Cited by 575Genetic Neurodegenerative DiseasesHereditary Neurological DisordersGenetics and Neurodevelopmental Disorders

Biallelic expansion of an intronic repeat in RFC1 is a common cause of late-onset ataxia

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Cortese, Andrea, Simone, Roberto, Sullivan, Roisin, Vandrovcova, Jana, Tariq, Huma, Yau, Wai Yan, Humphrey, Jack, Jaunmuktane, Zane +22 more·2019·Nature Genetics

Abstract

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”

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  1. [58]Dubowitz V, Sewry CA & Oldfors A Muscle Biopsy: a Practical Approach (Elsevier, 2013).

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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
Venue
Nature Genetics
Published
2019-03-29
Volume
51
Issue
4
Pages
649-658
ISSN
  • 1061-4036 (ISSN-L)
  • 1546-1718
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
Open access
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

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