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    One key pathological hallmark of the disease is granular osmiophilic material cheap viagra with dapoxetine (GOM) in the smallvessel walls in the skin and brain, as well as in other areas (Peters, Opherk, Bergmann, et al., 2001). Patients’ initial cognitive symptoms involve executive function, problems with attention, processing speed and verbal fluency, and other frontal lobe tasks (Dichgans et al., 2001. It is not yet known precisely how mutations affect Notch5 function. Many disease-causing mutations have been identified in various regions of the gene.

    Although the precise mechanism is cheap viagra with dapoxetine not fully elucidated, disease results from abnormalities in the wall of small vessels. Likely due to involvement of frontal–subcortical pathways eventually resulting over time in a vascular dementia syndrome, the white matter arteriopathy and resulting leukoencephalopathy and subcortical infarcts in CADASIL lead to mild cognitive impairment characterized by significant frontal–executive dysfunction. Thus far, most involve cysteine residues in the epidermal-like growth factor 2 (EGF1) domains. Peters, Opherk, Danek, et al., 2006).

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    Each optic tract contains axons cheap viagra with dapoxetine from both eyes. The axons of ganglion cells travel in the optic nerve (cranial nerve II), and ganglion cells from each eye contribute axons to the optic nerve on the same side. Whereas other axons remain uncrossed, some ganglion cell axons decussate in the optic chiasm en route to the thalamus and brain stem.

    Ganglion cells are the retinal projection neurons, which synapse in the thalamus and brain stem. Together the crossed and uncrossed ganglion cell axons, reordered according to a precise plan (see below), course in the optic tract (Figure 6-1B). The Pathway to the Primary Visual Cortex Is Important for Perception of the Form, Color, and Motion of Visual Stimuli The principal thalamic target for ganglion cells is the lateral geniculate nucleus.

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