Posterior cerebellar degeneration associates with executive dysfunction in multiple system atrophy: a voxel-based and atlas-based morphometric study

IF 2.7 Q3 CLINICAL NEUROLOGY

Clinical Parkinsonism Related Disorders Pub Date : 2026-01-01 Epub Date: 2026-06-28 DOI:10.1016/j.prdoa.2026.100477

Yoko Taniguchi, Yuto Uchida, Keita Sakurai, Haruto Shibata, Hiroyasu Inoue, Yuta Madokoro, Toyohiro Sato, Teppei Fujioka, Masayuki Mizuno, Masahiro Oomura, Kenichi Oishi, Noriyuki Matsukawa

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引用次数: 0

Abstract

Background

Executive dysfunction is frequently observed in multiple system atrophy (MSA), yet its neuroanatomical substrates remain incompletely characterized. Emerging evidence suggests that the cerebellum contributes to higher cognitive functions beyond motor control.

Objective

To investigate structural cerebellar alterations associated with executive dysfunction in patients with MSA using complementary voxel-based and atlas-based morphometric analyses.

Methods

In this case–control study, 27 patients with clinically established MSA and 19 age-matched healthy controls underwent 3D T1-weighted MRI. Voxel-based morphometry and subsequent atlas-based cerebellar volumetry were performed to identify regional brain volume differences between groups, adjusting for age, sex, total intracranial volume, and MSA clinical subtype (MSA-P vs. MSA-C). Executive function was assessed with the Frontal Assessment Battery (FAB). Partial correlations between regional cerebellar volumes and FAB scores were examined within the MSA group.

Results

Compared with healthy controls, patients with MSA showed significant gray matter volume reductions in the bilateral putamen and cerebellar cortex, as well as white matter reductions extending from the brainstem to the middle cerebellar peduncles. Atlas-based analyses demonstrated reduced normalized volumes in bilateral cerebellar white matter and left vermian VIIIA, whereas larger volumes were observed in bilateral vermian Crus II and left lobule IV. Within the MSA group, FAB scores showed nominal positive associations with left VIIIB, bilateral VIIIA, and right vermis IX volumes, without surviving multiple-comparison correction.

Conclusions

Posterior cerebellar degeneration may be related to executive dysfunction in MSA. These exploratory findings warrant validation in larger longitudinal studies with detailed cognitive and motor assessments.

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小脑后变性与多系统萎缩中的执行功能障碍相关：基于体素和基于图谱的形态计量学研究。

背景：在多系统萎缩（MSA）中经常观察到执行功能障碍，但其神经解剖学基础尚未完全表征。新出现的证据表明，小脑在运动控制之外还具有更高的认知功能。目的：利用互补体素和基于图谱的形态计量学分析，探讨与MSA患者执行功能障碍相关的小脑结构改变。方法：在本病例对照研究中，27例临床建立的MSA患者和19例年龄匹配的健康对照者进行了3D t1加权MRI检查。采用基于体素的形态测量和随后的基于图谱的小脑容量测量来确定各组之间的区域脑容量差异，并根据年龄、性别、颅内总容积和MSA临床亚型（MSA- p vs. MSA- c）进行调整。执行功能用正面评估组（FAB）进行评估。在MSA组中检查了区域小脑体积和FAB评分之间的部分相关性。结果：与健康对照相比，MSA患者双侧壳核和小脑皮层的灰质体积明显减少，白质体积从脑干延伸到小脑中脚。基于阿特拉斯的分析显示，双侧小脑白质和左侧蠕虫viii的标准化体积减少，而双侧蠕虫II和左侧小叶IV的体积更大。在MSA组中，FAB评分显示与左侧viii ib、双侧viii和右侧蠕虫IX的体积有名义上的正相关，没有幸存的多重比较校正。结论：脑后小脑变性可能与MSA的执行功能障碍有关。这些探索性的发现在更大的纵向研究中得到了验证，并进行了详细的认知和运动评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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