Cognitive impairment and structural brain damage in multiple system atrophy-parkinsonian variant

Caso, Francesca; Canu, Elisa; Lukić, Milica Ječmenica; Petrović, Igor; Fontana, Andrea; Nikolić, Ivan; Kostić, Vladimir; Filippi, Massimo

doi:10.1007/s00415-019-09555-y

Cited by 26 publications

(28 citation statements)

References 33 publications

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“…These studies demonstrated that the presence of significant temporal atrophy in MCI patients can be used to predict progression to dementia. However, our findings contradicted some previous studies of MSA patients (Chang et al, 2009;Fiorenzato et al, 2017;Koga et al, 2017;Caso et al, 2019), which suggested that morphological alterations in frontal lobule played a key role in cognitive impairment in MSA patients. Koga et al (2017) and Caso et al (2019) found that cognitive declines emanated from impaired frontal lobule in MSA.…”

Section: Discussioncontrasting

confidence: 99%

“…However, our findings contradicted some previous studies of MSA patients (Chang et al, 2009;Fiorenzato et al, 2017;Koga et al, 2017;Caso et al, 2019), which suggested that morphological alterations in frontal lobule played a key role in cognitive impairment in MSA patients. Koga et al (2017) and Caso et al (2019) found that cognitive declines emanated from impaired frontal lobule in MSA. Fiorenzato et al (2017) divided MSA patients into two groups, normal cognitive function and cognitive impairment, and they found that MSA patients with cognitive impairment showed greater frontal atrophy, illustrating that the dysfunction of the frontal-striatal connections might lead to cognitive impairment in MSA patients.…”

Section: Discussioncontrasting

confidence: 99%

“…Previous functional MRI studies suggested that the left temporal regions were involved in many cognitive processes, including semantic aspects of comprehension (superior temporal gyrus) (Friederici et al, 2003), language processing (superior and middle temporal gyrus) (Fan et al, 2017), semantic memory processing (middle temporal gyrus) (Kiehl et al, 2004;Wei et al, 2012;Fan et al, 2017), delayed memory (inferior temporal gyrus) (Kuroki et al, 2006), and visual processing (inferior temporal gyrus) (Kiernan, 2012;Ju et al, 2020). In addition, several recent studies confirmed that MSA-MCI patients had significant language decline, visual function decline, and memory impairment (Caso et al, 2019;Wang et al, 2019). Therefore, morphological changes in the left temporal region might be involved in cognitive impairment in MSA-MCI patients by affecting language, vision, and memory function.…”

Section: Discussionmentioning

confidence: 95%

“…Significant subcortical structural impairment was found in MSA patients with CI (Lee et al, 2016). Further studies found that GM atrophy in the bilateral thalamus, the left cerebellum, and the left pericalcarine gyrus was significantly associated with cognitive deficits in the cerebellar subtype of MSA (Lee et al, 2016); In the parkinsonian subtype of MSA, cerebellum, striatal, temporal, and frontal cortical areas of GM atrophy showed correlation with cognitive deficits (Kim et al, 2015;Caso et al, 2019). These results illustrated that cognitive dysfunction was associated with widespread fronto-temporal subcortical GM, basal ganglia, and cerebellum atrophies in MSA patients (Fiorenzato et al, 2017).…”

Section: Introductionmentioning

confidence: 97%

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Morphological Changes in Cortical and Subcortical Structures in Multiple System Atrophy Patients With Mild Cognitive Impairment

Cao

Wang

et al. 2021

Front. Hum. Neurosci.

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ObjectiveThis study aimed to investigate the morphometric alterations in the cortical and subcortical structures in multiple system atrophy (MSA) patients with mild cognitive impairment (MCI), and to explore the association with cognitive deficits.MethodsA total of 45 MSA patients (25 MSA-only, 20 MSA-MCI) and 29 healthy controls were recruited. FreeSurfer software was used to analyze cortical thickness, and voxel-based morphometry was used to analyze the gray matter volumes. Cortical thickness and gray matter volume changes were correlated with cognitive scores.ResultsCompared to healthy controls, both MSA subgroups exhibited widespread morphology alterations of brain structures in the fronto-temporal regions. Direct comparison of MSA-MCI and MSA-only patients showed volume reduction in the left superior and middle temporal gyrus, while cortical thinning was found in the left middle and inferior temporal gyrus in MSA-MCI patients. Cortical thinning in the left middle temporal gyrus correlated with cognitive assessment and disease duration.ConclusionStructural changes in the brain occur in MSA-MCI patients. The alteration of brain structure in the left temporal regions might be a biomarker of cognitive decline in MSA-MCI patients.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 97%

See 2 more Smart Citations

Morphological Changes in Cortical and Subcortical Structures in Multiple System Atrophy Patients With Mild Cognitive Impairment

Cao

Wang

et al. 2021

Front. Hum. Neurosci.

