201 population with only less than 2.5 years of motoric symptoms (mean) had many patients with no iron overload in many parts of their brain (putamen, globus pallidus, and dentate nucleus) and there was no decline in the volumes of cerebellum, brain stem, and globus pallidus of many patients. The variability of neurofilament light was quite big.
See the poster: https://alteritytherapeutics.com/wp-content/uploads/poster-MDS-2024-Stamler-201.pdf
In the bioMuse study ( more severe patients) the volume decrease in 12 months was quite significant in these brain areas. The variability of the UMSARS score was big. https://alteritytherapeutics.com/wp-content/uploads/poster-MDS-2024-Claassen-volume.pdf
In the 202 study, 6-month results support some effect in neurofilament light when compared with bioMuse results. However, in this study, the most important issue could be that the responded patients did not lose more brain volume at 12 months compared to 6-month measure.
https://alteritytherapeutics.com/wp-content/uploads/poster-MDS-2024-Claassen-202.pdf
So it could be possible that the patients in the 201 study would not lose almost any brain volume during the 12 months if ATH434 works. In the bioMuse survey, most of the brain volume loss is happened during the last 6 months. IMO real healing is perhaps happening only during the last 6 months and in early cases with only under 2.5 years of motoric symptoms (??), no additional or very minimal brain atrophy is seen.
If this is true, I would expect some effect on the MC.
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