Atypical clinical cases of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL)

Cover Page


Cite item

Full Text

Abstract

C

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary CNS disease with autosomal dominant inheritance caused by NOTCH3 gene mutations. In classic cases, CADASIL manifests with headaches, repeated cerebrovascular disorders, and progressive cognitive decline. Cerebral magnetic resonance imaging plays an important diagnostic role as it reveals multiple lacunar infarcts in the basal ganglia, brainstem, and cerebellum, as well as focal white matter lesions and diffuse leukoaraiosis changes. CADASIL can sometimes have other symptoms and be disguised as phenotypes atypical of this disease. We report two genetically confirmed cases of CADASIL with atypical clinical presentation that manifested with predominantly cerebellar or essential tremor combined with cognitive and affective disorders. The main principles of diagnosis of this disease characterized by clinical polymorphism are discussed.

About the authors

Anna A. Moroz

Research Center of Neurology

Author for correspondence.
Email: snillario@gmail.com
Россия, Moscow

Natalia Yu. Abramycheva

Research Center of Neurology

Email: snillario@gmail.com
Россия, Moscow

Ekaterina O. Ivanova

Research Center of Neurology

Email: snillario@gmail.com
Россия, Moscow

Rodion N. Konovalov

Research Center of Neurology

Email: snillario@gmail.com
ORCID iD: 0000-0001-5539-245X

Cand. Sci. (Med.), senior researcher, Neuroradiology department

Россия, 125367 Moscow, Volokolamskoye shosse, 80

Sofiya L. Timerbaeva

Research Center of Neurology

Email: snillario@gmail.com
Россия, Moscow

Sergey N. Illarioshkin

Research Center of Neurology

Email: snillario@gmail.com
ORCID iD: 0000-0002-2704-6282

D. Sci. (Med.), Prof., Corr. Member of the Russian Academy of Sciences, Deputy Director, Head, Department for brain research

