title: Simultaneous impairment of intracranial and peripheral artery vasoreactivity in CADASIL patients.
abstract: BACKGROUND
  Reduced cerebrovascular reactivity (CVR) is an important step in the pathogenesis of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). The present study utilized quantitative single photon emission computed tomography (SPECT) with the autoradiographic (ARG) method and reactive hyperemia peripheral arterial tonometry (RH-PAT) to assess vasoreactivity in intracranial arteries and in peripheral arteries in patients with CADASIL.
  
  
  METHODS
  Quantitative SPECT studies were conducted in eight patients with CADASIL, while RH-PAT analysis was conducted in eight CADASIL patients and in eight age-matched normal subjects. Quantitative SPECT studies with the ARG method were performed at baseline and after administration of acetazolamide. Regional cerebral blood flow (rCBF) values were measured using stereotactic extraction estimation (SEE) methods. The rCBF of CADASIL patients was averaged in the bilateral frontal, temporal, parietal, and occipital lobes as well as in the limbic system, cerebellar hemisphere, whole cerebral cortex and basal ganglia. The CVR index from acetazolamide stress of intracranial arteries was calculated in each area. Vasoreactivity of peripheral arteries was estimated by the reactive hyperemia index (RHI) measured with a PAT device before and after interruption of arterial flow.
  
  
  RESULTS
  Average RHI after post-deflation was lower in CADASIL patients than in normal subjects. RHI correlated significantly with CVR in all brain areas in CADASIL patients.
  
  
  CONCLUSIONS
  Vasoreactivity is reduced in peripheral arteries and in intracranial arteries in patients with CADASIL.
authors.affiliation: Department of Neurology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: Toshiki
authors.initials: T
authors.lastname: Mizuno
authors.forename: Chio
authors.initials: C
authors.lastname: Okuyama
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Nagakane
authors.forename: Akiko
authors.initials: A
authors.lastname: Watanabe-Hosomi
authors.forename: Masaki
authors.initials: M
authors.lastname: Kondo
authors.forename: Nagato
authors.initials: N
authors.lastname: Kuriyama
authors.forename: Takahiko
authors.initials: T
authors.lastname: Tokuda
authors.forename: Shigenori
authors.initials: S
authors.lastname: Matsushima
authors.forename: Tsunehiko
authors.initials: T
authors.lastname: Nishimura
authors.forename: Masanori
authors.initials: M
authors.lastname: Nakagawa
mesh_terms: D000086:Acetazolamide; D000328:Adult; D000368:Aged; D000662:Amphetamines; D000704:Analysis of Variance; D001345:Autoradiography; D046589:CADASIL / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016022:Case-Control Studies; D002536:Cerebral Arteries / Q000503:physiopathology*; D002560:Cerebrovascular Circulation; D005260:Female; D005385:Fingers / Q000098:blood supply*; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology; D007564:Japan; D008279:Magnetic Resonance Imaging; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012039:Regional Blood Flow; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D000662:Amphetamines; D019275:Radiopharmaceuticals; C041336:4-iodoamphetamine; D000086:Acetazolamide