TY - JOUR T1 - Frontal lobe function, behavioral changes and quality of life in patients with multiple system atrophy. AU - Zhang,LingYu, AU - Cao,Bei, AU - Zou,Yutong, AU - Wei,Qian-Qian, AU - Ou,RuWei, AU - Zhao,Bi, AU - Yang,Jing, AU - Wu,Ying, AU - Shang,HuiFang, PY - 2019/2/12/pubmed PY - 2019/7/10/medline PY - 2019/2/12/entrez KW - Multiple system atrophy KW - frontal assessment battery KW - frontal behavior inventory KW - quality of life SP - 11 EP - 19 JF - Restorative neurology and neuroscience JO - Restor Neurol Neurosci VL - 37 IS - 1 N2 - BACKGROUND: Cognitive impairment is an important and common symptom in patients with multiple system atrophy (MSA). OBJECTIVE: The objective of the study was to explore the potential relationships among frontal lobe function, behavioral changes and quality of life (QoL) in patients with MSA. METHODS: A total of 203 MSA patients were enrolled and evaluated using the Frontal Assessment Battery (FAB), the Frontal Behavioral Inventory (FBI) and the Parkinson's disease Questionnaire-39 item version (PDQ-39). Seventy-eight age-, sex-, and education-matched healthy controls were recruited to complete the FAB. RESULTS: Among MSA patients, those with frontal lobe dysfunction were older (P = 0.005), had older age of onset (P = 0.002), lower educational level (P < 0.001), higher scores in the PDQ-39 domains of mobility (P = 0.042), ADL (P = 0.020), cognition (P < 0.001) and communication compared to those with normal frontal lobe function. The most common frontal behavioral changes were logopenia followed by apathy and inflexibility. The severity of frontal behavioral changes was associated with MSA subtype (P = 0.015), disease severity (Unified Multiple System Atrophy Rating Scale-I (UMSARS-I), UMSARS-II, UMSARS-IV, and total UMSARS scores) (P < 0.001), orthostatic hypotension (P = 0.022), severity of depressive symptoms and total score on the PDQ-39 (P < 0.001). Binary logistic regression showed that the determinants of poor QoL in patients with MSA were disease severity (UMSARS-I and total UMSARS scores) (P < 0.05), depression (P = 0.013) and total FBI score (P = 0.003). CONCLUSIONS: Frontal behavioral changes were potential determinants of poor QoL in MSA, in addition to the disease severity and depressive symptoms. Early discovery and management of frontal behavioral changes in addition to motor and depressive symptoms will help to improve the QoL of MSA patients. SN - 1878-3627 UR - https://www.unboundmedicine.com/medline/citation/30741706/Frontal_lobe_function_behavioral_changes_and_quality_of_life_in_patients_with_multiple_system_atrophy_ DB - PRIME DP - Unbound Medicine ER -