Motor cortex cholinergic dysfunction in CADASIL: a transcranial magnetic demonstration.
OBJECTIVE
Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a hereditary small vessel disease responsible for an early onset cognitive impairment. Aim of our study was to test the cortical cholinergic innervation in CADASIL by short latency afferent inhibition (SAI) technique.


METHODS
We applied SAI in ten CADASIL patients and in ten age-matched normal controls. SAI is a phenomenon observed on motor evoked potential when transcranial magnetic stimulation is delivered after a time ranging from 2 to 8 ms longer than the time needed by the peripheral nerve afferent input to reach the somatosensory cortex.


RESULTS
The amount of short latency afferent inhibition was significantly smaller in CADASIL patients than in controls (79.5+/-21.7% Vs 42.7+/-14.1% of test size; p<0.001, two tailed Mann-Whitney test). The mean resting motor threshold (RMT) was significantly lower in CADASIL patients than in controls (49.4+/-14.4% Vs 65.6+/-15.4%; p=0.02).


CONCLUSIONS
We demonstrated by SAI technique a central cholinergic impairment in CADASIL.


CONCLUSIONS
SAI could be used to evaluate the cholinergic dysfunction and potentially the efficacy of cholinomimetic therapy in CADASIL.
Department of Neurological Sciences, University Federico II of Naples, Via Sergio Pansini, 5, 80131 Naples, Italy.
Fiore
F
Manganelli
Michele
M
Ragno
Gabriella
G
Cacchiò
Valeria
V
Iodice
Luigi
L
Trojano
Flavia
F
Silvaggio
Maria
M
Scarcella
Michela
M
Grazioli
Lucio
L
Santoro
Anna
A
Perretti
D000368:Aged; D046589:CADASIL / Q000473:pathology* / Q000503:physiopathology; D016022:Case-Control Studies; D004558:Electric Stimulation; D004576:Electromyography / Q000379:methods; D019054:Evoked Potentials, Motor / Q000502:physiology* / Q000528:radiation effects; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology*; D009433:Neural Inhibition / Q000502:physiology; D009483:Neuropsychological Tests; D011930:Reaction Time / Q000502:physiology; D013003:Somatosensory Cortex / Q000503:physiopathology; D018709:Statistics, Nonparametric; D013997:Time Factors; D050781:Transcranial Magnetic Stimulation