Motor cortex cholinergic dysfunction in CADASIL: A transcranial magnetic demonstration

Fiore Manganelli, Michele Ragno, Gabriella Cacchiò, Valeria Iodice, Luigi Trojano, Flavia Silvaggio, Maria Scarcella, Michela Grazioli, Lucio Santoro, Anna Perretti

Research output: Contribution to journalArticlepeer-review


Objective: Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a hereditary small vessel disease responsible for an early onset cognitive impairment. Aim of our study was to test the cortical cholinergic innervation in CADASIL by short latency afferent inhibition (SAI) technique. Methods: We applied SAI in ten CADASIL patients and in ten age-matched normal controls. SAI is a phenomenon observed on motor evoked potential when transcranial magnetic stimulation is delivered after a time ranging from 2 to 8 ms longer than the time needed by the peripheral nerve afferent input to reach the somatosensory cortex. Results: The amount of short latency afferent inhibition was significantly smaller in CADASIL patients than in controls (79.5 ± 21.7% Vs 42.7 ± 14.1% of test size; p <0.001, two tailed Mann-Whitney test). The mean resting motor threshold (RMT) was significantly lower in CADASIL patients than in controls (49.4 ± 14.4% Vs 65.6 ± 15.4%; p = 0.02). Conclusions: We demonstrated by SAI technique a central cholinergic impairment in CADASIL. Significance: SAI could be used to evaluate the cholinergic dysfunction and potentially the efficacy of cholinomimetic therapy in CADASIL.

Original languageEnglish
Pages (from-to)351-355
Number of pages5
JournalClinical Neurophysiology
Issue number2
Publication statusPublished - Feb 2008


  • SAI
  • TMS

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging
  • Neurology
  • Sensory Systems
  • Physiology (medical)


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