Biallelic expansion of an intronic repeat in RFC1 is a common cause of late-onset ataxia
Open accessAbstract
Late-onset ataxia is common, often idiopathic, and can result from cerebellar, proprioceptive, or vestibular impairment; when in combination, it is also termed cerebellar ataxia, neuropathy, vestibular areflexia syndrome (CANVAS). We used non-parametric linkage analysis and genome sequencing to identify a biallelic intronic AAGGG repeat expansion in the replication factor C subunit 1 (RFC1) gene as the cause of familial CANVAS and a frequent cause of late-onset ataxia, particularly if sensory neuronopathy and bilateral vestibular areflexia coexist. The expansion, which occurs in the poly(A) tail of an AluSx3 element and differs in both size and nucleotide sequence from the reference (AAAAG)11 allele, does not affect RFC1 expression in patient peripheral and brain tissue, suggesting no overt loss of function. These data, along with an expansion carrier frequency of 0.7% in Europeans, implies that biallelic AAGGG expansion in RFC1 is a frequent cause of late-onset ataxia.
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Alternative repeat motifs occur in some tandem repeat expansion disorders, complicating detection.
“Alternative repeat motifs are found in some disorders associated with tandem repeat expansions26,27, which complicates identification”
From Genome-wide detection of tandem DNA repeats that are expanded in autism (2020) · cites this paper as [26]
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- Authors
- Cortese, A., Simone, R., Sullivan, R., Vandrovcova, J., Tariq, H., Yau, W. Y., Humphrey, J., Jaunmuktane, Z., Sivakumar, P., Polke, J., Ilyas, M., Tribollet, E., Tomaselli, P. J., Devigili, G., Callegari, I., Versino, M., Salpietro, V., Efthymiou, S., Kaski, D., Wood, N. W., Andrade, N. S., Buglo, E., Rebelo, A., Rossor, A. M., Bronstein, A., Fratta, P., Marques, W. J., Züchner, S., Reilly, M. M., & Houlden, H.
- Affiliations
- National Hospital for Neurology and Neurosurgery (GB)
- International Islamic University, Islamabad (PK)
- Universidade de São Paulo (BR)
- Fondazione IRCCS Istituto Neurologico Carlo Besta (IT)
- University of Pavia (IT)
- University of Miami (US)
- Corresponding author
- Cortese, Andrea
- ORCID
- Cortese, Andrea
- Simone, Roberto
- Sullivan, Roisin
- Tariq, Huma
- Yau, Wai Yan
- Humphrey, Jack
- Jaunmuktane, Zane
- Polke, James
- Ilyas, Muhammad
- Tomaselli, Pedro J.
- Devigili, Grazia
- Callegari, Ilaria
- Versino, Maurizio
- Salpietro, Vincenzo
- Efthymiou, Stephanie
- Kaski, Diego
- Buglo, Elena
- Rebelo, Adriana
- Rossor, Alexander M.
- Bronstein, Adolfo
- Fratta, Pietro
- Marques, Wilson J.
- Reilly, Mary M.
- Houlden, Henry
- Venue
- Nature Genetics
- Published
- 2019-03-29
- Volume
- 51
- Issue
- 4
- Pages
- 649-658
- ISSN
- 1061-4036 (ISSN-L)
- 1546-1718
- PMC
- PMC6709527
- OpenAlex
- W2933273758
- Cited by
- 575
- References
- 68
- Citations by year
- 2026: 58 · 2025: 87 · 2024: 101 · 2023: 83 · 2022: 78 · 2021: 69 · 2020: 67 · 2019: 30
- FWCI
- 29.38
- Type
- journal article
- Language
- en
- Update notices
- correction (2019-04-26)
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Genetics (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- IrInSubria (University of Insubria) (submittedVersion)
- CINECA IRIS Institutial Research Information System (University of Genoa) (submittedVersion, other-oa)
- Funders
- Wellcome Trust (110043/Z/15/Z, 165908, 104033/Z/14/Z, 204841/Z/16/Z)
- Brain Research UK
- National Institute for Health and Care Research (NF-SI-0515-10082)
- Ataxia UK
- Motor Neurone Disease Association (Fratta/Mar19/951-795, FRATTA/JAN15/946-795)
- Rosetrees Trust
- Medical Research Council (MR/J004758/1, MR/S006508/1, MR/N004272/1, MR/S01165X/1, 1936823, MR/M008606/1)
- National Institute of Neurological Disorders and Stroke (R01NS075764, U54NS065712, R01NS072248)
- Topics
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Genetic Neurodegenerative Diseases
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Hereditary Neurological Disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Neurodevelopmental Disorders
- Keywords
- RFC1, late-onset ataxia, trinucleotide repeat disorders, carrier frequency, loss of function
- MeSH terms
- Whole Genome Sequencing, Adult, Aged, Alleles, Ataxia, Cerebellar Ataxia, Humans, Introns, Male, Middle Aged, Repetitive Sequences, Nucleic Acid, Replication Protein C
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 ›
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