1
|
Wang J, Wang Y, Cai X, Xia W, Zhu J. A Review: Visuospatial Dysfunction in Patients with the Cerebral Small Vessel Disease. Neuroscience 2024; 552:47-53. [PMID: 38880241 DOI: 10.1016/j.neuroscience.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 06/06/2024] [Accepted: 06/10/2024] [Indexed: 06/18/2024]
Abstract
Cerebral small vessel disease (CSVD) impairs visuospatial function, and this is one of the most obvious areas of cognitive impairment in CSVD. So, recognizing, monitoring, and treating visuospatial dysfunction are all important to the prognosis of CSVD. This review discussed the anatomical and pathological mechanisms, clinical recognition (scales, imaging, and biomarkers), and treatment of cognitive impairment especially visuospatial dysfunction in CSVD.
Collapse
Affiliation(s)
- Jiaxing Wang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Youmeng Wang
- Department of Neurology, Fuyang People's Hospital, Fuyang, China
| | - Xiuying Cai
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Wei Xia
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, China.
| | - Juehua Zhu
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China.
| |
Collapse
|
2
|
Saks DG, Bajorek B, Catts VS, Bentvelzen AC, Jiang J, Wen W, Mather KA, Thalamuthu A, Huang-Lung J, Nivison-Smith L, Griffiths LR, Smith RA, Sexton A, James P, Jayasena T, Poljak A, Hansra GK, Hosoki S, Park A, Hillenbrand CM, van Wijngaarden P, Chander RJ, Humphrey S, Chen R, Kochan NA, Helman TJ, Levi C, Brodtmann A, O'Sullivan MJ, Markus R, Butcher K, Parsons M, Kovacic JC, Sachdev PS. The protocol for an observational Australian cohort study of CADASIL: The AusCADASIL study. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2024; 6:100225. [PMID: 38841148 PMCID: PMC11152887 DOI: 10.1016/j.cccb.2024.100225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/09/2024] [Accepted: 05/14/2024] [Indexed: 06/07/2024]
Abstract
Introduction Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a rare genetic condition with a broad phenotypic presentation. This study aims to establish the first Australian cohort of individuals affected by CADASIL (AusCADASIL) and examine its clinical features and longitudinal course, and to investigate neuroimaging and blood biomarkers to assist in early diagnosis and identify disease progression. Methods Participants will be recruited from six study centres across Australia for an observational study of CADASIL. We aim to recruit 150 participants with diagnosed CADASIL, family history of CADASIL or suspected CADASIL symptoms, and 150 cognitively normal NOTCH3 negative individuals as controls. Participants will complete: 1) online questionnaires on medical and family history, mental health, and wellbeing; 2) neuropsychological evaluation; 3) neurological examination and brain MRI; 4) ocular examination and 5) blood sample donation. Participants will have annual follow-up for 4 years to assess their progression and will be asked to invite a study partner to corroborate their self-reported cognitive and functional abilities.Primary outcomes include cognitive function and neuroimaging abnormalities. Secondary outcomes include investigation of genetics and blood and ocular biomarkers. Data from the cohort will contribute to an international consortium, and cohort participants will be invited to access future treatment/health intervention trials. Discussion AusCADASIL will be the first study of an Australian cohort of individuals with CADASIL. The study will identify common pathogenic variants in this cohort, and characterise the pattern of clinical presentation and longitudinal progression, including imaging features, blood and ocular biomarkers and cognitive profile.