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“…The detected atrophy of the temporal cortex may account for the impairment of the verbal recall and working memory observed in patients with MSA (Robbins et al, 1992). A recent study found that patients with MSA-P showed decreased cortical thickness of fronto-temporal-parietal regions and that cortical thinning in temporal correlated with global cognitive status and memory impairment (Caso et al, 2020). Another study detected decreased cerebral blood flow and functional connectivity in the temporal gyrus in MSA-C using combined arterial spin labeling (ALS) perfusion and resting-state fMRI method (Zheng et al, 2019).…”

Section: Cerebral Cortexmentioning

confidence: 99%

Voxel-Based Meta-Analysis of Gray Matter Abnormalities in Multiple System Atrophy

Lin

Hou

et al. 2020

Front. Aging Neurosci.

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Purpose: This study aimed to identify consistent gray matter volume (GMV) changes in the two subtypes of multiple system atrophy (MSA), including parkinsonism subtype (MSA-P), and cerebellar subtype (MSA-C), by conducting a voxel-wise meta-analysis of whole brain voxel-based morphometry (VBM) studies.Method: VBM studies comparing MSA-P or MSA-C and healthy controls (HCs) were systematically searched in the PubMed, Embase, and Web of Science published from 1974 to 20 October 2020. A quantitative meta-analysis of VBM studies on MSA-P or MSA-C was performed using the effect size-based signed differential mapping (ES-SDM) method separately. A complementary analysis was conducted using the Seed-based d Mapping with Permutation of Subject Images (SDM-PSI) method, which allows a familywise error rate (FWE) correction for multiple comparisons of the results, for further validation of the results.Results: Ten studies were included in the meta-analysis of MSA-P subtype, comprising 136 MSA-P patients and 211 HCs. Five studies were included in the meta-analysis of MSA-C subtype, comprising 89 MSA-C patients and 134 HCs. Cerebellum atrophy was detected in both MSA-P and MSA-C, whereas basal ganglia atrophy was only detected in MSA-P. Cerebral cortex atrophy was detected in both subtypes, with predominant impairment of the superior temporal gyrus, inferior frontal gyrus, temporal pole, insula, and amygdala in MSA-P and predominant impairment of the superior temporal gyrus, middle temporal gyrus, fusiform gyrus, and lingual gyrus in MSA-C. Most of these results survived the FWE correction in the complementary analysis, except for the bilateral amygdala and the left caudate nucleus in MSA-P, and the right superior temporal gyrus and the right middle temporal gyrus in MSA-C. These findings remained robust in the jackknife sensitivity analysis, and no significant heterogeneity was detected.Conclusion: A different pattern of brain atrophy between MSA-P and MSA-C detected in the current study was in line with clinical manifestations and provided the evidence of the pathophysiology of the two subtypes of MSA.

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Alterations of voxel‐wise spontaneous activity and corresponding brain functional networks in multiple system atrophy patients with mild cognitive impairment

Liu

et al. 2022

Human Brain Mapping

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Emerging evidence has indicated that cognitive impairment is an underrecognized feature of multiple system atrophy (MSA). Mild cognitive impairment (MCI) is related to a high risk of dementia. However, the mechanism underlying MCI in MSA remains controversial. In this study, we conducted the amplitude of low‐frequency fluctuation (ALFF) and seed‐based functional connectivity (FC) analyses to detect the characteristics of local neural activity and corresponding network alterations in MSA patients with MCI (MSA‐MCI). We enrolled 80 probable MSA patients classified as cognitively normal (MSA‐NC, n = 36) and MSA‐MCI ( n = 44) and 40 healthy controls. Compared with MSA‐NC, MSA‐MCI exhibited decreased ALFF in the right dorsal lateral prefrontal cortex (RDLPFC) and increased ALFF in the right cerebellar lobule IX and lobule IV–V. In the secondary FC analyses, decreased FC in the left inferior parietal lobe (IPL) was observed when we set the RDLPFC as the seed region. Decreased FC in the bilateral cuneus, left precuneus, and left IPL and increased FC in the right middle temporal gyrus were shown when we set the right cerebellar lobule IX as the seed region. Furthermore, FC of DLPFC‐IPL and cerebello‐cerebral circuit, as well as ALFF alterations, were significantly correlated with Montreal Cognitive Assessment scores in MSA patients. We also employed whole‐brain voxel‐based morphometry analysis, but no gray matter atrophy was detected between the patient subgroups. Our findings indicate that altered spontaneous activity in the DLPFC and the cerebellum and disrupted DLPFC‐IPL, cerebello‐cerebral networks are possible biomarkers of early cognitive decline in MSA patients.

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Cognitive impairment and structural brain damage in multiple system atrophy-parkinsonian variant

Cited by 26 publications

References 33 publications

Morphological Changes in Cortical and Subcortical Structures in Multiple System Atrophy Patients With Mild Cognitive Impairment

Morphological Changes in Cortical and Subcortical Structures in Multiple System Atrophy Patients With Mild Cognitive Impairment

Voxel-Based Meta-Analysis of Gray Matter Abnormalities in Multiple System Atrophy

Alterations of voxel‐wise spontaneous activity and corresponding brain functional networks in multiple system atrophy patients with mild cognitive impairment

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