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Corpus callosal involvement is correlated with cognitive impairment in multiple system atrophy

Kazuhiro Hara1, Hirohisa Watanabe2,3, Epifanio Bagarinao4

  • 1Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan.

Journal of Neurology
|July 6, 2018
PubMed
Abstract

Insights

Cognitive impairment in multiple system atrophy (MSA) is linked to white matter changes in the brain, particularly the corpus callosum. Reduced fractional anisotropy in the anterior corpus callosum correlates with cognitive decline in MSA patients.

Area of Science:

  • Neuroscience
  • Neurology
  • Radiology

Background:

  • Multiple system atrophy (MSA) is a progressive neurodegenerative disorder.
  • Cognitive impairment is a common feature in MSA, impacting quality of life.
  • Understanding the neuroanatomical basis of cognitive impairment in MSA is crucial for diagnosis and management.

Purpose of the Study:

  • To investigate the specific brain regions and white matter tracts associated with cognitive impairment in patients with multiple system atrophy (MSA).
  • To differentiate anatomical changes between MSA patients with normal cognition and those with cognitive impairment.

Main Methods:

  • Voxel-based morphometry (VBM) and diffusion tensor imaging (DTI) were used to analyze 3 Tesla MRI scans from 30 probable MSA patients and 15 healthy controls.
  • Patients were categorized into normal cognition (MSA-NC) and cognitive impairment (MSA-CI) groups based on Addenbrooke's Cognitive Examination-Revised (ACE-R) scores.
  • Tract-based spatial statistics (TBSS) were applied to DTI data to assess white matter integrity.

Main Results:

  • VBM revealed cerebellar atrophy in both MSA-NC and MSA-CI groups compared to controls, but no significant cerebral atrophy.
  • DTI showed widespread reductions in fractional anisotropy (FA) and increased diffusivity in both cerebrum and cerebellum in MSA-CI patients compared to controls.
  • MSA-NC patients exhibited similar cerebellar involvement but less extensive cerebral white matter changes than MSA-CI patients. Significantly decreased FA in the anterior corpus callosum was observed in MSA-CI patients compared to MSA-NC patients and correlated with cognitive scores.

Conclusions:

  • White matter integrity, particularly in the anterior corpus callosum, is significantly compromised in MSA patients with cognitive impairment.
  • Reduced fractional anisotropy in the anterior corpus callosum is a key neuroimaging marker associated with cognitive dysfunction in MSA.
  • These findings highlight the importance of DTI in evaluating cognitive impairment in MSA.
Keywords:
Cognitive impairmentDiffusion tensor imagingMultiple system atrophy

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