title: Cognitive impairment in multiple system atrophy: a position statement by the Neuropsychology Task Force of the MDS Multiple System Atrophy (MODIMSA) study group.
abstract: Consensus diagnostic criteria for multiple system atrophy consider dementia as a nonsupporting feature, despite emerging evidence demonstrating that cognitive impairments are an integral part of the disease. Cognitive disturbances in multiple system atrophy occur across a wide spectrum from mild single domain deficits to impairments in multiple domains and even to frank dementia in some cases. Frontal-executive dysfunction is the most common presentation, while memory and visuospatial functions also may be impaired. Imaging and neuropathological findings support the concept that cognitive impairments in MSA originate from striatofrontal deafferentation, with additional contributions from intrinsic cortical degeneration and cerebellar pathology. Based on a comprehensive evidence-based review, the authors propose future avenues of research that ultimately may lead to diagnostic criteria for cognitive impairment and dementia associated with multiple system atrophy.
authors.affiliation: Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Iva
authors.initials: I
authors.lastname: Stankovic
authors.forename: Florian
authors.initials: F
authors.lastname: Krismer
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Jesic
authors.forename: Angelo
authors.initials: A
authors.lastname: Antonini
authors.forename: Thomas
authors.initials: T
authors.lastname: Benke
authors.forename: Richard G
authors.initials: RG
authors.lastname: Brown
authors.forename: David J
authors.initials: DJ
authors.lastname: Burn
authors.forename: Janice L
authors.initials: JL
authors.lastname: Holton
authors.forename: Horacio
authors.initials: H
authors.lastname: Kaufmann
authors.forename: Vladimir S
authors.initials: VS
authors.lastname: Kostic
authors.forename: Helen
authors.initials: H
authors.lastname: Ling
authors.forename: Wassilios G
authors.initials: WG
authors.lastname: Meissner
authors.forename: Werner
authors.initials: W
authors.lastname: Poewe
authors.forename: Marija
authors.initials: M
authors.lastname: Semnic
authors.forename: Klaus
authors.initials: K
authors.lastname: Seppi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takeda
authors.forename: Daniel
authors.initials: D
authors.lastname: Weintraub
authors.forename: Gregor K
authors.initials: GK
authors.lastname: Wenning
mesh_terms: D000818:Animals; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D003704:Dementia / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008568:Memory / Q000502:physiology*; D019578:Multiple System Atrophy / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D009483:Neuropsychological Tests
keywords: cognition; multiple system atrophy; neuropsychology
references.citation: Brain. 2006 Apr;129(Pt 4):1040-9
references.pmid: 16455792
references.citation: Mov Disord. 2005 Aug;20 Suppl 12:S29-36
references.pmid: 16092088
references.citation: Arch Neurol. 2003 Oct;60(10):1431-5
references.pmid: 14568814
references.citation: Mov Disord. 2010 Jun 15;25(8):1077-81
references.pmid: 20535826
references.citation: Brain. 2008 Feb;131(Pt 2):438-46
references.pmid: 18178568
references.citation: J Nucl Med. 2004 Jun;45(6):933-42
references.pmid: 15181127
references.citation: Brain. 2010 Aug;133(Pt 8):2382-93
references.pmid: 20576697
references.citation: Mov Disord. 2008 Apr 30;23(6):837-44
references.pmid: 18307261
references.citation: Neuropsychologia. 1993 Feb;31(2):207-10
references.pmid: 8455789
references.citation: Neurology. 2008 Jan 29;70(5):368-73
references.pmid: 18227417
references.citation: J Neurol Sci. 1996 Dec;144(1-2):77-83
references.pmid: 8994107
references.citation: J Neurol Neurosurg Psychiatry. 2011 Sep;82(9):1033-7
references.pmid: 21335570
references.citation: Neuropathol Appl Neurobiol. 2012 Feb;38(1):4-24
references.pmid: 22074330
references.citation: J Psychiatr Res. 1975 Nov;12(3):189-98
references.pmid: 1202204
references.citation: J Neurol Neurosurg Psychiatry. 1999 Apr;66(4):541-4
references.pmid: 10201434
references.citation: Neurology. 2008 Aug 26;71(9):670-6
references.pmid: 18725592
references.citation: Brain. 2008 May;131(Pt 5):1362-72
references.pmid: 18385183
references.citation: Neuroimage Clin. 2013 Aug 08;3:212-7
references.pmid: 24179865
references.citation: Neuroimage. 2008 Apr 1;40(2):796-801
references.pmid: 18203624
references.citation: Clin Auton Res. 1999 Feb;9(1):1-4
references.pmid: 10212741
references.citation: BMC Neurol. 2012 Nov 01;12:130
references.pmid: 23116490
references.citation: Neurology. 2010 May 4;74(18):1416-23
references.pmid: 20439843
references.citation: Mov Disord. 2012 Aug;27(9):1186-90
