Kazuhiro Hara1, Hirohisa Watanabe2,3, Epifanio Bagarinao4, Kazuya Kawabata1, Noritaka Yoneyama5, Reiko Ohdake4, Kazunori Imai1, Michihito Masuda1, Takamasa Yokoi1, Aya Ogura1, Takashi Tsuboi1, Mizuki Ito1, Naoki Atsuta1, Hisayoshi Niwa6, Toshiaki Taoka7, Satoshi Maesawa4,8, Shinji Naganawa4,7, Masahisa Katsuno1, Gen Sobue1,4. 1. Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan. 2. Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan. sobueg@med.nagoya-u.ac.jp. 3. Brain and Mind Research Center, Nagoya University, 466-8550, Nagoya, Japan. sobueg@med.nagoya-u.ac.jp. 4. Brain and Mind Research Center, Nagoya University, 466-8550, Nagoya, Japan. 5. Department of Neurology, Handa City Hospital, 475-8559, Handa, Japan. 6. Department of Neurology, Kariya Toyota General Hospital, 448-8505, Kariya, Japan. 7. Department of Radiology, Nagoya University Graduate School of Medicine, 466-8550, Nagoya, Japan. 8. Department of Neurosurgery, Nagoya University Graduate School of Medicine, 466-8550, Nagoya, Japan.
Abstract
OBJECTIVE: We examined the anatomical involvement related to cognitive impairment in patients with multiple system atrophy (MSA). METHODS: We examined 30 patients with probable MSA and 15 healthy controls. All MSA patients were assessed by the Unified MSA-Rating scale and Addenbrooke's Cognitive Examination-Revised (ACE-R). We classified 15 MSA patients with ACE-R scores > 88 as having normal cognition (MSA-NC) and 15 with scores ≤ 88 as having cognitive impairment (MSA-CI). All subjects underwent 3 T MRI scanning and were investigated using voxel-based morphometry and diffusion tensor imaging. RESULTS: Both the MSA-NC and MSA-CI patients exhibited cerebellar but not cerebral atrophy in voxel-based morphometry compared to controls. In contrast, tract-based spatial statistics revealed widespread and significantly decreased fractional anisotropy (FA) values, as well as increased mean diffusivity, radial diffusivity, and axial diffusivity in both the cerebrum and cerebellum in MSA-CI patients compared to controls. MSA-NC patients also exhibited similar involvement of the cerebellum but less extensive involvement of the cerebrum compared with the MSA-CI patients. In particular, FA values in MSA-CI patients were significantly decreased in the anterior part of the left corpus callosum compared with those in MSA-NC patients. The mean FA values in the left anterior part of the corpus callosum were significantly correlated with total ACE-R scores and subscores (memory, fluency, and language) in MSA patients. CONCLUSIONS: Decreased FA values in the anterior corpus callosum showed a significant correlation with cognitive impairment in MSA.
OBJECTIVE: We examined the anatomical involvement related to cognitive impairment in patients with multiple system atrophy (MSA). METHODS: We examined 30 patients with probable MSA and 15 healthy controls. All MSA patients were assessed by the Unified MSA-Rating scale and Addenbrooke's Cognitive Examination-Revised (ACE-R). We classified 15 MSA patients with ACE-R scores > 88 as having normal cognition (MSA-NC) and 15 with scores ≤ 88 as having cognitive impairment (MSA-CI). All subjects underwent 3 T MRI scanning and were investigated using voxel-based morphometry and diffusion tensor imaging. RESULTS: Both the MSA-NC and MSA-CI patients exhibited cerebellar but not cerebral atrophy in voxel-based morphometry compared to controls. In contrast, tract-based spatial statistics revealed widespread and significantly decreased fractional anisotropy (FA) values, as well as increased mean diffusivity, radial diffusivity, and axial diffusivity in both the cerebrum and cerebellum in MSA-CI patients compared to controls. MSA-NC patients also exhibited similar involvement of the cerebellum but less extensive involvement of the cerebrum compared with the MSA-CI patients. In particular, FA values in MSA-CI patients were significantly decreased in the anterior part of the left corpus callosum compared with those in MSA-NC patients. The mean FA values in the left anterior part of the corpus callosum were significantly correlated with total ACE-R scores and subscores (memory, fluency, and language) in MSA patients. CONCLUSIONS: Decreased FA values in the anterior corpus callosum showed a significant correlation with cognitive impairment in MSA.
Entities:
Keywords:
Cognitive impairment; Diffusion tensor imaging; Multiple system atrophy
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