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Abstract
To evaluate the correlation between “hot cross bun” sign (HCBs) and disease severity in multiple system atrophy (MSA). We recruited patients with probable and possible MSA with parkinsonism (MSA-P) or the cerebellar ataxia (MSA-C) subtypes. Clinical and imaging characteristics were collected and comparison was performed between MSA-C and MSA-P cases. Spearman test was used to evaluate the correlation between HCBs and other variables. Curve estimate and general linear regression was performed to evaluate the relationship between HCBs and the Scale for Assessment and Rating of Ataxia (SARA). Unified Multiple System Atrophy Rating Scale (UMSARS) IV was used to assess the severity of disease. Multinomial ordered logistic regression was used to confirm the increased likelihood of disability for the disease. Eighty-one MSA with HCBs comprising of 50 MSA-C and 31 MSA-P were recruited. We demonstrated that the severity of HCBs showed a positive linear correlation with SARA scores in MSA-C. Multinomial ordered logistic regression test revealed that the increase in the HCBs grade may be associated with an increased likelihood of disability for the disease severity in MSA, especially in those with cerebellar ataxia subtype. We demonstrated that HCBs is a potential imaging marker for the severity of cerebellar ataxia. The increase in the HCBs grade may be associated with an increased likelihood of disability in MSA-C, but not MSA-P cases, suggesting that it may be a useful imaging indicator for disease progression in Chinese patients with MSA-C.
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1 Shunde Hospital of Southern Medical University, Department of Neurology, Foshan, P.R. China (GRID:grid.284723.8) (ISNI:0000 0000 8877 7471); Zhujiang Hospital of Southern Medical University, Department of Neurology, Guangzhou, P.R. China (GRID:grid.417404.2) (ISNI:0000 0004 1771 3058)
2 Zhujiang Hospital of Southern Medical University, Department of Neurology, Guangzhou, P.R. China (GRID:grid.417404.2) (ISNI:0000 0004 1771 3058)
3 the Second Affiliated Hospital of Guangzhou Medical University, Department of Neurology, Guangdong, China (GRID:grid.412534.5)
4 Duke-NUS Medical School, Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Singapore, Singapore (GRID:grid.428397.3) (ISNI:0000 0004 0385 0924)
5 Linkuo Medical Center and Chang Gung University College of Medicine, Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan (GRID:grid.145695.a)
6 Zhujiang Hospital of Southern Medical University, Department of Neurology, Guangzhou, P.R. China (GRID:grid.417404.2) (ISNI:0000 0004 1771 3058); Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangdong, China (GRID:grid.417404.2)