title: Cerebrovascular reactivity and dynamic autoregulation in nondemented patients with CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy).
abstract: Reduced cerebrovascular reactivity has been reported in patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), and the measurement has been suggested as a useful surrogate marker of disease progression. Previous studies have not determined whether cerebral autoregulation is also impaired. We measured dynamic cerebral autoregulation and carbon dioxide reactivity in 24 nondemented CADASIL patients and 20 controls, using transcranial Doppler ultrasound (TCD). No impairment in either measure was found in the CADASIL group. We conclude that either cerebrovascular reactivity and autoregulation are not impaired in early disease, or that TCD may not be a sufficiently sensitive tool to detect haemodynamic changes in early disease. TCD is unlikely to be useful for disease monitoring in patients without advanced disease.
authors.affiliation: Department of Clinical Neuroscience, St George's Hospital Medical School, London, UK. sumeet@zinc.freeserve.co.uk
authors.forename: Sumeet
authors.initials: S
authors.lastname: Singhal
authors.forename: Hugh S
authors.initials: HS
authors.lastname: Markus
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity / Q000187:drug effects / Q000502:physiology; D046589:CADASIL / Q000235:genetics / Q000503:physiopathology*; D002245:Carbon Dioxide / Q000494:pharmacology; D016022:Case-Control Studies; D002560:Cerebrovascular Circulation / Q000187:drug effects / Q000502:physiology*; D005260:Female; D006706:Homeostasis / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000187:drug effects / Q000503:physiopathology*; D011518:Proto-Oncogene Proteins / Q000235:genetics; D011956:Receptors, Cell Surface / Q000235:genetics; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods
chemical_list: D011518:Proto-Oncogene Proteins; D011956:Receptors, Cell Surface; D002245:Carbon Dioxide
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