AUTHOR=Mukai Mao , Hamano Ai , Mizuta Ikuko , Yokota Isao , Watanabe-Hosomi Akiko , Matsuura Hiraku , Koizumi Takashi , Matsuura Jun , Ohara Tomoyuki , Matsushima Shigenori , Teramukai Satoshi , Yamada Kei , Mizuno Toshiki TITLE=Association between cerebrovasoreactivity and stroke in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy JOURNAL=Frontiers in Neurology VOLUME=13 YEAR=2023 URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.1087220 DOI=10.3389/fneur.2022.1087220 ISSN=1664-2295 ABSTRACT=Background

Impaired cerebrovasoreactivity is thought to play an important role in the pathophysiology of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). We aimed to clarify the association between cerebrovascular reactivity and stroke in patients with CADASIL.

Methods

We retrospectively recruited 14 patients with CADASIL, eight of whom had symptomatic stroke. They underwent quantitative single-photon emission computed tomography using an autoradiographic method at rest and after acetazolamide (ACZ) administration. Regional cerebral blood flow (rCBF) in the cerebral cortex, lenticular nucleus, thalamus, and cerebellum was measured. We compared the rCBF parameters between patients with and without stroke.

Results

The baseline characteristics and magnetic resonance imaging findings were similar between the two groups, except for a higher frequency of pyramidal tract sign (75% vs. 0%) and a larger number of old lacunes (15.4 ± 8.8 vs. 2.2 ± 1.8) in the patients with stroke. Of the rCBF parameters measured, significantly lower flow (mL/100 g/min) was observed in ACZ-rCBF in the thalamus (35.6 ± 9.4 vs. 51.1 ± 7.6, p = 0.01) and ΔrCBF in the thalamus (10.6 ± 3.7 vs. 21.0 ± 7.9, p = 0.02) in the patients with stroke.

Conclusion

Cerebrovasoreactivity in the thalamus was significantly associated with stroke in patients with CADASIL.