Vascular Risk Factors and Cognition in Multiple System Atrophy.

Lingyu Zhang,Junyu Lin,Tianmi Yang,Bei Cao,Yi Xiao,Yanbing Hou,Qian-Qian Wei,Ruwei Ou,Bi Zhao,Huifang Shang,Kuncheng Liu

doi:10.3389/fnins.2021.749949

Lingyu Zhang, Junyu Lin + Show 9 more

Open Access

https://doi.org/10.3389/fnins.2021.749949

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Journal: Frontiers in neuroscience	Publication Date: Oct 26, 2021
Citations: 3	License type: CC BY 4.0

Affiliation: Sichuan University

Abstract

Objective: Vascular risk factors have been reported to be associated with cognitive impairment (CI) in the general population, but their role on CI in multiple system atrophy (MSA) is unclear. This study aimed to explore the relationship between vascular risk factors and CI in patients with MSA.Methods: The clinical data and vascular risk factors were collected. The Montreal Cognitive Assessment tool was used to test the cognitive function of patients with MSA. Binary logistic regression was used to analyze the correlation between vascular risk factors and CI.Results: A total of 658 patients with MSA with a mean disease duration of 2.55 ± 1.47 years were enrolled. In MSA patients, hypertension was recorded in 20.2%, diabetes mellitus in 10.3%, hyperlipidemia in 10.2%, smoking in 41.2%, drinking in 34.8%, and obesity in 9.6%. The prevalence of CI in patients with MSA, MSA with predominant parkinsonism (MSA-P), and MSA with predominant cerebellar ataxia (MSA-C) was 45.0, 45.1, and 44.9%, respectively. In the binary logistic regression model, patients with more than one vascular risk factors were significantly more likely to have CI in MSA (OR = 4.298, 95% CI 1.456–12.691, P = 0.008) and MSA-P (OR = 6.952, 95% CI 1.390–34.774, P = 0.018), after adjusting for age, sex, educational years, disease duration, and total Unified multiple system atrophy rating scale scores.Conclusion: Multiple vascular risk factors had a cumulative impact on CI in MSA. Therefore, the comprehensive management of vascular risk factors in MSA should not be neglected.

Highlights

Multiple system atrophy (MSA) is a sporadic neurodegenerative disease clinically characterized by the combination of Parkinsonian, cerebellar, autonomic, or pyramidal signs and symptoms (Stefanova et al, 2009)
In order to exclude the common forms of spinocerebellar ataxia (SCA), patients were screened for SCA genes, including SCA1, 2, 3, 6, and 7
We found that a single vascular risk factor was not associated with cognitive impairment (CI) in patients with MSA, MSA with predominantly parkinsonian features (MSA-P), and MSA with predominantly cerebellar ataxia (MSA-C)

Summary

Introduction

Multiple system atrophy (MSA) is a sporadic neurodegenerative disease clinically characterized by the combination of Parkinsonian, cerebellar, autonomic, or pyramidal signs and symptoms (Stefanova et al, 2009). Patients with MSA only have a mean survival period of about 7–9 years after initial clinical presentation (Stefanova et al, 2009). Cognitive dysfunction had been underestimated previously, but an increasing number of studies have reported that cognitive impairment (CI) can present as a single-domain deficit or as a wide spectrum of domains (Stankovic et al, 2014; Cao et al, 2015b; Lee et al, 2015). A recent study reported that MSA patients with CI had a greater burden of neuronal cytoplasmic inclusions in the limbic regions (the dentate gyrus) (Koga et al, 2017)

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