Россия, Moscow

References

  1. Joutel A., Corpechot C., Ducros A. et al. Notch3 mutations in CADASIL, a hereditary adult-onset condition causing stroke and dementia. Nature. 1996; 383: 707–710. doi: 10.1038/383707a0. PMID: 8878478.
  2. Tournier-Lasserve E., Iba-Zizen M.-T., Romero N. et al. Autosomal dominant syndrome with stroke like episodes and leukoencephalopathy. Stroke. 1991; 22: 1297–1302. doi: 10.1161/01.STR.22.10.1297. PMID: 1926242.
  3. Choi J. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy: a genetic cause of cerebral small vessel disease. J. Clin. Neurol. 2010; 6: 1–9. doi: 10.3988/jcn.2010.6.1.1. PMID: 20386637.
  4. Dong Y., Hassan A., Zhang Z. et al. Yield of screening for CADASIL mutations in lacunar stroke and leukoaraiosis. Stroke. 2003; 34: 203–205. doi: 10.1161/01.STR.0000048162. 16852.88. PMID: 12511775.
  5. Abramycheva N., Stepanova M., Kalashnikova L. et al. 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. doi: http://dx.doi.org/10.1016/j.jns.2015.01.018. PMID: 25623805.
  6. Trojano M., Paolicelli D. The differential diagnosis of multiple sclerosis: classification and clinical features of relapsing and progressive neurological syndromes. Neurol. Sci. 2001; 22: 98–102. doi: http://dx.doi.org/10.1007/ s100720100044. PMID: 11794488.
  7. Kalaria R., Viitanen M., Kalimo H. The pathogenesis of CADASIL: an update. J. Neurol. Sci. 2004; 226: 35–39. doi: http://dx.doi.org/10.1016/j. jns.2004.09.008. PMID: 15537516.
  8. Razvi S., Davidson R., Bone I. et al. The prevalence of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) in the west of Scotland. J. Neurol. Neurosurg. Psychiatry. 2005; 76: 739–741. doi: 10.1136/jnnp.2004.051847. PMID: 15834040.
  9. Illarioshkin S.N., Slominsky P.A., Shadrina M.I. et al. [Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL): the first description of Russian pedigree with NOTCH3 identified mutation]. Annals of Clinical and Experimental Neurology. 2008; 2(2): 45–50.
  10. Gunda B., Herve D., Godin O. et al. Effects of gender on the phenotype of CADASIL. Stroke. 2012; 43: 137–141. doi: 10.1161/STROKEAHA.111.631028. PMID: 22033996.
  11. Illarioshkin S.N. [Genetics of cerebrovascular diseases]. In: Ocherki angionevrologii [Essays on angioneurology], Suslina Z.A. (Ed.). Moscow; 2005. Atmosphera: 327−345.
  12. Chabriat H., Joutel A., Vahedi K. et al. CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy): clinical features and neuroimaging. Bull. Acad. Natl. Med. 2000; 184: 1523–1531. PMID: 11261256.
  13. Kim Y., Choi E.J., Choi C.G. et al. Characteristics of CADASIL in Korea: a novel cysteine-sparing Notch3 mutation. Neurology 2006; 66: 1511–1516 doi: 10.1212/01.wnl.0000216259.99811.50. PMID: 16717210.
  14. Yousry T., Seelos K., Mayer M. et al. Characteristic MR lesion pattern and correlation of T1 and T2 lesion volume with neurologic and neuropsychological findings in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). AJNR Am. J. Neuroradiol. 1999; 20: 91–100. PMID: 9974062.
  15. Liem M., Lesnik-Oberstien S., Haan J. et al. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy: progression of MRI abnormalities in prospective 7-year follow-up study. Radiology. 2008; 249: 964–971. doi: http://dx.doi.org/10.1148/radiol.2492080357. PMID: 18840792.
  16. Davous P. CADASIL: a review with proposed diagnostic criteria. Eur. J. Neurol. 1998; 5: 219–223. doi: 10.1046/j.1468-1331.1998.530219.x. PMID: 10210836.
  17. Park S., Park B., Kyung Koh M., Ho Joo Y. Case report: bipolar disorder as the first manifestation of CADASIL. BMC Psychiatry. 2014; 14: 175. doi: 10.1186/1471-244X-14-175. PMID: 24929957.
  18. Valenti R., Pescini F., Antonini S. Major depression and bipolar disorders in CADASIL: a study using the DSM-IV semi-structured interview. Acta Neurol Scand. 2011; 124: 390–395. doi: 10.1111/j.1600-0404.2011.01512.x. PMID: 21428968.
  19. Chabriat H., Bousser M.-G. Neuropsychiatric manifestations in CADASIL. Dialogues in Clinical Neuroscience. 2007; 9: 199–208. PMID: 17726918.
  20. Kesebir S., Koca E.K., Kilicaslan E.E. CADASIL syndrome presenting with bipolar disorder. JMOOD. 2012; 2: 115–118 (in Turkish). doi:10.5455/ jmood.20120412113716.
  21. Vedeler C., Bindoff L. A family with atypical CADASIL. J. Neurol. 2011; 258: 1888–1889. doi: 10.1007/s00415-011-6023-z. PMID: 21465151.
  22. Yoon W.T., Lee P.H. Unusual manifestation of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) mimicking multiple system atrophy (MSA). Mov. Disord. 2014: Abstracts of the 18th International Congress of Parkinson’s disease and movement disorders. Stockholm, June 8–12, 2014.
  23. Malandrini A., Carrera P., Ciacci G. Unusual clinical features and early brain MRI lesions in a family with cerebral autosomal dominant arteriopathy. Neurology. 1997; 48: 1200–1203. PMID: 9153443.
  24. Velizarova R., Mourand I., Serafini A. et al. Focal epilepsy as first symptom in CADASIL. Seizure. 2011; 20: 502–504. doi: 10.1016/j.seizure.2011.02.006. PMID: 21414809.
  25. Ragno M., Berbellini A., Cacchio G. Parkinsonism is a late, not rare, feature of CADASIL. A study on Italian patients carrying the R1006C mutation. Stroke. 2013; 44: 1147–1149. doi: 10.1161/STROKEAHA.111.000458. PMID: 23412372.
  26. Song S.K., Lee J.S., Choi J.C., Kang J.H. Various phenotypes of parkinsonism in patients with CADASIL. Mov. Disord. 2012: Abstracts of the 16th International Congress of Parkinson’s disease and movement disorders. Dublin, June 17–21, 2012.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2017 Moroz A.A., Abramycheva N.A., Ivanova E.O., Konovalov R.N., Timerbaeva S.L., Illarioshkin S.N.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77-83204 от 12.05.2022.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies