Journal of Medicine and Life Science

Institute for Medical Science (제주대학교 의과학연구소)
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Clinical impact of cerebral microbleeds on cognition in patients with CADASIL

  • Lee, Jung Seok (Department of Neurology, Jeju National University College of Medicine) ;
  • Ko, Keun Hyuk (Department of Neurology, Jeju National University Hospital) ;
  • Oh, Jung-Hwan (Department of Neurology, Jeju National University College of Medicine) ;
  • Choi, Jay Chol (Department of Neurology, Jeju National University College of Medicine) ;
  • Kim, Joong-Goo (Department of Neurology, Jeju National University Hospital)
  • Received : 2018.10.23
  • Accepted : 2018.12.12
  • Published : 2018.12.31
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Abstract

Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is 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 dysfunction in CADASIL, few studies have examined the relationship between cognitive dysfunction and CMBs. We sought to assess whether CMBs are associated with cognitive dysfunction in CADASIL. This study enrolled 83 consecutive patients with CADASIL between April 2012 and January 2014. Their degree of cognitive dysfunction 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. In multiple logistic regression analysis, the grade of CMBs influenced tests of memory dysfunction (p=0.003). Three or more lacunes correlated with dysfunction in the executive domain (p=0.013) and attention domain (p=0.005). White matter hyperintensity (WMH) was an independent predictor of executive dysfunction (p=0.001). These findings suggest that in addition to lacunes, CMBs and WMHs may be useful imaging markers to associated with cognitive dysfunction in CADASIL.

Keywords

References

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