Symptomatic treatment in the fragile X-associated tremor/ataxia syndrome

There is no established treatment for the neurological features of the recently discovered fragile X–associated tremor/ataxia syndrome (FXTAS). Fifty‐six patients with FXTAS completed a questionnaire to determine whether any medications had been effective for neurological symptoms. Of 11 subjects wi...

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Published inMovement disorders Vol. 21; no. 10; pp. 1741 - 1744
Main Authors Hall, Deborah A., Berry-Kravis, Elizabeth, Hagerman, Randi J., Hagerman, Paul J., Rice, Cathlin D., Leehey, Maureen A.
Format Journal Article
LanguageEnglish
Published Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.10.2006
Wiley
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Online AccessGet full text
ISSN0885-3185
1531-8257
DOI10.1002/mds.21001

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Abstract There is no established treatment for the neurological features of the recently discovered fragile X–associated tremor/ataxia syndrome (FXTAS). Fifty‐six patients with FXTAS completed a questionnaire to determine whether any medications had been effective for neurological symptoms. Of 11 subjects with definite FXTAS, 8 (70%) were on medications for their neurological symptoms, whereas most subjects with possible or probable FXTAS, 31 (70%) of 45 subjects, were not on medications. Although no therapy was uniformly effective for intention tremor, ataxia, Parkinsonism, memory loss, or anxiety, some subjects with intention tremor or Parkinsonism reported improvement with medications frequently used in other movement disorders. Overall, all 22 subjects on medications reported improvement in one or more symptoms. Lack of insight, recall bias, and cognitive impairment may have resulted in an underestimation of the beneficial effect of medical therapy. This study suggests that patients with FXTAS can derive improvement from medication treatment for some of their symptoms. © 2006 Movement Disorder Society
AbstractList There is no established treatment for the neurological features of the recently discovered fragile X-associated tremor/ataxia syndrome (FXTAS). Fifty-six patients with FXTAS completed a questionnaire to determine whether any medications had been effective for neurological symptoms. Of 11 subjects with definite FXTAS, 8 (70%) were on medications for their neurological symptoms, whereas most subjects with possible or probable FXTAS, 31 (70%) of 45 subjects, were not on medications. Although no therapy was uniformly effective for intention tremor, ataxia, Parkinsonism, memory loss, or anxiety, some subjects with intention tremor or Parkinsonism reported improvement with medications frequently used in other movement disorders. Overall, all 22 subjects on medications reported improvement in one or more symptoms. Lack of insight, recall bias, and cognitive impairment may have resulted in an underestimation of the beneficial effect of medical therapy. This study suggests that patients with FXTAS can derive improvement from medication treatment for some of their symptoms.There is no established treatment for the neurological features of the recently discovered fragile X-associated tremor/ataxia syndrome (FXTAS). Fifty-six patients with FXTAS completed a questionnaire to determine whether any medications had been effective for neurological symptoms. Of 11 subjects with definite FXTAS, 8 (70%) were on medications for their neurological symptoms, whereas most subjects with possible or probable FXTAS, 31 (70%) of 45 subjects, were not on medications. Although no therapy was uniformly effective for intention tremor, ataxia, Parkinsonism, memory loss, or anxiety, some subjects with intention tremor or Parkinsonism reported improvement with medications frequently used in other movement disorders. Overall, all 22 subjects on medications reported improvement in one or more symptoms. Lack of insight, recall bias, and cognitive impairment may have resulted in an underestimation of the beneficial effect of medical therapy. This study suggests that patients with FXTAS can derive improvement from medication treatment for some of their symptoms.
There is no established treatment for the neurological features of the recently discovered fragile X-associated tremor/ataxia syndrome (FXTAS). Fifty-six patients with FXTAS completed a questionnaire to determine whether any medications had been effective for neurological symptoms. Of 11 subjects with definite FXTAS, 8 (70%) were on medications for their neurological symptoms, whereas most subjects with possible or probable FXTAS, 31 (70%) of 45 subjects, were not on medications. Although no therapy was uniformly effective for intention tremor, ataxia, Parkinsonism, memory loss, or anxiety, some subjects with intention tremor or Parkinsonism reported improvement with medications frequently used in other movement disorders. Overall, all 22 subjects on medications reported improvement in one or more symptoms. Lack of insight, recall bias, and cognitive impairment may have resulted in an underestimation of the beneficial effect of medical therapy. This study suggests that patients with FXTAS can derive improvement from medication treatment for some of their symptoms.
