Psychiatric phenotype of the fragile X-associated tremor/ataxia syndrome (FXTAS) in males: newly described fronto-subcortical dementia

J Clin Psychiatry. 2006 Jan;67(1):87-94. doi: 10.4088/jcp.v67n0112.

Abstract

Objective: The authors describe and quantify the neuropsychiatric symptoms present in a cohort of males with the fragile X mental retardation 1 (FMR1) premutation allele who have developed fragile X-associated tremor/ataxia syndrome (FXTAS).

Method: Fourteen male carriers of the FMR1 premutation who had clinical manifestations of the FXTAS syndrome and 14 age- and education-matched controls were assessed with the Neuropsychiatric Inventory (NPI), formal cognitive testing, and genetic analysis.

Results: Males with FXTAS had significantly higher total NPI scores (p < .004) and significantly higher scores on the agitation/aggression (p < .004), depression (p < .004), apathy (p < .004), disinhibition (p < .004), and irritability (p < .004) scales, compared with controls. Cognitive performances on the Mini-Mental State Examination did not correlate with severity of symptoms on the NPI.

Conclusions: The neuropsychiatric manifestations of FXTAS, based on this preliminary report, appear to cluster as a fronto-subcortical dementia. Clinicians encountering patients with clinical dementia with motor symptoms suggesting FXTAS should consider genetic testing to determine whether the patient's dementia syndrome is secondary to a fragile X premutation carrier status.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Ataxia / diagnosis
  • Ataxia / genetics*
  • Dementia / classification
  • Dementia / diagnosis
  • Dementia / genetics*
  • Fragile X Mental Retardation Protein / genetics*
  • Fragile X Syndrome / diagnosis*
  • Fragile X Syndrome / genetics*
  • Genetic Carrier Screening
  • Genetic Predisposition to Disease / genetics
  • Genetic Testing
  • Heterozygote
  • Humans
  • Male
  • Middle Aged
  • Personality Inventory
  • Phenotype*
  • Psychiatric Status Rating Scales
  • Severity of Illness Index
  • Sex Factors
  • Syndrome
  • Tremor / diagnosis
  • Tremor / genetics*
  • Wechsler Scales

Substances

  • FMR1 protein, human
  • Fragile X Mental Retardation Protein