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Quantitative vascular pathology and phenotyping familial and sporadic cerebral small vessel diseases.
[cadasil]
We
quantified
vascular
changes
in
the
frontal
lobe
and
basal
ganglia
of
four
inherited
small
vessel
diseases
(
SVDs
)
including
cerebral
autosomal
dominant
arteriopathy
with
subcortical
infarcts
and
leukoencephalopathy
(
CADASIL
)
,
pontine
autosomal
dominant
microangiopathy
and
leukoencephalopathy
(
PADMAL
)
,
hereditary
multi-infarct
dementia
of
Swedish
type
(
Swedish
hMID
)
,
and
hereditary
endotheliopathy
with
retinopathy
,
nephropathy
,
and
stroke
(
HERNS
)
.
Vascular
pathology
was
most
severe
in
CADASIL
,
and
varied
with
marginally
greater
severity
in
the
basal
ganglia
compared
to
the
frontal
lobe
.
The
overall
sclerotic
index
values
in
frontal
lobe
were
in
the
order
CADASIL
 
≥
 
HERNS
 
>
 
PADMAL
 
>
 
Swedish
hMID
 
>
 
sporadic
SVD
,
and
in
basal
ganglia
CADASIL
 
>
 
HERNS
 
>
 
Swedish
hMID
 
>
 
PADMAL
>
sporadic
SVD
.
The
subcortical
white
matter
was
almost
always
more
affected
than
any
gray
matter
.
We
observed
glucose
transporter-
1
(
GLUT-
1
)
protein
immunoreactivities
were
most
affected
in
the
white
matter
indicating
capillary
degeneration
whereas
collagen
IV
(
COL
4
)
immunostaining
was
increased
in
PADMAL
cases
in
all
regions
and
tissue
types
.
Overall
,
GLUT-
1
 
:
 
COL
4
ratios
were
higher
in
the
basal
ganglia
indicating
modifications
in
capillary
density
compared
to
the
frontal
lobe
.
Our
study
shows
that
the
extent
of
microvascular
degeneration
varies
in
these
genetic
disorders
exhibiting
common
end-
stage
pathologies
but
is
the
most
aggressive
in
CADASIL
.
Diseases
Validation
Diseases presenting
"dementia"
symptom
adrenomyeloneuropathy
alexander disease
cadasil
canavan disease
carcinoma of the gallbladder
cushing syndrome
gm1 gangliosidosis
hereditary cerebral hemorrhage with amyloidosis
homocystinuria without methylmalonic aciduria
hydrocephalus with stenosis of the aqueduct of sylvius
inclusion body myositis
phenylketonuria
sneddon syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated