Common Genetic Variants and Early Onset Stroke Clues but No Answers

The incidence of stroke in young adults (early-onset stroke [EOS]) is increasing, and survivors face increased mortality risks and potentially decades living with a disability. Despite this, few studies focus on this population. In approximately 40% of people with EOS, the stroke is cryptogenic,(2) and there are scant data from clinical trials to guide the selection of preventative strategies in this population because people with EOS are often excluded from trials. Genetic determinants of EOS have long been suspected, but remain elusive. Monogenic causes (e.g., CADASIL, Fabry disease, and sickle-cell disease) have been implicated in some people with EOS, but the proportion of overall EOS cases with established etiologies remains low.