graecia University  Catanzaro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0270-0029","authenticated-orcid":false,"given":"Ida","family":"Wilkens","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital, LMU Munich  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeyu","family":"Zhu","sequence":"additional","affiliation":[{"name":"Institute for Stroke and Dementia Research, University Hospital, LMU  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irfan A.","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Biohaven Pharmaceuticals Inc  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9736-2283","authenticated-orcid":false,"given":"Nicolai","family":"Franzmeier","sequence":"additional","affiliation":[{"name":"Institute for Stroke and Dementia Research, University Hospital, LMU  Munich Germany"},{"name":"Munich Cluster for Systems Neurology (SyNergy)  Munich Germany"},{"name":"Department of Psychiatry and Neurochemistry, University of Gothenburg, The Sahlgrenska Academy, Institute of Neuroscience and Physiology  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7587-6187","authenticated-orcid":false,"given":"G\u00fcnter U.","family":"H\u00f6glinger","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital, LMU Munich  Munich Germany"},{"name":"Munich Cluster for Systems Neurology (SyNergy)  Munich Germany"},{"name":"German Center for Neurodegenerative Diseases (DZNE) Munich  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the M\u2010STAR Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-011-0852-9"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000214316"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.14802\/jmd.18020"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awh303"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2990.2007.00907.x"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-010-0672-3"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.29005"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2018.08.004"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/9631041"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20877"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.70028"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awad105"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.29633"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.30182"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-015-7785-5"},{"issue":"2","key":"e_1_2_9_17_1","article-title":"Safety and efficacy of verdiperstat, a novel myeloperoxidase inhibitor, in MSA [Abstract]","volume":"37","author":"Qureshi I","year":"2022","journal-title":"Mov Disord"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/trc2.70140"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/gigascience\/giae049"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.29866"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26973"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.28348"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.28923"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27669"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12311-015-0728-y"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26715"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2393050459"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/braincomms\/fcae019"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.29324"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(26)00100-6"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/braincomms\/fcaf022"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-021-00782-w"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-023-11741-y"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-024-12647-z"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25824"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awac253"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000324625.00404.15"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.29879"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-022-04554-y"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.70153"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26471"}],"container-title":["Movement Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mds.70585","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mds.70585","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mds.70585","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T03:23:59Z","timestamp":1792466639000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mds.70585"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,19]]},"references-count":40,"alternative-id":["10.1002\/mds.70585"],"URL":"https:\/\/doi.org\/10.1002\/mds.70585","archive":["Portico"],"relation":{},"ISSN":["0885-3185","1531-8257"],"issn-type":[{"value":"0885-3185","type":"print"},{"value":"1531-8257","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,19]]},"assertion":[{"value":"2026-05-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"mds.70585"}}