Cadasil Clinical Trial
Official title:
Développement de Nouveaux Biomarqueurs en Imagerie Par résonance magnétique Pour Les études Longitudinales Dans l'Angiopathie CADASIL
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.
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