There is an evolving history of structural images with SCA3 patients in different disease stages. The WM damage starts with the impairment of ICP and goes through SCP extends to the midbrain, then widespread to the whole brain. The alteration of GMV does not occur until the arise of ataxia symptom, then began to involve the medulla, cerebellum, and pons, and developed to involve basal ganglion, finally affect the cortical cortex. The impairment of WM tracts precedes the GM atrophy and, irrespective of the patients with or without clinical manifestation, the identified WM damage was significantly correlated with SARA.
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