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FMR1 and the fragile X syndrome: Human genome epidemiology review
Open accessAbstract
The fragile X syndrome, an X-linked dominant disorder with reduced penetrance, is one of the most common forms of inherited mental retardation. The cognitive, behavioral, and physical phenotype varies by sex, with males being more severely affected because of the X-linked inheritance of the mutation. The disorder-causing mutation is the amplification of a CGG repeat in the 5' untranslated region of FMR1 located at Xq27.3. The fragile X CGG repeat has four forms: common (6-40 repeats), intermediate (41-60 repeats), premutation (61-200 repeats), and full mutation (>200-230 repeats). Population-based studies suggest that the prevalence of the full mutation, the disorder-causing form of the repeat, ranges from 1/3,717 to 1/8,918 Caucasian males in the general population. The full mutation is also found in other racial/ethnic populations; however, few population-based studies exist for these populations. No population-based studies exist for the full mutation in a general female population. In contrast, several large, population-based studies exist for the premutation or carrier form of the disorder, with prevalence estimates ranging from 1/246 to 1/468 Caucasian females in the general population. For Caucasian males, the prevalence of the premutation is approximately 1/1,000. Like the full mutation, little information exists for the premutation in other populations. Although no effective cure or treatment exists for the fragile X syndrome, all persons affected with the syndrome are eligible for early intervention services. The relatively high prevalence of the premutation and full mutation genotypes coupled with technological advances in genetic testing make the fragile X syndrome amenable to screening. The timing as well as benefits and harms associated with the different screening strategies are the subject of current research and discussion.
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“FXS is the most common inherited cause of intellectual disability, occurring in 1 in 4,000 males and 1 in 8,000 females [706]”
From Reward circuitry dysfunction in psychiatric and neurodevelopmental disorders and genetic syndromes: animal models and clinical findings (2012) · cites this paper as [706]
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“Fragile X (FX) syndrome is the most common form of inherited mental retardation (Crawford et al., 2001; Rousseau et al., 1992).”
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Pavlova, M. A. (2011) · Cerebral Cortex · doi:10.1093/cercor/bhr156 · Cited by 407
“FXS or Martin-Bell syndrome is a rare genetic condition (1:4000 in males and 1:8000 in females, Crawford et al. 2001) that is associated with the expansion of a single trinucleotide gene sequence (CGG) on the X chromosome and yields a failure to express the FMR1 protein, which is required for…”
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“Fragile X Syndrome Fragile X syndrome (FXS) is the most common identifiable inherited cause of intellectual disability and of autism, worldwide, with a prevalence in the general population of approximately 1/4000 males and 1/8,000 females [Turner et al., 1996; Crawford et al., 2001; Coffee et al., 2009].”
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“FXS is the most common inherited cause of intellectual disability, occurring in 1 in 4,000 males and 1 in 8,000 females [706], and is caused by a mutation of the FMR1 gene on the long arm of the X chromosome(locus Xq27.”
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“…Approximately 1/4000 males have fragile X syndrome and, by inference, about 1/8000 females have significant features of the syndrome (for review, see Crawford et al. (2001)).6 Premutation alleles are defined as long, unmethylated repeat tracks that are unstably transmitted from parent to child.”
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“However, population studies in Caucasians, the only population for which significant data exist, indicate that ∼1 in 246–468 females have 55–200 repeats and ∼1 in 3717–8918 males have 200 to >1000 repeats at this locus (Crawford et al. 2001).”
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“The repeat expansion leads to DNA hypermethylation and histone deacetylation of FMR1, resulting in loss of FMR1 expression.(27) In several cases with an expanded repeat allele, the absence of DNA methylation results in a normal clinical phenotype,(56,57) highlighting the importance of epigenetic modifications in produ…”
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“Fragile X syndrome (FXS) is the most common inherited cause of mental retardation, occurring in approximately 1 per 4,000males and 1 in 8,000 females [Crawford et al., 2001].”
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“The prevalence of Frax is between 1/3500 and 1/9000 in males [36].”
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“…are not firmly established, with some clinical and prevalence studies defining the lower bound at 35 CGG repeats [Rousseau et al., 1995; Bretherick et al., 2005; Curlis et al., 2005] and others defining the upper bound at 60 repeats [Crawford et al., 2001;Curlis et al., 2005;Mitchell et al., 2005].”
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“…a hypermethylated CGG repeat expansion in the FMR1 gene that leads to a drastic reduction in its protein product, FMRP. FMRP is an RNA binding protein that has been implicated in regulating protein expression (Bagni & Greenough 2005; Chen & Joseph 2015; Crawford et al. 2001; Kazdoba et al. 2014).”
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“…(FXS) is the most common inherited form of intellectual disability with an incidence in males of one in 3,600, and it is caused by the silencing of the fragile X mental retardation 1 (FMR1) gene located on chromosome X (Crawford et al., 2001; O’Donnell and Warren, 2002; Penagarikano et al., 2007).”
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“Fragile X mental retardation 1 (FMR1) gene is located on chromosome X, and its silencing causes the most common inherited intellectual disability, fragile X syndrome (FXS) [45].”
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“Fragile X syndrome (FXS) is the most prevalent cause of inherited intellectual disability and is a leading genetic cause of autism (Crawford et al., 2001).”
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“This disease affects males more often, and more severely, than females, with an estimated incidence of 1 in 5000 males and 1 in 9000 females [33].”
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A study of the distributional characteristics of FMR1 transcript levels in 238 individuals
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“Fragile X Syndrome (FXS) is the leading cause of autism and the most common form of inherited mental retardation (Crawford et al., 2001; Garber et al., 2008).”
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“6-1/4000 live births for fraX (Crawford et al., 2001).”
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“In this study, 12 of 45 affected male sibpairs were diagnosed with fragile X, which would correspond to an incidence of fragile X of about one in 6000 in males, which fits rather well with current estimates of one in four to 6000 males in various populations”
BackgroundArginines of the RGG box regulate FMRP association with polyribosomes and mRNA
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“Fragile X syndrome (FXS) is the most common form of heritable mental retardation, affecting 1/4000 males and 1/8000 females and is due to loss of expression of the fragile X mental retardation protein FMRP (1).”
BackgroundLanguage comprehension in boys with fragile X syndrome and boys with Down syndrome
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“The most common inherited form of mental retardation, Fragile X Syndrome (FXS), affects approximately 1 in 4000 males and 1 in 8000 females (Crawford et al., 2001; Visootsak et al., 2005).”
BackgroundPractice parameter: Evaluation of the child with global developmental delay
Whelen, M. A. (2003) · Neurology · doi:10.1212/wnl.61.9.1315 · Cited by 110
Oddi, D., Subashi, E., Middei, S., Bellocchio, L., Lemaire, V., Guzmán, M., Crusio, W. E., D'Amato, F. R., & Pietropaolo, S. (2014) · Neuropsychopharmacology · doi:10.1038/npp.2014.291 · Cited by 107
Heussler, H., Cohen, J., Silove, N., Tich, N., Bonn-Miller, M. O., Du, W., O’Neill, C., & Sebree, T. (2019) · Journal of Neurodevelopmental Disorders · doi:10.1186/s11689-019-9277-x · Cited by 106
Kamm, C., Healy, D. G., Quinn, N. P., Wüllner, U., Möller, J. C., Schöls, L. J., Geser, F., Bürk, K., Børglum, A. D., Pellecchia, M. T., et al. (2005) · Brain · doi:10.1093/brain/awh535 · Cited by 106
“The observed frequencies for grey-zone and premutation alleles (Table 1) in our control population were similar to those observed in previous studies and other populations (Crawford et al., 2001).”
ResultBrady, N. C., Skinner, D., Roberts, J. E., & Hennon, E. A. (2006) · American Journal of Speech-Language Pathology · doi:10.1044/1058-0360(2006/033 · Cited by 105
Hanson, J. E., & Madison, D. V. (2007) · Journal of Neuroscience · doi:10.1523/jneurosci.4717-06.2007 · Cited by 103
“Fragile X syndrome (FXS) is one of the most common inherited forms of mental retardation (Crawford et al., 2001).”
BackgroundBarnes, E., Roberts, J. E., Long, S. H., Martin, G. E., Berni, M. C., Mandulak, K. C., & Sideris, J. H. (2009) · Journal of Speech Language and Hearing Research · doi:10.1044/1092-4388(2009/08-0001 · Cited by 105
The Fragile X Family of Disorders: A Model for Autism and Targeted Treatments
Hagerman, R. J., Rivera, S. M., & Hagerman, P. J. (2008) · Current Pediatric Reviews · doi:10.2174/157339608783565770 · Cited by 101
“The prevalence of FXS with mental retardation is approximately 1 per 3,600 males in the general population; however, females with FXS usually present with learning disabilities [36-39].”
BackgroundHall, S. S., Lightbody, A. A., Huffman, L. C., Lazzeroni, L. C., & Reiss, A. L. (2009) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/chi.0b013e318195bd15 · Cited by 100
Exploring the Adult Life of Men and Women With Fragile X Syndrome: Results From a National Survey
Hartley, S. L., Seltzer, M. M., Raspa, M., Olmsted, M. G., Bishop, E. E., & Bailey, D. B. (2011) · American Journal on Intellectual and Developmental Disabilities · doi:10.1352/1944-7558-116.1.16 · Cited by 100
McDuffie, A. S., Abbeduto, L., Lewis, P. F., Kover, S. T., Kim, J.-S., Weber, A., & Brown, W. T. (2010) · American Journal on Intellectual and Developmental Disabilities · doi:10.1352/1944-7558-115.4.307 · Cited by 101
“In general, prevalence rates have been reported as 1 in 4000 males and 1 in 8000 females (Crawford et al., 2001); however, recent studies have yielded rates closer to 1 in 2500 (Fernandez-Carvajal., Walichiewicz, Xiaosen, Pan, Hagerman, & Tassone, 2009; Hagerman, 2008).”
ResultThe Impact of Genetic Research on our Understanding of Normal Cognitive Ageing: 1995 to 2009
Payton, A. (2009) · Neuropsychology Review · doi:10.1007/s11065-009-9116-z · Cited by 95
“3) contains a CGG repeat in the 5′ untranslated region which can silence the gene and cause mental retardation if the number of repeats exceeds 200 (Crawford et al. 2001).”
BackgroundFragile X Syndrome: The FMR1 CGG Repeat Distribution Among World Populations
Peprah, E. K. (2011) · Annals of Human Genetics · doi:10.1111/j.1469-1809.2011.00694.x · Cited by 96
“Within western European populations, significant differences in allelic and haplotypic distributions exist between normal chromosomes found in the general population and chromosomes that harbour the full mutation which causes FXS (Rousseau et al., 1995; Crawford et al., 2001).”
BackgroundResultInfluentialTherapeutic Potential of Metabotropic Glutamate Receptor Modulators
Hovelsø, N., Sotty, F., Montezinho, L. P., Pinheiro, P. S., Herrik, K. F., & Mørk, A. (2012) · Current Neuropharmacology · doi:10.2174/157015912799362805 · Cited by 100
A systematic review of population screening for fragile X syndrome
Hill, M. K., Archibald, A. D., Cohen, J., & Metcalfe, S. A. (2010) · Genetics in Medicine · doi:10.1097/gim.0b013e3181e38fb6 · Cited by 95
Stride-level analysis of mouse open field behavior using deep-learning-based pose estimation
Sheppard, K., Gardin, J., Sabnis, G. S., Peer, A., Darrell, M., Deats, S., Geuther, B. Q., Lutz, C. M., & Kumar, V. (2022) · Cell Reports · doi:10.1016/j.celrep.2021.110231 · Cited by 109
Fragile X carrier screening and FMR1 allele distribution in the Japanese population
Otsuka, S., Sakamoto, Y., Siomi, H., Itakura, M., Yamamoto, K., Matumoto, H., Sasaki, T., Kato, N., & Nanba, E. (2009) · Brain and Development · doi:10.1016/j.braindev.2008.12.015 · Cited by 95
“Fragile X syndrome (FXS) has been reported to be the common cause of inherited mental retardation [1].”
BackgroundEvidence of a Distinct Behavioral Phenotype in Young Boys With Fragile X Syndrome and Autism
Wolff, J. J., Bodfish, J. W., Hazlett, H. C., Lightbody, A. A., Reiss, A. L., & Piven, J. (2012) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2012.09.001 · Cited by 96
Longitudinal Profiles of Adaptive Behavior in Fragile X Syndrome
Klaiman, C., Quintin, E., Jo, B., Lightbody, A. A., Hazlett, H. C., Piven, J., Hall, S. S., & Reiss, A. L. (2014) · PEDIATRICS · doi:10.1542/peds.2013-3990 · Cited by 94
Qin, M., Entezam, A., Usdin, K., Huang, T., Liu, Z., Hoffman, G. E., & Smith, C. B. (2011) · Neurobiology of Disease · doi:10.1016/j.nbd.2011.01.008 · Cited by 91
Potential therapeutic interventions for fragile X syndrome
Levenga, J., de Vrij, F. M. S., Oostra, B. A., & Willemsen, R. (2010) · Trends in Molecular Medicine · doi:10.1016/j.molmed.2010.08.005 · Cited by 90
Roy, S., Watkins, N. W., & Heck, D. H. (2012) · PLoS ONE · doi:10.1371/journal.pone.0044816 · Cited by 92
“Due to the mosaicism of the x-linked mutation, symptoms are typically milder in females but about 1/8000 females have significant features of the syndrome [1].”
BackgroundThe genetics of mental retardation
Raymond, F. L., & Tarpey, P. S. (2006) · Human Molecular Genetics · doi:10.1093/hmg/ddl189 · Cited by 90
Multielectrode array analysis of EEG biomarkers in a mouse model of Fragile X Syndrome
Jonak, C. R., Lovelace, J. W., Ethell, I. M., Razak, K. A., & Binder, D. K. (2020) · Neurobiology of Disease · doi:10.1016/j.nbd.2020.104794 · Cited by 87
Gene, brain, and behavior relationships in fragile X syndrome: Evidence from neuroimaging studies
Lightbody, A. A., & Reiss, A. L. (2009) · Developmental Disabilities Research Reviews · doi:10.1002/ddrr.77 · Cited by 85
“Keywords fragile X syndrome; MRI; FMR1; behavior and intellectual disability Fragile X syndrome (FraX) remains the most common inherited cause of intellectual disability, occurring in ~1 in 4,000 males and 1 in 8,000 females [Crawford et al., 2001].”
BackgroundBar‐Nur, O., Caspi, I., & Benvenisty, N. (2012) · Journal of Molecular Cell Biology · doi:10.1093/jmcb/mjs007 · Cited by 86
“Fragile-X (FX) syndrome belongs to the autism spectrum disorders, and is the most common cause of inherited mental retardation with the prevalence of 1/3600 (Crawford et al., 2001).”
BackgroundLai, J., Sobala-Drozdowski, M., Zhou, L., Doering, L. C., Faure, P. A., & Foster, J. A. (2013) · Behavioural Brain Research · doi:10.1016/j.bbr.2013.10.049 · Cited by 82
“[1] Crawford DC, Acuna JM, Sherman SL.”
