A NOTCH3 p.Gly1105Cys variant in CADASIL: clinical characterization and an updated overview of exon 20 variants
Abstract
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), an autosomal dominant cerebrovascular disorder caused by NOTCH3 variants. Although more than 400 NOTCH3 variants have been reported, exon 20 variants remain rare, and clinical characterization is limited. We report a 39-year-old Chinese male with recurrent lacunar infarctions involving the brainstem, basal ganglia, and corona radiata. He had right-sided hemiplegia and cognitive deficits, without dizziness, headache, dysphagia, or dysarthria. His mother and maternal uncle had a history of ischemic stroke. Genetic testing identified a heterozygous NOTCH3 c.3313G > T (p.Gly1105Cys) variant in exon 20 (NM_000435.3), classified as likely pathogenic according to the American College of Medical Genetics and Genomics (ACMG) criteria. Alongside adjusted medications for secondary stroke prevention, he received acupuncture and physical rehabilitation, followed by an improvement in mood and motor function. We also reviewed NOTCH3 exon 20 variants and found marked phenotypic heterogeneity across variants and populations. Migraine appears less frequent among Chinese carriers than in Western cohorts, whereas cognitive impairment may occur relatively early. Radiologically, temporal pole white matter hyperintensities were absent in our patient and other Chinese carriers of NOTCH3 variants in epidermal growth factor-like repeat (EGFr) domain 28, but reported in some with domain 27 variants.…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Calcium Ions in the Physiology and Pathology of the Central Nervous System
- AI-powered in silico twins: redefining precision medicine through simulation, personalization, and predictive healthcare
- In silico functional, structural and pathogenicity analysis of missense single nucleotide polymorphisms in human MCM6 gene
- In Silico drug repurposing pipeline using deep learning and structure based approaches in epilepsy
- Targeting serotonin receptors with phytochemicals – an in-silico study
- In silico exploration of anti-prostate cancer compounds from differential expressed genes
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.