Lenticulostriate Arteries and Basal Ganglia Changes in Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy, a High-Field MRI Study

Abstract

Background and Purpose: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) mainly affects the cerebral small arteries. We aimed to analyze changes in the lenticulostriate arteries (LSAs) and the basal ganglia in patients with CADASIL using high-field magnetic resonance imaging (7.0-T MRI). Methods: We examined 46 patients with CADASIL and 46 sex- and age-matched healthy individuals using 7.0-T MRI. The number and length of the LSAs, and the proportion of discontinuous LSAs were compared between the two groups. The Mini-Mental State Examination score, the modified Rankin Scale, the Barthel Index, and the MRI lesion load of the basal ganglia were also examined in patients with CADASIL. We analyzed the association between LSA measurements and the basal ganglia lesion load, as well as the association between LSA measurements and clinical phenotypes in this patient group. Results: We observed a decrease in the number of LSA branches ( t = −2.591, P = 0.011), and an increase in the proportion of discontinuous LSAs ( z = −1.991, P = 0.047) in patients with CADASIL when compared with healthy controls. However, there was no significant difference in the total length of LSAs between CADASIL patients and healthy individuals ( t = −0.412, P = 0.682). There was a positive association between the number of LSA branches and the Mini-Mental State Examination scores of CADASIL patients after adjusting for age and educational level (β = 0.438; 95% CI: 0.093, 0.782; P = 0.014). However, there was no association between LSA measurements and the basal ganglia lesion load among CADASIL patients. Conclusions: 7.0-T MRI provides a promising and non-invasive method for the study of small artery damage in CADASIL. The abnormalities of small arteries may be related to some clinical symptoms of CADASIL patients such as cognitive impairment. The lack of association between LSA measurements and the basal ganglia lesion load among the patients suggests that changes in the basal ganglia due to CADASIL are caused by mechanisms other than anatomic narrowing of the vessel lumen.

Compressed Sensing Algorithm-Based Magnetic Resonance Imaging Guided for Prognosis of Early Neurological Deterioration after Intravenous Thrombolysis in Ischemic Stroke Patients

“…CS-MRI on the head is an effective measure to evaluate cerebrovascular diseases, and the diagnosis of cerebral infarction is more sensitive than CT. Studies have reported that the incidence of basal ganglia infarction in stroke Scientific Programming patients was lower in deteriorating patients than in nondeteriorating patients, and the incidence of watershed infarction in deteriorating patients was higher than that in nondeteriorating patients [16]. is study found that basal ganglia infarction was more common in the nondeteriorating group, and internal watershed infarction was more common in the deteriorating group.…”

A Processing Pipeline for Quantifying Lenticulostriate Artery Vascular Volume in Subcortical Nuclei

“…However, the analysis tools of LSAs, particularly the quantitative characterization, are still limited. In most studies, the number of LSA stems and branches arising from the first segment of the bilateral ACAs and MCAs are counted manually (7,9,12). Some studies have measured the angles, lengths, and curvatures of the longest LSAs on 2D maximum intensity projection (MIP) images (6,13,14) or 3D extracted vessels (15,16).…”

“…In addition, LSA orifices (8) and vascular densities obtained with rough threshold segmentations (17) have also been proposed. However, due to morphologic variations in LSA structures, these quantification methods have poor sensitivity and stability in being able to evaluate patient groups and sometimes have led to controversial clinical study results (12,18).…”

Altered Regional Brain Homogeneity of BOLD Signal in CADASIL: A Resting State fMRI Study

“…12,13 Several studies have reported a correlation between quantitative assessment of a variety of structural brain damage measurements and cognitive decline in CADASIL gene carriers. The former include the overall burden of lacunar infarcts, 14,15 brain atrophy, 8,16 thinning of the corpus callosum, 17 severity or extent of WM or thalamic damage evaluated in T 2 -weighted or diffusion tensor images, 4,6,7,[18][19][20] the number and continuity of lenticulostriate arteries, 21 and deep gray matter (GM) iron deposition. 22 Functional MRI (fMRI), exploiting the blood oxygenation level dependent (BOLD) contrast, is sensitive to hemodynamic changes and has been applied to CADASIL patients during the execution of motor, 23,24 visual 23 and cognitive 25 tasks.…”

“…Several studies have reported a correlation between quantitative assessment of a variety of structural brain damage measurements and cognitive decline in CADASIL gene carriers. The former include the overall burden of lacunar infarcts, 14,15 brain atrophy, 8,16 thinning of the corpus callosum, 17 severity or extent of WM or thalamic damage evaluated in T 2 ‐weighted or diffusion tensor images, 4,6,7,18–20 the number and continuity of lenticulostriate arteries, 21 and deep gray matter (GM) iron deposition 22 …”