We thank Tison and colleagues for their important comments on our article concerning the specificity of our findings in patients with MSA. We agree that a combination of hypointense signal changes in the dorsolateral putamen with a hyperintense lateral rim on T2-weighted images may not be a specific pattern for the identification of patients with MSA of striatonigral degeneration type. Patients with other neurodegenerative diseases may also reveal this lesion pattern on T2-weighted MRI studies, as described in their series. However, the key point in our considerations was the role of MRI in the differential diagnosis of hypokinetic rigid syndromes, in particular in distinguishing between idiopathic PD and MSA.
Kraft E, Schwarz J, Trenkwalder C, Oertel WH. In reply. Arch Neurol. 2001;58(6):1024-1026. doi: