The genetic architecture of pentanucleotide repeat variation and disease association
Abstract
Pentanucleotide tandem repeats (PNTRs) are associated with at least eleven neurological disorders in which pathogenic alleles are defined by both large repeat expansions and disease-specific non-reference motifs. However, population-scale, sequence-resolved datasets of PNTR variation have not been available, limiting interpretation of repeat alleles identified through long-read sequencing. Here, we genotyped 47,952 PNTR loci in 543 high-coverage PacBio HiFi genomes spanning five ancestry superpopulations, with validation in 500 Oxford Nanopore genomes. Using base-pair-resolved decomposition, we generated a genome-wide reference of PNTR length and sequence variation. Disease-associated PNTR loci emerged as extreme outliers for repeat-length variability, extreme allele length, and motif diversity. Sequence-resolved analyses further revealed that repeat length and sequence composition are frequently coupled, whereby alleles of distinct motif and interruption configurations occupy discrete length ranges. Finally, haplotype-resolved analyses showed that repeat variability and disease association converge on specific chromosomal backgrounds, exemplified by the SAMD12 locus. Together, these findings establish principles of PNTR variation for interpreting repeat alleles, prioritizing candidate loci, and discovering novel repeat expansion disorders.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Biallelic expansion of an intronic repeat in RFC1 is a common cause of late-onset ataxia
Cortese, A., Simone, R., Sullivan, R., Vandrovcova, J., Tariq, H., Yau, W. Y., Humphrey, J., Jaunmuktane, Z., Sivakumar, P., Polke, J., et al. (2019) · Nature Genetics · doi:10.1038/s41588-019-0372-4 · Cited by 575 · see citing works
Self-citationCAG Repeat Not Polyglutamine Length Determines Timing of Huntington’s Disease Onset
Lee, J., Correia, K., Loupe, J. M., Kim, K., Barker, D., Hong, E. P., Chao, M. J., Long, J. D., Lucente, D. E., Vonsattel, J. P., et al. (2019) · Cell · doi:10.1016/j.cell.2019.06.036 · Cited by 531 · see citing works
Large expansion of the ATTCT pentanucleotide repeat in spinocerebellar ataxia type 10
Matsuura, T., Yamagata, T., Burgess, D., Rasmussen, A., Grewal, R., Watase, K., Khajavi, M., McCall, A., Davis, C., Zu, L., et al. (2000) · Nature Genetics · doi:10.1038/79911 · Cited by 522 · see citing works
30 years of repeat expansion disorders: What have we learned and what are the remaining challenges?
Depienne, C., & Mandel, J.-L. (2021) · The American Journal of Human Genetics · doi:10.1016/j.ajhg.2021.03.011 · Cited by 429 · see citing works
Heterogeneous mutation processes in human microsatellite DNA sequences
Ellegren, H. (2000) · Nature Genetics · doi:10.1038/74249 · Cited by 377 · see citing works
Expansions of intronic TTTCA and TTTTA repeats in benign adult familial myoclonic epilepsy
Ishiura, H., Doi, K., Mitsui, J., Yoshimura, J., Matsukawa, M. K., Fujiyama, A., Toyoshima, Y., Kakita, A., Takahashi, H., Suzuki, Y., et al. (2018) · Nature Genetics · doi:10.1038/s41588-018-0067-2 · Cited by 322 · see citing works
Sato, N., Amino, T., Kobayashi, K., Asakawa, S., Ishiguro, T., Tsunemi, T., Takahashi, M., Matsuura, T., Flanigan, K. M., Iwasaki, S., et al. (2009) · The American Journal of Human Genetics · doi:10.1016/j.ajhg.2009.09.019 · Cited by 302 · see citing works
