Skip to main content

Neuroimaging Findings in FXTAS

  • Chapter
  • First Online:

Abstract

In this chapter, we review the neuroimaging findings associated with fragile X-associated tremor/ataxia syndrome (FXTAS). We review what is currently known about radiological signs of the disorder including both white matter lesions and mild to severe cortical loss. We also review findings on the integrity of white matter tracts in the brain (using diffusion tensor imaging) and in vivo brain function (using functional magnetic resonance imaging) in individuals with the FX premutation with and without FXTAS. Brain-molecular relationships in FXTAS including associations that have been observed between cortical and white matter changes and molecular variables such as CGG repeat length are also discussed. Similarly, we review relationships that have been reported between brain abnormalities and the neuropsychological phenotype in FXTAS. While much knowledge has been gained about the neuropathology of FXTAS, future work will focus on continuing our understanding of the developmental time course of this pathogenesis as well as searching for brain biomarkers of the disease in asymptomatic premutation carriers.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • Adams JS, Adams PE, Nguyen D, Brunberg JA, Tassone F, Zhang W, Koldewyn K, Rivera SM, Grigsby J, Zhang L, Decarli C, Hagerman PJ, Hagerman RJ (2007) Volumetric brain changes in females with fragile X-associated tremor/ataxia syndrome (FXTAS). Neurology 69(9):851–859

    Article  CAS  PubMed  Google Scholar 

  • Adams P, Adams J, Nguyen D, Hessl D, Brunberg J, Tassone F, Zhang W, Koldewyn K, Rivera S, Grigsby J (2010) Psychological symptoms correlate with reduced hippocampal volume in fragile X premutation carriers. Am J Med Genet B Neuropsychiatr Genet 153(3):775–785

    Google Scholar 

  • Arocena DG, Iwahashi CK, Won N, Beilina A, Ludwig AL, Tassone F, Schwartz PH, Hagerman PJ (2005) Induction of inclusion formation and disruption of lamin A/C structure by premutation CGG-repeat RNA in human cultured neural cells. Hum Mol Genet 14(23):3661–3671

    Article  CAS  PubMed  Google Scholar 

  • Basser PJ, Pierpaoli C (1996) Microstructural and physiological features of tissues elucidated by quantitative-diffusion-tensor MRI. J Magn Reson B 111(3):209–219

    Article  CAS  PubMed  Google Scholar 

  • Basser PJ, Mattiello J, Lebihan D (1994) MR diffusion tensor spectroscopy and imaging. Biophys J 66(1):259–267

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Battistella G, Niederhauser J, Fornari E, Hippolyte L, Perrin AG, Lesca G, Forzano F, Hagmann P, Vingerhoets FJ, Draganski B (2013) Brain structure in asymptomatic FMR1 premutation carriers at risk for fragile X-associated tremor/ataxia syndrome. Neurobiol Aging 34(6):1700–1707

    Article  CAS  PubMed  Google Scholar 

  • Besterman AD, Wilke SA, Mulligan T-E, Allison SC, Hagerman R, Seritan AL, Bourgeois JA (2014) Towards an understanding of neuropsychiatric manifestations in fragile X premutation carriers. Future Neurol 9(2):227–239

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Birch RC, Hocking DR, Cornish KM, Menant JC, Georgiou-Karistianis N, Godler DE, Wen W, Hackett A, Rogers C, Trollor JN (2015) Preliminary evidence of an effect of cerebellar volume on postural sway in FMR1 premutation males. Genes Brain Behav 14(3):251–259

    Article  CAS  PubMed  Google Scholar 

  • Bourgeois JA, Seritan AL, Casillas EM, Hessl D, Schneider A, Yang Y, Kaur I, Cogswell JB, Nguyen DV, Hagerman RJ (2011) Lifetime prevalence of mood and anxiety disorders in fragile X premutation carriers. J Clin Psychiatry 72(2):175

    Article  PubMed  Google Scholar 

  • Brega AG, Goodrich G, Bennett RE, Hessl D, Engle K, Leehey MA, Bounds LS, Paulich MJ, Hagerman RJ, Hagerman PJ, Cogswell JB, Tassone F, Reynolds A, Kooken R, Kenny M, Grigsby J (2008) The primary cognitive deficit among males with fragile X-associated tremor/ataxia syndrome (FXTAS) is a dysexecutive syndrome. J Clin Exp Neuropsychol 30(8):853–869

    Article  PubMed  PubMed Central  Google Scholar 

  • Brunberg J, Jaquemont S, Hagerman RJ, Berry-Kravis EM, Grigsby J, Leehey MA, Tassone F, Brown WT, Greco CM, Hagerman PJ (2002) Fragile X premutation carriers: characteristic MR imaging findings in adult male patients with progressive cerebellar and cognitive dysfunction. Am J Neurol Radiol 23:1757–1766

    Google Scholar 

  • Cabeza R, Nyberg L (2000) Neural bases of learning and memory: functional neuroimaging evidence. Curr Opin Neurol 13(4):415–421

    Article  CAS  PubMed  Google Scholar 

  • Capelli LP, Goncalves MR, Kok F, Leite CC, Nitrini R, Barbosa ER, Vianna-Morgante AM (2007) Fragile X-associated tremor/ataxia syndrome: intrafamilial variability and the size of the FMR1 premutation CGG repeat. Mov Disord 22(6):866–870

    Article  PubMed  Google Scholar 

  • Cohen S, Masyn K, Adams J, Hessl D, Rivera S, Tassone F, Brunberg J, Decarli C, Zhang L, Cogswell J, Loesch D, Leehey M, Grigsby J, Hagerman PJ, Hagerman R (2006) Molecular and imaging correlates of the fragile X-associated tremor/ataxia syndrome. Neurology 67(8):1426–1431

    Article  CAS  PubMed  Google Scholar 

  • Filley CM, Brown MS, Onderko K, Ray M, Bennett RE, Berry-Kravis E, Grigsby J (2015) White matter disease and cognitive impairment in FMR1 premutation carriers. Neurology 84(21):2146–2152

    Article  PubMed  PubMed Central  Google Scholar 

  • Fuster J (2008) The prefrontal cortex. Academic, London

    Google Scholar 

  • Greco CM, Hagerman RJ, Tassone F, Chudley AE, Del Bigio MR, Jacquemont S, Leehey M, Hagerman PJ (2002) Neuronal intranuclear inclusions in a new cerebellar tremor/ataxia syndrome among fragile X carriers. Brain 125(Pt 8):1760–1771

    Article  CAS  PubMed  Google Scholar 

  • Greco CM, Berman RF, Martin RM, Tassone F, Schwartz PH, Chang A, Trapp BD, Iwahashi C, Brunberg J, Grigsby J, Hessl D, Becker EJ, Papazian J, Leehey MA, Hagerman RJ, Hagerman PJ (2006) Neuropathology of fragile X-associated tremor/ataxia syndrome (FXTAS). Brain 129(Pt 1):243–255

    CAS  PubMed  Google Scholar 

  • Grigsby J, Brega AG, Jacquemont S, Loesch DZ, Leehey MA, Goodrich GK, Hagerman RJ, Epstein J, Wilson R, Cogswell JB, Jardini T, Tassone F, Hagerman PJ (2006a) Impairment in the cognitive functioning of men with fragile X-associated tremor/ataxia syndrome (FXTAS). J Neurol Sci 248(1–2):227–233

    Article  PubMed  Google Scholar 

  • Grigsby J, Leehey MA, Jacquemont S, Brunberg JA, Hagerman RJ, Wilson R, Epstein JH, Greco CM, Tassone F, Hagerman PJ (2006b) Cognitive impairment in a 65-year-old male with the fragile X-associated tremor-ataxia syndrome (FXTAS). Cogn Behav Neurol 19(3):165–171

    Article  PubMed  Google Scholar 

  • Grigsby J, Brega AG, Leehey MA, Goodrich GK, Jacquemont S, Loesch DZ, Cogswell JB, Epstein J, Wilson R, Jardini T, Gould E, Bennett RE, Hessl D, Cohen S, Cook K, Tassone F, Hagerman PJ, Hagerman RJ (2007) Impairment of executive cognitive functioning in males with fragile X-associated tremor/ataxia syndrome. Mov Disord 22(5):645–650

    Article  PubMed  Google Scholar 

  • Grigsby J, Brega AG, Engle K, Leehey MA, Hagerman RJ, Tassone F, Hessl D, Hagerman PJ, Cogswell JB, Bennett RE, Cook K, Hall DA, Bounds LS, Paulich MJ, Reynolds A (2008) Cognitive profile of fragile X premutation carriers with and without fragile X-associated tremor/ataxia syndrome. Neuropsychology 22(1):48–60

    Article  PubMed  Google Scholar 

  • Hagerman PJ, Hagerman RJ (2015) Fragile X-associated tremor/ataxia syndrome. Ann N Y Acad Sci 1338:58–70

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hallett M, Grafman J (1997) Executive functioning and motor skill learning. The cerebellum and cognition. Academic Press, San Diego, pp 297–323

    Google Scholar 

  • Hashimoto R, Backer KC, Tassone F, Hagerman RJ, Rivera SM (2011a) An fMRI study of the prefrontal activity during the performance of a working memory task in premutation carriers of the fragile X mental retardation 1 gene with and without fragile X-associated tremor/ataxia syndrome (FXTAS). J Psychiatr Res 45(1):36–43

    Article  PubMed  Google Scholar 

  • Hashimoto R, Javan AK, Tassone F, Hagerman RJ, Rivera SM (2011b) A voxel-based morphometry study of grey matter loss in fragile X-associated tremor/ataxia syndrome. Brain 134(3):863–878

    Article  PubMed  PubMed Central  Google Scholar 

  • Hashimoto R, Srivastava S, Tassone F, Hagerman RJ, Rivera SM (2011c) Diffusion tensor imaging in male premutation carriers of the fragile X mental retardation gene. Mov Disord 26(7):1329–1336

    Article  PubMed  PubMed Central  Google Scholar 

  • Iwahashi CK, Yasui DH, An HJ, Greco CM, Tassone F, Nannen K, Babineau B, Lebrilla CB, Hagerman RJ, Hagerman PJ (2006) Protein composition of the intranuclear inclusions of FXTAS. Brain 129(Pt 1):256–271

    CAS  PubMed  Google Scholar 

  • Jacquemont S (2005) Screening for FXTAS. Eur J Hum Genet 13(1):2–3

    Article  PubMed  Google Scholar 

  • Jacquemont S, Hagerman RJ, Leehey M, Grigsby J, Zhang L, Brunberg JA, Greco C, Des Portes V, Jardini T, Levine R, Berry-Kravis E, Brown WT, Schaeffer S, Kissel J, Tassone F, Hagerman PJ (2003) Fragile X premutation tremor/ataxia syndrome: molecular, clinical, and neuroimaging correlates. Am J Hum Genet 72(4):869–878

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Jacquemont S, Farzin F, Hall D, Leehey M, Tassone F, Gane L, Zhang L, Grigsby J, Jardini T, Lewin F, Berry-Kravis E, Hagerman PJ, Hagerman RJ (2004) Aging in individuals with the FMR1 mutation. Am J Ment Retard 109(2):154–164

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Leehey LM, Munhoz RP, Lang AE, Brunberg JA, Gringsby J, Greco C, Jaquemont S, Tassone F, Lozano AM, Hagerman PJ, Hagermann RJ (2003) The fragile X premutation presenting as essential tremor. Arch Neurol 60:117–121

    Article  PubMed  Google Scholar 

  • Leiner HC, Leiner AL, Dow RS (1993) Cognitive and language functions of the human cerebellum. Trends Neurosci 16(11):444–447

    Article  CAS  PubMed  Google Scholar 

  • Loesch DZ, Litewka L, Brotchie P, Huggins RM, Tassone F, Cook M (2005) Magnetic resonance imaging study in older fragile X premutation male carriers. Ann Neurol 58(2):326–330