BackgroundMethodInfluentialDiscriminating Down Syndrome and Fragile X Syndrome based on language ability
Finestack, L. H., Sterling, A. M., & Abbeduto, L. (2012) · Journal of Child Language · doi:10.1017/s0305000912000207 · Cited by 84
Farzin, F., Rivera, S. M., & Hessl, D. R. (2009) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-009-0744-1 · Cited by 83
“Fragile X syndrome (FXS) is the most common cause of inherited mental impairment (Crawford et al. 2001) and, to date, the most common known genetic cause of autism (Cohen et al. 2005).”
Sinclair, D., Featherstone, R. E., Naschek, M. J., Nam, A. J., Du, A., Wright, S., Pance, K., Melnychenko, O., Weger, R., Akuzawa, S., et al. (2017) · eNeuro · doi:10.1523/eneuro.0380-16.2017 · Cited by 88
“This is consistent with the increased severity of FXS in human males (Crawford et al. 2001).”
Lovelace, J. W., Rais, M., Palacios, A. R., Shuai, X. S., Bishay, S., Popa, O., Pirbhoy, P. S., Binder, D. K., Nelson, D. L., Ethell, I. M., et al. (2019) · Cerebral Cortex · doi:10.1093/cercor/bhz141 · Cited by 82
“Sensory processing deficits commonly co-occur with ASD.”
BackgroundInfluentialFragile X mental retardation protein interactions with the microtubule associated protein 1B RNA
Menon, L., Mader, S. A., & Mihailescu, M. (2008) · RNA · doi:10.1261/rna.1100708 · Cited by 82
“Keywords: FMRP; fragile X syndrome; G quadruplex; MAP1B RNA; RGG box The lack of fragile X mental retardation protein (FMRP) results in the fragile X syndrome, the most prevalent inherited mental disorder (Crawford et al. 2001).”
BackgroundMathematics learning disability in girls with Turner syndrome or fragile X syndrome
Murphy, M. M., Mazzocco, M. M. M., Gerner, G. J., & Henry, A. E. (2006) · Brain and Cognition · doi:10.1016/j.bandc.2005.12.014 · Cited by 82
Peprah, E. K., Xu, H., Ayele, F. T., & Royal, C. D. M. (2014) · Public Health Genomics · doi:10.1159/000367962 · Cited by 82
Kogan, C. S., Boutet, I., Cornish, K. M., Graham, G. E., Berry‐Kravis, E., Drouin, A., & Milgram, N. W. (2008) · Journal of Intellectual Disability Research · doi:10.1111/j.1365-2788.2008.01135.x · Cited by 79
Metadata
- Authors
- Crawford, D. C., Acuña, J. M., & Sherman, S. L.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Emory University (US)
- Venue
- Genetics in Medicine
- Publisher
- Elsevier BV
- Published
- 2001-09
- Volume
- 3
- Issue
- 5
- Pages
- 359-371
- ISSN
- 1098-3600 (ISSN-L)
- PMC
- PMC4493892
- OpenAlex
- W2073347350
- Cited by
- 711
- References
- 153
- Citations by year
- 2026: 12 · 2025: 16 · 2024: 17 · 2023: 14 · 2022: 35 · 2021: 24 · 2020: 46 · 2019: 37 · 2018: 32 · 2017: 39 · 2016: 29 · 2015: 28 · 2014: 46 · 2013: 35 · 2012: 38
- FWCI
- 0.95
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Genetics in Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (NIH-R01, R01‐grant)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01 HD 29909, R01HD029909)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Neurodevelopmental Disorders
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Genetic Neurodegenerative Diseases
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
- Keywords
- fragile X syndrome, FMR1 gene, CGG repeat expansion, premutation, full mutation, X-linked dominant inheritance, prevalence, carrier frequency, intellectual disability, sex differences in phenotype, genetic testing, screening method, early intervention
- MeSH terms
- Female, Fragile X Syndrome, Gene Frequency, Genetic Testing, Heterozygote, Humans, Male, Mutation, Nerve Tissue Proteins, Genome, Human, RNA-Binding Proteins, Trinucleotide Repeats, White People, Fragile X Mental Retardation Protein, Fragile X Messenger Ribonucleoprotein 1
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