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Protic DD, Aishworiya R, Salcedo-Arellano MJ, Tang SJ, Milisavljevic J, Mitrovic F, Hagerman RJ, Budimirovic DB. Fragile X Syndrome: From Molecular Aspect to Clinical Treatment. Int J Mol Sci 2022; 23:ijms23041935. [PMID: 35216055 PMCID: PMC8875233 DOI: 10.3390/ijms23041935] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 02/01/2023] Open
Abstract
Fragile X syndrome (FXS) is a neurodevelopmental disorder caused by the full mutation as well as highly localized methylation of the fragile X mental retardation 1 (FMR1) gene on the long arm of the X chromosome. Children with FXS are commonly co-diagnosed with Autism Spectrum Disorder, attention and learning problems, anxiety, aggressive behavior and sleep disorder, and early interventions have improved many behavior symptoms associated with FXS. In this review, we performed a literature search of original and review articles data of clinical trials and book chapters using MEDLINE (1990-2021) and ClinicalTrials.gov. While we have reviewed the biological importance of the fragile X mental retardation protein (FMRP), the FXS phenotype, and current diagnosis techniques, the emphasis of this review is on clinical interventions. Early non-pharmacological interventions in combination with pharmacotherapy and targeted treatments aiming to reverse dysregulated brain pathways are the mainstream of treatment in FXS. Overall, early diagnosis and interventions are fundamental to achieve optimal clinical outcomes in FXS.
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Affiliation(s)
- Dragana D. Protic
- Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, 11129 Belgrade, Serbia
- Correspondence: (D.D.P.); (D.B.B.); Tel.: +381-11-36-43-389 (D.D.P.); +1-443-923-2634 (D.B.B.)
| | - Ramkumar Aishworiya
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute UCDH, University of California Davis, 2825 50th Street, Sacramento, CA 95817, USA; (R.A.); (M.J.S.-A.); (S.J.T.); (R.J.H.)
- Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, 5 Lower Kent Ridge Road, Singapore 119074, Singapore
| | - Maria Jimena Salcedo-Arellano
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute UCDH, University of California Davis, 2825 50th Street, Sacramento, CA 95817, USA; (R.A.); (M.J.S.-A.); (S.J.T.); (R.J.H.)
- Department of Pediatrics, University of California Davis School of Medicine, Sacramento, CA 95817, USA
- Department of Pathology and Laboratory Medicine, University of California Davis School of Medicine, Sacramento, CA 95817, USA
| | - Si Jie Tang
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute UCDH, University of California Davis, 2825 50th Street, Sacramento, CA 95817, USA; (R.A.); (M.J.S.-A.); (S.J.T.); (R.J.H.)
| | - Jelena Milisavljevic
- Faculty of Medicine, University of Belgrade, 11129 Belgrade, Serbia; (J.M.); (F.M.)
| | - Filip Mitrovic
- Faculty of Medicine, University of Belgrade, 11129 Belgrade, Serbia; (J.M.); (F.M.)
| | - Randi J. Hagerman
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute UCDH, University of California Davis, 2825 50th Street, Sacramento, CA 95817, USA; (R.A.); (M.J.S.-A.); (S.J.T.); (R.J.H.)
- Department of Pediatrics, University of California Davis School of Medicine, Sacramento, CA 95817, USA
| | - Dejan B. Budimirovic
- Department of Psychiatry, Fragile X Clinic, Kennedy Krieger Institute, Baltimore, MD 21205, USA
- Department of Psychiatry & Behavioral Sciences-Child Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
- Correspondence: (D.D.P.); (D.B.B.); Tel.: +381-11-36-43-389 (D.D.P.); +1-443-923-2634 (D.B.B.)
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Fernandes G, Mishra PK, Nawaz MS, Donlin-Asp PG, Rahman MM, Hazra A, Kedia S, Kayenaat A, Songara D, Wyllie DJA, Schuman EM, Kind PC, Chattarji S. Correction of amygdalar dysfunction in a rat model of fragile X syndrome. Cell Rep 2021; 37:109805. [PMID: 34644573 DOI: 10.1016/j.celrep.2021.109805] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 07/19/2021] [Accepted: 09/16/2021] [Indexed: 10/20/2022] Open
Abstract
Fragile X syndrome (FXS), a commonly inherited form of autism and intellectual disability, is associated with emotional symptoms that implicate dysfunction of the amygdala. However, current understanding of the pathogenesis of the disease is based primarily on studies in the hippocampus and neocortex, where FXS defects have been corrected by inhibiting group I metabotropic glutamate receptors (mGluRs). Here, we observe that activation, rather than inhibition, of mGluRs in the basolateral amygdala reverses impairments in a rat model of FXS. FXS rats exhibit deficient recall of auditory conditioned fear, which is accompanied by a range of in vitro and in vivo deficits in synaptic transmission and plasticity. We find presynaptic mGluR5 in the amygdala, activation of which reverses deficient synaptic transmission and plasticity, thereby restoring normal fear learning in FXS rats. This highlights the importance of modifying the prevailing mGluR-based framework for therapeutic strategies to include circuit-specific differences in FXS pathophysiology.
