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Chen X, Cen Z, Wang B, Liu P, Luo W. Multiple System Atrophy-like Phenotype Accompanied by Prominent Weight Loss and Fatigue. Mov Disord Clin Pract 2023; 10:S45-S47. [PMID: 37636226 PMCID: PMC10448613 DOI: 10.1002/mdc3.13802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 05/10/2023] [Accepted: 05/24/2023] [Indexed: 08/29/2023] Open
Affiliation(s)
- Xinhui Chen
- Department of Neurology, The Second Affiliated HospitalZhejiang University School of MedicineZhejiangChina
| | - Zhidong Cen
- Department of Neurology, The Second Affiliated HospitalZhejiang University School of MedicineZhejiangChina
| | - Bo Wang
- Department of Neurology, The Second Affiliated HospitalZhejiang University School of MedicineZhejiangChina
| | - Peng Liu
- Department of NeurologyTaizhou Central Hospital (Taizhou University Hospital)ZhejiangChina
| | - Wei Luo
- Department of Neurology, The Second Affiliated HospitalZhejiang University School of MedicineZhejiangChina
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Kwon DY. Movement Disorders Following Cerebrovascular Lesions: Etiology, Treatment Options and Prognosis. J Mov Disord 2016; 9:63-70. [PMID: 27240807 PMCID: PMC4886206 DOI: 10.14802/jmd.16008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 02/23/2016] [Accepted: 03/07/2016] [Indexed: 12/15/2022] Open
Abstract
Post-stroke movement disorders are uncommon, but comprise an important part of secondary movement disorders. These exert variable and heterogeneous clinical courses according to the stroke lesion and its temporal relationships. Moreover, the predominant stroke symptoms hinder a proper diagnosis in clinical practice. This article describes the etiology, treatment options and prognosis of post-stroke movement disorders.
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Affiliation(s)
- Do-Young Kwon
- Department of Neurology, Korea University College of Medicine, Ansan Hospital, Ansan, Korea
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Abramycheva N, Stepanova M, Kalashnikova L, Zakharova M, Maximova M, Tanashyan M, Lagoda O, Fedotova E, Klyushnikov S, Konovalov R, Sakharova A, Illarioshkin S. New mutations in the Notch3 gene in patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL). J Neurol Sci 2015; 349:196-201. [PMID: 25623805 DOI: 10.1016/j.jns.2015.01.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 12/08/2014] [Accepted: 01/12/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL) is a cerebrovascular small-vessel disease caused by stereotyped mutations in the Notch3 gene altering the number of cysteine residues. METHODS We directly sequenced exons 2-23 of the Notch3 gene in 30 unrelated Russian patients with clinical/neuroimaging picture suggestive of CADASIL. To confirm the pathogenicity of new nucleotide variants, we used the standard bioinformatics tools and screened 200 ethnically matched individuals as controls. RESULTS We identified 16 different point mutations in the Notch3 gene in 18 unrelated patients, including 4 new missense mutations (C194G, V252M, C338F, and C484G). All but two mutations affected the cysteine residue. The non-cysteine change V322M was shown to be associated with CADASIL-specific deposits of granular osmiophilic material in the vascular smooth-muscle cells, which confirmed the pathogenicity of this Notch3 variant. Two patients were shown to be compound-heterozygotes carrying two pathogenic Notch3 mutations. The disease was characterized by marked clinical variability, without evident phenotype-genotype correlations. CONCLUSIONS In our sample, 60% of Russian patients with 'clinically suspected' CADASIL received the definitive molecularly proven diagnosis. Careful assessment of genealogical, clinical, and neuroimaging data in patients with lacunar stroke can help selecting patients with a high probability of finding mutations on genetic screening.
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Affiliation(s)
- Natalya Abramycheva
- Department of Neurogenetics, Research Center of Neurology, Russian Academy of Medical Sciences, Volokolamskoye Shosse 80, Moscow 125367, Russia
| | - Maria Stepanova
- Department of Neurogenetics, Research Center of Neurology, Russian Academy of Medical Sciences, Volokolamskoye Shosse 80, Moscow 125367, Russia
| | - Lyudmila Kalashnikova
- Department of Neurorehabilitation, Research Center of Neurology, Russian Academy of Medical Sciences, Volokolamskoye Shosse 80, Moscow 125367, Russia
| | - Maria Zakharova
- Department of Demyelinating Diseases, Research Center of Neurology, Russian Academy of Medical Sciences, Volokolamskoye Shosse 80, Moscow 125367, Russia
| | - Marina Maximova
- Department of Acute Stroke with Intensive Care Unit, Research Center of Neurology, Russian Academy of Medical Sciences, Volokolamskoye Shosse 80, Moscow 125367, Russia
| | - Marine Tanashyan
- Department of Chronic Cerebrovascular Diseases, Research Center of Neurology, Russian Academy of Medical Sciences, Volokolamskoye Shosse 80, Moscow 125367, Russia
| | - Olga Lagoda
- Department of Chronic Cerebrovascular Diseases, Research Center of Neurology, Russian Academy of Medical Sciences, Volokolamskoye Shosse 80, Moscow 125367, Russia
| | - Ekaterina Fedotova
- Department of Neurogenetics, Research Center of Neurology, Russian Academy of Medical Sciences, Volokolamskoye Shosse 80, Moscow 125367, Russia
| | - Sergey Klyushnikov
- Department of Neurogenetics, Research Center of Neurology, Russian Academy of Medical Sciences, Volokolamskoye Shosse 80, Moscow 125367, Russia
| | - Rodion Konovalov
- Department of Neuroradiology, Research Center of Neurology, Russian Academy of Medical Sciences, Volokolamskoye Shosse 80, Moscow 125367, Russia
| | - Alla Sakharova
- Department of Pathology, Research Center of Neurology, Russian Academy of Medical Sciences, Volokolamskoye Shosse 80, Moscow 125367, Russia
| | - Sergey Illarioshkin
- Department of Neurogenetics, Research Center of Neurology, Russian Academy of Medical Sciences, Volokolamskoye Shosse 80, Moscow 125367, Russia.
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Valenti R, Bianchi S, Pescini F, D'Eramo C, Inzitari D, Dotti MT, Pantoni L. First report of a pathogenic mutation on exon 24 of the NOTCH3 gene in a CADASIL family. J Neurol 2011; 258:1632-6. [PMID: 21409506 DOI: 10.1007/s00415-011-5983-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2010] [Revised: 02/24/2011] [Accepted: 02/25/2011] [Indexed: 11/26/2022]
Abstract
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a genetically transmitted small vessel disease clinically characterized by migraine, recurrent subcortical strokes, and cognitive and mood disorders. Pathogenic mutations are located on any of the exons of the NOTCH3 gene coding for epidermal-growth factor (EGF)-like repeats of the extracellular domain of the NOTCH3 receptor. Because the gene is large and the mutations cluster on some exons, many laboratories restrict the analysis to these exons. We report the first missense mutation involving exon 24 and causing CADASIL in a 64-year-old man. The patient was admitted to the hospital for a loss of consciousness accompanied by profuse sweating. On examination, some parkinsonian features were present. Over the last 4 years, he had developed postural instability and gait disturbances with repeated falls, behavioral disorders, and cognitive impairment. A diagnostic hypothesis of atypical parkinsonism had been advanced. The presence of multiple subcortical lacunar infarcts and leukoencephalopathy extended to the external capsule on cerebral MRI suggested the presence of CADASIL. The diagnosis was confirmed by finding a heterozygous mutation leading to a cysteine substitution on exon 24 of the NOTCH3 gene. One proband's brother, who had progressive gait disturbances, unilateral action tremor and bradykinesia, and an asymptomatic niece also resulted affected. This report underlines that when CADASIL is suspected the genetic analysis should be performed on all the NOTCH3 exons coding for EGF-like repeats including exon 24 and confirms that CADASIL may have heterogeneous phenotypes.
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Affiliation(s)
- Raffaella Valenti
- Department of Neurological and Psychiatric Sciences, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
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