FMR1 Carriers Report Executive Function Changes Prior to Fragile X-Associated Tremor/Ataxia Syndrome: A Longitudinal
David Hessl1,2, Karina Mandujano Rojas1,3, Emilio Ferrer4
1MIND Institute, University of California Davis Health, Sacramento, California, USA.
Executive function decline in men with the FMR1 premutation (PC) precedes and predicts fragile X-associated tremor/ataxia syndrome (FXTAS). These changes in cognitive abilities serve as an early warning sign for the developing movement disorder.
Area of Science:
- Neuroscience
- Genetics
- Neurology
Background:
- Fragile X-associated tremor/ataxia syndrome (FXTAS) in men is linked to executive dysfunction, including disinhibition and attention deficits.
- Previous studies suggested early executive function changes, but lacked longitudinal data to confirm this hypothesis.
Purpose of the Study:
- To investigate if executive function deterioration in FMR1 premutation carriers (PC) precedes and predicts FXTAS development.
- To establish a longitudinal understanding of cognitive changes in PC.
Main Methods:
- A longitudinal study tracked 66 FMR1 PC and 31 healthy controls (HC) over 1-9 years.
- Participants completed the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) at multiple visits; 28 PC developed FXTAS.
Main Results:
- Premutation carriers showed a greater age-related decline in Metacognition Index (MI) compared to controls.
- FXTAS development correlated with worsening MI and Behavioral Regulation Index (BRI) scores.
- Baseline self-reported executive function issues predicted later FXTAS onset.
Conclusions:
- Executive function changes in male PC act as a prodrome for FXTAS.
- Early cognitive alterations are key indicators of future movement disorder development.
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