Cognitive impairment in multiple system atrophy and spinocerebellar ataxias: A case series

Background Multiple system atrophy (MSA) and spinocerebellar ataxias (SCAs) share similar clinical symptoms. Therefore, it is challenging to differentiate MSA and SCAs according to clinical symptoms, especially in the early stage. Currently, the diagnosis still relies on auxiliary inspection and genetic testing. The difference in cognitive symptoms between MSA and SCAs has not been fully investigated. Hence, the aim of this study was to analyze the differences in cognitive impairment between MSA and SCAs. Methods Five MSA patients and 5 patients with SCAs were recruited from the memory clinic of Xuanwu Hospital from March to September 2021. We collected detailed clinical information, imaging data, neuropsychological scales and genetic analysis of the patients. Then, we compared the differences in each cognitive domain between MSA and SCA patients. Results Comparison of SCA and MSA patients revealed that MSA patients had lower scores on the Clinical Dementia Rating Scale (CDR). There were no statistically significant group difference in global cognitive functioning, as indicated by Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores. Conclusion Both MSA and SCAs present with cognitive impairment, but MSA presents more obvious symptom severity.