    Article  CAS  PubMed  Google Scholar 

  • Loesch DZ, Cook M, Litewka L, Gould E, Churchyard A, Tassone F, Slater HR, Storey E (2008) A low symptomatic form of neurodegeneration in younger carriers of the FMR1 premutation, manifesting typical radiological changes. J Med Genet 45(3):179–181

    Article  CAS  PubMed  Google Scholar 

  • Louis E, Moskowitz C, Friez M, Amaya M, Vonsattel JP (2006) Parkinsonism, dysautonomia, and intranuclear inclusions in a fragile X carrier: a clinical-pathological study. Mov Disord 21(3):420–425

    Article  PubMed  Google Scholar 

  • Middleton FA, Strick PL (1997) New concepts about the organization of basal ganglia output. The basal ganglia and new surgical approaches for Parkinson’s disease, advances in neurology. Lippincott-Raven, Philadelphia, pp 57–68

    Google Scholar 

  • Moore CJ, Daly EM, Tassone F, Tysoe C, Schmitz N, Ng V, Chitnis X, Mcguire P, Suckling J, Davies KE, Hagerman RJ, Hagerman PJ, Murphy KC, Murphy DG (2004) The effect of pre-mutation of X chromosome CGG trinucleotide repeats on brain anatomy. Brain 127(Pt 12):2672–2681

    Article  PubMed  Google Scholar 

  • Ngai S, Tang YM, Du L, Stuckey S (2006) Hyperintensity of the middle cerebellar peduncles on fluid-attenuated inversion recovery imaging: variation with age and implications for the diagnosis of multiple system atrophy. AJNR Am J Neuroradiol 27(10):2146–2148

    CAS  PubMed  Google Scholar 

  • Renaud M, Perriard J, Coudray S, Sévin-Allouet M, Marcel C, Meissner WG, Chanson J-B, Collongues N, Philippi N, Gebus O (2014) Relevance of corpus callosum splenium versus middle cerebellar peduncle hyperintensity for FXTAS diagnosis in clinical practice. J Neurol 262(2):435–442

    Article  PubMed  Google Scholar 

  • Schmahmann JD (2000) Cerebellum and brainstem. Brain mapping: the systems. Academic, San Diego, pp 207–259

    Book  Google Scholar 

  • Storey E, Billimoria P (2005) Increased T2 signal in the middle cerebellar peduncles on MRI is not specific for fragile X premutation syndrome. J Clin Neurosci 12(1):42–43

    Article  CAS  PubMed  Google Scholar 

  • Tullberg M, Fletcher E, Decarli C, Mungas D, Reed BR, Harvey DJ, Weiner MW, Chui HC, Jagust WJ (2004) White matter lesions impair frontal lobe function regardless of their location. Neurology 63(2):246–253

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Wang JY, Hessl D, Hagerman RJ, Tassone F, Rivera SM (2012) Age-dependent structural connectivity effects in fragile x premutation. Arch Neurol 69(4):482–489

    Article  PubMed  PubMed Central  Google Scholar 

  • Wang JY, Hagerman RJ, Rivera SM (2013a) A multimodal imaging analysis of subcortical gray matter in fragile X premutation carriers. Mov Disord 28(9):1278–1284

    Article  PubMed  PubMed Central  Google Scholar 

  • Wang JY, Hessl D, Schneider A, Tassone F, Hagerman RJ, Rivera SM (2013b) Fragile X-associated tremor/ataxia syndrome: influence of the FMR1 gene on motor fiber tracts in males with normal and premutation alleles. JAMA Neurol 70(8):1022–1029

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

This work was partially supported by R01MH078041-06, R01HD036071-14, RL1NS062412, R21MH080025, and the Pharmaceutical Research and Manufacturers of America postdoctoral fellowship.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Susan M. Rivera .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Halket, E.S., Wang, J.Y., Hessl, D., Rivera, S.M. (2016). Neuroimaging Findings in FXTAS. In: Tassone, F., Hall, D. (eds) FXTAS, FXPOI, and Other Premutation Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-33898-9_4

Download citation

Publish with us

Policies and ethics