title: Assessment of dementia in patients with multiple system atrophy.
abstract: OBJECTIVE
  We investigated dementia in patients with multiple system atrophy (MSA) in order to characterize the prevalence and nature of impairments in these patients.
  
  
  METHODS
  Fifty-eight MSA patients were recruited in our institution between April 1996 and December 2006 and investigated.
  
  
  RESULTS
  Of 58 patients, 10 were diagnosed with dementia. There were no significant differences in age at onset, gender, duration of disease, or severity of cerebellar dysfunction between patients with and without dementia. The early and delayed heart to mediastinum (H/M) ratios obtained with (123)I-metaidobenylguanidine (MIBG) cardiac scintigraphy were significantly decreased in patients with dementia compared with those without dementia. Of the 10 patients with dementia, three were found to have cognitive decline that preceded onset of motor symptoms. White matter lesions were evident in these patients, whilst frontal atrophy was prominent in patients whose cognitive decline was preceded by onset of motor symptoms.
  
  
  CONCLUSIONS
  Dementia in patients with MSA may be more common than previously thought, furthermore, we speculate that clinical features of dementia in these patients might be heterogeneous.
authors.affiliation: Department of Neurology, Faculty of Medicine, Institute of Neurological Sciences, Tottori University, Yonago, Japan. mickita@med.tottori-u.ac.jp
authors.forename: M
authors.initials: M
authors.lastname: Kitayama
authors.forename: K
authors.initials: K
authors.lastname: Wada-Isoe
authors.forename: Y
authors.initials: Y
authors.lastname: Irizawa
authors.forename: K
authors.initials: K
authors.lastname: Nakashima
mesh_terms: D000368:Aged; D003704:Dementia / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D055414:Myocardial Perfusion Imaging; D009483:Neuropsychological Tests