Collapse
Affiliation(s)
- Danit G. Saks
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, 2052, Australia
| | - Beata Bajorek
- Heart and Stroke Program, Hunter Medical Research Institute, Newcastle, 2305, Australia
- Pharmacy Department, John Hunter Hospital, Newcastle, 2305, Australia
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, 2308, Australia
| | - Vibeke S. Catts
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, 2052, Australia
| | - Adam C. Bentvelzen
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, 2052, Australia
| | - Jiyang Jiang
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, 2052, Australia
| | - Wei Wen
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, 2052, Australia
| | - Karen A. Mather
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, 2052, Australia
| | - Anbupalam Thalamuthu
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, 2052, Australia
| | - Jessie Huang-Lung
- School of Optometry and Vision Science, University of New South Wales, Sydney, 2052, Australia
| | - Lisa Nivison-Smith
- School of Optometry and Vision Science, University of New South Wales, Sydney, 2052, Australia
| | - Lyn R. Griffiths
- Genomics Research Centre, Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, 4059, Australia
| | - Robert A. Smith
- Genomics Research Centre, Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, 4059, Australia
| | - Adrienne Sexton
- Genomic Medicine, Royal Melbourne Hospital, Melbourne, 3052, Australia
| | - Paul James
- Genomic Medicine, Royal Melbourne Hospital, Melbourne, 3052, Australia
| | - Tharusha Jayasena
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, 2052, Australia
| | - Anne Poljak
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, 2052, Australia
- Bioanalytical Mass Spectrometry Facility, University of New South Wales, Sydney, 2052, Australia
| | - Gurpreet K. Hansra
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, 2052, Australia
| | - Satoshi Hosoki
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, 2052, Australia
| | - Ashley Park
- Department of Neurology, Royal Melbourne Hospital, Melbourne, 3052, Australia
| | | | - Peter van Wijngaarden
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, 3002, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, 3052, Australia
| | - Russell J. Chander
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, 2052, Australia
| | - Sam Humphrey
- Department of Neurology, Royal Melbourne Hospital, Melbourne, 3052, Australia
| | - Rory Chen
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, 2052, Australia
| | - Nicole A. Kochan
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, 2052, Australia
| | - Tessa J. Helman
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, 2052, Australia
| | - Christopher Levi
- School of Medicine and Public Health, University of Newcastle, Newcastle, 2308, Australia
- John Hunter Health and Innovation Precinct (JHHIP), Newcastle, 2305, Australia
- Neurology Department, John Hunter Hospital, Newcastle, 2305, Australia
| | - Amy Brodtmann
- Department of Neurology, Royal Melbourne Hospital, Melbourne, 3052, Australia
| | - Michael J. O'Sullivan
- Institute for Molecular Bioscience, University of Queensland, Brisbane, 4067, Australia
| | - Romesh Markus
- Department of Neurology, St Vincent's Hospital, Sydney, 2010, Australia
| | - Ken Butcher
- Department of Neurology, Prince of Wales Hospital, Sydney, 2031, Australia
| | - Mark Parsons
- School of Clinical Medicine, University of New South Wales, Sydney, 2052, Australia
| | - Jason C. Kovacic
- School of Clinical Medicine, University of New South Wales, Sydney, 2052, Australia
- Victor Chang Cardiac Research Institute, Sydney, 2010, Australia
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, 2052, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, 2031, Australia
| |
Collapse
|
3
|
Macoir J. Language Impairment in Vascular Dementia: A Clinical Review. J Geriatr Psychiatry Neurol 2024; 37:87-95. [PMID: 37551643 PMCID: PMC10802085 DOI: 10.1177/08919887231195225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
Vascular cognitive impairment (VCI) encompasses a wide range of conditions, including cognitive impairment associated with stroke or vascular brain injury, mild vascular cognitive impairment, and vascular dementia (VD). Knowledge of language impairment associated with VD is far less extensive than that of Alzheimer's disease. Although not prevalent in VD, impairment in language skills has been reported. A better understanding of the neurolinguistic features associated with the different presentations of VD could facilitate medical diagnosis. In this article, we report data on language impairment in VD, with particular attention to their primary or secondary functional origin. To better appreciate this functional origin, we also outline the main characteristics of impairment in other cognitive functions. Key elements that should be considered in the speech-language assessment of individuals with possible or proven VD are also highlighted.
