Can CADASIL alter personality?
Sometimes the cognitive problems in CADASIL can result in an apparent alteration in personality. It can make the sufferer lose motivation and interest in their previous activities; this is called apathy. Sometimes they can make the sufferer appear less tolerant and become angry more easily. These symptoms can be distressing for both the CADASIL patient and their family. Similar symptoms can also be produced by depression and therefore it is important to ask your doctor if they could be due to depression because this can respond to treatment.
In what way is CADASIL dementia different from Alzheimer’s disease?
CADASIL can cause cognitive problems and dementia by damaging the white matter in the brain through which pathways run connecting different regions of the brain. It therefore causes what we call a “disconnection syndrome” in which complex networks in the brain are disrupted. This tends to produce symptoms such as slowing of brain processes, and also difficulty in planning or multi-tasking. Sometimes attention is also affected. Memory problems can occur but are not such a prominent early feature of the disease.
In contrast, Alzheimer’s disease affects the cortex (outer surface) of the brain and tends to produce prominent memory and orientation problems earlier in the disease.
Can CADASIL affect libido?
Many diseases including CADASIL can affect libido when the disease becomes severe. Libido can also be greatly affected by psychological consequences of disease such as anxiety and depression. Therefore if you suffer from this symptom it is worth asking your doctor because if it is due to anxiety or depression treating this can improve libido.