title: White-matter lesions without lacunar infarcts in CADASIL.
abstract: To better characterize the clinical spectrum related to white-matter hyperintensities (WMH) in small vessel disease, 66 patients with WMH but without any lacunar infarct were selected out of a cohort of 248 CADASIL individuals. Characteristics of these patients were compared to those of patients with lacunar infarcts. Relationships between the normalized volume of WMH (nWMH), presence of microhemorrhages, brain parenchymal fraction (BPF). and cognitive performances were assessed. The Trail Making Test (TMT) A and B times, Mattis Dementia Rating Scale (MDRS) total score, attention subscore, verbal fluency score and delayed memory recall were significantly correlated with nWMH but not with BPF. Presence of microhemorrhages was associated with worse TMT B time and attention MDRS subscore after adjustment for WMH. All subjects had Mini-Mental Status Examination scores ≥24 and presented with no or only mild disability. These results suggest that CADASIL patients with isolated WMH can present with executive and attention deficit but not with severe disability and that additional lesions are needed to cause significant disability and/or dementia.
authors.affiliation: Department of Geriatrics , Lariboisière-Fernand Widal Hospital, AP-HP, Paris Denis Diderot University, Paris, France.
authors.forename: Sarah
authors.initials: S
authors.lastname: Benisty
authors.forename: Sonia
authors.initials: S
authors.lastname: Reyes
authors.forename: Ophelia
authors.initials: O
authors.lastname: Godin
authors.forename: Dominique
authors.initials: D
authors.lastname: Hervé
authors.forename: Nikola
authors.initials: N
authors.lastname: Zieren
authors.forename: Eric
authors.initials: E
authors.lastname: Jouvent
authors.forename: Yicheng
authors.initials: Y
authors.lastname: Zhu
authors.forename: Marco
authors.initials: M
authors.lastname: During
authors.forename: Martin
authors.initials: M
authors.lastname: Dichgans
authors.forename: Hugues
authors.initials: H
authors.lastname: Chabriat
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology*; D046589:CADASIL / Q000150:complications / Q000473:pathology*; D003072:Cognition Disorders / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D011569:Psychiatric Status Rating Scales; D059409:Stroke, Lacunar / Q000473:pathology; D014145:Trail Making Test; D055815:Young Adult