Collapse
Affiliation(s)
- Joël Macoir
- Département de réadaptation, Faculté de médecine, Université Laval, Québec, QC, Canada
- Centre de Recherche CERVO – Brain Research Centre, Québec, QC, Canada
| |
Collapse
|
4
|
Chhoa H, Chabriat H, Chevret S, Biard L. Comparison of models for stroke-free survival prediction in patients with CADASIL. Sci Rep 2023; 13:22443. [PMID: 38105268 PMCID: PMC10725863 DOI: 10.1038/s41598-023-49552-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 12/09/2023] [Indexed: 12/19/2023] Open
Abstract
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, which is caused by mutations of the NOTCH3 gene, has a large heterogeneous progression, presenting with declines of various clinical scores and occurrences of various clinical event. To help assess disease progression, this work focused on predicting the composite endpoint of stroke-free survival time by comparing the performance of Cox proportional hazards regression to that of machine learning models using one of four feature selection approaches applied to demographic, clinical and magnetic resonance imaging observational data collected from a study cohort of 482 patients. The quality of the modeling process and the predictive performance were evaluated in a nested cross-validation procedure using the time-dependent Brier Score and AUC at 5 years from baseline, the former measuring the overall performance including calibration and the latter highlighting the discrimination ability, with both metrics taking into account the presence of right-censoring. The best model for each metric was the componentwise gradient boosting model with a mean Brier score of 0.165 and the random survival forest model with a mean AUC of 0.773, both combined with the LASSO feature selection method.
Collapse
Affiliation(s)
- Henri Chhoa
- ECSTRRA Team, Université Paris Cité, UMR1153, INSERM, Paris, France
| | - Hugues Chabriat
- Centre NeuroVasculaire Translationnel - Centre de Référence CERVCO, DMU NeuroSciences, Hôpital Lariboisière, GHU APHP-Nord, Université Paris Cité, Paris, France
- INSERM NeuroDiderot UMR 1141, GenMedStroke Team, Paris, France
| | - Sylvie Chevret
- ECSTRRA Team, Université Paris Cité, UMR1153, INSERM, Paris, France
| | - Lucie Biard
- ECSTRRA Team, Université Paris Cité, UMR1153, INSERM, Paris, France.
| |
Collapse
|
5
|
Aguilar-Fuentes V, Justo-Hernández D, Arredondo-Dubois JM, Ruiz-Sandoval JL, Jiménez-Ruiz A. Palliative care in CADASIL: diagnosis is only the first step. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:1022-1024. [PMID: 38035586 PMCID: PMC10689096 DOI: 10.1055/s-0043-1777009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/20/2023] [Indexed: 12/02/2023]
Affiliation(s)
- Victor Aguilar-Fuentes
- Benemérita Universidad Autónoma de Puebla, Facultad de Medicina, Puebla de Zaragoza, Puebla, México.
| | | | | | - José Luis Ruiz-Sandoval
- Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Departamento de Neurología, Clínica de Enfermedad Vascular Cerebral, Guadalajara, Jalisco, México.
| | - Amado Jiménez-Ruiz
- Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Departamento de Neurología, Clínica de Enfermedad Vascular Cerebral, Guadalajara, Jalisco, México.
| |
Collapse
|
6
|
Aljaberi K, Ahli A, Palat Chirakkara SK, Shatila A. A Case Report of Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy Misdiagnosed as Multiple Sclerosis. Cureus 2023; 15:e40986. [PMID: 37503502 PMCID: PMC10370503 DOI: 10.7759/cureus.40986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 07/29/2023] Open
Abstract
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a rare genetic disorder due to a NOTCH 3 mutation on chromosome 19 resulting in a small vessel disease that may mimic many other neurological disorders like migraine, stroke, transient ischaemic attack (TIA), dementia and psychiatric illnesses. The disease is confirmed by genetic testing and other investigations like MRI and skin biopsy are also helpful. Here, we present a 43-year-old male with a confirmed CADASIL through genetic testing, who was initially diagnosed as having multiple sclerosis due to recurrent attacks of focal neurological deficits in the form of weakness and vertigo and other progressive features like mental slowing and difficulties in performing the usual tasks at work, He had a strong family history of neurological illnesses from his mother's side that made us think of an alternative diagnosis.
