Cognitive impairments in multiple system atrophy - MSA-C vs MSA-P
Cognitive impairments in multiple system atrophy - MSA-C vs MSA-P
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DOI：
10.1212/01.wnl.0000310413.04462.6a
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发表时间：
2008-04-15
期刊：
影响因子：
9.9
通讯作者：
Sobue, G.
中科院分区：
文献类型：
--
作者：
Kawai, Y.;Suenaga, M.;Sobue, G.
目的：我们评估了全面的神经心理学测试和局部脑血流量，比较两种类型的多系统萎缩：主要小脑共济失调（MSA-C）和主要帕金森综合征（MSA-P）的认知功能障碍。方法：21例MSA-C患者，14例MSA-P患者和21例年龄和教育相匹配的对照组进行了神经心理学测试和SPECT。神经心理学测试检查一般认知，言语和视觉记忆，工作记忆，视觉空间和结构能力，语言，执行功能，抑郁和焦虑，而SPECT分析检查脑perfusion.Results：患者与MSA-P表现出严重的视觉空间和结构功能，言语流畅性，执行功能与对照组相比。与对照组相比，MSA-C患者仅累及视觉空间和结构功能，与MSA-P患者相比累及程度较轻。与MSA-C患者相比，MSA-P患者的认知功能损害倾向于广泛和严重。此外，MSA-P患者的神经心理损害与前额叶灌注减少显著相关。这种显着的关系是不相关的其他因素，如年龄，教育，小脑性共济失调和帕金森综合征的严重程度，这是与认知performance.Conclusions相关的因素：多系统萎缩性帕金森综合征患者表现出更严重，更广泛的认知功能障碍比多系统萎缩性小脑性共济失调患者。我们的研究结果还表明，多系统萎缩帕金森综合征患者的认知功能障碍可能与前额叶受累有关。
Objective: We evaluated comprehensive neuropsychological tests and regional brain blood flow to compare cognitive dysfunction between two types of multiple system atrophy: predominant cerebellar ataxia (MSA-C) and predominant parkinsonism (MSA-P).Methods: Twenty-one patients with MSA-C, 14 patients with MSA-P, and 21 age-and education-matched control subjects were subjected to neuropsychological tests and SPECT. The neuropsychological tests examined general cognition, verbal and visual memory, working memory, visuospatial and constructional ability, language, executive function, depression, and anxiety, while SPECT analysis examined brain perfusion.Results: Patients with MSA-P showed severe involvement of visuospatial and constructional function, verbal fluency, and executive function compared with control subjects. Patients with MSA-C showed involvement only in visuospatial and constructional function compared with control subjects and a milder degree of involvement compared with patients with MSA-P. Patients with MSA-P tended toward a wide and severe impairment in cognitive function compared with patients with MSA-C. In addition, neuropsychological impairment in patients with MSA-P was significantly correlated with a decrease in prefrontal perfusion. This significant relation was not correlated to other factors such as age, education, and severity of cerebellar ataxia and parkinsonism, which are relevant factors associated with cognitive performance.Conclusions: Patients with multiple system atrophy-parkinsonism show more severe and more widespread cognitive dysfunctions than patients with multiple system atrophy-cerebellar ataxia. Our results also indicate that cognitive dysfunction in patients with multiple system atrophy parkinsonism may be associated with prefrontal involvement.