AUTHOR=Maass Fabian , Hermann Peter , Varges Daniela , Nuhn Sabine , van Riesen Christoph , Jamous Ala , Focke Niels K. , Hewitt Manuel , Leha Andreas , Bähr Mathias , Zerr Inga 

TITLE=Prospective CERAD Neuropsychological Assessment in Patients With Multiple System Atrophy

JOURNAL=Frontiers in Neurology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.881369

DOI=10.3389/fneur.2022.881369

ISSN=1664-2295

ABSTRACT=<p>The objective of the study was to characterize the pattern of cognitive dysfunction in patients with multiple system atrophy (MSA) applying a standardized neuropsychological assessment. A total of 20 patients with the diagnosis of probable or possible MSA were enrolled for neuropsychological assessment applying the CERAD plus battery. All patients were tested at baseline and 14/20 patients received additional follow-up assessments (median follow-up of 24 months). Additionally, relationship between cortical thickness values/subcortical gray matter volumes and CERAD subitems was evaluated at baseline in a subgroup of 13/20 patients. Trail Making Test (TMT) was the most sensitive CERAD item at baseline with abnormal performance (z-score &lt; −1.28) in one or both pathological TMT items (TMT-A, TMT-B) in 60% of patients with MSA. Additionally, there was a significant inverse correlation between the volume of the left and the right accumbens area and the TMT A item after adjusting for age (left side: <italic>p</italic> = 0.0009; right side <italic>p</italic> = 0.003). Comparing both subtypes, patients with MSA-C had significant lower values in phonemic verbal fluency (<italic>p</italic> = 0.04) and a trend for lower values in semantic verbal fluency (<italic>p</italic> = 0.06) compared to MSA-P. Additionally, patients with MSA-C showed significantly worse performance in the TMT-B task (<italic>p</italic> = 0.04) and a trend for worse performance in the TMT-A task (<italic>p</italic> = 0.06). Concerning longitudinal follow-up, a significant worsening in the TMT-B (<italic>p</italic> = 0.03) can be reported in MSA. In conclusion, frontal-executive dysfunction presents the hallmark of cognitive impairment in MSA.</p>