Collapse
Affiliation(s)
- Kholoud Aljaberi
- Neurology Department, Sheikh Shakhbout Medical City, Abu Dhabi, ARE
| | - Amna Ahli
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, ARE
| | | | - Ahmed Shatila
- Neurology Department, Sheikh Shakhbout Medical City, Abu Dhabi, ARE
| |
Collapse
|
7
|
Alqarni AA, Shirah B, Algahtani H, Almohiy H, Hassan A. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy: Atypical clinical presentation with isolated frontotemporal dementia. J Neurosci Rural Pract 2023; 14:371-373. [PMID: 37181160 PMCID: PMC10174151 DOI: 10.25259/jnrp_88_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/17/2023] [Indexed: 04/08/2023] Open
Abstract
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary syndrome caused by heterozygous mutations in the NOTCH3 gene that manifests in adulthood and is characterized by recurrent transient ischemic attacks and strokes, migraine-like headaches, psychiatric disturbance, and progressive dementia. The current study reports an interesting case of CADASIL in a Saudi patient with a heterozygous mutation in exon 18 of the NOTCH3 gene presenting only with cognitive decline without migraine or stroke. The diagnosis was suspected mainly because of the typical brain magnetic resonance imaging (MRI) features that led to performing genetic testing to confirm the diagnosis. This illustrates the importance of brain MRI in the diagnosis of CADASIL. Increased awareness of neurologists and neuroradiologists about the typical MRI features of CADASIL is of paramount importance to reach the diagnosis in a timely manner. Awareness of the atypical presentations of CADASIL will lead to identifying more CADASIL cases.
Collapse
Affiliation(s)
- Abdulaziz A. Alqarni
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Bader Shirah
- Department of Neuroscience, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
| | | | - Hussain Almohiy
- Department of Radiological Science, King Khalid University, Abha, Saudi Arabia
| | - Ahmed Hassan
- Department of Neuroscience, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
| |
Collapse
|
8
|
Reyes S, Jabouley A, Alili N, De Sanctis MH, Machado C, Taleb A, Herve D, Dias-Gastellier N, Chabriat H. Psychological impact of COVID-19 containment on CADASIL patients. J Neurol 2023; 270:2370-2379. [PMID: 36869886 PMCID: PMC9985090 DOI: 10.1007/s00415-023-11648-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/05/2023]
Abstract
INTRODUCTION COVID-19 restrictive containment was responsible for major psychological distress and alteration of quality of life (QoL) in the general population. Their impact in a group of patients having cerebral small vessel disease (SVD) and at high risk of stroke and disability was unknown. OBJECTIVE We aimed to determine the potential psychological impact of strict containment during the COVID-19 pandemic in a sample of CADASIL patients, a rare SVD caused by NOTCH3 gene mutations. METHODS Interviews of 135 CADASIL patients were obtained just after the end of the strict containment in France. Depression, QoL and negative subjective experience of the containment were analysed, as well as predictors of posttraumatic and stressor-related manifestations, defined as an Impact Event Scale-Revised score ≥ 24, using multivariable logistic analysis. RESULTS Only 9% of patients showed a depressive episode. A similar proportion had significant posttraumatic and stressor-related disorder manifestations independently associated only with socio-environment factors, rather than clinical ones: living alone outside a couple (OR 7.86 (1.87-38.32), unemployment (OR 4.73 (1.17-18.70)) and the presence of 2 or more children at home (OR 6.34 (1.35-38.34). CONCLUSION Psychological impact of the containment was limited in CADASIL patients and did not appear related to the disease status. About 9% of patients presented with significant posttraumatic and stressor-related disorder manifestations which were predicted by living alone, unemployment, or exhaustion related to parental burden.
