Association of Systemic Immune-Inflammation Index with Cognitive Impairment and Magnetic Resonance Imaging Markers in Patients with CADASIL

ABSTRACT Background Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a monogenic hereditary cerebral small vessel disease (CSVD). Existing studies have confirmed that it is caused by mutations in the NOTCH3 gene, but the specific mechanisms underlying its pathogenesis and progression remain elusive. Existing research indicates that inflammation plays a critical role in the development and progression of CSVD. The Systemic Immune-Inflammation Index (SII) has revealed to be a reliable new marker to assess immune status and inflammatory response intensity. This study reveals the relationship of SII with cognitive impairment and magnetic resonance imaging (MRI) markers of CSVD in patients with CADASIL. Methods This cross-sectional investigate included patients diagnosed with CADASIL who had confirmed NOTCH3 gene mutations and complete clinical data. Cognitive function in patients with CADASIL was appraised by the Mini-Mental State Examination (MMSE). SII is obtained by calculating the number of platelets, neutrophils and lymphocytes in blood routine examination. Summary SVD score and imaging markers of CSVD, including cerebral microbleeds, lacunae, white enlarged perivascular space and matter hyperintensity were evaluated based on magnetic resonance imaging. The association between cognitive impairment and SII and MRI markers in CADASIL were evaluated using logistic regression models and Spearman correlation. Results At baseline, A total of 96 Patients with CADASIL were enrolled in this cross-sectional study. the median age of patients with CADASIL was 59.00 (interquartile range 52.25-66.75) years, and 58.3% of patients were male. The correlation analysis results indicate that the SII level was negatively correlated with MMSE scores in patients with CADASIL (rs=-0.336, P