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

Chang, Chiung‐Chih; Chang, Ya-Ting; Chang, Wen-Neng; Lee, Y. C.; Wang, Y. L.; Lui, Chun‐Chung; Huang, Chao‐Cheng; Liu, W. L.

doi:10.1111/j.1468-1331.2009.02661.x

Cited by 108 publications

(119 citation statements)

References 32 publications

(47 reference statements)

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“…Dementia was recently reported by some authors [16,17,22,23,34,35]. Wenning et al [34] in a retrospective, pathologically confirmed case study, showed that dementia was detected in 15.7% of a sample of 38 MSA cases and in none of them dementia onset was reported within the first 5 years.…”

Section: Review On Cognitive Impairment In Msamentioning

confidence: 96%

“…Heterogeneous cognitive dysfunctions in MSA have been reported by many authors [6,7,8,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33]. The executive functions are described as the most frequent impaired abilities but other cognitive domains that can be involved are memory, visuospatial, and constructional functions.…”

Section: Review On Cognitive Impairment In Msamentioning

confidence: 99%

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Cognitive and Sleep Features of Multiple System Atrophy: Review and Prospective Study

et al. 2014

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Background: The profile and degree of cognitive impairment in Multiple System Atrophy (MSA) and the impact of sleep disorders, REM sleep behavior disorder (RBD) in particular, in parkinsonism-related cognitive deficits are currently being debated. Summary: We reviewed the cognitive, affective and sleep findings in MSA and also carried out a longitudinal investigation of 10 MSA patients. At the first evaluation, 3 patients showed isolated cognitive deficits. After a mean of 16 months, these patients remained unchanged, while 1 patient worsened from a normal condition. No significant differences emerged when the cognitive, affective and video-polysomnographic findings of MSA-P and MSA-C were compared. Depression was present in half of the patients, although it did not influence their cognitive performance. Comparisons between the first and second evaluation data showed significant worsening in visual attention and in ADL/IADL and UMSARS. Key Messages: Isolated cognitive deficits are evidenced in a minority of MSA patients with the absence of a clear-cut diagnosis of dementia in the early stages of the disease. Attention and executive functions are often impaired. This study with a short follow-up period showed that RBD, although present in almost all patients affected by MSA, does not appear a clear early marker of cognitive impairment. Future longer-term studies with a larger patient sample are thus encouraged.

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Section: Review On Cognitive Impairment In Msamentioning

confidence: 96%

Section: Review On Cognitive Impairment In Msamentioning

confidence: 99%

Cognitive and Sleep Features of Multiple System Atrophy: Review and Prospective Study

et al. 2014

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“…Episodic memory and attentional and executive deficits were the most prevalent cognitive alterations observed. Some of these cognitive abilities depend on prefrontal cortical areas and on their connections with frontal subcortical structures, which are usually involved in MSA 11 . Temporospatial disorientation, episodic memory and visuospatial and language dysfunctions were exclusively identified in patients with the MSA-P variant.…”

Section: Discussionmentioning

confidence: 99%

Cognition in a multiple system atrophy series of cases from Argentina

Gatto

Demey²,

Sanguinetti³

et al. 2014

Arq. Neuro-Psiquiatr.