references.pmid: 22806758
references.citation: Mov Disord. 2006 Jun;21(6):809-15
references.pmid: 16502399
references.citation: Eur J Neurol. 2009 Oct;16(10):1144-50
references.pmid: 19486137
references.citation: Eur J Neurol. 2009 May;16(5):589-94
references.pmid: 19236466
references.citation: Neuroimage. 2007 Jul 15;36(4):1086-95
references.pmid: 17512219
references.citation: Brain Cogn. 2002 Nov;50(2):194-206
references.pmid: 12464189
references.citation: Neurosci Lett. 1994 Dec 5;182(2):197-200
references.pmid: 7715809
references.citation: Neuropathology. 2007 Jun;27(3):221-7
references.pmid: 17645235
references.citation: Neuroscience. 1988 May;25(2):363-87
references.pmid: 2969464
references.citation: J Neurol Sci. 1998;156(1):114-7
references.pmid: 9559999
references.citation: J Neurol Neurosurg Psychiatry. 1995 Feb;58(2):174-9
references.pmid: 7876847
references.citation: Neurology. 2000 Dec 12;55(11):1621-6
references.pmid: 11113214
references.citation: Neuroimage. 2005 Mar;25(1):287-93
references.pmid: 15734363
references.citation: Arch Neurol. 2005 Aug;62(8):1265-9
references.pmid: 16087767
references.citation: Brain. 1998 Apr;121 ( Pt 4):561-79
references.pmid: 9577385
references.citation: J Neurol Sci. 2000 Feb 15;173(2):109-12
references.pmid: 10675653
references.citation: J Neurol Neurosurg Psychiatry. 2000 Sep;69(3):313-8
references.pmid: 10945805
references.citation: Lancet Neurol. 2005 Oct;4(10):605-10
references.pmid: 16168928
references.citation: J Neurol Neurosurg Psychiatry. 1996 Apr;60(4):393-8
references.pmid: 8774403
references.citation: J Neural Transm (Vienna). 2010 Mar;117(3):369-75
references.pmid: 20091064
references.citation: Neuropathology. 2007 Oct;27(5):484-93
references.pmid: 18018485
references.citation: Acta Neuropathol. 2001 Mar;101(3):285-93
references.pmid: 11307630
references.citation: J Neurol Neurosurg Psychiatry. 2006 Apr;77(4):454-6
references.pmid: 16543521
references.citation: J Neurol Sci. 2000 Oct 1;179(S 1-2):50-8
references.pmid: 11054485
references.citation: Alzheimer Dis Assoc Disord. 2009 Oct-Dec;23(4):365-70
references.pmid: 19935145
references.citation: Arch Neurol. 1998 Mar;55(3):372-8
references.pmid: 9520011
references.citation: Mov Disord. 1997 Mar;12(2):133-47
references.pmid: 9087971
references.citation: Eur J Nucl Med Mol Imaging. 2003 Jan;30(1):16-24
references.pmid: 12483405
references.citation: Neurology. 2002 Sep 24;59(6):944-6
references.pmid: 12297588
references.citation: Mov Disord. 2005 Aug;20(8):951-7
references.pmid: 15782421
references.citation: Neurology. 2008 Apr 15;70(16 Pt 2):1390-6
references.pmid: 18413566
references.citation: J Neurol Neurosurg Psychiatry. 1994 Jan;57(1):79-88
references.pmid: 8301310
references.citation: Ann Neurol. 1994 Aug;36(2):166-75
references.pmid: 8053652
references.citation: J Neurol. 2010 Jan;257(1):5-14
references.pmid: 19669613
references.citation: J Neural Transm (Vienna). 2005 Dec;112(12):1687-94
references.pmid: 16284910
references.citation: Brain. 1994 Apr;117 ( Pt 2):235-43
references.pmid: 8186951
references.citation: Neurology. 1996 Nov;47(5):1113-24
references.pmid: 8909416
references.citation: Parkinsonism Relat Disord. 2003 Mar;9(4):205-11
references.pmid: 12618055
references.citation: Arch Neurol. 2011 Feb;68(2):223-30
references.pmid: 21320989
references.citation: Mov Disord. 2006 Oct;21(10):1674-81
references.pmid: 16830312
references.citation: Mov Disord. 2010 Dec 15;25(16):2891-2
references.pmid: 20925069
references.citation: Mov Disord. 2007 Sep 15;22(12):1689-707; quiz 1837
references.pmid: 17542011
references.citation: Acta Neuropathol. 1999 Apr;97(4):423-8
references.pmid: 10208284
references.citation: J Gen Psychol. 1948 Jul;39:15-22
references.pmid: 18889466
references.citation: Mov Disord. 2006 Jun;21(6):772-6
references.pmid: 16475154
references.citation: Parkinsonism Relat Disord. 2013 Jun;19(6):617-21
references.pmid: 23529023
references.citation: Ann Neurol. 1989 Aug;26(2):239-47
references.pmid: 2789014
references.citation: J Neurol. 2013 Jul;260(7):1922-4
references.pmid: 23719789
references.citation: J Neurol. 2007 Feb;254(2):191-6
references.pmid: 17334661
references.citation: Mov Disord. 2010 Nov 15;25(15):2604-12
references.pmid: 20922810
references.citation: J Neural Transm (Vienna). 2013 Apr;120(4):613-8
references.pmid: 23462799
references.citation: J Neural Transm (Vienna). 2003 Sep;110(9):983-95
references.pmid: 12938023
references.citation: Mov Disord. 2006 Feb;21(2):159-65
references.pmid: 16161039
references.citation: Mov Disord. 2003 Oct;18(10):1132-8
references.pmid: 14534916
references.citation: Brain. 1992 Feb;115 Pt 1:271-91
references.pmid: 1559159
references.citation: J Neurol Sci. 2002 Mar 30;195(2):123-7
references.pmid: 11897242