To characterize the heterogeneity of Friedreich ataxia (FRDA) by identifying MRI-based subtypes using machine learning.
Key Findings:
Three MRI-based subtypes of FRDA identified: classical (67%), early cerebral (26%), and early cerebellar (8%).
All subtypes showed early changes in key brain pathways but differed in atrophy progression.
MRI-derived disease stage correlated with symptom duration and severity, with variations by subtype.
Interpretation:
MRI-based subtypes may reveal disease-related heterogeneity not captured by standard clinical or genetic measures, suggesting a need for refined diagnostic approaches.