Abstract Background and aims CADASIL is the most common genetic cause of dementia. MRI features include white matter hyperintensities, lacunes and microbleeds. CMBs have not consistently correlated with disease severity and very extensive CMBs can exist with minimal symptoms or other radiological features. We investigated the clinical and radiological associations of cerebral microbleeds in CADASIL. Methods Cases had genetically confirmed CADASIL. Routine MRIs (1.5 or 3T) were reviewed. CMB counts were derived from GE or SWI sequences (SWI preferred if both available), white-matter hyperintensity volumes and lacunes from T2 FLAIR. Clinical and radiological features were compared across groups based on CMB count (no CMBs; 1 to 3 CMBs; and 3 CMBs). Results There were 88 participants, 60 (68.2%) with no microbleeds, 14 (15.9%) with few microbleeds and 14 (15.9%) with many microbleeds. The high CMBs group (median 7.5 IQR 4.75 to 16.25, maximum 38) had numerically higher levels of hypertension, history of stroke, depression and more advanced NOTCH3-SVD stage. There was a trend for smoking to be associated with fewer CMBs. CMBs correlated closely with other small vessel disease markers of lacunes and white matter hyperintensity volume. Conclusions Higher CMB count was associated with other markers of greater radiological severity in CADASIL. Potential clinical risk factors did not differ clearly across groups. Conflict of interest Sam Neilson: nothing to disclose, Keith Muir; nothing to disclose Table 1 - belongs to Results
Neilson et al. (Fri,) studied this question.