AUTHOR=Zhang Lingyu , Li Ruicen , Hou Yanbing , Cao Bei , Wei Qianqian , Ou Ruwei , Liu Kuncheng , Lin Junyu , Yang Tianmi , Xiao Yi , Huang Wenxia , Shang Huifang 

TITLE=Cystatin C predicts cognitive decline in multiple system atrophy: A 1-year prospective cohort study

JOURNAL=Frontiers in Aging Neuroscience

VOLUME=14

YEAR=2022

URL=https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2022.1069837

DOI=10.3389/fnagi.2022.1069837

ISSN=1663-4365

ABSTRACT=<sec><title>Background</title><p>Accumulating evidence has suggested that cystatin C is associated with cognitive impairment in patients with neurodegenerative diseases. However, the association between cystatin C and cognitive decline in patients with multiple system atrophy (MSA) remains largely unknown.</p></sec><sec><title>Objectives</title><p>The objective was to determine whether cystatin C was independently associated with cognitive decline in patients with early-stage MSA.</p></sec><sec><title>Methods</title><p>Patients with MSA underwent evaluation at baseline and the 1-year follow-up. Cognitive function was evaluated with Montreal cognitive assessment (MoCA). Changes in the MoCA score and the absolute MoCA score at the 1-year assessment were considered the main cognitive outcome. The cystatin C concentrations in patients with MSA and age, sex, and body mass index matched-healthy controls (HCs) were measured. A multiple linear regression model was used to test the association between cystatin C and cognitive decline.</p></sec><sec><title>Results</title><p>A total of 117 patients with MSA and 416 HCs were enrolled in the study. The cystatin C levels were significantly higher in patients with MSA than in HCs (<italic>p</italic> &lt; 0.001). Cystatin C levels were negatively correlated with MoCA score at baseline and at 1-year follow-up. Multiple linear regression model adjusted for potential confounders showed that baseline cystatin C levels were significantly associated with the MoCA score (<italic>p</italic> = 0.004) or change in the MoCA score (<italic>p</italic> = 0.008) at 1-year follow-up.</p></sec><sec><title>Conclusion</title><p>Our results suggested that cystatin C may serve as a potential biomarker of cognitive decline in patients with early-stage MSA.</p></sec>