AUTHOR=Shen Cong , Chen Li , Ge Jing-Jie , Lu Jia-Ying , Chen Qi-Si , He Shu-Jin , Li Xin-Yi , Zhao Jue , Sun Yi-Min , Wu Ping , Wu Jian-Jun , Liu Feng-Tao , Wang Jian 

TITLE=Cerebral Metabolism Related to Cognitive Impairments in Multiple System Atrophy

JOURNAL=Frontiers in Neurology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.652059

DOI=10.3389/fneur.2021.652059

ISSN=1664-2295

ABSTRACT=<p><bold>Objective:</bold> We aimed to characterize the cognitive profiles in multiple system atrophy (MSA) and explore the cerebral metabolism related to the cognitive decline in MSA using <sup>18</sup>F-fluorodeoxyglucose (<sup>18</sup>F-FDG) Positron Emission Tomography (PET).</p><p><bold>Methods:</bold> In this study, 105 MSA patients were included for cognitive assessment and 84 of them were enrolled for <sup>18</sup>F-FDG PET analysis. The comprehensive neuropsychological tests covered five main domains including execution, attention, memory, language, and visuospatial function. The cognitive statuses were classified to MSA with normal cognition (MSA-NC) and MSA with cognitive impairment (MSA-CI), including dementia (MSA-D), and mild cognitive impairment (MSA-MCI). With <sup>18</sup>F-FDG PET imaging, the cerebral metabolism differences among different cognitive statuses were analyzed using statistical parametric mapping and <italic>post-hoc</italic> analysis.</p><p><bold>Results:</bold> Among 84 MSA patients, 52 patients were found with MSA-CI, including 36 patients as MSA-MCI and 16 patients as MSA-D. In detail, the cognitive impairments were observed in all the five domains, primarily in attention, executive function and memory. In <sup>18</sup>F-FDG PET imaging, MSA-D and MSA-MCI patients exhibited hypometabolism in left middle and superior frontal lobe compared with MSA-NC (<italic>p</italic> &lt; 0.001). The normalized regional cerebral metabolic rate of glucose (rCMRglc) in left middle frontal lobe showed relative accuracy in discriminating MSA-CI and MSA-NC [areas under the curve (AUC) = 0.750; 95%CI = 0.6391–0.8609].</p><p><bold>Conclusions:</bold> Cognitive impairments were not rare in MSA, and the hypometabolism in frontal lobe may contribute to such impairments.</p>