title: Effects of lacunar infarctions on cognitive impairment in patients with cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy.
abstract: OBJECTIVE
  Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited microangiopathy caused by mutations in the Notch3 gene. Although previous studies have shown an association between lacunar infarction and cognitive impairment, the relationship between MRI parameters and cognition remains unclear. In this study we investigated the influence of MRI parameters on cognitive impairment in CADASIL.
  
  
  METHODS
  We applied a prospective protocol to 40 patients. MRI analysis included the normalized volume of white-matter hyperintensities (nWMHs), number of lacunes, and number of cerebral microbleeds. Cognition was assessed with the aid of psychometric tests [Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-cognition (ADAS-cog), Trail-Making Test, and Stroop interference (Stroop IF)].
  
  
  RESULTS
  A multivariate regression analysis revealed that the total number of lacunes influenced the performance in the MMSE, ADAS-cog, and Stroop IF, while nWMHs had a strong univariate association with ADAS-cog and Stroop IF scores. However, this association disappeared in the multivariate analysis.
  
  
  CONCLUSIONS
  These findings demonstrate that the number of lacunes is the main predictive factor of cognitive impairment in CADASIL.
authors.affiliation: Department of Neurology, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Korea. nrlee71@yahoo.co.kr
authors.forename: Jung Seok
authors.initials: JS
authors.lastname: Lee
authors.forename: Jay Chol
authors.initials: JC
authors.lastname: Choi
authors.forename: Sa-Yoon
authors.initials: SY
authors.lastname: Kang
authors.forename: Ji-Hoon
authors.initials: JH
authors.lastname: Kang
authors.forename: Hae Ri
authors.initials: HR
authors.lastname: Na
authors.forename: Ji-Kang
authors.initials: JK
authors.lastname: Park