1,781 results match your criteria: "CADASIL Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy"

Determining Clinical Disease Progression in Symptomatic Patients With CADASIL.

Neurology

January 2025

From the ARAMIS (S.K., S.T.D.M.), Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Groupe Hospitalier Sorbonne Université; Centre de référence pour les maladies vasculaires rares du cerveau et de l'œil (CERVCO) and Centre Neurovascular Translationnel (CNVT) (D.H., A.J., S.R., C.M., S.G., A.T., F.F., H.C.), AP-HP, Paris; and INSERM U1141 - FHU NeuroVasc (D.H., S.G., H.C.), Université Paris Cité, France.

Background And Objectives: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most frequent small artery brain disease caused by pathogenic variants of the NOTCH3 gene. During the disease, we still do not know how the various deficits progress and develop with each other at different stages of the disease. We aim to model disease progression and identify possible progressive subgroups and the effects of different covariates on clinical worsening.

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Introduction: The NOTCH3 gene encodes for an evolutionarily conserved protein, whose functions encompass both embryonic cell proliferation and adult tissue-specific differentiation. Among others, a pivotal role in maintaining functional integrity of neurovascular unit (NVU) is supported by the association of several NOTCH3 gene mutations with neuroimaging markers of cerebral small vessel disease (SVD). Indeed, a pathogenic role of NOTCH3 is recognised in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL).

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This report describes the case of a 48-year-old Japanese man with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) who also presented with aortic dissection. The patient had a history of hypertension, diabetes mellitus, dyslipidemia, and mild renal failure but had not received any treatment. He developed back pain and was diagnosed with type A aortic dissection via contrast-enhanced chest computed tomography (CT).

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Article Synopsis
  • NOTCH3cys variants are common and linked to various small vessel diseases, including early-onset stroke and dementia, but there is no comprehensive staging system to assess their severity.
  • A cohort study created and validated a simple staging system for NOTCH3-SVD by analyzing data from several international cohorts and the UK Biobank, focusing on the impact of these variants on CVD outcomes and cognition.
  • The new system includes 9 disease stages, aiding in understanding the relationship between stages and clinical outcomes like ischemic strokes, cognitive function, and brain damage.
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Introduction: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common hereditary cerebral small vessel disease with slow natural progression. Ischemic stroke and cognitive impairment are its most common clinical symptoms. Here, we report a rare 50-year-old woman who had rapid disease progression with c.

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Input of exome sequencing in early-onset cerebral amyloid angiopathy.

Alzheimers Dement (Amst)

November 2024

Department of Neurology and CNRMAJ Univ Rouen Normandie Rouen France.

Article Synopsis
  • The study explores the genetics of cerebral amyloid angiopathy (CAA), which is not widely researched and can impact the understanding of Alzheimer's disease (AD).
  • Researchers conducted exome sequencing on 78 patients diagnosed with early-onset CAA, finding notable genetic variants, including pathogenic NOTCH3 mutations in two patients related to CADASIL, a rare vascular condition.
  • The findings suggest that there are shared genetic factors between AD and CAA beyond just the APOE gene, with potential susceptibility linked to other rare genetic variants in various risk factor genes.
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Fabry Disease: A Rare Mutation With Common Clinical Presentation.

Cureus

October 2024

Internal Medicine, Unidade Local de Saúde de Trás-os-Montes e Alto Douro, Chaves, PRT.

Strokes are infrequent in younger adults, making diagnosis of their underlying causes challenging. Fabry disease, a rare genetic condition with a complex and not fully understood pathophysiology, is one potential cause. This report describes a 41-year-old woman with a history of glaucoma, recurrent uveitis, ischemic stroke affecting the posterior circulation, and sensorineural hearing loss.

