Table 2.

Brain MRI markers of MSA diagnosis⁶

Changes seen	Areas involved for MSA-P	Areas involved for MSA-C
Atrophy	Putamen Middle cerebellar peduncle Pons Cerebellum	Putamen Middle cerebellar peduncle Pons
Increased diffusivity	Putamen Middle cerebellar peduncle	Putamen
Decreased signal on iron-sensitive sequences	Putaminal rim
T2 hyperintensity	‘Hot-cross bun’ sign in pons

MSA, multiple system atrophy; MSA-C, MSA-cerebellar; MSA-P, MSA-parkinsonian.