Parkinsonism in fragile X-associated tremor/ataxia syndrome (FXTAS): Revisited

Yu Qiong Niu, Jin Chen Yang, Deborah A. Hall, Maureen A. Leehey, Flora Tassone, John M Olichney, Randi J Hagerman, Lin Zhang

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

Background: Parkinsonian features have been used as a minor diagnostic criterion for fragile X-associated tremor/ataxia syndrome (FXTAS). However, prior studies have examined parkinsonism (defined as having bradykinesia with at least rest tremor or postural instability) mostly in premutation carriers without a diagnosis of FXTAS. The current study was intended to elaborate this important aspect of the FXTAS spectrum, and to quantify the relationships between parkinsonism, FXTAS clinical staging and genetic/molecular measures. Methods: Thirty eight (38) FXTAS patients and 10 age-matched normal controls underwent a detailed neurological examination that included all but one item (i.e. rigidity) of the motor section of the Unified Parkinson's Disease Rating Scale (UPDRS). Results: The FXTAS patient group displayed substantially higher prevalence of parkinsonian features including body bradykinesia (57%) and rest tremor (26%), compared to the control group. Furthermore, parkinsonism was identified in 29% of FXTAS patients. Across all patients, body bradykinesia scores significantly correlated with FXTAS clinical stage, FMR1 mRNA level, and ataxic gait of cerebellar origin, while postural instability was associated with intention tremor. Interpretation: Parkinsonian features in FXTAS appear to be characterized as bradykinesia concurrent with cerebellar gait ataxia, postural instability accompanied by intention tremor, and frequent rest tremor, representing distinctive patterns that highlight the need for further clinical studies including genetic testing for the FMR1 premutation. The association between FMR1 mRNA level and bradykinesia implicates pathophysiological mechanisms which may link FMR1 mRNA toxicity, dopamine deficiency and parkinsonism in FXTAS.

Original languageEnglish (US)
Pages (from-to)456-459
Number of pages4
JournalParkinsonism and Related Disorders
Volume20
Issue number4
DOIs
StatePublished - 2014

Keywords

  • Bradykinesia
  • FMR1 mRNA
  • Fragile X premutation
  • Parkinsonism

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Clinical Neurology
  • Neurology
  • Medicine(all)

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