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The Global Cognition, Frontal Lobe Dysfunction and Behavior Changes in Chinese Patients with Multiple System Atrophy.

Cao B, Zhao B, Wei QQ, Chen K, Yang J, Ou R, Wu Y, Shang HF - PLoS ONE (2015)

Bottom Line: Cognitive impairment is common in Chinese MSA patients.MSA-C patients with low education levels and severe motor symptoms are likely to experience frontal lobe dysfunction, while MSA patients with low education levels and severe motor symptoms are likely to experience global cognitive deficits.These findings strongly suggest that cognitive impairment should not be an exclusion criterion for the diagnosis of MSA.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, West China Hospital, SiChuan University, Chengdu, Sichuan, China.

ABSTRACT

Background: Studies on cognition in multiple system atrophy (MSA) patients are limited.

Methods: A total of 110 MSA patients were evaluated using Addenbrooke's Cognitive Examination-Revised (ACE-R), Frontal Assessment Battery (FAB), Frontal Behavioral Inventory (FBI), and Unified MSA Rating Scale (UMSARS) tests. Fifty-five age-, sex-, education- and domicile-matched healthy controls were recruited to perform the FAB and ACE-R scales.

Results: Approximately 32.7% of the patients had global cognitive deficits with the most impaired domain being verbal fluency and visuospatial ability (26.4%), followed by memory (24.5%), language (20%) and orientation/attention (20%) based on a cut-off score of ACE-R ≤ 70. A total of 41.6% of the patients had frontal lobe dysfunction, with inhibitory control (60.9%) as the most impaired domain based on a cut-off score of FAB ≤14. Most patients (57.2%) showed moderate frontal behavior changes (FBI score 4-15), with incontinence (64.5%) as the most impaired domain. The binary logistic regression model revealed that an education level < 9 years (OR:13.312, 95% CI:2.931-60.469, P = 0.001) and UMSARS ≥ 40 (OR: 2.444, 95%CI: 1.002-5.962, P< 0.049) were potential determinants of abnormal ACE-R, while MSA-C (OR: 4.326, 95%CI: 1.631-11.477, P = 0.003), an education level < 9 years (OR:2.809 95% CI:1.060-7.444, P = 0.038) and UMSARS ≥ 40 (OR:5.396, 95%CI: 2.103-13.846, P < 0.0001) were potential determinants of abnormal FAB.

Conclusions: Cognitive impairment is common in Chinese MSA patients. MSA-C patients with low education levels and severe motor symptoms are likely to experience frontal lobe dysfunction, while MSA patients with low education levels and severe motor symptoms are likely to experience global cognitive deficits. These findings strongly suggest that cognitive impairment should not be an exclusion criterion for the diagnosis of MSA.

No MeSH data available.


Related in: MedlinePlus

The frequencies of the ACE-R scores for MSA patients less than 1.5 standard deviations below the mean of healthy controls.
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pone.0139773.g001: The frequencies of the ACE-R scores for MSA patients less than 1.5 standard deviations below the mean of healthy controls.

Mentions: In the present study, the cut-off score for ACE-R was set as “70” based on the mean ACE-R score for the HCs (83.2 ± 8.6) (Table 2). The mean ACE-R score for the patients was 73.9 ± 13.4. Therefore, the prevalence of global cognitive deficits based on a cut-off score of ACE-R ≤ 70 was 32.7% (36/110) (Fig 1). The frequency of cognitive deficit of ACE-R domains was 26.3% for verbal fluency, 26.3% for visuospatial ability, 24.5% for language, 24.5% for memory and 10.9% for orientation/attention (Fig 1). The ACE-R-abnormal group had a lower education level, longer disease duration, lower FAB score and higher frequency of abnormal FAB (Table 2). However, based on the MMSE score, 23 patients (20.9%) had cognitive deficits.


The Global Cognition, Frontal Lobe Dysfunction and Behavior Changes in Chinese Patients with Multiple System Atrophy.

Cao B, Zhao B, Wei QQ, Chen K, Yang J, Ou R, Wu Y, Shang HF - PLoS ONE (2015)

The frequencies of the ACE-R scores for MSA patients less than 1.5 standard deviations below the mean of healthy controls.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4591982&req=5

pone.0139773.g001: The frequencies of the ACE-R scores for MSA patients less than 1.5 standard deviations below the mean of healthy controls.
Mentions: In the present study, the cut-off score for ACE-R was set as “70” based on the mean ACE-R score for the HCs (83.2 ± 8.6) (Table 2). The mean ACE-R score for the patients was 73.9 ± 13.4. Therefore, the prevalence of global cognitive deficits based on a cut-off score of ACE-R ≤ 70 was 32.7% (36/110) (Fig 1). The frequency of cognitive deficit of ACE-R domains was 26.3% for verbal fluency, 26.3% for visuospatial ability, 24.5% for language, 24.5% for memory and 10.9% for orientation/attention (Fig 1). The ACE-R-abnormal group had a lower education level, longer disease duration, lower FAB score and higher frequency of abnormal FAB (Table 2). However, based on the MMSE score, 23 patients (20.9%) had cognitive deficits.

Bottom Line: Cognitive impairment is common in Chinese MSA patients.MSA-C patients with low education levels and severe motor symptoms are likely to experience frontal lobe dysfunction, while MSA patients with low education levels and severe motor symptoms are likely to experience global cognitive deficits.These findings strongly suggest that cognitive impairment should not be an exclusion criterion for the diagnosis of MSA.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, West China Hospital, SiChuan University, Chengdu, Sichuan, China.

ABSTRACT

Background: Studies on cognition in multiple system atrophy (MSA) patients are limited.

Methods: A total of 110 MSA patients were evaluated using Addenbrooke's Cognitive Examination-Revised (ACE-R), Frontal Assessment Battery (FAB), Frontal Behavioral Inventory (FBI), and Unified MSA Rating Scale (UMSARS) tests. Fifty-five age-, sex-, education- and domicile-matched healthy controls were recruited to perform the FAB and ACE-R scales.

Results: Approximately 32.7% of the patients had global cognitive deficits with the most impaired domain being verbal fluency and visuospatial ability (26.4%), followed by memory (24.5%), language (20%) and orientation/attention (20%) based on a cut-off score of ACE-R ≤ 70. A total of 41.6% of the patients had frontal lobe dysfunction, with inhibitory control (60.9%) as the most impaired domain based on a cut-off score of FAB ≤14. Most patients (57.2%) showed moderate frontal behavior changes (FBI score 4-15), with incontinence (64.5%) as the most impaired domain. The binary logistic regression model revealed that an education level < 9 years (OR:13.312, 95% CI:2.931-60.469, P = 0.001) and UMSARS ≥ 40 (OR: 2.444, 95%CI: 1.002-5.962, P< 0.049) were potential determinants of abnormal ACE-R, while MSA-C (OR: 4.326, 95%CI: 1.631-11.477, P = 0.003), an education level < 9 years (OR:2.809 95% CI:1.060-7.444, P = 0.038) and UMSARS ≥ 40 (OR:5.396, 95%CI: 2.103-13.846, P < 0.0001) were potential determinants of abnormal FAB.

Conclusions: Cognitive impairment is common in Chinese MSA patients. MSA-C patients with low education levels and severe motor symptoms are likely to experience frontal lobe dysfunction, while MSA patients with low education levels and severe motor symptoms are likely to experience global cognitive deficits. These findings strongly suggest that cognitive impairment should not be an exclusion criterion for the diagnosis of MSA.

No MeSH data available.


Related in: MedlinePlus