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Affiliation(s)
- Giselle Fernandes
- National Centre for Biological Sciences, TIFR, Bangalore 560065, India
| | - Pradeep K Mishra
- National Centre for Biological Sciences, TIFR, Bangalore 560065, India; Centre for Brain Development and Repair, Institute for Stem Cell Biology and Regenerative Medicine, Bangalore 560065, India
| | - Mohammad Sarfaraz Nawaz
- National Centre for Biological Sciences, TIFR, Bangalore 560065, India; Centre for Brain Development and Repair, Institute for Stem Cell Biology and Regenerative Medicine, Bangalore 560065, India
| | | | - Mohammed Mostafizur Rahman
- Department of Molecular and Cellular Biology, Center for Brain Science, Harvard University, Cambridge, MA, USA
| | - Anupam Hazra
- National Centre for Biological Sciences, TIFR, Bangalore 560065, India; Centre for Brain Development and Repair, Institute for Stem Cell Biology and Regenerative Medicine, Bangalore 560065, India
| | - Sonal Kedia
- Department of Biology, Brandeis University, Waltham, MA, USA
| | - Aiman Kayenaat
- National Centre for Biological Sciences, TIFR, Bangalore 560065, India; Centre for Brain Development and Repair, Institute for Stem Cell Biology and Regenerative Medicine, Bangalore 560065, India; University of Transdisciplinary Health Sciences and Technology, Bangalore 560064, India
| | - Dheeraj Songara
- National Centre for Biological Sciences, TIFR, Bangalore 560065, India
| | - David J A Wyllie
- Centre for Brain Development and Repair, Institute for Stem Cell Biology and Regenerative Medicine, Bangalore 560065, India; Simons Initiative for the Developing Brain and Centre for Discovery Brain Sciences, University of Edinburgh, Edinburgh EH8 9XD, UK
| | - Erin M Schuman
- Max Planck Institute for Brain Research, Frankfurt, Germany
| | - Peter C Kind
- Centre for Brain Development and Repair, Institute for Stem Cell Biology and Regenerative Medicine, Bangalore 560065, India; Simons Initiative for the Developing Brain and Centre for Discovery Brain Sciences, University of Edinburgh, Edinburgh EH8 9XD, UK
| | - Sumantra Chattarji
- National Centre for Biological Sciences, TIFR, Bangalore 560065, India; Centre for Brain Development and Repair, Institute for Stem Cell Biology and Regenerative Medicine, Bangalore 560065, India; Simons Initiative for the Developing Brain and Centre for Discovery Brain Sciences, University of Edinburgh, Edinburgh EH8 9XD, UK.
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Gabrielli A, Poje AB, Manzardo A, Butler MG. STARTLE RESPONSE ANALYSIS OF FOOD-IMAGE PROCESSING IN PRADER-WILLI SYNDROME. THE JOURNAL OF RARE DISORDERS 2018; 6:18-27. [PMID: 30637262 PMCID: PMC6326586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Prader-Willi syndrome (PWS) is a complex genetic neurodevelopmental disorder with endocrine disturbances, hyperphagia and often life-threatening obesity as key features. We investigated emotional-processing of food and eating behavior in PWS using startle response-modulation. Startle eyeblink response is an involuntary reflex activated by the autonomic nervous system in response to sudden or disturbing auditory/visual stimuli which may be modulated by the emotional valence of concurrently viewed visual stimuli. METHODOLOGY Differences in affective modulation of startle reflex were recorded in 13 individuals with PWS versus 8 healthy controls when viewing standard neutral, negative, positive and food-derived images. Electromyogram (EMG) of the orbicularis oculi muscle was measured in response to binaural white noise before and after consumption of a standard 500 Kcal meal. Participants reported their perceived emotional valence for each image, pre- and post-meal, using a 1-10 Likert rating scale. RESULTS Subjective ratings of food images and urge to eat were significantly higher in PWS than controls and did not significantly decline post-meal. Acoustic startle responding was detected in PWS but was significantly lower than control participants under all conditions. Startle responses to food images in PWS were attenuated relative to other picture types with potentially abnormal emotional modulation of responses to non-food images which contrasted self-reported picture ratings. A stable positive emotional valence to food images was observed pre- and post-feeding with a sustained urge to consume food in PWS. CONCLUSIONS Emotional processing measured using startle modulation in response to non-food images was abnormal in PWS which may reflect unique physiological attributes such as hypotonia and abnormal skin conductivity due to increased fat mass. Alternatively, disruption of autonomic or sympathetic nervous system functioning reported in PWS may impact on hunger and/or food drive states. Our findings parallel attentional/processing attributes of affective stimuli reported in autism spectrum disorder and support the feasibility of eyeblink startle modulation to assess food motivation in PWS and provide preliminary data to optimize methodological parameters.
