Authors: Len Abbeduto, Angela John Thurman, Laura A. Potter, Kyoungmi Kim, Flora Tassone, Amy Banasik, Sarah Nelson Potter, Lauren Bullard, Vivian Nguyen, Andrea McDuffie, and Randi Hagerman from the UC Davis MIND Institute
Drs. Angela Thurman, Len Abbeduto, Randi Hagerman (UC Davis MIND Institute), and colleagues conducted a clinical trial combining lovastatin with a behavioral intervention called parent-implemented language intervention (PILI). Thanks to NIH funding, these researchers were able to explore whether the combined lovastatin/behavioral therapy approach would be more effective than just behavioral therapy alone.
Lovastatin is an FDA-approved drug used to treat high cholesterol. Lovastatin has been investigated in Fragile X, as it may counteract some of the associated challenges related to the FMR1 gene. PILI was delivered through teleconferencing with parents, showing them how to use PILI language-facilitation strategies that incorporate shared storytelling activities and how to ask questions that encourage their child’s participation in a conversation. The study enrolled 30 participants aged 10–17; 16 participants received only PILI and 14 participants received PILI and lovastatin.
The study team suggested the combined lovastatin and behavioral therapy approach may better address learning or behavior problems in individuals with FXS than PILI alone. The study team found significant improvement in both groups, but no additional benefits in the group that received lovastatin. Participants in both groups demonstrated significant changes in the primary outcome measures. They also found that the parents’ progress in learning and using the PILI strategies was associated with their children’s progress in language.
Why This Matters
Understanding language development, a commonly cited challenge for individuals with FXS, is incredibly important. This clinical trial provides additional support for the effectiveness of using PILI in young people with FXS and provides an evidence-based treatment option for older children and adolescents who have Fragile X. It also shows the importance of exploring both medical and non-medical treatment options in Fragile X, suggesting teleconferencing as an effective modality for delivering treatment.
Researchers would like to understand how to effectively get PILI into the hands of parents. This may take time and more research, but the goal is to be able to share these learnings with parents and caregivers. Validating teleconferencing will help improve access and ability to deliver treatment outside of standard in-person care.
This study was funded by Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) (U54HD079125) and National Center for Advancing Translational Sciences (NCATS) (UL1 TR000002).
more research results
Telehealth-Enabled Behavioral Treatment for Problem Behaviors in Boys With Fragile X Syndrome: A Randomized Controlled Trial
Dr. Hall and his team at Stanford University are learning about potential behavioral treatments for problem behaviors. Previous research suggests that problem behaviors, like aggression, self-injury, and property destruction, may occur at higher rates in individuals with FXS.
A Genotype-Phenotype Study of High-Resolution FMR1 Nucleic Acid and Protein Analyses in Fragile X Patients with Neurobehavioral Assessments
We know that FMRP is expressed throughout our body, including our blood, tissues, and brain. Levels of FMRP in the blood of patients with FXS have been positively correlated with cognitive performance, specifically intelligence quotient and adaptive behavior.
Clustering of Comorbid Conditions Among Women Who Carry an FMR1 Premutation
RESEARCH RESULTS ROUNDUP — The authors sought to clarify how often other health-related conditions, such as migraines and sleep problems, occur among women with a premutation.
Cerebellar-Cortical Function and Connectivity during Sensorimotor Behavior in Aging FMR1 Gene Premutation Carriers
RESEARCH RESULTS ROUNDUP — Investigation into how aging as a premutation carrier of the FMR1 gene may affect sensorimotor (exactly as it sounds, both sensory and motor) brain systems.
Inhibition Deficits Are Modulated by Age and CGG Repeat Length in Carriers of the FMR1 Premutation Allele Who Are Mothers of Children with Fragile X Syndrome
RESEARCH RESULTS ROUNDUP — Older mothers of children with Fragile X syndrome who have mid-range CGG repeats (~80–100) may be at increased risk for difficulties with inhibition.
Language Across the Lifespan in Fragile X Syndrome: Characteristics and Considerations for Assessment
RESEARCH RESULTS ROUNDUP — Describe cognition and language in FXS using the data from a large group, while trying to understand if the standard assessments are feasible (able to be done accurately) and valid (reflect reality) in FXS and then compared the assessment results to caregiver report.