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24.10.2016 | Neurology and Preclinical Neurological Studies - Original Article

Brain structural profile of multiple system atrophy patients with cognitive impairment

verfasst von: Eleonora Fiorenzato, Luca Weis, Klaus Seppi, Marco Onofrj, Pietro Cortelli, Stefano Zanigni, Caterina Tonon, Horacio Kaufmann, Timothy Michael Shepherd, Werner Poewe, Florian Krismer, Gregor Wenning, Angelo Antonini, Roberta Biundo, On behalf of the Movement Disorders Society MSA (MODIMSA) Neuropsychology and Imaging Study Groups

Erschienen in: Journal of Neural Transmission | Ausgabe 3/2017

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Abstract

Current consensus diagnostic criteria for multiple system atrophy (MSA) consider dementia a non-supporting feature, although cognitive impairment and even frank dementia are reported in clinical practice. Mini-Mental State Examination (MMSE) is a commonly used global cognitive scale, and in a previous study, we established an MSA-specific screening cut-off score <27 to identify cognitive impairment. Finally, MSA neuroimaging findings suggest the presence of structural alterations in patients with cognitive deficits, although the extent of the anatomical changes is unclear. The aim of our multicenter study is to better characterize anatomical changes associated with cognitive impairment in MSA and to further investigate cortical and subcortical structural differences versus healthy controls (HC). We examined retrospectively 72 probable MSA patients [50 with normal cognition (MSA-NC) and 22 cognitively impaired (MSA-CI) based on MMSE <27] and compared them to 36 HC using gray- and white-matter voxel-based morphometry and fully automated subcortical segmentation. Compared to HC, MSA patients showed widespread cortical (bilateral frontal, occipito-temporal, and parietal areas), subcortical, and white-matter alterations. However, MSA-CI showed only focal volume reduction in the left dorsolateral prefrontal cortex compared with MSA-NC. These results suggest only a marginal contribution of cortical pathology to cognitive deficits. We believe that cognitive dysfunction is driven by focal fronto-striatal degeneration in line with the concept of “subcortical cognitive impairment”.

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Titel: Brain structural profile of multiple system atrophy patients with cognitive impairment
verfasst von: Eleonora Fiorenzato
Luca Weis
Klaus Seppi
Marco Onofrj
Pietro Cortelli
Stefano Zanigni
Caterina Tonon
Horacio Kaufmann
Timothy Michael Shepherd
Werner Poewe
Florian Krismer
Gregor Wenning
Angelo Antonini
Roberta Biundo
On behalf of the Movement Disorders Society MSA (MODIMSA) Neuropsychology and Imaging Study Groups
Publikationsdatum: 24.10.2016
Verlag: Springer Vienna
Erschienen in: Journal of Neural Transmission / Ausgabe 3/2017
Print ISSN: 0300-9564
Elektronische ISSN: 1435-1463
DOI: https://doi.org/10.1007/s00702-016-1636-0

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Brain structural profile of multiple system atrophy patients with cognitive impairment

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