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KMID : 1161920180150020089
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Journal of Medicine and Life Science
2018 Volume.15 No. 2 p.89 ~ p.94
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Clinical impact of Cerebral Microbleeds on cognition in patients with CADASIL Short title: Clinical impact of Cerebral Microbleeds in CADASIL
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Lee Jung-Seok
Ko Keun-Hyuk
Oh Jung-Hwan
Choi Jay-Chol
Kim Joong-Goo
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Abstract
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Background: Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited microangiopathy caused by mutations in the Notch3 gene. Typical findings from brain magnetic resonance imaging (MRI) include subcortical lacunes, extensive white matter change and cerebral microbleeds (CMBs). CMBs are indicative of bleeding-prone microangiopathy. Despite some studies investigating the association between lacunes and cognitive impairment in CADASIL, few studies have examined the relationship between cognitive impairment and CMBs. We sought to assess whether CMBs are associated with cognitive impairment in patients with CADASIL.
Methods: We enrolled 83 consecutive patients with CADASIL between April 2012 and January 2014. Their degree of cognitive impairment was assessed by the Korean version of the CERAD neuropsychological assessment battery, digit span test, and the Stroop test. A 3.0-T MRI was used to obtain T1-weighted, fluid-attenuated inversion recovery, and susceptibility weighted images.
Results: In multiple logistic regression analysis, the grade of CMBs influenced tests of memory impairment (p=0.003). Three or more lacunes correlated with executive domain (p=0.013) and attention domain (p=0.005). WMHs was an independent predictor of executive dysfunction (p=0.001).
Conclusion: These findings suggest that in addition to lacunes, CMBs and WMHs may be useful imaging markers to predict cognitive impairment in CADASIL.
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KEYWORD
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Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), Hypertension, Lacunar infarct, Cognition
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