Journal
MOVEMENT DISORDERS
Volume 29, Issue 7, Pages 857-867Publisher
WILEY
DOI: 10.1002/mds.25880
Keywords
cognition; multiple system atrophy; neuropsychology
Categories
Funding
- Austrian Science Fund (FWF) [F04404-B19]
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre
- Dementia Biomedical Research Unit at South London, and Maudsley NHS Foundation Trust and King's College London
- Reta Lila Weston Institute for Neurological Studies
- Multiple System Atrophy Trust
- National Institute for Health Research University College London Hospitals Biomedical Research Centre
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Consensus diagnostic criteria for multiple system atrophy consider dementia as a nonsupporting feature, despite emerging evidence demonstrating that cognitive impairments are an integral part of the disease. Cognitive disturbances in multiple system atrophy occur across a wide spectrum from mild single domain deficits to impairments in multiple domains and even to frank dementia in some cases. Frontal-executive dysfunction is the most common presentation, while memory and visuospatial functions also may be impaired. Imaging and neuropathological findings support the concept that cognitive impairments in MSA originate from striatofrontal deafferentation, with additional contributions from intrinsic cortical degeneration and cerebellar pathology. Based on a comprehensive evidencebased review, the authors propose future avenues of research that ultimately may lead to diagnostic criteria for cognitive impairment and dementia associated with multiple system atrophy. (C) 2014 International Parkinson and Movement Disorder Society
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