Category: Parkinsonism, Atypical: MSA
Objective: The aim of the present study was to assess cognitive dysfunction in a Multiple System Atrophy (MSA) cohort and possible differences between disorder subtypes MSA-parkinsonism (MSA-P) and MSA-cerebellar (MSA-C).
Background: It has been increasingly recognized that a variable degree of cognitive decline is present in most MSA cases, although frank dementia is rare at least in early disease stages. MSA patients exhibit executive dysfunction and selective visuospatial skills decline along with learning deficits.
Method: We conducted a retrospective study of MSA-P and MSA-C patients who attended Movement Disorders outpatient clinic from January 2020- January 2021. Patients underwent Montreal Cognitive Assessment scale (MoCA), Frontal Assessment Battery (FAB), semantic (animals) and phonemic (words starting from the Greek letter ‘’chi’’) verbal fluency evaluation and Digit Span (Forwards and Backwards) testing. Disease severity was assessed by Unified Parkinson’s Disease Rating scale part III. Comparison between MSA subtypes was performed using age, sex and education as covariates.
Results: A total of 28 MSA patients including 11 MSA-P subjects (age, 59.8±9.2 years; education, 11.1±4.7 years; UPDRSIII, 44.1± 21.1) and 17 MSA-C subjects (age, 64.6 ±6.7 years; education, 12.2±4.1 years; UPDRSIII, 29.1± 18) were enrolled. MSA patients scored 21.5±5.1 in the MoCA (Cut-off <26) and 12.4±3.8 in the FAB testing (Cut-off <12). Semantic verbal fluency (6±2.7, cut-off <13) and phonemic verbal fluency outcomes (5.4±2.3, cut-off <11) were low. Total Digit Span scoring was 15.6±7 with Digit Span Forwards and Backwards being 8.1±3.6 and 7.4±3.5 respectively. Regarding comparisons in cognitive assessment between MSA-P and MSA-C, no significant differences could be demonstrated for any score [MoCA (p=0.31), FAB (p=0.599), semantic fluency (p=0.289), phonemic fluency (p=0.251) and Total Digit Span (p=0.67)].
Conclusion: MSA patients exhibited decline in global cognitive scores like MoCA mainly reflecting deficits in attention/concentration and executive functions. Frontal function assessment score exemplified by FAB was marginal. Notably, striking low scores in semantic and phonemic fluencies were noticed. Moreover, despite literature data reporting differences between MSA-P and MSA-C in specific cognitive domains, we were unable to verify a distinct cognitive profile of each subtype.
To cite this abstract in AMA style:
A. Bougea, C. Koros, A-M. Simitsi, N. Papagiannakis, E. Efthymiopoulou, I. Pachi, C. Chrysovitsanou, R. Antonelou, V. Constantinides, E. Kapaki, L. Stefanis. Cognitive assessment in a Greek cohort of Multiple System Atrophy patients. [abstract]. Mov Disord. 2021; 36 (suppl 1). https://www.mdsabstracts.org/abstract/cognitive-assessment-in-a-greek-cohort-of-multiple-system-atrophy-patients/. Accessed July 10, 2025.« Back to MDS Virtual Congress 2021
MDS Abstracts - https://www.mdsabstracts.org/abstract/cognitive-assessment-in-a-greek-cohort-of-multiple-system-atrophy-patients/