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Cognitive dysfunction may occur in 17-40% of patients with multiple system atrophy (MSA). It has been suggested a milder cognitive impairment in cerebellar (MSA-C) than in parkinsonian variant (MSA-P). However, differences in cognitive profiles remain under discussion. Objective: To evaluate cognitive features in a series of patients with "probable MSA" from Argentina. Method: After informed consent was obtained, an extensive cognitive tests battery was administered. Nine patients (6 MSA-P and 3 MSA-C) composed the sample. Results: Depression was detected in 43% of patients. Seven patients showed at least one cognitive domain impairment. Temporospatial orientation, visuospatial abilities, executive and attentional functions, episodic memory and language were compromised in MSA-P, while MSA-C dysfunction was restricted to attentional and executive domains. Conclusion: Despite the small sample size, our findings could suggest a more widespread cognitive impairment in MSA-P than MSA-C.Keywords: parkinsonism, multiple system atrophy, cognition. RESUMO Disfunção cognitiva pode ocorrer em 17-40 % dos pacientes com atrofia de múltiplos sistemas (AMS). Alguns estudos têm sugerido a presença de disfunção cognitiva mais leve nos pacientes com AMS do tipo cerebelar (AMS-C) do que na variante parkinsoniana (AMS-P).Objetivo: Avaliar os perfis cognitivos de uma série de pacientes argentinos com "Provável AMS". Método: Foram selecionados 6 AMS-P e 3 AMS-C aos quais foi aplicada uma extensa bateria de testes cognitivos. Resultados: Depressão foi detectada em 43% dos pacientes. Sete pacientes apresentaram comprometimento de pelo menos um domínio cognitivo. As funções de orientação temporo-espacial, habilidades visuo-espaciais, função executiva e de atenção, memória episódica e linguagem foram comprometidas em pacientes com AMS-P. Nos pacientes com AMS-C as dificuldades cognitivas ficaram restritas às funções executivas e de atenção. Conclusão: Apesar do pequeno tamanho da amostra, nossos achados sugerem que pacientes com AMS-P apresentam um comprometimento cognitivo mais amplo do que pacientes com AMS-C.Palavras-chave: parkinsonismo, atrofia de múltiplos sistemas, cognição.

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“…The detailed neuropsychological evaluation studies revealed a cognitive profile in MSA patients where executive functions, reasoning, attention, verbal memory and visuospatial functions were impaired and indicated a spectrum of cognitive disorders ranging between normal cognitive findings and subcortical dementia (7,18). In addition to the reports showing the relationship between frontal atrophy and the disease duration, there have been case studies where the cognitive disorders became obvious at the onset of the disease (18,19). In a study where the cognitive and neuropsychiatric findings of synucleinopathies were evaluated, MSA patients performed worse than Parkinson's Disease patients and better than Lewy body dementia patients (20).…”

Section: Discussionmentioning

confidence: 99%

“…Through its anatomical and functional connections to the structures critical in cognition (prefrontal cortex, parietal cortex, anterior cingulate cortex, basal ganglia, subcortical limbic structures, thalamus, hypothalamus, periaqueductal gray matter and the brainstem nuclei that produce monoamine), cerebellum assures that functions are sustained at a basal level (2,17,18,23). The involvement of the non-motor cerebellar parts, therefore, causes emotional disorders and present as cerebellar cognitive affective syndrome (3).…”

Section: Discussionmentioning

confidence: 99%

Kognitif Affektif Serebellar Sendrom ve Psikoz Bulguları ile Ortaya Çıkan bir Multisistem Atrofi (MSA-C) Olgusu

Tatlidede¹,

Hanağası²,

Çabalar³

et al. 2013

Tnd

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Besides its well-established motor functions, the modulatory role of cerebellum in the neural networks subserving cognition and emotion has been supported by several lines of evidence obtained from neuroanatomical investigations, functional neuroimaging and clinical research. Damage to cerebellar posterior lobe and vermis may lead to a cognitive affective cerebellar syndrome primarily comprising cognitive disorders characterized by executive dysfunctioning, language and visuospatial impairments in addition to disorders of affect and other psychiatric impairments. Cognitive and affective symptoms have often been reported in neurodegenerative cerebellar diseases while psychotic symptoms occur less frequently. In this article, we describe an extraordinary case of multiple system atrophy (MSA-C), who presented with cognitive affective cerebellar syndrome and psychotic symptoms before cerebellar ataxia was evident. The wide variety of symptoms observed in this case underlines the critical role of cerebellum in modulation of networks engaged in cognition, affect, thought and perception, and provides further evidence regarding the contribution of cerebellar dysfunction to several neuropsychiatric symptoms.

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

Abstract: In conclusion, although dementia is not a typical presenting feature of MSA and is regarded as a sub-cortical movement disorder, frontal atrophy, cognitive changes, and dementia are identifiable as MSA progresses.

Cited by 108 publications

References 32 publications

Cognitive and Sleep Features of Multiple System Atrophy: Review and Prospective Study

Cognitive and Sleep Features of Multiple System Atrophy: Review and Prospective Study

Cognition in a multiple system atrophy series of cases from Argentina

Kognitif Affektif Serebellar Sendrom ve Psikoz Bulguları ile Ortaya Çıkan bir Multisistem Atrofi (MSA-C) Olgusu

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