Cognitive impairment in multiple system atrophy is related to white matter damage detected by the T1w/T2w ratio

Abstract Introduction This study aimed to use a novel MRI contrast, the standardized T1-weighted/T2-weighted (sT1w/T2w) ratio, to assess damage of the white matter and gray matter in multiple system atrophy (MSA). Furthermore, this study investigated whether the sT1w/T2w ratio was associated with cognitive impairment in MSA. Methods The white matter and gray matter sT1w/T2w ratio of 37 MSA patients and 19 healthy controls was measured. Correlation analyses were used to evaluate the relationship between sT1w/T2w ratio values and clinical variables, and a multivariate analysis was used to identify independent factors associated with cognitive impairment in MSA. Results MSA patients showed a higher white matter sT1w/T2w ratio value than controls (P  Conclusion The sT1w/T2w ratio is sensitive to degenerative changes in the white matter that are associated with cognitive ability in MSA patients.