Clinical and neuroimaging differences of cognitive impairment in CADASIL and dyscirculatory encephalopathy

Аннотация

Introduction. CADASIL is a hereditary cerebral microangiopathy, whereas dyscirculatory encephalopathy represents chronic cerebrovascular insufficiency leading to cognitive impairment. The aim of this study was to comparatively evaluate the clinical and neuroimaging characteristics of cognitive impairment in patients with CADASIL and dyscirculatory encephalopathy. Materials and Methods. A cross-sectional study included 106 participants: 31 patients with CADASIL, 45 patients with dyscirculatory encephalopathy, and 30 healthy controls. All participants underwent clinical and neurological examination, neuropsychological testing, and brain magnetic resonance imaging. White matter lesions were assessed using the Fazekas scale. Results. SDMT scores in the CADASIL group were significantly lower than in the control group (33.8 ± 7.1 vs 48.6 ± 6.3; p < 0.001). In the dyscirculatory encephalopathy group, SDMT scores were 38.9 ± 8.4. White matter lesions of Fazekas grade ≥2 were detected in 74.2% of CADASIL patients and in 51.1% of patients with dyscirculatory encephalopathy (p = 0.03). Anterior temporal pole lesions were observed in 45.2% of CADASIL patients and external capsule lesions in 41.9%, whereas in the dyscirculatory encephalopathy group these findings were 13.3% and 17.8%, respectively (p < 0.05). Conclusion. Cognitive impairment in CADASIL patients was more pronounced compared with dyscirculatory encephalopathy, and MRI more frequently revealed lesions in the anterior temporal pole and external capsule.