title: Cognitive impairments associated with morphological changes in cortical and subcortical structures in multiple system atrophy of the cerebellar type.
abstract: OBJECTIVE
  Patients with the cerebellar variant of multiple system atrophy (MSA-C) often show cognitive deficits in various cognitive domains. The association between morphometric changes in cortical and subcortical structures and cognitive impairments in MSA-C were investigated to explore the neural correlates responsible for cognitive deficits in MSA-C patients.
  
  
  METHODS
  Using surface-based morphometry, region-of-interest cortical thickness and the volumes and shapes of subcortical structures were examined in 18 patients who fulfilled the criteria of probable MSA-C and were compared to 50 healthy controls. The association between regional changes and cognitive functions in MSA-C were investigated by applying linear regression analyses after controlling for confounding factors.
  
  
  RESULTS
  Compared with controls, the patients with MSA-C showed significant cortical thinning in the fronto-temporo-parietal regions and volume reduction in subcortical structures with shape changes. Cerebellar volume had no significant effect on cortical and subcortical volumes. The severity of atrophic changes in the bilateral thalamus, the left cerebellum and the left pericalcarine gyrus were significantly correlated with attentional, executive and visuospatial dysfunctions.
  
  
  CONCLUSIONS
  Cognitive impairment in MSA-C might result from functional disruption of the corticostriatal and pontocerebellar circuit mediated by primary cortical, cerebellar or thalamic pathology.
authors.affiliation: Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, Korea.
authors.forename: M J
authors.initials: MJ
authors.lastname: Lee
authors.affiliation: Department of Bio-convergence Engineering, Korea University College of Health Science, Seoul, Korea.
authors.forename: J-H
authors.initials: JH
authors.lastname: Shin
authors.affiliation: Department of Biomedical Engineering, Korea University College of Health Science, Seoul, Korea.
authors.forename: J-K
authors.initials: JK
authors.lastname: Seoung
authors.affiliation: Department of Neurology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine and Medical Research Institute, Yangsan, Korea.
authors.forename: J-H
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Biomedical Engineering, Catholic University of Daegu, Gyeongsan, Korea.
authors.forename: U
authors.initials: U
authors.lastname: Yoon
authors.affiliation: Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, Korea.
authors.forename: J-H
authors.initials: JH
authors.lastname: Oh
authors.affiliation: Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, Korea.
authors.forename: D S
authors.initials: DS
authors.lastname: Jung
authors.affiliation: Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, Korea.
authors.forename: E-J
authors.initials: EJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy / Q000473:pathology; D002525:Cerebellar Cortex / Q000473:pathology*; D002531:Cerebellum / Q000473:pathology*; D003072:Cognition Disorders / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D013788:Thalamus / Q000473:pathology*
keywords: MRI; cognitive impairment; multiple system atrophy; surface based morphometry