title: Headache among CADASIL patients with R544C mutation: prevalence, characteristics, and associations.
abstract: OBJECTIVE
  There are variations of migraine prevalence in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) among different regions of the world. Previous studies on Asian CADASIL patients have not provided detailed descriptions of the characteristics of their headaches. The aims of this study were to determine prevalence and characteristics of headaches and to investigate associations between headache and other clinical symptoms or brain magnetic resonance imaging (MRI) findings among homogenous group of patients having the same R544C mutation.
  
  
  METHODS
  In this cross-sectional study, we enrolled 53 CADASIL patients with the R544C mutation between May 2010 and April 2011. We obtained the history of headache using a structured questionnaire and detailed interview. Other clinical features and brain MRI findings were also assessed for potential associations.
  
  
  RESULTS
  Overall headache prevalence was 45.3% (24 patients). Among them, 21 patients (87.5%) were classified as having tension-type headache, followed by migraine (two patients) and unclassifiable headaches (one patient). Except for alcohol consumption, no significant associations were observed between the headaches and other clinical features or brain MRI findings.
  
  
  CONCLUSIONS
  Migraine was found in only 3.8% of CADASIL patients with the R544C mutation. Such a low prevalence of migraine may hinder clinical detection of CADASIL among ethnically Asian patients.
authors.affiliation: Department of Neurology and Institute of Medical Science, Jeju National University, Korea.
authors.forename: Jay Chol
authors.initials: JC
authors.lastname: Choi
authors.forename: Sook-Keun
authors.initials: SK
authors.lastname: Song
authors.forename: Jung Seok
authors.initials: JS
authors.lastname: Lee
authors.forename: Sa-Yoon
authors.initials: SY
authors.lastname: Kang
authors.forename: Ji-Hoon
authors.initials: JH
authors.lastname: Kang
mesh_terms: D000428:Alcohol Drinking / Q000208:ethnology / Q000235:genetics; D044466:Asian People / Q000235:genetics* / Q000706:statistics & numerical data; D046589:CADASIL / Q000453:epidemiology / Q000235:genetics*; D005260:Female; D056726:Genetic Association Studies; D020022:Genetic Predisposition to Disease / Q000208:ethnology / Q000235:genetics; D020773:Headache Disorders / Q000453:epidemiology / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D020641:Polymorphism, Single Nucleotide / Q000235:genetics*; D015995:Prevalence; D000071656:Receptor, Notch3; D051880:Receptors, Notch / Q000235:genetics*; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors
chemical_list: C499374:NOTCH3 protein, human; D000071656:Receptor, Notch3; D051880:Receptors, Notch
keywords: CADASIL; headache; magnetic resonance imaging; migraine; prevalence