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Cognitive deficits in multiple system atrophy correlate with frontal atrophy and disease duration

C C Chang1, Y Y Chang, W N Chang

  • 1Department of Neurology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan. neur099@adm.cgmh.org.tw

European Journal of Neurology
|June 3, 2009
PubMed
Abstract

Insights

Multiple system atrophy (MSA) patients exhibit cognitive decline and brain atrophy, particularly in frontal regions, as the disease progresses. These changes, including dementia, are identifiable even though dementia is not a typical initial feature.

Area of Science:

  • Neuroscience
  • Neurology
  • Radiology

Background:

  • Multiple system atrophy (MSA) is a neurodegenerative disorder.
  • Dementia is currently an exclusion criterion for MSA diagnosis.
  • Understanding cognitive and atrophic changes is crucial for accurate diagnosis and management.

Purpose of the Study:

  • To investigate cognitive deficits in patients with multiple system atrophy.
  • To identify patterns of brain atrophy in Parkinsonian (MSA-P) and cerebellar (MSA-C) variants of MSA.
  • To correlate cognitive test performance with neuroimaging findings.

Main Methods:

  • Voxel-based morphometry (VBM) analysis of MRI scans.
  • Neuro-psychological testing including Stroop and Trail-Making tests.
  • Comparison of 10 MSA-C, 13 MSA-P patients, and 37 age-matched controls.

Main Results:

  • MSA patients showed deficits in executive function (Stroop) and processing speed (Trail-Making).
  • MSA-C variant patients performed worse than MSA-P on memory, Stroop, and Trail-Making tests.
  • Brain atrophy was observed in the cerebellum, insula, orbito-frontal cortex, and caudate nucleus.
  • Memory scores correlated with pre-frontal lobe atrophy.

Conclusions:

  • Cognitive impairment and frontal atrophy are identifiable in progressive MSA.
  • These findings suggest that dementia can be a feature of advanced MSA.
  • Distinguishing cognitive profiles between MSA variants may aid in diagnosis.

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