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”.
| Original language | English |
|---|---|
| Pages (from-to) | 1-10 |
| Number of pages | 10 |
| Journal | Journal of Neural Transmission |
| DOIs | |
| Publication status | E-pub ahead of print - 2016 |
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Keywords
- Cognition
- Dementia
- Mini-Mental State Examination (MMSE)
- Multiple system atrophy (MSA)
- Neuroimaging
- Voxel-based morphometry
ASJC Scopus subject areas
- Neurology
- Clinical Neurology
- Psychiatry and Mental health
- Biological Psychiatry
Cite this
Brain structural profile of multiple system atrophy patients with cognitive impairment. / Fiorenzato, Eleonora; Weis, Luca; Seppi, Klaus; Onofrj, Marco; Cortelli, Pietro; Zanigni, Stefano; Tonon, Caterina; Kaufmann, Horacio; Shepherd, Timothy Michael; Poewe, Werner; Krismer, Florian; Wenning, Gregor; Antonini, Angelo; Biundo, Roberta.
In: Journal of Neural Transmission, 2016, p. 1-10.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Brain structural profile of multiple system atrophy patients with cognitive impairment
AU - Fiorenzato, Eleonora
AU - Weis, Luca
AU - Seppi, Klaus
AU - Onofrj, Marco
AU - Cortelli, Pietro
AU - Zanigni, Stefano
AU - Tonon, Caterina
AU - Kaufmann, Horacio
AU - Shepherd, Timothy Michael
AU - Poewe, Werner
AU - Krismer, Florian
AU - Wenning, Gregor
AU - Antonini, Angelo
AU - Biundo, Roberta
N1 - Ricercatore distaccato presso IRCCS a seguito Convenzione esclusiva con Università di Bologna (Cortelli Pietro)
PY - 2016
Y1 - 2016
N2 - 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”.
AB - 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”.
KW - Cognition
KW - Dementia
KW - Mini-Mental State Examination (MMSE)
KW - Multiple system atrophy (MSA)
KW - Neuroimaging
KW - Voxel-based morphometry
UR - http://www.scopus.com/inward/record.url?scp=84992217881&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84992217881&partnerID=8YFLogxK
U2 - 10.1007/s00702-016-1636-0
DO - 10.1007/s00702-016-1636-0
M3 - Article
C2 - 27778099
AN - SCOPUS:84992217881
SP - 1
EP - 10
JO - Journal of Neural Transmission
JF - Journal of Neural Transmission
SN - 0300-9564
ER -