Expanding the cerebrovascular phenotype of the p.R258H variant in ACTA2 related hereditary thoracic aortic disease (HTAD)

Birgitte Rode Diness*, Rachel Nina Palmquist, Rikke Norling, Hanne Hove, Henning Bundgaard, Jens Michael Hertz, Daniel Kondziella, Derk Krieger, Morten Dunø, Sabine Grønborg

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Heterozygous variants in smooth muscle alpha-actin gene (ACTA2) are the most frequent cause of autosomal dominant hereditary thoracic aortic disease (HTAD). Several genotype-phenotype associations have been described, including a severe multisystemic smooth muscle disorder associated with de novo ACTA2 p.R179 variants, characterized by highly penetrant and early onset vascular disease, involvement of smooth muscle cell (SMC)-dependent organs and a distinct cerebrovascular phenotype. Missense variants at position 258 (p.R258C and p.R258H) have also been reported to have a more severe presentation including an increased risk for aortic dissection and a high risk of stroke. It has previously been suggested that the cerebrovascular phenotype of patients with p.R258 variants could represent a mild presentation of the cerebrovascular phenotype associated with p.R179 variants. Here we report on a five generation HTAD family with the p.R258H variant and describe the cerebrovascular findings seen in three family members, to expand on the previously reported phenotype associated with variants at this codon.

Original languageEnglish
Article number116897
JournalJournal of the Neurological Sciences
Volume415
ISSN0022-510X
DOIs
Publication statusPublished - 15. Aug 2020

Keywords

  • ACTA2
  • Arteriopathy
  • HTAD

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