title: Cognitive Impairment and Its Structural Correlates in the Parkinsonian Subtype of Multiple System Atrophy.
abstract: OBJECTIVE
  Previous studies indicate that patients with the parkinsonian subtype of multiple system atrophy (MSA-P) experience cognitive impairment. This study aimed to identify the existence of cognitive impairments and the different topographic patterns of morphological changes in MSA-P by means of imaging analysis, and also whether these morphological changes could be associated with cognitive dysfunctions in MSA-P.
  
  
  METHODS
  We recruited 15 nondemented probable MSA-P patients and 32 normal controls (NC) for neuropsychological testing and MRI. We analyzed morphological changes using cortical thickness analysis, voxel-based morphometry (VBM) and cerebellar volumetry. Multiple linear regression analysis was performed to evaluate the correlation of each cognitive score with the mean thickness of significant cortical-thinning clusters, mean gray-matter density of VBM clusters and cerebellar volume.
  
  
  RESULTS
  The scores on the Digit Span Test, the Seoul Verbal Learning Test (immediate and delayed), the phonemic Controlled Oral Word Association Test and the Stroop color test were significantly lower in the MSA-P group than in the NC group. We found two clusters exhibiting significant cortical thinning in the right paracentral lobule and parahippocampal gyrus. VBM analysis revealed significant gray-matter atrophy in the MSA-P group in the bilateral basal ganglia, cerebellum and temporal and frontal cortical areas. Multiple linear regression analysis demonstrated that cognitive dysfunction correlated significantly with thinning in the neocortex, cerebellum and striatum.
  
  
  CONCLUSIONS
  Our data demonstrate that cortical and cerebellar atrophy and striatal degeneration are associated with cognitive impairment in patients with MSA-P.
authors.affiliation: Department of Neurology, Soonchunhyang University Hospital, Soonchunhyang University School of Medicine, Seoul, Korea.
authors.forename: Ji Sun
authors.initials: JS
authors.lastname: Kim
authors.forename: Jin-Ju
authors.initials: JJ
authors.lastname: Yang
authors.forename: Dong-Kyun
authors.initials: DK
authors.lastname: Lee
authors.forename: Jong-Min
authors.initials: JM
authors.lastname: Lee
authors.forename: Jinyoung
authors.initials: J
authors.lastname: Youn
authors.forename: Jin Whan
authors.initials: JW
authors.lastname: Cho
mesh_terms: D000368:Aged; D001921:Brain / Q000473:pathology*; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000150:complications / Q000473:pathology* / Q000523:psychology*; D009483:Neuropsychological Tests; D020734:Parkinsonian Disorders / Q000150:complications / Q000473:pathology* / Q000523:psychology*