Multiple system atrophy with cerebellar features (MSA-C) is a distinct subtype of MSA characterized by predominant cerebellar symptoms. Neuroimaging studies have demonstrated cerebellar abnormalities; however, abnormality of structural connectivity of the motor subnetwork has not been studied and this study aims to investigate this aspect. We observed impairment in the structural segregation, integration and network resilience with significantly reduced nodal strength and connectivity in several cerebellar as well as non-cerebellar regions that correlate with UMSARS scores. Our findings provide definitive evidence of abnormalities that may be causally implicated in the motor features of cerebellar dysfunction and Parkinsonism observed in MSA-C.
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