Cognitive deficits in multiple system atrophy correlate with frontal atrophy and disease duration
Cognitive deficits in multiple system atrophy correlate with frontal atrophy and disease duration
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DOI：
10.1111/j.1468-1331.2009.02661.x
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发表时间：
2009-10-01
影响因子：
5.1
通讯作者：
Liu, W. L.
中科院分区：
文献类型：
--
作者：
Chang, C. C.;Chang, Y. Y.;Liu, W. L.
背景和目的：痴呆症仍然是诊断多系统萎缩(MSA)的排除标准。本研究旨在探讨帕金森病(MSA-P)和小脑(MSA-C)变异型MSA的认知改变和脑萎缩模式。方法：对10例MSA-C和13例MSA-P患者进行基于体素的磁共振成像形态测量(VBM)和神经心理测试，并与37例年龄匹配的对照组进行比较。结果：在神经心理测试中，23例MSA患者在Stroop干扰测验中得分低于对照组，在连线测验中花费的时间长于对照组，而MSA-C在记忆成绩、Stroop测验和完成连线测验的时间上均逊于MSA-P。MSA表现为小脑、岛叶皮质、梭形回、眶下回、颞上回和尾状核萎缩。结论：虽然痴呆不是MSA的典型表现，被认为是一种皮质下运动性障碍，但随着MSA的进展，额叶萎缩、认知改变和痴呆是可以识别的。
Background and purpose:Dementia remains an exclusion criterion in diagnosing multiple system atrophy (MSA). This study aimed to determine the cognitive changes and brain atrophy patterns in the Parkinsonian (MSA-P) and cerebellar (MSA-C) variants of MSA.Methods:Voxel-based morphometry (VBM) of magnetic resonance imaging (MRI) and neuro-psychological tests were applied to 10 MSA-C and 13 MSA-P patients, and compared to 37 age-matched controls. Correlation analyses were performed between cognitive test results and morphometric data extracted from the VBM data.Results:In neuro-psychological testing, the 23 MSA patients scored lower in the Stroop interference test and took longer in the trail-making test as compared with the controls, whereas MSA-C performed worse than MSA-P in the memory scores, Stroop test, and time to complete the trail-making test. MSA, as a group, showed atrophy in the cerebellum, insular cortex, fusiform gyrus, inferior orbito-frontal gyrus, superior temporal gyrus, and caudate nucleus. Memory scores correlated well with pre-frontal lobe atrophy but not in the insular area.Conclusion: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.