Cortical hypometabolism associated with cognitive impairment of multiple system atrophy. (December 2020)

• Record Type: Journal Article
• Authors: Park, Kye Won; Ko, Ji Hyun; Choi, Nari; Jo, Sungyang; Park, Yun Jik; Lee, Eun-Jae; Kim, Su Jung; Chung, Sun Ju; Lee, Chong S.
• Is Part Of: Parkinsonism & related disorders. Volume 81(2020)
• Page Start: 151
• Page End: 156
• Publication Date: 2020-12
• Subjects: Multiple system atrophy -- Cognitive impairment -- Fluorodeoxyglucose positron emission tomography imaging; Parkinson's disease -- Periodicals; Movement disorders -- Periodicals; Movement Disorders -- Periodicals; Nerve Degeneration -- Periodicals; Nervous System Diseases -- Periodicals; Parkinson Disease -- Periodicals; Tremor -- Periodicals; Parkinson, Maladie de -- Périodiques; Parkinson's disease; 616.833
• DOI: 10.1016/j.parkreldis.2020.10.039
• Languages: English
• ISSNs: 1353-8020

Abstract

Abstract: Introduction: Cognitive impairment is not uncommon in patients with multiple system atrophy (MSA). This study investigated the cortical metabolic changes of MSA and the cortical structure associated with cognitive impairment. Methods: The study included probable/definite MSA patients who underwent fluorodeoxyglucose positron emission tomography and cognitive evaluation based on mini-mental status examination (MMSE). Cerebral metabolism of the entire MSA patients (n = 88) was compared with healthy controls (n = 19) by voxel-wise statistical parametric mapping. Eight brain regions of interest (ROIs) were selected accordingly: the dorsolateral prefrontal, medial superior frontal, insular, posterior parietal, precuneus, lateral temporal, medial temporal, and posterior cingulate regions. Using validated population-based norms, MSA patients were divided by MMSE z-scores into MSA with cognitive dysfunction (MSA-D, n = 30) and without cognitive dysfunction (MSA-ND, n = 58). Regional metabolism of the selected ROIs was compared between the MSA-D and MSA-ND groups by logistic regression models. Correlations between the regional metabolism of the selected ROIs and MMSE z-scores were analyzed with a linear regression model. Results: Voxel-wise analysis showed hypometabolism in the frontal, temporal, parietal, and limbic areas in MSA patients than in controls. ROI-based comparisons showed that metabolism in the posterior cingulate ( P = 0.006) and medial temporal ( P = 0.039) regions was significantly lower in the MSA-D than in the MSA-ND group. The degree of posterior cingulate metabolism correlated significantly with MMSE z-score ( P = 0.023). Conclusions: MSA shows fronto-temporo-parietal cortical involvement. Hypometabolism of the limbic regions is associated with cognitive impairment in MSA. Highlights: Cognitive impairment is not uncommon in multiple system atrophy (MSA). MSA shows fronto-temporo-parietal cortical hypometabolism in FDG-PET. Hypometabolism of limbic regions is associated with cognitive impairment in MSA.