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The pathophysiological understanding of this disorder is very limited. In order to identify patterns of neuroanatomical involvement within the brain, we applied advanced magnetic resonance imaging-based techniques to a group of six patients with the diagnosis of FOSMN, using unbiased analysis techniques with atlas-based volumetry of volume-rendering T1-weighted data and whole brain-based spatial statistics of diffusion tensor imaging (DTI). The volumetric data showed significant global atrophy with prominent involvement of the medulla oblongata, while DTI demonstrated significant decreases in the right-hemispheric frontal lobe and bilaterally along the superior and inferior longitudinal fasciculi. In summary, this application of volumetry and DTI to a group of FOSMN patients demonstrated, beyond global brain atrophy as a correlate of a systemic disease process, regional atrophy in the brainstem\/medulla oblongata, together with tract alterations of polymodal frontotemporoparietal interconnections. Future neuroimaging studies in larger patient groups of FOSMN are needed for detailed phenotype\u2013neuroimaging correlations.<\/jats:p>","DOI":"10.1007\/s00415-026-14174-5","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T08:44:00Z","timestamp":1791189840000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neuroimaging signatures of facial onset sensory and motor neuronopathy (FOSMN)"],"prefix":"10.1007","volume":"273","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9700-0338","authenticated-orcid":false,"given":"Angela","family":"Rosenbohm","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1450-0412","authenticated-orcid":false,"given":"Francisco","family":"Herrera-Angeles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3856-9094","authenticated-orcid":false,"given":"Hans-J\u00fcrgen","family":"Huppertz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6389-5054","authenticated-orcid":false,"given":"Karl Georg","family":"Haeusler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3399-9784","authenticated-orcid":false,"given":"Jochen H.","family":"Weishaupt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5706-9381","authenticated-orcid":false,"given":"Hans-Peter","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7106-9270","authenticated-orcid":false,"given":"Jan","family":"Kassubek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"issue":"Pt 12","key":"14174_CR1","doi-asserted-by":"publisher","first-page":"3384","DOI":"10.1093\/brain\/awl258","volume":"129","author":"S Vucic","year":"2006","unstructured":"Vucic S, Tian D, Chong PS, Cudkowicz ME, Hedley-Whyte ET, Cros D (2006) Facial onset sensory and motor neuronopathy (FOSMN syndrome): a novel syndrome in neurology. 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