Prognostic Significance of <i>NOTCH3</i> Small Vessel Disease Staging for the <i>NOTCH3</i> p.R544C Variant

Background and Objectives: p.R544C variant to evaluate its clinical relevance and prognostic value. Methods: -SVD staging system, ranging from stage 0 (premanifest stage) to stage 4B (end stage). Baseline characteristics were compared across stages. Multivariable models were used to identify factors associated with prior stroke or cognitive impairment. Stroke-free survival was analyzed using Kaplan-Meier curves and Cox proportional hazards models. Cognitive decline, assessed by Mini-Mental State Examination, was evaluated using a generalized estimating equation. Results: = 0.023; adjusted hazard ratio 3.38; 95% CI 1.10-10.4, adjusted for age and hypertension). MMSE scores declined progressively over 2 years in individuals with stage ≥2B, whereas those with stage <2B remained cognitively stable (p for interaction = 0.024). Discussion: p.R544C, with stage ≥2B indicating a higher risk.