Postępy Psychiatrii i Neurologii

Abstract

2/2026 vol. 35
Case report

A novel missense variant Cys559Gly in NOTCH3 in CADASIL family and vascular lesions in patients with migraine

  1. Department of Extrapyramidal Diseases, Medical University of Lodz, Poland
  2. Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
  3. Neurology Department, University Clinical Hospital No. 2, Medical University of Lodz, Poland
  4. Rehabilitation Department, University Clinical Hospital No. 2, Medical University of Lodz, Poland
Adv Psychiatry Neurol 2026; 35 (2): 132-135
Online publish date: 2026/05/13
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Purpose

To report a novel NOTCH3 pathologic variant in a family presenting CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, OMIM #125310).

Case description

Two affected sisters with dementia and ischemic stroke (only the proband) in their medical history, and the pro- band’s daughter with migraine without aura underwent clinical and imaging evaluations. Magnetic resonance imaging revealed typical CADASIL lesions in both sisters. Next-generation sequencing and targeted Sanger sequencing were performed to link the phenotype to a variant in the NOTCH3.

Comment

Sequencing data revealed a likely pathogenic variant in the NOTCH3 gene. Using ACMG guSequencing data revealed a likely pathogenic variant in the NOTCH3 gene. Using ACMG guidelines, the variant was classified as likely pathogenic. We have described a new likely pathogenic NOTCH3 missense variant c.1675T>G p. (Cys559Gly) and linked it to the CADASIL phenotype, confirming the predictions of genetic analyses. We particularly emphasize co-occurring central vascular lesions in patients with migraine, which may be de facto caused by pathogenic NOTCH3 variants.

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