Reply from the Authors

Abstract

Reply from the Authors: We thank Dr. Savoiardo et al for their interest in our review and acknowledge their group's major contribution to the delineation of multiple system atrophy (MSA), particularly the neuroradiologic features. On clinical presentation, most MSA patients predominantly have signs of extrapyramidal disease with or without accompanying signs of cerebellar disorder. We use the term striatonigral degeneration (SND)-type MSA for these patients. A smaller proportion show chiefly signs of cerebellar disease, and some of these patients show additional signs of extrapyramidal disorder. We use the term olivopontocerebellar atrophy (OPCA)-type MSA for these patients. Our review [1] deliberately addressed the difficult subject of the diagnosis of sporadic OPCA (sOPCA) and the question of whether some, most, or all of these patients have MSA. In SND-type MSA, which we did not address specifically, putaminal hypointensity (relative to globus pallidus) on 1.0- to …