Advances in fMRI of brain white matter (WM) have established the feasibility of understanding how functional signals of WM evolve with brain diseases. By combining functional signals with structural features of WM, the current study characterizes functional and structural impairments of WM in cerebelar type multiple system atrophy, with the goal to derive new mechanistic insights into the pathological progression of this disease. Our analysis of 30 well-diagnosed patients revealed pronounced decreases in functional connectivity in WM bundles of the cerebellum and brainstem, and concomitant local structural alterations that depended on the disease stage. The novel findings implicate a critical time point in the pathological evolution of the disease, which could guide optimal therapeutic interventions. Furthermore, fMRI signals of impaired WM bundles exhibited superior sensitivity in differentiating initial disease development, which demonstrates great potential of using these signals to inform disease management.

脑白质 (WM) 功能磁共振成像的进展已经确立了了解 WM 的功能信号如何随着脑部疾病演变的可行性。通过将功能信号与 WM 的结构特征相结合，目前的研究表征了小脑型多系统萎缩中 WM 的功能和结构损伤，目的是对该疾病的病理进展获得新的机制见解。我们对 30 名确诊患者的分析显示，小脑和脑干的 WM 束的功能连接显着下降，并伴随着取决于疾病阶段的局部结构改变。新发现暗示了疾病病理演变的关键时间点，可以指导最佳治疗干预。此外，