Clinical and imaging characteristics of dementia in multiple system atrophy

Dementia was found in 15% of the probable MSA patients, which was similar to those reported in previous studies. It appears that amyloid pathology has limited role in dementia in MSA, although some patients had increased cortical amyloid burden. Cortical thinning in MSA-D was observed in areas where cortical thinning was reported in Alzheimer disease or Parkinson disease dementia, but its pathological relevance is unclear. The neuropathological processes leading to the development of dementia in MSA appears to be multifactorial and heterogenous.