CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy) is an cerebral microangiopathy secondary to mutations in the NOTCH3 gene located on chromosome 19. This disease is the most frequent of the hereditary vascular leukoencephalopathies. CADASIL begins between the ages of 20 and 40 with the appearance of hyper-signs of brain white matter visible on T2 sequences in magnetic resonance imaging (MRI). Before the age of 30, patients are most often asymptomatic. The disease is then responsible for different neurological manifestations: 1. Migraine attacks with aura occur on average in one in three patients, most often at the beginning of the course of the disease, sometimes even before the appearance of MRI abnormalities; 2. Transient ischemic strokes or strokes associated with small cerebral infarcts occur most frequently after the age of 50-60 years in more than two out of three patients; 3. Mood disorders are reported by one in three patients in the same age group; 4. Cognitive disorders that affect executive functions, especially after the age of 60, until the stage of severe dementia associated with walking disorders are observed during the course of the disease. To date, there is no treatment whose efficacy has been proven in CADASIL. Various studies have shown that the accumulation of the most destructive brain tissue lesions at the subcortical level was closely correlated in CADASIL with the clinical severity of patients (motor and cognitive disability). It is now possible to measure microstructural changes in brain tissue in diffusion imaging during the course of the disease, even before significant clinical changes are detected.
Study Type
OBSERVATIONAL
Enrollment
80
Cerebral Magnetic resonance imaging (MRI) 3 Tesla at Inclusion Cerebral Magnetic resonance imaging (MRI) 3 Tesla at Month 1 Cerebral Magnetic resonance imaging (MRI) 3 Tesla at Year 1
Lariboisiere hospital
Paris, France
RECRUITINGIntra-axonal
Intra-axonal volume fraction
Time frame: 1 year
Extra-axonal
Extra-axonal volume fraction
Time frame: 1 year
Intra-myelinic edema
Volume fraction of intra-myelinic edema
Time frame: 1 year
Microvascular compartment fraction measured using diffusion MRI (IVIM)
Measures of the Flowing blood volume fraction (corresponding to slow intra-voxel incoherent motion (IVIM) of water molecules in the cerebral microvasculature at voxel level)
Time frame: 1 year
variation
Overall variation of cerebral blood flow over 20 and 40 seconds stimulations (area under a curve)
Time frame: 1 year
blood flow
Maximum cerebral blood flow measured over 20 and 40 seconds stimulations
Time frame: 1 year
Slope
Slope of the regression curve when cerebral blood flow is measured 15 and 35 seconds after the onset of the stimulation
Time frame: 1 year
Dynamics of the cerebral blood
Dynamics of the cerebral blood flow curve between 15 and 35 seconds (model with dual component responses; fast (before 20 seconds) and slow (after 20 seconds))
Time frame: 1 year
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.