Objective: This study aimed to characterize the cognitive profiles of multiple system atrophy (MSA) and explore the possible mechanisms involved using ¹⁸F-fluorodeoxyglucose (FDG) Positron Emission Tomography (PET).

Background: Cognitive decline has been accepted as a clinical symptom in MSA. However, the detailed profiles and underlying mechanisms remain unclear.

Method: Herein, 47 MSA patients were assessed by comprehensive neuropsychological tests covering executive function, attention, memory, visuospatial function and language domains. The cognition statuses were classified to dementia (MSA-D), mild cognitive impairment (MSA-MCI) and normal cognition (MSA-NC). All subjects accepted ¹⁸F-FDG PET imaging. The cerebral metabolism differences among cognitive statuses and correlations between regional FDG uptake and cognitive lesions in 5 domains were analyzed using statistical parametric mapping.

Results: Cognitive impairments were observed in all the five domains, primarily in attention, memory and executive function. Twenty-one and twelve patients were classified as MSA-MCI and MSA-D. In ¹⁸F-FDG imaging, MSA-D patients exhibited hypometabolism in frontal lobe and hypermetabolism in temporal lobe compared with MSA-NC. Correlation analysis showed the executive function/ attention scores correlated positively with the metabolism in frontal gyrus, and negatively with that in lentiform nucleus, insula, cingulate and temporal lobe.

Conclusion: Cognitive impairments were not rare in MSA, and the hypometabolism in frontal lobe and hypermetabolism in temporal lobe contributed to such impairments.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-profile-and-cerebral-metabolic-characteristic-of-cognitive-impairments-in-multiple-system-atrophy/