CADASIL Affects Multiple Aspects of Cerebral Small Vessel Function on 7T-MRI

Area of Science:

• Neurology
• Radiology
• Vascular Biology

Background:

• Cerebral small vessel diseases (cSVDs) are a significant cause of stroke and dementia.
• Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a monogenic form of cSVD.

Purpose of the Study:

• To investigate cerebral small vessel function in CADASIL patients using advanced 7T-MRI techniques.
• To identify specific functional deficits in cerebral small vessels associated with this genetic form of cSVD.

Main Methods:

• Recruited 23 CADASIL patients and 13 age/sex-matched controls.
• Measured perforating artery blood flow velocity and pulsatility in basal ganglia and centrum semiovale.
• Assessed vascular reactivity using visual stimuli and hypercapnia challenges in various brain regions via 7T-MRI.

Main Results:

• CADASIL patients demonstrated reduced blood flow velocity and increased pulsatility in perforating arteries.
• Vascular reactivity to visual stimuli was decreased in CADASIL patients.
• Reactivity to hypercapnia was preserved in most brain areas but reduced in white matter hyperintensities within patients.

Conclusions:

• CADASIL patients exhibit multiple cerebral small vessel functional abnormalities, including increased arteriolar stiffness and regional reactivity deficits.
• These findings suggest novel MRI-based markers for cSVD research and potential therapeutic interventions.