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Article Synopsis
  • The study aimed to evaluate relationships between three key cerebrovascular functions (blood-brain barrier permeability, vascular pulsatility, and cerebrovascular reactivity) in patients with cerebral small vessel diseases (SVD), including both sporadic cases and a genetic condition known as CADASIL.
  • Researchers used advanced brain imaging techniques to analyze these functions in a group of 77 patients, assessing how they relate to SVD severity, subtype, and specific brain changes.
  • Findings revealed that worse white matter hyperintensity (WMH) was linked to lower cerebrovascular reactivity and blood plasma volume fraction, with the type of SVD having little impact on these vascular functions after accounting for WMH severity.
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Changes in the prognosis of CADASIL over time: a 23-year study in 555 individuals.

J Neurol Neurosurg Psychiatry

November 2024

Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, Cambridgeshire, UK

Article Synopsis
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Clonal hematopoiesis (CH) is nearly universal in the elderly. The molecular and cellular mechanisms driving CH and the clinical consequences of carrying clonally derived mutant mature blood cells are poorly understood. We recently identified a C223Y mutation in the extracellular domain (ECD) of NOTCH3 as a putative CH driver in mice.

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This case report describes a 32-year-old male with a familial history of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), presenting with right-sided weakness and visual disturbances. The symptoms, consistent with a transient ischemic attack (TIA), resolved spontaneously. Subsequent evaluation, including MRI brain imaging, revealed a high T2 signal in subcortical white matter in the frontal and parietal lobes, consistent with CADASIL.

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Quantitative modeling of lenticulostriate arteries on 7-T TOF-MRA for cerebral small vessel disease.

Eur Radiol Exp

November 2024

State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, 100101, Beijing, China.

Article Synopsis
  • Researchers created a framework to segment and model lenticulostriate arteries using advanced MRI techniques, specifically targeting patients with CADASIL and comparing them to healthy controls.
  • The framework involves a small-patch convolutional neural network for accurate segmentation, supported by a random forest model for further analysis, with performance evaluated against manual segmentation methods.
  • Results showed that the framework achieved high accuracy in artery measurements, demonstrating better reliability than manual methods, suggesting it could be beneficial for diagnosing and studying CADASIL.
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Background: Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) represents the most common heritable cause of vascular dementia. Subcortical volumes might be proxies of brain reserve capacity and reflective of cognitive function. We explored the impact of subcortical volumes on cognition in CADASIL patients.

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Modifiable vascular risk factors for outcomes in patients with CADASIL: A literature review and meta-analysis of cross-sectional analyzes.

J Stroke Cerebrovasc Dis

October 2023

Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China. Electronic address:

Objective: To investigate the association between outcomes of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) and common modifiable vascular risk factors.

Methods: Studies published between 1993 and February 2023 from PubMed, Embase, Cochrane, CNKI, and WanFang, along with their references, were systematically examined. Cross-sectional analyzes in patients with CADASIL with information on modifiable cerebrovascular risk factors and outcomes were included.

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Rationale: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited cerebrovascular disease caused by the neurogenic locus notch homolog protein 3 (NOTCH3) gene mutation. In recent years, most of the newly reported mutations of CADASIL patients mainly occur in exon 3 to 24, while the cases related to exon 2 mutation are rare, and clinical research data are relatively insufficient. In this study, we have reported a case of a rare heterozygous mutation c.

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Study protocol for LOMCAD Trial: Effect of lomerizine hydrochloride to prevent recurrence of cerebral ischemic events in CADASIL patients.

J Stroke Cerebrovasc Dis

December 2024

Division of Data Science, The Clinical and Translational Research Center, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Objectives: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is one of the most common monogenic cerebral small vessel diseases. Our previous observational study suggested that lomerizine hydrochloride, a calcium channel blocker approved in Japan in 1999 for the prevention of migraine headaches, is also effective for preventing recurrent ischemic stroke in CADASIL patients. The aim of this study (LOMCAD trial) is to verify the efficacy of lomerizine hydrochloride.

