Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, LN, China.
Department of Neurology, Shenzhen People's Hospital, Second Clinical Medical College of Jinan University, Shenzhen 518020, China.
Clin Neurophysiol. 2020 Jan;131(1):54-62. doi: 10.1016/j.clinph.2019.09.026. Epub 2019 Nov 4.
There is increasing evidence of cognitive impairment (CI) frequently occurring in patients with multiple system atrophy (MSA); however, the neurobiological mechanisms underlying CI in patients with MSA remain unclear.
We enrolled 61 patients with probable MSA and 33 healthy controls (HC). We used degree centrality (DC) analysis to assess changes in the centrality level of MSA-CI related brain nodes. We conducted a secondary seed-based functional connectivity (FC) analysis to investigate dysfunctions in cognitive networks related to MSA. Further, we analysed the correlation between clinical symptoms and acquired connectivity measures.
Compared with HC, patients with MSA-CI and those with MSA with normal cognition (MSA-NCI) exhibited lower DC values in the left calcarine and right postcentral regions and higher DC values in the bilateral caudate and left precuneus. There were significant differences in the DC values in the right middle prefrontal gyrus between the MSA-CI and MSA-NCI groups. The mean DC values in the right middle prefrontal gyrus (RMPFG) were correlated with clinical cognitive severity. Consequently, we used this brain region as a seed in secondary seed-based FC analysis and observed FC changes within the right precuneus, inferior parietal lobe, and right insula.
Decreased middle prefrontal cortex activity and its altered functional connectivity with the precuneus, inferior parietal lobe, and insula are possible biomarkers of cognitive dysfunction in patients with MSA-CI.
Cognitive impairment in MSA is associated with alterations in the dorsolateral prefrontal cortex network.
越来越多的证据表明，多系统萎缩（MSA）患者常发生认知障碍（CI）；然而，MSA 患者 CI 的神经生物学机制仍不清楚。
我们纳入了 61 例可能的 MSA 患者和 33 名健康对照者（HC）。我们使用度中心度（DC）分析来评估与 MSA-CI 相关的脑节点的中心度水平变化。我们进行了二次种子点功能连接（FC）分析，以研究与 MSA 相关的认知网络功能障碍。此外，我们分析了临床症状与获得的连接测量值之间的相关性。
与 HC 相比，MSA-CI 患者和 MSA 认知正常（MSA-NCI）患者的左侧距状回和右侧中央后回的 DC 值较低，双侧尾状核和左侧楔前叶的 DC 值较高。MSA-CI 组和 MSA-NCI 组右侧额中回的 DC 值存在显著差异。右侧额中回（RMPFG）的平均 DC 值与临床认知严重程度相关。因此，我们将该脑区作为二次种子点 FC 分析的种子点，观察到右侧楔前叶、顶下小叶和右侧岛叶的 FC 变化。
中前额叶皮质活动减少及其与楔前叶、顶下小叶和岛叶的功能连接改变可能是 MSA-CI 患者认知功能障碍的生物标志物。
MSA 的认知障碍与背外侧前额叶皮质网络的改变有关。
