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Abstract：
BACKGROUND: Vascular cognitive impairment (VCI) is a common cause of dementia. Research suggests that hereditary factors (gene mutations) play an important role in the pathogenesis of VCI, and a mutation of the NOTCH3 locus is frequently identified in affected patients. Herein, we report the case of a patient with confirmed VCI associated with a NOTCH3 exon 33 gene mutation and review the relevant VCI literature.
UNASSIGNED: A 48-year-old man presented to our neurology clinic with gradually progressive cognitive impairment.
UNASSIGNED: Brain magnetic resonance imaging revealed multiple punctate hyperintensities in the patient\'s periventricular white matter. Genetic analysis showed a c.6744C > T, p. Ala2223Val substitution in exon 33 of the NOTCH3 gene. We diagnosed thepatient with VCI secondary to a NOTCH3 gene mutation.
METHODS: Donepezil (5 mg) and memantine (5 mg) daily.
RESULTS: The patient showed symptom improvement at his 3-month and 6-month follow-up appointments.
CONCLUSIONS: This patient may have a new type of mutation that is different from the one seen in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, although it involves a NOTCH3 defect. We propose that the entire NOTCH3 gene should be sequenced in patients with suspected hereditary VCI. This practice could facilitate the discovery of newpathogenic mutations and diseases.
UNASSIGNED: A 48-year-old man presented to our neurology clinic with gradually progressive cognitive impairment.
UNASSIGNED: Brain magnetic resonance imaging revealed multiple punctate hyperintensities in the patient\'s periventricular white matter. Genetic analysis showed a c.6744C > T, p. Ala2223Val substitution in exon 33 of the NOTCH3 gene. We diagnosed thepatient with VCI secondary to a NOTCH3 gene mutation.
METHODS: Donepezil (5 mg) and memantine (5 mg) daily.
RESULTS: The patient showed symptom improvement at his 3-month and 6-month follow-up appointments.
CONCLUSIONS: This patient may have a new type of mutation that is different from the one seen in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, although it involves a NOTCH3 defect. We propose that the entire NOTCH3 gene should be sequenced in patients with suspected hereditary VCI. This practice could facilitate the discovery of newpathogenic mutations and diseases.
摘要：
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