Gene therapy for spinocerebellar ataxias

Spinocerebellar ataxias (SCAs), rare neurodegenerative disorders characterized by progressive cerebellar degeneration, cause impaired balance and motor dysfunction. Although most cases are inherited, sporadic forms also occur, and effective disease-modifying therapies remain unavailable despite advances in understanding their genetic and molecular mechanisms. This unmet need is particularly significant because many SCAs are monogenic disorders caused by well-characterized mutations, making them promising candidates for gene- and RNA-based therapies. Recent advances in antisense oligonucleotides, RNA interference, vector engineering, and genome editing have increasingly enabled the alignment of therapeutic strategies with specific mutational architectures. Therefore, this review aims to examine how genetic subclassification informs platform selection, summarize recent advances in gene- and RNA-based therapeutics, and outline key translational barriers to clinical implementation in SCAs.