Ruggero Bacchin, Matteo Salgarello, Michela Trentin, Giampietro Zanette, Stefano Tamburin
ABSTRACT: Fragile X-associated tremor/ataxia syndrome (FXTAS) is a rare movement disorder caused by a 55-to-200 CGG-trinucleotide expansion premutation in the FMR1 gene. Core diagnostic criteria are tremor, ataxia, and T2-weighted hyperintensity of the middle cerebellar peduncles on MRI, but FXTAS encompass a broad spectrum of neurological symptoms. FXTAS pathophysiology is largely unknown, and some animal models and neuropathology findings suggest possible overlap with Alzheimer disease. We report the combined PET imaging of a genetically confirmed FXTAS patient, presenting reduced temporal-frontal 18F-FDG uptake, and pathological cortical deposition of amyloid to 18F-flumetamol PET scan. This report may offer clues to FXTAS pathophysiology.
Berry-Kravis E, Abrams L, Coffey SM, et al. Fragile X-associated tremor/ataxia syndrome: clinical features, genetics, and testing guidelines. Mov Disord . 2007;22:2018–2030.
Lee C, Park KW, Choi N, et al. Fragile X-associated tremor/ataxia syndrome: an illustrative case. J Mov Disord . 2019;12:184–186.
Dr’Agata V, Warren ST, Zhao W, et al. Gene expression profiles in a transgenic animal model of fragile X syndrome. Neurobiol Dis . 2002;10:211–218.
Malter JS, Ray BC, Westmark PR, et al. Fragile X syndrome and Alzheimerr’s disease: another story about APP and beta-amyloid. Curr Alzheimer Res . 2010;7:200–206.
Sokol DK, Maloney B, Long JM, et al. Autism, Alzheimer disease, and fragile X: APP, FMRP, and mGluR5 are molecular links. Neurology . 2011;76:1344–1352.
Renoux AJ, Carducci NM, Ahmady AA, et al. Fragile X mental retardation protein expression in Alzheimer’s disease. Front Genet . 2014;5:360.
Tassone F, Greco CM, Hunsaker MR, et al. Neuropathological, clinical and molecular pathology in female fragile X premutation carriers with and without FXTAS. Genes Brain Behav . 2012;11:577–855.
Glineburg MR, Todd PK, Charlet-Berguerand N, et al. Repeat-associated non-AUG (RAN) translation and other molecular mechanisms in fragile X tremor ataxia syndrome. Brain Res . 2018;1693(Pt A:43–54.