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Diffuse Tract Damage in CADASIL Is Correlated with Global Cognitive Impairment
Shiyu Ban1, Hongzhi Wang1, Mengxing Wang2
1Shanghai Key Laboratory of Magnetic Resonance and Department of Physics, School of Physics and Electronic Science, East China Normal University, Shanghai, China.
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) patients exhibit widespread white matter damage, significantly impacting cognitive function and stroke severity. This study highlights the crucial role of white matter integrity in CADASIL-related cognitive decline.
Area of Science:
- Neurology
- Neuroimaging
- Genetics
Background:
- Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a genetic small vessel disease linked to NOTCH3 mutations.
- It commonly causes ischemic stroke and dementia, with patients showing cognitive impairment and white matter lesions.
- The precise link between white matter lesions and cognitive deficits in CADASIL remains unclear.
Purpose of the Study:
- To investigate white matter (WM) microstructural abnormalities in CADASIL patients using diffusion tensor imaging (DTI).
- To explore the relationship between WM alterations and cognitive impairment in individuals with CADASIL.
Main Methods:
- Diffusion tensor imaging (DTI) was employed to assess white matter (WM) degeneration.
- Key DTI metrics included fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD).
- 18 CADASIL patients and 18 healthy controls were evaluated.
Main Results:
- CADASIL patients displayed significant reductions in FA and increases in RD, AD, and MD compared to controls.
- These widespread WM microstructural changes were observed in major white matter tracts.
- WM alterations strongly correlated with cognitive and stroke scale scores.
Conclusions:
- CADASIL is characterized by extensive white matter abnormalities.
- WM microstructural integrity is significantly associated with cognitive impairment in CADASIL.
- Damage to white matter tracts is a key factor contributing to cognitive deficits in this condition.
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