Cystatin C predicts cognitive decline in multiple system atrophy: A 1-year prospective cohort study

BackgroundAccumulating evidence has suggested that cystatin C is associated with cognitive impairment in patients with neurodegenerative diseases. However, the association between cystatin C and cognitive decline in patients with multiple system atrophy (MSA) remains largely unknown. ObjectivesThe objective was to determine whether cystatin C was independently associated with cognitive decline in patients with early-stage MSA. MethodsPatients with MSA underwent evaluation at baseline and the 1-year follow-up. Cognitive function was evaluated with Montreal cognitive assessment (MoCA). Changes in the MoCA score and the absolute MoCA score at the 1-year assessment were considered the main cognitive outcome. The cystatin C concentrations in patients with MSA and age, sex, and body mass index matched-healthy controls (HCs) were measured. A multiple linear regression model was used to test the association between cystatin C and cognitive decline. ResultsA total of 117 patients with MSA and 416 HCs were enrolled in the study. The cystatin C levels were significantly higher in patients with MSA than in HCs (p < 0.001). Cystatin C levels were negatively correlated with MoCA score at baseline and at 1-year follow-up. Multiple linear regression model adjusted for potential confounders showed that baseline cystatin C levels were significantly associated with the MoCA score (p = 0.004) or change in the MoCA score (p = 0.008) at 1-year follow-up. ConclusionOur results suggested that cystatin C may serve as a potential biomarker of cognitive decline in patients with early-stage MSA.

Automated summary

This study found that cystatin C is associated with cognitive decline in patients with early-stage multiple system atrophy (MSA). Through evaluation of 117 MSA patients and 416 healthy controls, it was observed that cystatin C levels were significantly higher in MSA patients and were negatively correlated with cognitive function scores at baseline and 1-year follow-up. These findings suggest that cystatin C may serve as a potential biomarker for cognitive decline in patients with early-stage MSA.