AGG interruptions within the maternal FMR1 gene reduce the risk of offspring with fragile X syndrome
Yrigollen, C. M., Durbin-Johnson, B., Gane, L., Nelson, D. L., Hagerman, R., Hagerman, P. J., & Tassone, F. (2012) · Genetics in Medicine · doi:10.1038/gim.2012.34 · Cited by 179 · see citing works
Florian, R. T., Kraft, F., Leitão, E., Kaya, S., Klebe, S., Magnin, É., van Rootselaar, A., Buratti, J., Kühnel, T., Schröder, C., et al. (2019) · Nature Communications · doi:10.1038/s41467-019-12763-9 · Cited by 166 · see citing works
Corbett, M. A., Kroes, T., Veneziano, L., Bennett, M. F., Florian, R. T., Schneider, A., Coppola, A., Licchetta, L., Franceschetti, S., Suppa, A., et al. (2019) · Nature Communications · doi:10.1038/s41467-019-12671-y · Cited by 159 · see citing works
Seixas, A. I., Loureiro, J. R., Costa, C., Ordóñez‐Ugalde, A., Marcelino, H., Oliveira, C. L., Loureiro, J. L., Dhingra, A., Brandão, E., Cruz, V. T., et al. (2017) · The American Journal of Human Genetics · doi:10.1016/j.ajhg.2017.06.007 · Cited by 148 · see citing works
Human-specific tandem repeat expansion and differential gene expression during primate evolution
Sulovari, A., Li, R., Audano, P. A., Porubskỳ, D., Vollger, M. R., Logsdon, G. A., Warren, W. C., Pollen, A. A., Chaisson, M., Eichler, E. E., et al. (2019) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1912175116 · Cited by 131 · see citing works
Characterization and visualization of tandem repeats at genome scale
Dolzhenko, E., English, A. C., Dashnow, H., Brandine, G. D. S., Mokveld, T., Rowell, W. J., Karniski, C., Kronenberg, Z. N., Danzi, M. C., Cheung, W., et al. (2024) · Nature Biotechnology · doi:10.1038/s41587-023-02057-3 · Cited by 130 · see citing works
Self-citationCen, Z., Jiang, Z., Chen, Y., Zheng, X., Xie, F., Yang, X., Lu, X., Ouyang, Z., Wu, H., Chen, S., et al. (2018) · Brain · doi:10.1093/brain/awy160 · Cited by 97 · see citing works
Increased frequency of repeat expansion mutations across different populations
Ibáñez, K., Jadhav, B., Zanovello, M., Gagliardi, D., Clarkson, C., Facchini, S., Garg, P., Martin-Trujillo, A., Gies, S. J., Deforie, V. G., et al. (2024) · Nature Medicine · doi:10.1038/s41591-024-03190-5 · Cited by 94 · see citing works
Rajan‐Babu, I., Dolzhenko, E., Eberle, M. A., & Friedman, J. M. (2024) · Nature Reviews Genetics · doi:10.1038/s41576-024-00696-z · Cited by 93 · see citing works
Self-citationRead-Based Phasing and Analysis of Phased Variants with WhatsHap
Martin, M., Ebert, P., & Marschall, T. (2022) · Methods in molecular biology · doi:10.1007/978-1-0716-2819-5_8 · Cited by 90 · see citing works
The Role of Interruptions in polyQ in the Pathology of SCA1
Menon, R., Nethisinghe, S., Faggiano, S., Vannocci, T., Rezaei, H., Pemble, S., Sweeney, M., Wood, N., Davis, M., Pastore, A., et al. (2013) · PLoS Genetics · doi:10.1371/journal.pgen.1003648 · Cited by 83 · see citing works
Nolin, S. L., Glicksman, A., Tortora, N. D., Allen, E. G., Macpherson, J., Milà, M., Vianna‐Morgante, A. M., Sherman, S. L., Dobkin, C., Latham, G. J., et al. (2019) · American Journal of Medical Genetics Part A · doi:10.1002/ajmg.a.61165 · Cited by 73 · see citing works
Kraus-Perrotta, C., & Lagalwar, S. (2016) · Cerebellum & Ataxias · doi:10.1186/s40673-016-0058-y · Cited by 59 · see citing works
Evolution of a Human-Specific Tandem Repeat Associated with ALS
Course, M. M., Gudsnuk, K. M., Smukowski, S. N., Winston, K., Desai, N., Ross, J. P., Sulovari, A., Bourassa, C. V., Spiegelman, D., Couthouis, J., et al. (2020) · The American Journal of Human Genetics · doi:10.1016/j.ajhg.2020.07.004 · Cited by 56 · see citing works
Advances in repeat expansion diseases and a new concept of repeat motif–phenotype correlation
Ishiura, H., & Tsuji, S. (2020) · Current Opinion in Genetics & Development · doi:10.1016/j.gde.2020.05.029 · Cited by 54 · see citing works
Complete sequencing of expandedSAMD12repeats by long-read sequencing and Cas9-mediated enrichment
Mizuguchi, T., Toyota, T., Miyatake, S., Mitsuhashi, S., Doi, H., Kudo, Y., Kishida, H., Hayashi, N., Tsuburaya, R. S., Kinoshita, M., et al. (2021) · Brain · doi:10.1093/brain/awab021 · Cited by 47 · see citing works
The mutational dynamics of short tandem repeats in large, multigenerational families
Steely, C. J., Watkins, W. S., Baird, L. M., & Jorde, L. B. (2022) · Genome biology · doi:10.1186/s13059-022-02818-4 · Cited by 45 · see citing works
Kay, C., Collins, J. A., Caron, N. S., Agostinho, L. D. A., Black, H. F., Casal, L. L., Sumathipala, D., Dissanayake, V. H. W., Cornejo‐Olivas, M., Baine, F., et al. (2019) · The American Journal of Human Genetics · doi:10.1016/j.ajhg.2019.10.011 · Cited by 42 · see citing works
A common flanking variant is associated with enhanced stability of the FGF14-SCA27B repeat locus
Pellerin, D., Gobbo, G. F. D., Couse, M., Dolzhenko, E., Nageshwaran, S., Cheung, W., Xu, I. R. L., Dicaire, M., Spurdens, G., Matos-Rodrigues, G. E., et al. (2024) · Nature Genetics · doi:10.1038/s41588-024-01808-5 · Cited by 41 · see citing works
Self-citationCCG•CGG interruptions in high‐penetrance SCA8 families increase RAN translation and protein toxicity
Perez, B. A., Shorrock, H. K., Báñez-Coronel, M., Zu, T., Romano, L. E. L., Laboissonniere, L. A., Reid, T. S., Ikeda, Y., Reddy, K., Gomez, C. M., et al. (2021) · EMBO Molecular Medicine · doi:10.15252/emmm.202114095 · Cited by 37 · see citing works
Pentanucleotide Repeat Insertions in RAI1 Cause Benign Adult Familial Myoclonic Epilepsy Type 8
Yeetong, P., Dembélé, M. E., Pongpanich, M., Cissé, L., Srichomthong, C., Maīga, A. B., Dembélé, K., Assawapitaksakul, A., Bamba, S., Yalcouyé, A., et al. (2023) · Movement Disorders · doi:10.1002/mds.29654 · Cited by 28 · see citing works
Genetics of familial adult myoclonus epilepsy: From linkage studies to noncoding repeat expansions
Corbett, M. A., Depienne, C., Veneziano, L., Klein, K. M., Brancati, F., Guerrini, R., Zara, F., Tsuji, S., & Gécz, J. (2023) · Epilepsia · doi:10.1111/epi.17610 · Cited by 28 · see citing works
Loureiro, J. R., Oliveira, C. L., Mota, C., Castro, A. F., Costa, C., Loureiro, J. L., Coutinho, P., Martins, S., Sequeiros, J., & Silveira, I. (2018) · Human Mutation · doi:10.1002/humu.23704 · Cited by 27 · see citing works
Curlis, Y., Zhang, C., Holden, J. J. A., Kirkby, K. (., Loesch, D. Z., & Mitchell, R. J. (2005) · Human Biology · doi:10.1353/hub.2005.0029 · Cited by 20 · see citing works
Maroilley, T., Tsai, M., Mascarenhas, R., Diao, C. T. M., Khanbabaei, M., Kaya, S., Depienne, C., Tarailo‐Graovac, M., & Klein, K. M. (2023) · Epilepsia Open · doi:10.1002/epi4.12702 · Cited by 19 · see citing works
Delforge, V., Tard, C., Davion, J., Dujardin, K., Wissocq, A., Dhaenens, C., Mutez, E., & Huin, V. (2024) · Revue Neurologique · doi:10.1016/j.neurol.2024.03.006 · Cited by 18 · see citing works
