Simultaneous assessment of cognitive and affective functions in multiple system atrophy and cortical cerebellar atrophy in relation to computerized touch-panel screening tests

Published:February 16, 2015DOI:


      • We examined cognitive and affective ability in MSA and CCA patients.
      • Standard cognitive assessments were significantly lower in MSA-C patients.
      • MSA-C patients showed a decrease of rCBF of frontal lobe with cognitive impairment.
      • MSA and CCA patients showed a mild to moderate depressive state.
      • Touch-panel tests showed worse results in disease groups than normal controls.


      Cognitive impairment and affective dysfunction of multiple system atrophy (MSA) and cortical cerebellar atrophy (CCA) have not been simultaneously examined comparing standard test batteries and a sensitive tool to detect subtle cognitive decline in patients. In the present study, we simultaneously examined cognitive and affective ability in MSA with predominant cerebellar ataxia (MSA-C, n = 25), MSA with predominant parkinsonism (MSA-P, n = 8), and CCA (n = 14) patients using computerized touch panel screening tests. Mini-mental state examination (MMSE), Hasegawa dementia scale-revised (HDS-R), frontal assessment battery (FAB), and Montreal cognitive assessment (MoCA) scores were significantly lower in MSA-C patients than in age-and gender-matched normal controls. One MSA-C patient showed a decrease in the regional cerebral blood flow (rCBF) of the frontal lobe. MSA-P patients showed no such cognitive decline. Only FAB and MoCA scores were significantly lower in the CCA patients. MSA and CCA patients also showed a mild to moderate depressive state. Touch-panel screening tests demonstrated a significant decline of beating devils game in all three disease groups including MSA-P patients, and a significant extension of the flipping cards game only in MSA-C patients. The present study demonstrated different cognitive and affective functions among MSA-C, MSA-P, and CCA patients, and a sensitive screening method for cognitive assessment using touch-panel tests.


      AD (Alzheimer's disease), ALS (amyotrophic lateral sclerosis), ANOVA (analysis of variance), CCA (cortical cerebellar atrophy), CNS (central nerve system), DSM-IV (diagnostic and statistical manual of mental disorders, 4th edition), eZIS (easy Z-score imaging system), FAB (frontal assessment battery), GDS (geriatric depression scale), HDS-R (Hasegawa dementia scale-revised), IS (ischemic stroke), MMSE (mini-mental state examination), MoCA (Montreal cognitive assessment), MRI (magnetic resonance imaging), MSA (multiple system atrophy), MSA-C (MSA with predominant cerebellar ataxia), MSA-P (MSA with predominant parkinsonism), NC (normal controls), PD (Parkinson's disease), rCBF (regional cerebral blood flow), SD (standard deviation), SPECT (single-photon emission tomography), 99mTc-ECD (99mTc labeled ethyl cysteinate dimer), VI (vitality index.)


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