Brain structural profile of multiple system atrophy patients with cognitive impairment
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- 作者：Eleonora Fiorenzato ; Luca Weis ; Klaus Seppi ; Marco Onofrj…
- 关键词：Multiple system atrophy (MSA) ; Cognition ; Mini ; Mental State Examination (MMSE) ; Dementia ; Neuroimaging ; Voxel ; based morphometry
- 刊名：Journal of Neural Transmission
- 出版年：2017
- 出版时间：March 2017
- 年：2017
- 卷：124
- 期：3
- 页码：293-302
- 全文大小：
- 刊物类别：Medicine
- 刊物主题：Neurology; Psychiatry; Pharmacology/Toxicology; Neurosciences;
- 出版者：Springer Vienna
- ISSN：1435-1463
- 卷排序：124
文摘
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”.