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Affiliation(s)
| | | | | | - Merlin G. Butler
- Departments of Psychiatry & Behavioral Sciences
- Pediatrics, University of Kansas Medical Center, Kansas City, Kansas
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Solomon M, Di Martino A. Increasing Traction for Discovery: The Research Domain Criteria Framework and Neurodevelopmental Disorders. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 2:458-460. [PMID: 29348036 DOI: 10.1016/j.bpsc.2017.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 07/27/2017] [Accepted: 07/27/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Marjorie Solomon
- Department of Psychiatry and Behavioral Sciences and the Imaging Research Center, University of California-Davis, Sacramento, California; MIND Institute, Sacramento, California.
| | - Adriana Di Martino
- Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, New York
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Pretto D, Yrigollen CM, Tang HT, Williamson J, Espinal G, Iwahashi CK, Durbin-Johnson B, Hagerman RJ, Hagerman PJ, Tassone F. Clinical and molecular implications of mosaicism in FMR1 full mutations. Front Genet 2014; 5:318. [PMID: 25278957 PMCID: PMC4166380 DOI: 10.3389/fgene.2014.00318] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 08/25/2014] [Indexed: 12/27/2022] Open
Abstract
Expansions of more than 200 CGG repeats (full mutation) in the FMR1 gene give rise to fragile X syndrome (FXS) through a process that generally involves hypermethylation of the FMR1 promoter region and gene silencing, resulting in absence of expression of the encoded protein, FMRP. However, mosaicism with alleles differing in size and extent of methylation often exist within or between tissues of individuals with FXS. In the current work, CGG-repeat lengths and methylation status were assessed for eighteen individuals with FXS, including 13 mosaics, for which peripheral blood cells (PBMCs) and primary fibroblast cells were available. Our results show that for both PBMCs and fibroblasts, FMR1 mRNA and FMRP expression are directly correlated with the percent of methylation of the FMR1 allele. In addition, Full Scale IQ scores were inversely correlated with the percent methylation and positively correlated with higher FMRP expression. These latter results point toward a positive impact on cognition for full mutation mosaics with lower methylation compared to individuals with fully methylated, full mutation alleles. However, we did not observe a significant reduction in the number of seizures, nor in the severity of hyperactivity or autism spectrum disorder, among individuals with mosaic genotypes in the presentation of FXS. These observations suggest that low, but non-zero expression of FMRP may be sufficient to positively impact cognitive function in individuals with FXS, with methylation mosaicism (lowered methylation fraction) contributing to a more positive clinical outcome.
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Affiliation(s)
- Dalyir Pretto
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California at Davis Davis, CA, USA
| | - Carolyn M Yrigollen
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California at Davis Davis, CA, USA
| | - Hiu-Tung Tang
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California at Davis Davis, CA, USA
| | - John Williamson
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California at Davis Davis, CA, USA
| | - Glenda Espinal
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California at Davis Davis, CA, USA
| | - Chris K Iwahashi
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California at Davis Davis, CA, USA
| | - Blythe Durbin-Johnson
- Department of Public Health Sciences, School of Medicine, University of California at Davis Davis, CA, USA
| | - Randi J Hagerman
- Department of Pediatrics, School of Medicine, University of California at Davis Davis, CA, USA ; MIND Institute, UC Davis Medical Center Sacramento, CA, USA
| | - Paul J Hagerman
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California at Davis Davis, CA, USA ; Department of Pediatrics, School of Medicine, University of California at Davis Davis, CA, USA
| | - Flora Tassone
- Department of Biochemistry and Molecular Medicine, School of Medicine, University of California at Davis Davis, CA, USA ; Department of Pediatrics, School of Medicine, University of California at Davis Davis, CA, USA
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