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Related Experiment Video

Updated: Sep 5, 2025

Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis
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Cognitive and Autonomic Dysfunction in Multiple System Atrophy Type P and C: A Comparative Study.

Giulia Lazzeri1,2, Giulia Franco1,2, Teresa Difonzo1

  • 1Neurology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.

Frontiers in Neurology
|July 5, 2022
PubMed
Summary
This summary is machine-generated.

Multiple System Atrophy (MSA) patients show moderate cognitive deficits, particularly in executive functions and memory, especially in the cerebellar subtype (MSA-C). Autonomic dysfunction does not appear to drive these cognitive differences between MSA subtypes.

Keywords:
cognitive dysfunctiondysautonomiaheart rate variabilitymultiple system atrophyneuropsychological assessment

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Area of Science:

  • Neuroscience
  • Neurology
  • Cognitive Science

Background:

  • Multiple System Atrophy (MSA) is a rare neurodegenerative disease characterized by autonomic dysfunction and motor symptoms.
  • While dementia is typically absent in MSA, cognitive impairment, especially in executive functions, is increasingly recognized.
  • The physiopathological basis of cognitive involvement in MSA and its relationship with autonomic dysfunction remain unclear.

Purpose of the Study:

  • To investigate cognitive functions and their relationship with cardiovascular autonomic function in patients with Multiple System Atrophy (MSA).
  • To compare cognitive performance and autonomic parameters between the two main subtypes of MSA: predominantly extrapyramidal (MSA-P) and cerebellar (MSA-C).

Main Methods:

  • A cohort of 20 MSA patients (9 MSA-P, 11 MSA-C) underwent a neuropsychological battery.
  • Hemodynamic assessment (heart rate, arterial blood pressure) during rest and active standing was performed.
  • Bedside autonomic function tests, including heart rate variability (HRV) and sympathetic skin response (SSR), were assessed.

Main Results:

  • Global cognitive functioning (MoCA score) was preserved in most MSA patients.
  • Moderate impairments were observed in short- and long-term memory, attention, and frontal-executive functions.
  • MSA-C patients scored lower on executive function and verbal memory tests compared to MSA-P patients.
  • No significant differences in cardiovascular autonomic parameters were found between MSA-P and MSA-C subtypes.

Conclusions:

  • Moderate cognitive deficits, particularly affecting executive functions and memory, are present in MSA patients, with a more pronounced impact in the MSA-C subtype.
  • The findings do not support dysautonomia as a primary driver of cognitive differences between MSA-P and MSA-C patients.