Posted at October 31, 2012 | By: | Categories: Fragile Xtras,Keeping You Informed | 4 Comments

Full Mutation, Premutation or No Mutation At All

Robert Miller
Executive Director
National Fragile X Foundation

Here in the Fragile X world we spend a lot of time parsing mutations, CGG repeat numbers and trying to define Fragile X. From a medical and scientific point of view, that effort is necessary so that clinicians and researchers can communicate with each other in a descriptive and mutually understood way. Defining things and being as specific as possible is absolutely essential in research and treatment.

But, in my experience, it’s a different story in the world of families. In families, members want to know who is affected, what the symptoms and prognosis are, what types of treatments and interventions are available, who else in the extended family is at risk to be affected, and what steps can be taken to minimize the effects. Whether your concern is fragile X syndrome, fragile X-associated tremor/ataxia syndrome, fragile X-associated primary ovarian insufficiency or any other medical, psychological or learning problem that some researchers are increasingly suggesting may be the result of a Fragile X mutation, the NFXF will do its best to keep you informed of what the evidence is and where consensus about treatment exists (and where it does not). (See: Consensus Documents on Clinical Practices.)

The above is one reason why the NFXF recently awarded grants to Stephanie Sherman at Emory University and David Hessl at the UC Davis MIND Institute. Dr. Sherman is attempting to better understand the health consequences of the FMR1 premutation in women. Dr. Hessl will be undertaking a project to extend autism behavioral intervention to young children with fragile X syndrome.

Recently, some researchers have found evidence that FMRP (the protein that the FX gene controls) plays a role in autism that is not associated with fragile X syndrome or the Fragile X mutation. This is intriguing and makes a strong case for breaking down the barriers between autism research and Fragile X research. Combined with the aforementioned research on carriers, I think we are seeing the blurring of the boundaries between the full mutation, the premutation and having no mutation at all. The story about what constitutes Fragile X is still an open book, awaiting further research.


  • I think that the two studies you have funded are very important. As a female carrier, I would be willing to participate and give information. Also, I have seen the enormous progress my grandson with autism has made through much behavioral intervention begun very early, before age two. I know now that if my son with FRXS, born in 1966, had had the same teaching, his outcome could have been greatly improved. Some science to back up my conviction would be most welcome.

  • Dorothea Battle

    I have two sisters and a mother who are the carriers of the fragile x gene. My older sister two sons (only kids) inherited the full mutation of the gene. I took the genetic testing eight years ago, and my results were negative for being a carrier. I appreciate any information the NFX community shares with me. If I’m needed, I would be willing to participate in a research study.

  • I think it is great that even more research will be taking place in my life time. I have Fragile X, but I am not completely affected by it, and I even went to college, and will return some day. I look forward to hearing about all the new information out there from the Fragile X community, etc.

    • Ours is a curious case. Our 9 yr old daughter is FX carrier. My husband and I both tested negative! My daughter speaks full sentences now. her speech is still not clear. For someone who is only a carrier, she is affected pretty seriously in our view. She is sociable, but cannot play with children her age. She is currently homeschooled and goes twice a week for 3 hrs to an inclusive montessori learning centre, where she fits into the 4 to 6 yr old group. she can read 3 to 4 letter words and recognise alphabets and numbers. she cannot write yet. she also goes for occupational therapy,speech and language therapy thrice a week.

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