Changes in Cerebral Small Vessel Density and Hemodynamics in CADASIL Patients Revealed by high-resolution Black-Blood MRI and Multi-Delay pCASL

Motivation: CADASIL causes reduction in small vessels, disrupted cerebral hemodynamics, and cognitive impairments. Their interrelations remain unclear. Goal(s): To evaluate changes in cerebral small vessel density and cerebral hemodynamics including CBF, ATT, and their contribution to cognitive impairments in CADASIL patients. Approach: 29 CADASIL patients and 33 healthy controls underwent 5-PLD pCASL and high-resolution black blood MRI. Alterations in ATT, CBF, and small vessel density, and their relationships with cognitive performance were assessed. Results: significant reductions in small vessel density and CBF, along with prolonged ATT, were observed across multiple brain regions in CADASIL patients. Similar changes are also associated with poor cognitive ability. Impact: This study employed a high-resolution black blood MRI alongside 5-PLD pCASL to offer comprehensive assessments of the alterations of cerebral small vessel density and hemodynamics and their relationships with cognitive impairments in CADASIL patients.