Alu-Mediated Acquisition of Unstable ATTCT Pentanucleotide Repeats in the Human ATXN10 Gene
Kurosaki, T., Matsuura, T., Ohno, K., & Ueda, S. (2009) · Molecular Biology and Evolution · doi:10.1093/molbev/msp172 · Cited by 13 · see citing works
Costa, I. P. D., Almeida, B. C., Sequeiros, J., Amorim, A., & Martins, S. (2019) · Frontiers in Genetics · doi:10.3389/fgene.2019.00038 · Cited by 13 · see citing works
The impact of interrupted ATXN10 expansions on clinical findings of spinocerebellar ataxia type 10
Hasan, A., Furtado, G. V., Miglorini, E. C., Mergener, R., Massuyama, B. K., Barsottini, O. G. P., Pedroso, J. L., Teive, H. G., Pereira, M. L. S., Ashizawa, T., et al. (2025) · Journal of Neurology · doi:10.1007/s00415-025-13003-5 · Cited by 10 · see citing works
de Sabando, A. R., Lafuente, E. U., Galbete, A., Ciosi, M., Amigot, F. G., García-Solaesa, V., Spanish HD Collaborative group, Martínez, V. Á., Martínez‐Descals, A., Milà, M., et al. (2022) · Human Molecular Genetics · doi:10.1093/hmg/ddac224 · Cited by 10 · see citing works
Biallelic GGGCC repeat expansion leading to NAXE-related mitochondrial encephalopathy
Ozaki, K., Yatsuka, Y., Oyazato, Y., Nishiyama, A., Nitta, K. R., Kishita, Y., Fushimi, T., Shimura, M., Noma, S., Sugiyama, Y., et al. (2024) · npj Genomic Medicine · doi:10.1038/s41525-024-00429-5 · Cited by 9 · see citing works
Weisburd, B., Dolzhenko, E., Bennett, M. F., Danzi, M. C., Xu, I. R. L., Tanudisastro, H. A., Gu, B., English, A. C., Hiatt, L., Mokveld, T., et al. (2026) · The American Journal of Human Genetics · doi:10.1016/j.ajhg.2026.03.020 · Cited by 6 · see citing works
Self-citationRautila, O. S., Kaivola, K., Rautila, H., Hokkanen, L., Launes, J., Strandberg, T. E., Laaksovirta, H., Palmio, J., & Tienari, P. J. (2024) · The American Journal of Human Genetics · doi:10.1016/j.ajhg.2023.12.019 · Cited by 5 · see citing works
Said, I., Barbash, D. A., & Clark, A. G. (2024) · Genome Biology and Evolution · doi:10.1093/gbe/evae153 · Cited by 5 · see citing works
Diverse short tandem repeat sequences influence gene regulation in human populations
Mitina, A., Engchuan, W., Trost, B., Pellecchia, G., Scherer, S. W., & Yuen, R. K. C. (2025) · Genome biology · doi:10.1186/s13059-025-03754-9 · Cited by 5 · see citing works
Flagged first, then by citations
Cited by
Still being checked.
- Authors
- Xu, I. R. L., Pellerin, D., Van De Vondel, L., Weisburd, B., Dolzhenko, E., Danzi, M. C., & Zuchner, S.
- Affiliations
- University of Miami (US)
- Montreal Neurological Institute and Hospital (CA)
- Broad Institute (US)
- Pacific Biosciences (United States) (US)
- Corresponding author
- Zuchner, Stephan
- Venue
- The American Journal of Human Genetics
- Publisher
- Elsevier BV
- Published
- 2026-10
- ISSN
- 0002-9297 (ISSN-L)
- OpenAlex
- W7222496565
- Cited by
- 0
- References
- 42
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Human Genetics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Genetic Neurodegenerative Diseases
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genomics and Rare Diseases
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Neurodevelopmental Disorders
- Keywords
- repeat expansion disorders, neurological disorders, long-read sequencing
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review