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CADASIL and CARASIL.

Saara Tikka1, Marc Baumann, Maija Siitonen

  • 1Protein Chemistry Unit, Institute of Biomedicine/Anatomy, University of Helsinki, Helsinki, Finland.

Brain Pathology (Zurich, Switzerland)
|October 18, 2014
PubMed
Summary
This summary is machine-generated.

CADASIL and CARASIL are rare genetic small vessel diseases causing vascular dementia. Mutations in NOTCH3 (CADASIL) or HTRA1 (CARASIL) genes lead to distinct pathological changes and clinical symptoms.

Keywords:
CADASILCARASIL

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Area of Science:

  • Neurology
  • Genetics
  • Pathology

Background:

  • Hereditary small vessel diseases, CADASIL and CARASIL, are leading causes of vascular dementia.
  • CADASIL, often starting with migraines and strokes, is linked to NOTCH3 gene mutations.
  • CARASIL presents with similar symptoms but earlier cognitive decline, gait issues, and alopecia, linked to HTRA1 gene mutations.

Purpose of the Study:

  • To summarize the genetic basis, pathogenesis, and diagnostic features of CADASIL and CARASIL.
  • To differentiate the molecular mechanisms and clinical presentations of these two hereditary conditions.

Main Methods:

  • Review of genetic mutations in NOTCH3 and HTRA1 genes.
  • Analysis of pathological findings in cerebral vasculature, including VSMC degeneration and hyalinosis.
  • Comparison of clinical manifestations and diagnostic criteria for CADASIL and CARASIL.

Main Results:

  • CADASIL results from NOTCH3 mutations causing Notch3 extracellular domain accumulation, VSMC degeneration, and arteriolar stenosis.
  • CARASIL stems from HTRA1 mutations impairing its TGF-β signaling repression, leading to VSMC loss and arterial hyalinosis.
  • Diagnostic methods include molecular genetics, electron microscopy, and immunohistochemistry.

Conclusions:

  • Both CADASIL and CARASIL are distinct hereditary small vessel diseases with unique genetic origins and pathological pathways.
  • Understanding these differences is crucial for accurate diagnosis and potential therapeutic strategies for vascular dementia.