Small artery dementia in Japan: Radiological differences between CADASIL, leukoaraiosis and Binswanger's disease

Hidekazu Tomimoto, Ryo Ohtani, Hideaki Wakita, Jin Xi Lin, Masafumi Ihara, Yukio Miki, Fumiko Oshima, Takaho Murata, Kenichi Ishibashi, Toshihiko Suenaga, Toshiki Mizuno

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Abstract

CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy) is a hereditary small artery disease which is phenotypically similar to Binswanger's disease (BD), a nonhereditary form of small artery disease. Recent studies have indicated that lesions in the temporopolar, medial frontopolar areas and external capsule are frequently seen in Caucasian patients with CADASIL. However, it remains unclear whether magnetic resonance (MR) imaging findings are helpful in diagnosing small artery disease outside countries with Caucasian populations, since CADASIL is rare despite the high prevalence of small artery disease in Japan. We examined 58 patients with small artery disease, all of whom were devoid of major vessel occlusion or severe stenosis. These patients included 7 patients from 3 families with CADASIL, 27 nondemented patients with extensive leukoaraiosis (LA) and 24 patients with BD. On T 2-weighted MR images, hyperintensities in the temporopolar areas were observed in all 7 patients with CADASIL, whereas these lesions were observed in only 1 subject from each of the nondemented LA and BD groups. Hyperintensities in the medial frontopolar areas were seen in 4 of the 7 patients with CADASIL (57%) and in 14 of the 24 patients with BD (58%), and were more frequent than in the nondemented LA group (4 of the 27 patients; 15%). In contrast, hyperintensities in the external capsule were frequently observed in all groups. Therefore, temporopolar lesions can also serve as diagnostic markers for CADASIL in non-Caucasian patients.

Original languageEnglish
Pages (from-to)162-169
Number of pages8
JournalDementia and Geriatric Cognitive Disorders
Volume21
Issue number3
DOIs
Publication statusPublished - 01-02-2006
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Geriatrics and Gerontology
  • Cognitive Neuroscience
  • Psychiatry and Mental health

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    Tomimoto, H., Ohtani, R., Wakita, H., Lin, J. X., Ihara, M., Miki, Y., Oshima, F., Murata, T., Ishibashi, K., Suenaga, T., & Mizuno, T. (2006). Small artery dementia in Japan: Radiological differences between CADASIL, leukoaraiosis and Binswanger's disease. Dementia and Geriatric Cognitive Disorders, 21(3), 162-169. https://doi.org/10.1159/000090677