Mukai Mao, Hamano Ai, Mizuta Ikuko, Yokota Isao, Watanabe-Hosomi Akiko, Matsuura Hiraku, Koizumi Takashi, Matsuura Jun, Ohara Tomoyuki, Matsushima Shigenori, Teramukai Satoshi, Yamada Kei, Mizuno Toshiki
Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Department of Biostatistics, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
Front Neurol. 2023 Jan 9;13:1087220. doi: 10.3389/fneur.2022.1087220. eCollection 2022.
Impaired cerebrovasoreactivity is thought to play an important role in the pathophysiology of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). We aimed to clarify the association between cerebrovascular reactivity and stroke in patients with CADASIL.
We retrospectively recruited 14 patients with CADASIL, eight of whom had symptomatic stroke. They underwent quantitative single-photon emission computed tomography using an autoradiographic method at rest and after acetazolamide (ACZ) administration. Regional cerebral blood flow (rCBF) in the cerebral cortex, lenticular nucleus, thalamus, and cerebellum was measured. We compared the rCBF parameters between patients with and without stroke.
The baseline characteristics and magnetic resonance imaging findings were similar between the two groups, except for a higher frequency of pyramidal tract sign (75% vs. 0%) and a larger number of old lacunes (15.4 ± 8.8 vs. 2.2 ± 1.8) in the patients with stroke. Of the rCBF parameters measured, significantly lower flow (mL/100 g/min) was observed in ACZ-rCBF in the thalamus (35.6 ± 9.4 vs. 51.1 ± 7.6, = 0.01) and ΔrCBF in the thalamus (10.6 ± 3.7 vs. 21.0 ± 7.9, = 0.02) in the patients with stroke.
Cerebrovasoreactivity in the thalamus was significantly associated with stroke in patients with CADASIL.
脑血管反应性受损被认为在伴有皮质下梗死和白质脑病的脑常染色体显性动脉病（CADASIL）的病理生理学中起重要作用。我们旨在阐明CADASIL患者脑血管反应性与中风之间的关联。
我们回顾性招募了14例CADASIL患者，其中8例有症状性中风。他们在静息状态下以及给予乙酰唑胺（ACZ）后，采用放射自显影法进行定量单光子发射计算机断层扫描。测量大脑皮质、豆状核、丘脑和小脑的局部脑血流量（rCBF）。我们比较了有中风和无中风患者的rCBF参数。
两组患者的基线特征和磁共振成像结果相似，但中风患者的锥体束征频率更高（75%对0%），陈旧性腔隙数量更多（15.4±8.8对2.2±1.8）。在所测量的rCBF参数中，中风患者丘脑的ACZ-rCBF（35.6±9.4对51.1±7.6，P=0.01）和丘脑的ΔrCBF（10.6±3.7对21.0±7.9，P=0.02）明显更低。
CADASIL患者丘脑中的脑血管反应性与中风显著相关。
