Session Information
Date: Tuesday, September 24, 2019
Session Title: Parkinsonisms and Parkinson-Plus
Session Time: 1:45pm-3:15pm
Location: Agora 3 West, Level 3
Objective: To explore the cortical metabolic pattern associated with cognitive impairment in multiple system atrophy (MSA).
Background: Cognitive impairment (CI) has been increasingly recognized in MSA, especially in later stage of disease course. We aimed to investigate the cortical metabolic pattern associated with CI in MSA by [18F]fluorodeoxyglucose-positron emission tomography ([18F]FDG-PET).
Method: We retrospectively reviewed patients who were diagnosed as MSA from March 2004 to December 2018. Among them, we included probable MSA patients according to the secondary consensus criteria with available [18F]FDG-PET. Illiterate patients, patients without available cognitive assessment, patients with other intracranial pathology that might contaminate analysis (e.g., stroke, encephalomalacia) and possible MSA patients were excluded. Region of interest (ROI) analysis was performed by statistical parametric mapping (SPM). The metabolism of major ROIs between MSA patients with MMSE < 26 and with MMSE >= 26 were compared by logistic regression analysis.
Results: A total of 91 patients were finally included. Among them, 37 (41%) were MMSE < 26 (MSA-CI) and 54 (59%) were MMSE >=26 (MSA-NCI). MSA-CI, compared to MSA-NCI, showed advanced age (64.5 ± 6.7 years vs 58.7 ± 9.3 years, p = 0.002), low education level (9.9 ± 4.5 years vs 12.9 ± 4.1 years, p = 0.002) and higher female ratio (26(70%) vs 26(48%), p = 0.029). On univariate logistic regression analysis, MSA-CI patients, compared with MSA-NCI, showed hypometabolism in orbitofrontal (94 ± 5% vs 97 ± 5%, p = 0.003), anterior cingulate (87 ± 9% vs 92 ± 9%, p = 0.011), middle cingulate (91 ± 13 % vs 97 ± 7%, p = 0.010), and posterior cingulate cortex (89 ± 14% vs 95 ± 13%, p = 0.045). Multivariate logistic regression analysis adjusted for age, sex, and education years showed hypometabolism in anterior cingulate (p = 0.046), middle cingulate cortex (p = 0.029), and parahippocampus (99 ± 13% vs 103 ± 6%, p = 0.043) in MSA-CI patients compared to MSA-NCI patients.
Conclusion: Our findings suggest that structures associated with memory and Papez circuit (e.g., cingulate and parahippocampus) may be affected in MSA-CI.
To cite this abstract in AMA style:
KW. Park, NR. Choi, SY. Jo, SJ. Kim, YJ. Park, SJ. Chung, CS. Lee. [18F] FDG-PET findings associated with cognitive impairment if multiple system atrophy [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/18f-fdg-pet-findings-associated-with-cognitive-impairment-if-multiple-system-atrophy/. Accessed May 11, 2025.« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/18f-fdg-pet-findings-associated-with-cognitive-impairment-if-multiple-system-atrophy/