Relationship Between Orthostatic Hypotension and Cognitive Functions in Multiple System Atrophy: A Longitudinal Study.

Autor: Cuoco S; Center for Neurodegenerative diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience section, University of Salerno, Salerno, Italy., Carotenuto I; Center for Neurodegenerative diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience section, University of Salerno, Salerno, Italy., Cappiello A; Center for Neurodegenerative diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience section, University of Salerno, Salerno, Italy., Scannapieco S; Center for Neurodegenerative diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience section, University of Salerno, Salerno, Italy., Russillo MC; Center for Neurodegenerative diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience section, University of Salerno, Salerno, Italy., Andreozzi V; Center for Neurodegenerative diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience section, University of Salerno, Salerno, Italy., Forino L; Center for Neurodegenerative diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience section, University of Salerno, Salerno, Italy., Amboni M; Center for Neurodegenerative diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience section, University of Salerno, Salerno, Italy., Picillo M; Center for Neurodegenerative diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience section, University of Salerno, Salerno, Italy., Erro R; Center for Neurodegenerative diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience section, University of Salerno, Salerno, Italy., Barone P; Center for Neurodegenerative diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience section, University of Salerno, Salerno, Italy., Pellecchia MT; Center for Neurodegenerative diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience section, University of Salerno, Salerno, Italy.
Jazyk: angličtina
Zdroj: Frontiers in neurology [Front Neurol] 2021 Sep 03; Vol. 12, pp. 711358. Date of Electronic Publication: 2021 Sep 03 (Print Publication: 2021).
DOI: 10.3389/fneur.2021.711358
Abstrakt: Introduction: The aim of this study is to investigate the impact of orthostatic hypotension (OH) on cognitive functions in patients with multiple system atrophy (MSA) followed over time. Methods: Thirty-two MSA patients were enrolled and underwent a comprehensive neuropsychological battery; at baseline (T 0 ) 15 out of 32 patients presented OH, assessed by means of orthostatic standing test. All patients underwent a follow-up (T 1 ) evaluation 12 months after baseline. Thirteen out of 32 patients also underwent a second follow-up (T 2 ) evaluation at 24 months. Changes over time on different neuropsychological tasks were compared between patients with and without OH by means of Mann-Whitney's U -test. Moreover, clinical categories of normal cognition, mild cognitive impairment, and dementia were determined, and changes at T 1 and T 2 in global cognitive status were compared between patients with and without OH. Results: At T 0 , patients with OH had better performance on words/non-words repetition task ( p = 0.02) compared to patients without OH. Compared to patients without OH, patients with OH performed worse on semantic association task ( p < 0.01) at T 1 and on Stroop test-error effect ( p = 0.04) at T 2 . The percentage of patients with worsened cognitive status at T 1 was higher among patients with OH than among patients without OH (93 vs. 59%, p = 0.03). OH (β = -4.67, p = 0.01), education (β = 0.45, p = 0.02), age (β = 0.19, p = 0.03), and Montreal Cognitive Assessment battery (MOCA) score at T 0 (β = -0.26, p = 0.04) were significant predictors of global cognitive status worsening at T 1 . Discussion: We found that global cognitive status worsened at 1-year follow-up in 93% of patients with OH, and OH, along with age, education, and MOCA score, predicted cognitive worsening over time. To clarify the relationship between OH and cognitive dysfunction in MSA, we suggest the use of clinical categories of normal cognition, mild cognitive impairment, and dementia in further longitudinal studies on MSA patients with and without OH.
Competing Interests: Unrelated to this study, PB received consultancies as a member of the advisory board for Zambon, Lundbeck, UCB, Chiesi, Abbvie, and Acorda. RE received consultancies from Zambon and honoraria from TEVA. The other authors report no financial disclosures. The other authors report no financial disclosures. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2021 Cuoco, Carotenuto, Cappiello, Scannapieco, Russillo, Andreozzi, Forino, Amboni, Picillo, Erro, Barone and Pellecchia.)
Databáze: MEDLINE