Neurology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Data Supplement
Right arrow Correspondence:
Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Correspondence are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kawai, Y.
Right arrow Articles by Sobue, G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kawai, Y.
Right arrow Articles by Sobue, G.
Related Collections
Right arrow SPECT
Right arrow Multiple system atrophy
Right arrow All Neuropsychology/Behavior
Right arrow Neuropsychological assessment
NEUROLOGY 2008;70:1390-1396
© 2008 American Academy of Neurology

Cognitive impairments in multiple system atrophy

MSA-C vs MSA-P

Y. Kawai, MD, M. Suenaga, MD, A. Takeda, MD, M. Ito, MD, H. Watanabe, MD, F. Tanaka, MD, K. Kato, MD, H. Fukatsu, MD, S. Naganawa, MD, T. Kato, MD, K. Ito, MD and G. Sobue, MD

From the Departments of Neurology (Y.K., M.S., M.I., H.W., F.T., G.S.) and Radiology (K.K., H.F., S.N.), Nagoya University Graduate School of Medicine, Nagoya, Japan; and Departments of Neurology (A.T.) and Radiology (T.K., K.I.), National Hospital for Geriatric Medicine, Aichi, Japan.

Address correspondence and reprint requests to Dr. G. Sobue, 65 Tsurumai-cho Showa-ku, Nagoya 466-8550, Japan

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.

GLOSSARY: MSA = multiple system atrophy; MSA-C = MSA-cerebellar; MSA-P = MSA-parkinsonism.

sobueg{at}med.nagoya-u.ac.jp

Supplemental data at www.neurology.org

All authors were supported by grants from the Ministry of Health, Labour, and Welfare of Japan.

Disclosure: The authors report no conflicts of interest.

Received April 23, 2007. Accepted in final form August 14, 2007.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2008 by AAN Enterprises, Inc.