Clinicoradiographic and genetic features of cerebral small vessel disease indicate variability in mode of inheritance for monoallelic HTRA1 variants

Abstract Background Biallelic pathogenic variants in HTRA1 cause CARASIL. More recently, monoallelic variants have been associated with the autosomal dominant disorder CADASIL2 but not all carriers develop disease manifestations. We describe the clinicoradiologic and mutation spectrum of four new CA...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Karthik Muthusamy, Alejandro Ferrer, Eric W. Klee, Klaas J. Wierenga, Ralitza H. Gavrilova
Formato: article
Lenguaje:EN
Publicado: Wiley 2021
Materias:
Acceso en línea:https://doaj.org/article/2962f7d32b1f48f1a28dc54b74eb2e4e
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
id oai:doaj.org-article:2962f7d32b1f48f1a28dc54b74eb2e4e
record_format dspace
spelling oai:doaj.org-article:2962f7d32b1f48f1a28dc54b74eb2e4e2021-11-10T16:39:24ZClinicoradiographic and genetic features of cerebral small vessel disease indicate variability in mode of inheritance for monoallelic HTRA1 variants2324-926910.1002/mgg3.1799https://doaj.org/article/2962f7d32b1f48f1a28dc54b74eb2e4e2021-10-01T00:00:00Zhttps://doi.org/10.1002/mgg3.1799https://doaj.org/toc/2324-9269Abstract Background Biallelic pathogenic variants in HTRA1 cause CARASIL. More recently, monoallelic variants have been associated with the autosomal dominant disorder CADASIL2 but not all carriers develop disease manifestations. We describe the clinicoradiologic and mutation spectrum of four new CADASIL2 individuals. Methods Medical records at Mayo Clinic between 2013 and 2020 were retrospectively reviewed to identify patients with cerebral small vessel disease related to monoallelic HTRA1 variants. Results Four patients met the study inclusion criteria for cerebral small vessel disease related to HTRA1 monoallelic variants. The mean age at onset of first clinical stroke was 51.25 years (range 41–64 years). The mean disease duration was 6.5 years (range 4–12). All individuals had recurrent strokes within the duration of follow‐up with a mean number of strokes per patient being 5.5 (range 2–12). Three individuals had leukoencephalopathy with brain stem involvement. Microhemorrhages were seen on brain MRI in three patients. HTRA1 monoallelic variants identified in our cohort were missense variants in three patients and a novel frameshift variation in one patient. Interestingly, two of these missense variants were previously reported in an autosomal recessive pattern of inheritance and here are associated with a dominant effect. Conclusions Clinicoradiologic characteristics of heterozygous HTRA1‐related CSVD may overlap with sporadic CSVD. Heterozygous HTRA1 variants can contribute to dominant or recessive disease mechanisms.Karthik MuthusamyAlejandro FerrerEric W. KleeKlaas J. WierengaRalitza H. GavrilovaWileyarticleCADASIL2cerebral small vessel diseaseHTRA1leukoencephalopathystrokeGeneticsQH426-470ENMolecular Genetics & Genomic Medicine, Vol 9, Iss 10, Pp n/a-n/a (2021)
institution DOAJ
collection DOAJ
language EN
topic CADASIL2
cerebral small vessel disease
HTRA1
leukoencephalopathy
stroke
Genetics
QH426-470
spellingShingle CADASIL2
cerebral small vessel disease
HTRA1
leukoencephalopathy
stroke
Genetics
QH426-470
Karthik Muthusamy
Alejandro Ferrer
Eric W. Klee
Klaas J. Wierenga
Ralitza H. Gavrilova
Clinicoradiographic and genetic features of cerebral small vessel disease indicate variability in mode of inheritance for monoallelic HTRA1 variants
description Abstract Background Biallelic pathogenic variants in HTRA1 cause CARASIL. More recently, monoallelic variants have been associated with the autosomal dominant disorder CADASIL2 but not all carriers develop disease manifestations. We describe the clinicoradiologic and mutation spectrum of four new CADASIL2 individuals. Methods Medical records at Mayo Clinic between 2013 and 2020 were retrospectively reviewed to identify patients with cerebral small vessel disease related to monoallelic HTRA1 variants. Results Four patients met the study inclusion criteria for cerebral small vessel disease related to HTRA1 monoallelic variants. The mean age at onset of first clinical stroke was 51.25 years (range 41–64 years). The mean disease duration was 6.5 years (range 4–12). All individuals had recurrent strokes within the duration of follow‐up with a mean number of strokes per patient being 5.5 (range 2–12). Three individuals had leukoencephalopathy with brain stem involvement. Microhemorrhages were seen on brain MRI in three patients. HTRA1 monoallelic variants identified in our cohort were missense variants in three patients and a novel frameshift variation in one patient. Interestingly, two of these missense variants were previously reported in an autosomal recessive pattern of inheritance and here are associated with a dominant effect. Conclusions Clinicoradiologic characteristics of heterozygous HTRA1‐related CSVD may overlap with sporadic CSVD. Heterozygous HTRA1 variants can contribute to dominant or recessive disease mechanisms.
format article
author Karthik Muthusamy
Alejandro Ferrer
Eric W. Klee
Klaas J. Wierenga
Ralitza H. Gavrilova
author_facet Karthik Muthusamy
Alejandro Ferrer
Eric W. Klee
Klaas J. Wierenga
Ralitza H. Gavrilova
author_sort Karthik Muthusamy
title Clinicoradiographic and genetic features of cerebral small vessel disease indicate variability in mode of inheritance for monoallelic HTRA1 variants
title_short Clinicoradiographic and genetic features of cerebral small vessel disease indicate variability in mode of inheritance for monoallelic HTRA1 variants
title_full Clinicoradiographic and genetic features of cerebral small vessel disease indicate variability in mode of inheritance for monoallelic HTRA1 variants
title_fullStr Clinicoradiographic and genetic features of cerebral small vessel disease indicate variability in mode of inheritance for monoallelic HTRA1 variants
title_full_unstemmed Clinicoradiographic and genetic features of cerebral small vessel disease indicate variability in mode of inheritance for monoallelic HTRA1 variants
title_sort clinicoradiographic and genetic features of cerebral small vessel disease indicate variability in mode of inheritance for monoallelic htra1 variants
publisher Wiley
publishDate 2021
url https://doaj.org/article/2962f7d32b1f48f1a28dc54b74eb2e4e
work_keys_str_mv AT karthikmuthusamy clinicoradiographicandgeneticfeaturesofcerebralsmallvesseldiseaseindicatevariabilityinmodeofinheritanceformonoallelichtra1variants
AT alejandroferrer clinicoradiographicandgeneticfeaturesofcerebralsmallvesseldiseaseindicatevariabilityinmodeofinheritanceformonoallelichtra1variants
AT ericwklee clinicoradiographicandgeneticfeaturesofcerebralsmallvesseldiseaseindicatevariabilityinmodeofinheritanceformonoallelichtra1variants
AT klaasjwierenga clinicoradiographicandgeneticfeaturesofcerebralsmallvesseldiseaseindicatevariabilityinmodeofinheritanceformonoallelichtra1variants
AT ralitzahgavrilova clinicoradiographicandgeneticfeaturesofcerebralsmallvesseldiseaseindicatevariabilityinmodeofinheritanceformonoallelichtra1variants
_version_ 1718439852916080640