Cited by 196Cerebrovascular and genetic disordersNeurological Disease Mechanisms and TreatmentsGenetic Neurodegenerative Diseases

CADASIL and CARASIL

Open access
Tikka, Saara, Baumann, Marc, Siitonen, Maija, Pasanen, Petra, Pöyhönen, Minna, Myllykangas, Liisa, Viitanen, Matti, Fukutake, Toshio +3 more·2014·Brain Pathology

Abstract

CADASIL and CARASIL are hereditary small vessel diseases leading to vascular dementia. CADASIL commonly begins with migraine followed by minor strokes in mid‐adulthood. Dominantly inherited CADASIL is caused by mutations (n > 230) in NOTCH 3 gene, which encodes Notch3 receptor expressed in vascular smooth muscle cells ( VSMC ). Notch3 extracellular domain ( N 3 ECD ) accumulates in arterial walls followed by VSMC degeneration and subsequent fibrosis and stenosis of arterioles, predominantly in cerebral white matter, where characteristic ischemic MRI changes and lacunar infarcts emerge. The likely pathogenesis of CADASIL is toxic gain of function related to mutation‐induced unpaired cysteine in N 3 ECD . Definite diagnosis is made by molecular genetics but is also possible by electron microscopic demonstration of pathognomonic granular osmiophilic material at VSMC s or by positive immunohistochemistry for N 3 ECD in dermal arteries. In rare, recessively inherited CARASIL the clinical picture and white matter changes are similar as in CADASIL , but cognitive decline begins earlier. In addition, gait disturbance, low back pain and alopecia are characteristic features. CARASIL is caused by mutations (presently n = 10) in high‐temperature requirement. A serine peptidase 1 ( HTRA 1 ) gene, which result in reduced function of HTRA 1 as repressor of transforming growth factor‐β ( TGF β) ‐signaling. Cerebral arteries show loss of VSMC s and marked hyalinosis, but not stenosis.

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Crossref · 10.1111/bpa.12181

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  • Biallelic mutations in HTRA1 result in subcortical lacunar infarcts and subsequent vascular dementia.

    “Biallelic mutations in high-temperature requirement serine peptidase A1 ( HTRA1 ) gene located on chromosome 10q25 result in subcortical lacunar infarcts and subsequent vascular dementia (591).”

    From Blood-Brain Barrier: From Physiology to Disease and Back (2019) · cites this paper as [591]

    The Genetics and Biochemistry > CARASIL section says mutations on both HTRA1 alleles cause CARASIL and maps the gene defect to chromosome 10q. The Clinical Pictures > Clinical picture in CARASIL section says lacunar-type strokes can lead to dementia, while Imaging in CARASIL reports multiple lacunar infarcts. The copy does not specify the narrower 10q25 location stated in the citing sentence, and says recurrent ischemic strokes occur in half of patients rather than all. (LLM, conf=0.86)

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2 of the 138 references couldn’t be matched to a known paper.

Research works printed but not linked: 4

  1. [18]Chabriat H, Joutel A, Dichgans M, Tournier‐Lasserve E, Bousser MG (2009) CADASIL. Lancet Neurol 8: 643– 653. 19539236
  2. [55]Joutel A, Dodick DD, Parisi JE, Cecillon M, Tournier‐Lasserve E, Bousser MG (2000a) De novo mutation in the NOTCH3 gene causing CADASIL. Ann Neurol 47: 388– 391. 10716263
  3. [85]Miao Q, Kalimo H, Bogdanovic N, Kostulas K, Börjesson‐Hanson A, Viitanen M (2006) Cerebral arteriolar pathology in a 32‐year‐old patient with CADASIL. Neuropathol Appl Neurobiol 32: 455– 458. 16866991
  4. [106]Reyes S, Viswanathan A, Godin O, Dufouil C, Benisty S, Hernandez K (2009) Apathy: a major symptom in CADASIL. Neurology 72: 905– 910. 19273824

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Authors
Tikka, S., Baumann, M., Siitonen, M., Pasanen, P., Pöyhönen, M., Myllykangas, L., Viitanen, M., Fukutake, T., Cognat, E., Joutel, A., & Kalimo, H.
Affiliations
  • University of Helsinki (FI)
  • University of Turku (FI)
  • Helsinki University Hospital (FI)
  • Karolinska Institutet (SE)
  • Kameda Medical Center (JP)
  • Inserm (FR)
Corresponding author
Kalimo, Hannu
Venue
Brain Pathology
Publisher
Wiley
Published
2014-09
Volume
24
Issue
5
Pages
525-544
ISSN
  • 1015-6305 (ISSN-L)
  • 1750-3639
OpenAlex
W1604840218
Cited by
189
References
138
Citations by year
2026: 6 · 2025: 20 · 2024: 14 · 2023: 19 · 2022: 19 · 2021: 15 · 2020: 17 · 2019: 20 · 2018: 24 · 2017: 10 · 2016: 13 · 2015: 10 · 2014: 1 · 2013: 1
FWCI
1.55
Type
journal article
Language
en
Open access
Locations
  • Brain Pathology (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Työväentutkimus Vuosikirja (submittedVersion)
Funders
  • Fondation Leducq
  • Finnish Cultural Foundation
  • Sigrid Juselius Foundation
  • Swedish Research Council
Topics
  • Health Sciences › Medicine › Neurology › Cerebrovascular and genetic disorders
  • Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Genetic Neurodegenerative Diseases
Keywords
CADASIL, CARASIL, vascular dementia, NOTCH3 mutations, vascular smooth muscle cells, osmiophilic granules, lacunar infarction, TGF-beta signaling, gain-of-function, hyalinosis
MeSH terms
Alopecia, Brain, Cerebral Infarction, Humans, Spinal Diseases, CADASIL, Leukoencephalopathies

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