Collapse
Affiliation(s)
- S Reyes
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France
| | - A Jabouley
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France
| | - N Alili
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France
| | - M H De Sanctis
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France
| | - C Machado
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France
| | - A Taleb
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France
| | - D Herve
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France
| | - N Dias-Gastellier
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France
| | - H Chabriat
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France. .,INSERM U1141-FHU-NeuroVasc, Paris, France.
| |
Collapse
|
9
|
Dupé C, Guey S, Biard L, Dieng S, Lebenberg J, Grosset L, Alili N, Hervé D, Tournier-Lasserve E, Jouvent E, Chevret S, Chabriat H. Phenotypic variability in 446 CADASIL patients: Impact of NOTCH3 gene mutation location in addition to the effects of age, sex and vascular risk factors. J Cereb Blood Flow Metab 2023; 43:153-166. [PMID: 36254369 PMCID: PMC9875352 DOI: 10.1177/0271678x221126280] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The recent discovery that the prevalence of cysteine mutations in the NOTCH3 gene responsible for CADASIL was more than 100 times higher in the general population than that estimated in patients highlighted that the mutation location in EGFr-like-domains of the NOTCH3 receptor could have a major effect on the phenotype of the disease. The exact impact of such mutations locations on the multiple facets of the disease has not been fully evaluated. We aimed to describe the phenotypic spectrum of a large population of CADASIL patients and to investigate how this mutation location influenced various clinical and imaging features of the disease. Both a supervised and a non-supervised approach were used for analysis. The results confirmed that the mutation location is strongly related to clinical severity and showed that this effect is mainly driven by a different development of the most damaging ischemic tissue lesions at cerebral level. These effects were detected in addition to those of aging, male sex, hypertension and hypercholesterolemia. The exact mechanisms relating the location of mutations along the NOTCH3 receptor, the amount or properties of the resulting NOTCH3 products accumulating in the vessel wall, and their final consequences at cerebral level remain to be determined.
Collapse
Affiliation(s)
- Charlotte Dupé
- Translational Neurovascular Centre (CERVCO) and Department of Neurology, FHU NeuroVasc, Hopital Lariboisière, Assistance Publique des Hôpitaux de Paris APHP, Université Paris Cité, Paris, France.,UMR 1141 NeuroDiderot, INSERM and Université Paris Cité, Paris, France
| | - Stéphanie Guey
- Translational Neurovascular Centre (CERVCO) and Department of Neurology, FHU NeuroVasc, Hopital Lariboisière, Assistance Publique des Hôpitaux de Paris APHP, Université Paris Cité, Paris, France.,UMR 1141 NeuroDiderot, INSERM and Université Paris Cité, Paris, France
| | - Lucie Biard
- ECSTRRA Team, UMR-S 1153, Université Paris Cité, INSERM, Paris, France
| | - Sokhna Dieng
- ECSTRRA Team, UMR-S 1153, Université Paris Cité, INSERM, Paris, France
| | - Jessica Lebenberg
- UMR 1141 NeuroDiderot, INSERM and Université Paris Cité, Paris, France
| | - Lina Grosset
- Translational Neurovascular Centre (CERVCO) and Department of Neurology, FHU NeuroVasc, Hopital Lariboisière, Assistance Publique des Hôpitaux de Paris APHP, Université Paris Cité, Paris, France
| | - Nassira Alili
- Translational Neurovascular Centre (CERVCO) and Department of Neurology, FHU NeuroVasc, Hopital Lariboisière, Assistance Publique des Hôpitaux de Paris APHP, Université Paris Cité, Paris, France
| | - Dominique Hervé
- Translational Neurovascular Centre (CERVCO) and Department of Neurology, FHU NeuroVasc, Hopital Lariboisière, Assistance Publique des Hôpitaux de Paris APHP, Université Paris Cité, Paris, France
| | | | - Eric Jouvent
- Translational Neurovascular Centre (CERVCO) and Department of Neurology, FHU NeuroVasc, Hopital Lariboisière, Assistance Publique des Hôpitaux de Paris APHP, Université Paris Cité, Paris, France.,UMR 1141 NeuroDiderot, INSERM and Université Paris Cité, Paris, France
| | - Sylvie Chevret
- ECSTRRA Team, UMR-S 1153, Université Paris Cité, INSERM, Paris, France
| | - Hugues Chabriat
- Translational Neurovascular Centre (CERVCO) and Department of Neurology, FHU NeuroVasc, Hopital Lariboisière, Assistance Publique des Hôpitaux de Paris APHP, Université Paris Cité, Paris, France.,UMR 1141 NeuroDiderot, INSERM and Université Paris Cité, Paris, France
| |
Collapse
|