title: Enhanced rapid-onset cortical plasticity in CADASIL as a possible mechanism of preserved cognition.
abstract: Ischemic small vessel disease (SVD) may lead to cognitive impairment, but cognitive deficits with a given burden of SVD vary significantly. The underlying mechanisms of impaired or preserved cognition are unknown. Here, we investigated the impact of ischemic SVD on rapid-onset cortical plasticity, as induced with a paired-associative stimulation protocol. To exclude concomitant effects of aging, we examined 12 middle-aged patients (48.3 ± 8.3 years) with cerebral autosomal dominant arteriopathy with subcortical infarctions and leucoencephalopathy (CADASIL) who suffered from severe ischemic SVD and a group of 12 age-matched controls (49.9 ± 8.3 years). Cognitive status, motor performance and learning, and motor cortex excitability in response to cathodal transcranial direct current stimulation (ctDCS) were assessed. White matter integrity was analyzed by conventional magnetic resonance imaging and diffusion tensor imaging. We found that cognitive and motor functions were largely preserved in CADASIL patients, while rapid-onset cortical plasticity was significantly higher in the CADASIL group compared with controls (repeated measures analysis of variance [group × time] interaction: P = 0.03). This finding was even more pronounced in patients with higher white matter lesion load. ctDCS revealed no evidence of cortical dysplasticity. We conclude that increased rapid-onset cortical plasticity may contribute to largely preserved cognitive and motor function despite extensive ischemic SVD.
authors.affiliation: Department of Neurology, University Hospital of Münster, 48149 Münster, Germany.
authors.forename: Jonathan
authors.initials: J
authors.lastname: List
authors.forename: Thomas
authors.initials: T
authors.lastname: Duning
authors.forename: Marcus
authors.initials: M
authors.lastname: Meinzer
authors.forename: Julia
authors.initials: J
authors.lastname: Kürten
authors.forename: Anja
authors.initials: A
authors.lastname: Schirmacher
authors.forename: Michael
authors.initials: M
authors.lastname: Deppe
authors.forename: Stefan
authors.initials: S
authors.lastname: Evers
authors.forename: Peter
authors.initials: P
authors.lastname: Young
authors.forename: Agnes
authors.initials: A
authors.lastname: Flöel
mesh_terms: D000328:Adult; D000368:Aged; D046589:CADASIL / Q000473:pathology* / Q000503:physiopathology*; D003071:Cognition / Q000502:physiology*; D038524:Diffusion Magnetic Resonance Imaging; D019054:Evoked Potentials, Motor / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009473:Neuronal Plasticity / Q000502:physiology*; D009483:Neuropsychological Tests; D011597:Psychomotor Performance / Q000502:physiology