Neuropsychological and clinical heterogeneity of cognitive impairment in patients with multiple system atrophy

• Published in: Clinical neurology and neurosurgery 2018-01, Vol.164, p.121-126
• Main Authors: Barcelos, Lorena Broseghini, Saad, Flávia, Giacominelli, Carla, Saba, Roberta Arb, de Carvalho Aguiar, Patrícia Maria, Silva, Sonia Maria Azevedo, Borges, Vanderci, Bertolucci, Paulo Henrique Ferreira, Ferraz, Henrique Ballalai
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Atrophy; Attention; Atypical parkinsonism; Brain diseases; Cerebellum; Cognitive ability; Cognitive Dysfunction - complications; Cognitive Dysfunction - diagnosis; Cognitive Dysfunction - psychology; Cognitive impairment; Cross-Sectional Studies; Degeneration; Dementia; Female; Humans; Impairment; Male; Medical prognosis; Memory; Middle Aged; Multiple system atrophy; Multiple System Atrophy - complications; Multiple System Atrophy - diagnosis; Multiple System Atrophy - psychology; Neurology; Neuropsychological Tests; Neuropsychology; Quality of life; Semantics; Studies
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2017.10.039

•Cognitive impairments in multiple system atrophy.•Neuropsychological tests to compare cognitive dysfunction between two types of multiple system atrophy: MSA-P and MSA-C.•Cognitive impairment in multiple system atrophy patients with or without postural hypotension. We evaluated neuropsychological tests to compare cognitive impairment between two types of multiple system atrophy: predominant parkinsonism (MSA-P) and predominant cerebellar ataxia (MSA-C). This cross-sectional study included 14 patients diagnosed with MSA: four with MSA-C and ten with MSA-P. Presence of motor symptoms was determined by using the Unified Rating MSA Scale (URMSAS). Non-motor symptoms were evaluated by the Short Form Health Survey (SF-36), Scales for Outcomes in Parkinson’s disease Autonomic (SCOPA-AUT), Hospital Anxiety and Depression Scale (HADS), and Beck Depression Inventory (BDI). Neuropsychological tests were used to evaluate general cognition, verbal and visual memory, working memory, constructional ability, visuospatial, language, and executive function. The median age of the patients was 62 years, median disease duration was 3.5 years, and median education level was 10 years. The median Mini-Mental State Examination (MMSE) score was 26.5 points, and median Mattis Dementia Rating Scale (MDRS) score was 131.5. We compared the continuous data between the two MSA subtypes and observed that bodily pain reported in the quality of life questionnaire, SF-36, was worse in MSA-P (p