Ling Chen, Fang Xiaojing, Kong Qingle, Sun Yunchuang, Wang Bo, Zhuo Yan, An Jing, Zhang Wei, Wang Zhaoxia, Zhang Zihao, Yuan Yun
Department of Neurology, Peking University First Hospital, Beijing, China.
Department of Neurology, Peking University International Hospital, Beijing, China.
Front Neurol. 2019 Aug 9;10:870. doi: 10.3389/fneur.2019.00870. eCollection 2019.
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) mainly affects the cerebral small arteries. We aimed to analyze changes in the lenticulostriate arteries (LSAs) and the basal ganglia in patients with CADASIL using high-field magnetic resonance imaging (7.0-T MRI). We examined 46 patients with CADASIL and 46 sex- and age-matched healthy individuals using 7.0-T MRI. The number and length of the LSAs, and the proportion of discontinuous LSAs were compared between the two groups. The Mini-Mental State Examination score, the modified Rankin Scale, the Barthel Index, and the MRI lesion load of the basal ganglia were also examined in patients with CADASIL. We analyzed the association between LSA measurements and the basal ganglia lesion load, as well as the association between LSA measurements and clinical phenotypes in this patient group. We observed a decrease in the number of LSA branches ( = -2.591, = 0.011), and an increase in the proportion of discontinuous LSAs ( = -1.991, = 0.047) in patients with CADASIL when compared with healthy controls. However, there was no significant difference in the total length of LSAs between CADASIL patients and healthy individuals ( = -0.412, = 0.682). There was a positive association between the number of LSA branches and the Mini-Mental State Examination scores of CADASIL patients after adjusting for age and educational level (β = 0.438; 95% CI: 0.093, 0.782; = 0.014). However, there was no association between LSA measurements and the basal ganglia lesion load among CADASIL patients. 7.0-T MRI provides a promising and non-invasive method for the study of small artery damage in CADASIL. The abnormalities of small arteries may be related to some clinical symptoms of CADASIL patients such as cognitive impairment. The lack of association between LSA measurements and the basal ganglia lesion load among the patients suggests that changes in the basal ganglia due to CADASIL are caused by mechanisms other than anatomic narrowing of the vessel lumen.
伴有皮质下梗死和白质脑病的常染色体显性遗传性脑动脉病（CADASIL）主要影响脑小动脉。我们旨在使用高场磁共振成像（7.0-T MRI）分析CADASIL患者的豆纹动脉（LSA）和基底节的变化。我们使用7.0-T MRI检查了46例CADASIL患者和46例年龄及性别匹配的健康个体。比较了两组之间LSA的数量和长度以及不连续LSA的比例。还对CADASIL患者进行了简易精神状态检查表评分、改良Rankin量表、Barthel指数和基底节的MRI病变负荷检查。我们分析了LSA测量值与基底节病变负荷之间的关联，以及该患者组中LSA测量值与临床表型之间的关联。与健康对照相比，我们观察到CADASIL患者的LSA分支数量减少（=-2.591，=0.011），不连续LSA的比例增加（=-1.991，=0.047）。然而，CADASIL患者与健康个体之间LSA的总长度没有显著差异（=-0.412，=0.682）。在调整年龄和教育水平后，CADASIL患者的LSA分支数量与简易精神状态检查表评分之间存在正相关（β=0.438；95%CI：0.093，0.782；=0.014）。然而，CADASIL患者中LSA测量值与基底节病变负荷之间没有关联。7.0-T MRI为研究CADASIL中的小动脉损伤提供了一种有前景的非侵入性方法。小动脉异常可能与CADASIL患者的一些临床症状如认知障碍有关。患者中LSA测量值与基底节病变负荷之间缺乏关联表明，CADASIL导致的基底节变化是由血管腔解剖学狭窄以外的机制引起的。
