Vasoreactivity in CADASIL: comparison to structural MRI and neuropsychology
Open accessAbstract
Impaired cerebrovascular reactivity precedes histological and clinical evidence of CADASIL in animal models. We aimed to more fully characterise peripheral and cerebral vascular function and reactivity in a cohort of adult CADASIL patients, and explore the associations of these with conventional clinical, imaging and neuropsychological measures. A total of 22 adults with CADASIL gave informed consent to participate in an exploratory study of vascular function in CADASIL. Clinical assessment, comprehensive vascular assessment, MRI and neuropsychological testing were conducted. We measured cerebral vasoreactivity with transcranial Doppler and arterial spin labelling MRI with hypercapnia challenge. Number and volume of lacunes, subcortical hyperintensity volume, microbleeds and normalised brain volume were assessed on MRI. Analysis was exploratory and examined the associations between different markers. Cerebrovascular reactivity measured by ASL correlated with peripheral vasoreactivity measured by flow mediated dilatation. Subjects with ≥5 lacunes were older, with higher carotid intima-media thickness and had impaired cerebral and peripheral vasoreactivity. Subjects with depressive symptoms, disability or delayed processing speed also showed a trend to impaired vasoreactivity. Impaired vasoreactivity and vascular dysfunction may play a significant role in the pathophysiology of CADASIL, and vascular assessments may be useful biomarkers of severity in both longitudinal and clinical trials.
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A larger volume of lacunes is consistently linked with poorer clinical outcomes or cognitive performances in CADASIL patients.
“In contrast with WMH or CM, a larger volume of lacunes has been consistently linked with poorer clinical outcomes or cognitive performances in CADASIL patients [11, 36, 40, 50, 53, 59, 71, 73].”
From Clinical and research applications of magnetic resonance imaging in the study of CADASIL (2019) · cites this paper as [50]
The vast majority of studies investigating associations between clinical symptoms and global volumetric brain measures such as the brain parenchymal fraction have revealed significant relationships with cognitive scores and functional outcomes in CADASIL patients.
“The vast majority of studies investigating associations between clinical symptoms and global volumetric brain measures, such as the brain parenchymal fraction (BPF), have revealed significant relationships with cognitive scores and functional outcomes in CADASIL patients [34, 50, 53, 60, 71].”
From Clinical and research applications of magnetic resonance imaging in the study of CADASIL (2019) · cites this paper as [50]
Moreton et al. (2018) found that CADASIL patients with lower cerebral vasoreactivity, as estimated using Arterial Spin Labeling, tended to present greater levels of disability, depressive symptoms, and impaired processing speed.
“Moreton et al. (2018) found that CADASIL patients with lower cerebral vasoreactivity, as estimated using Arterial Spin Labeling (ASL), tended to present greater levels of disability, depressive symptoms and impaired processing speed [50].”
From Clinical and research applications of magnetic resonance imaging in the study of CADASIL (2019) · cites this paper as [50]
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References 41 · Cited by 37
- Authors
- Moreton, F. C., Cullen, B., Delles, C., Santosh, C., Gonzalez, R. L., Dani, K., & Muir, K. W.
- Affiliations
- Queen Elizabeth University Hospital (GB)
- University of Glasgow (GB)
- Department of Clinical Physics and Bioengineering, Glasgow Royal Infirmary, Glasgow, UK
- Corresponding author
- Muir, Keith W
- Venue
- Journal of Cerebral Blood Flow & Metabolism
- Publisher
- SAGE Publications
- Published
- 2017-05-24
- Volume
- 38
- Issue
- 6
- Pages
- 1085-1095
- ISSN
- 0271-678X (ISSN-L)
- 1559-7016
- PMC
- PMC5998994
- OpenAlex
- W2613003586
- Cited by
- 37
- References
- 41
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 4 · 2023: 3 · 2022: 3 · 2021: 7 · 2020: 4 · 2019: 7 · 2018: 1 · 2017: 1
- FWCI
- 2.48
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Cerebral Blood Flow & Metabolism (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion, cc-by-sa)
- Funders
- British Heart Foundation (RE/13/5/30177)
- Medical Research Council (MC_PC_15039)
- Topics
- Health Sciences › Medicine › Neurology › Cerebrovascular and genetic disorders
- Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- CADASIL, cerebrovascular reactivity, cerebral vasoreactivity, arterial spin labeling, transcranial Doppler, flow-mediated dilation, lacunes, subcortical hyperintensities, microbleeds, carotid intima-media thickness, depressive symptoms, processing speed, vascular dysfunction, disease severity markers
- MeSH terms
- Adolescent, Adult, Cerebrovascular Circulation, Depression, Female, Humans, Male, Middle Aged, Vasodilation, Ultrasonography, Doppler, Transcranial, Magnetic Resonance Angiography, CADASIL, Carotid Intima-Media Thickness
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