Analysis on executive dysfunction of patients with multiple system atrophy and Parkinson's disease

Abstract

Objective To explore the characteristics of executive dysfunction of patients with multiple system atrophy (MSA) and Parkinson's disease (PD) by neuropsychological tests.  Methods Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Stroop Color-Word Test (SCWT), Digital Symbol Substitution Test (DSST)/Graphic Symbol Substitution Test (GSST), Clock Drawing Test (CDT) and Trail Making Test (TMT) were used to assess the overall cognitive and executive function of 34 patients with MSA [21 with cerebellar-predominant (MSA-C) and 13 with parkinsonism-predominant (MSA-P)], 18 patients with primary PD and 14 normal controls.  Results There was significant difference in MoCA score among different groups (P = 0.019). PD and MSA-C groups had lower MoCA score than that in normal control group (P = 0.015, 0.002). There were significant differences in each SCWT score (P = 0.035, 0.013, 0.012, 0.037), DSST (P = 0.000), GSST (P = 0.000) and TMT (P = 0.035) among different groups. Among them, MSA-C and MSA-P groups had significantly higher SCWT-A (P = 0.004, 0.045), SCWT-B (P = 0.001, 0.036) and SCWT-D scores (P = 0.023, 0.010) than those in normal control group. PD, MSA-C and MSA-P groups had significantly higher SCWT-C (P = 0.005, 0.014, 0.003), DSST (P = 0.003, 0.000, 0.000) and GSST scores (P = 0.001, 0.000, 0.000) than those in normal control group. MSA-P group had significantly higher TMT score than that in normal control group (P = 0.006).  Conclusions Patients with MSA and PD may present executive dysfunction to different degrees. SCWT and DSST/GSST tests are useful in assessing executive dysfunction in those patients.

DOI: 10.3969/j.issn.1672-6731.2016.05.006