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Article Synopsis
  • A study investigated the characteristics of asymptomatic diffusion-weighted imaging-positive (aDWI+) lesions in CADASIL patients, using data from the Taiwan CADASIL Registry.
  • Out of 154 patients, 11% had aDWI+ lesions, which were linked to a higher prevalence of small vessel disease markers, like lacunes and cerebral microbleeds, compared to patients without these lesions.
  • The research found that aDWI+ lesions were smaller and less likely to impact critical brain areas compared to symptomatic diffusion-weighted imaging-positive (sDWI+) lesions, highlighting the need for further investigation into their long-term effects.
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White Matter Hyperintensities and Cognitive Functions in People With the R544C Variant of the Gene Without Stroke or Dementia.

Neurology

November 2024

From the Department of Post-Baccalaureate Medicine (H.T., C.-C.C., Y.-M.C., W.-J.L.), College of Medicine, National Chung Hsing University; Center of Faculty Development (H.T.), Department of Medical Education, and Department of Neurology (H.T., W.-J.L.), Neurological Institute, Taichung Veterans General Hospital; Graduate Institute of Clinical Medicine (C.-C.C.), College of Medicine, National Taiwan University, Taipei; Department of Ophthalmology (C.-C.C.), Taichung Veterans General Hospital; School of Medicine (C.-C.C., Y.-M.C., H.-C.C.), National Yang Ming Chiao Tung University, Taipei; Center for Quantitative Imaging in Medicine (H.-M.C.), Department of Medical Research, Division of Allergy, Immunology and Rheumatology (Y.-M.C.), Department of Internal Medicine, and Department of Medical Research (Y.-M.C.), Taichung Veterans General Hospital; Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine & Program in Translational Medicine (Y.-M.C.), and Precision Medicine Research Center (Y.-M.C.), College of Medicine, National Chung Hsing University, Taichung; Department of Radiology (Y.-Y.W., J.-W.C., H.-C.C.), Taichung Veterans General Hospital; Department of Electrical Engineering (Y.-Y.W.), National Chung Hsing University, Taichung; Biostatistics Task Force of Taichung Veterans General Hospital (J.-P.C.), Taichung; Institute of Statistical Science (S.-C.C.), Academia Sinica, Taipei; Dementia Center (W.-J.L.), Taichung Veterans General Hospital; and Brain Research Center (W.-J.L.), National Yang Ming Chiao Tung University, Taipei, Taiwan.

Article Synopsis
  • The study focused on R544C variant carriers in Taiwan who have CADASIL, investigating if white matter hyperintensities (WMHs) appear before symptoms and how these WMHs relate to cognitive function.
  • It included 63 asymptomatic R544C carriers and 37 controls, revealing that the carriers had significantly higher WMH volumes and cognitive scores were lower, especially after age 48.
  • Factors linked to increased WMH volumes were identified as age, hypercholesterolemia, and a vascular risk factor index, with a notable association between WMHs and cognitive performance.
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Objective: To assess the prevalence, timing, and functional impact of neuropsychiatric symptoms in patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) and to assess whether these neuropsychiatric symptoms are associated with magnetic resonance imaging (MRI) features of the patients.

Methods: Our study included a total of 78 patients with CADASIL. To assess neuropsychiatric symptoms, we evaluated the caregivers using the Neuropsychiatric Inventory (NPI).

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Monogenic causes of cerebral small vessel disease and stroke.

Handb Clin Neurol

September 2024

Translational Centre for Neurovascular Disorders, Hôpital Lariboisière AP-HP, Paris, France; Paris-Cité University, Inserm U1141 NeuroDiderot, Paris, France.

Article Synopsis
  • * Key indicators for genetic screening include early onset of the disease, family history, and a significant presence of cSVD imaging markers despite a low vascular risk profile.
  • * Currently, there are several known genes associated with Mendelian cSVDs, but less than 15% of patients with suspected genetic issues have identified pathogenic variants, indicating that more genetic factors are likely yet to be discovered.
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