Şanli Zeynep Selcan, Anlaş Özlem
Department of Neurology, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey.
Department of Medical Genetics, Çiğli Training and Research Hospital, Bakırçay University, Izmir, Turkey.
Mol Syndromol. 2024 Mar;15(2):89-95. doi: 10.1159/000534243. Epub 2023 Oct 20.
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common form of familial cerebral small vessel disease in adults and is caused by variants. Clinical manifestations of CADASIL include recurrent ischemic strokes, dementia, migraine or migraineous headaches, epileptic seizures, and psychiatric disorders. The clinical-radiological phenotype of the disease is also highly variable. In this study, we investigated the variability of clinical, radiological, and genetic data in patients analyzed for variant in our clinic.
We performed clinical and neuropsychological examination, cerebral magnetic resonance imaging (MRI) and Doppler sonography of cerebral arteries in all patients. Next-generation sequencing test was used for detect variants in gene from all CADASIL patients.
By using the next-generation sequencing method, heterozygous c.380C>T pathogenic variant was detected in the 4th exon of the gene in 3 patients. This is a previously unreported novel variant and resulted in the replacement of the amino acid Proline at 127th position with Leucine.
The discovery of this novel pathogenic variant region may contribute to the expansion of the clinical and genetic spectrum of diseases associated with NOTCH3, leading to further research and treatment options for this disease in the future.
大脑常染色体显性动脉病伴皮质下梗死和白质脑病(CADASIL)是成人家族性脑小血管病最常见的形式,由变异引起。CADASIL的临床表现包括复发性缺血性中风、痴呆、偏头痛或偏头痛样头痛、癫痫发作和精神障碍。该疾病的临床放射学表型也高度可变。在本研究中,我们调查了在我们诊所分析 变异的患者的临床、放射学和基因数据的变异性。
我们对所有患者进行了临床和神经心理学检查、脑磁共振成像(MRI)和脑动脉多普勒超声检查。采用新一代测序试验检测所有CADASIL患者 基因中的变异。
通过新一代测序方法,在3例患者的 基因第4外显子中检测到杂合子c.380C>T致病变异。这是一个先前未报道的新变异,导致第127位的脯氨酸被亮氨酸取代。
这一新的致病变异区域的发现可能有助于扩大与NOTCH3相关疾病的临床和基因谱,为未来该疾病的进一步研究和治疗选择提供依据。