There is no established treatment for the neurological features of the recently discovered fragile X–associated tremor/ataxia syndrome (FXTAS). Fifty‐six patients with FXTAS completed a questionnaire to determine whether any medications had been effective for neurological symptoms. Of 11 subjects with definite FXTAS, 8 (70%) were on medications for their neurological symptoms, whereas most subjects with possible or probable FXTAS, 31 (70%) of 45 subjects, were not on medications. Although no therapy was uniformly effective for intention tremor, ataxia, Parkinsonism, memory loss, or anxiety, some subjects with intention tremor or Parkinsonism reported improvement with medications frequently used in other movement disorders. Overall, all 22 subjects on medications reported improvement in one or more symptoms. Lack of insight, recall bias, and cognitive impairment may have resulted in an underestimation of the beneficial effect of medical therapy. This study suggests that patients with FXTAS can derive improvement from medication treatment for some of their symptoms. © 2006 Movement Disorder Society
Author Rice, Cathlin D.
Hagerman, Paul J.
Hagerman, Randi J.
Berry-Kravis, Elizabeth
Leehey, Maureen A.
Hall, Deborah A.
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Cites_doi 10.1086/374321
10.1002/mds.10208
10.1352/0895-8017(2004)109<154:AIIWTF>2.0.CO;2
10.1212/WNL.57.1.127
10.1212/01.wnl.0000188821.51055.52
10.1212/01.wnl.0000192393.05850.ec
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Issue 10
Keywords Chromosome fragility
Nervous system diseases
Tremor
fragile X
Cerebral disorder
Involuntary movement
Chemotherapy
Treatment
Central nervous system disease
FXTAS
medications
Ataxia
Fragile X syndrome
Neurological disorder
Language English
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References Benito-Leon J, Louis E, Bermigo-Pareja F. Population-based case-control study of cognitive function in essential tremor. Neurology 2006; 66: 69-74.
Ceravolo R, Antonini A, Volterrani D, et al. Dopamine transporter imaging study in parkinsonism occurring in fragile X premutation carriers. Neurology 2005; 65: 1971-1973.
Hagerman RJ, Leehey MA, Heinreichs W, et al. Intention tremor, parkinsonism, and generalized brain atrophy in male carriers of fragile X. Neurology 2001; 57: 127-130.
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2002; 17
2003; 72
2001; 57
2005; 65
2006; 66
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References_xml – reference: Jacquemont S, Farzin F, Hall DA, et al. Aging in individuals with the FMR1 mutation. Am J Mental Retard 2004; 109: 154-164.
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– reference: Hagerman RJ, Leehey MA, Heinreichs W, et al. Intention tremor, parkinsonism, and generalized brain atrophy in male carriers of fragile X. Neurology 2001; 57: 127-130.
– reference: Jacquemont S, Hagerman RJ, Leehey MA, et al. Fragile X premutation tremor/ataxia syndrome: molecular, clinical, and neuroimaging correlates. Am J Hum Genet 2003; 72: 869-878.
– reference: Leehey MA, Hagerman RJ, Landau WM, et al. Tremor/ataxia syndrome in Fragile X carrier males. Mov Disord 2002; 17: 744-745.
– volume: 109
  start-page: 154
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  article-title: Aging in individuals with the mutation
  publication-title: Am J Mental Retard
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  start-page: 744
  year: 2002
  end-page: 745
  article-title: Tremor/ataxia syndrome in Fragile X carrier males
  publication-title: Mov Disord
– volume: 66
  start-page: 69
  year: 2006
  end-page: 74
  article-title: Population‐based case‐control study of cognitive function in essential tremor
  publication-title: Neurology
– volume: 57
  start-page: 127
  year: 2001
  end-page: 130
  article-title: Intention tremor, parkinsonism, and generalized brain atrophy in male carriers of fragile X
  publication-title: Neurology
– volume: 72
  start-page: 869
  year: 2003
  end-page: 878
  article-title: Fragile X premutation tremor/ataxia syndrome: molecular, clinical, and neuroimaging correlates
  publication-title: Am J Hum Genet
– volume: 65
  start-page: 1971
  year: 2005
  end-page: 1973
  article-title: Dopamine transporter imaging study in parkinsonism occurring in fragile X premutation carriers
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Snippet There is no established treatment for the neurological features of the recently discovered fragile X–associated tremor/ataxia syndrome (FXTAS). Fifty‐six...
There is no established treatment for the neurological features of the recently discovered fragile X-associated tremor/ataxia syndrome (FXTAS). Fifty-six...
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SubjectTerms Adrenergic beta-Antagonists - therapeutic use
Aged
Anxiety Disorders - drug therapy
ataxia
Benzodiazepines - therapeutic use
Biological and medical sciences
Carbidopa - therapeutic use
Central Nervous System Agents - therapeutic use
Cerebellar Ataxia - drug therapy
Cholinesterase Inhibitors - therapeutic use
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Dopamine Agonists - therapeutic use
Female
fragile X
Fragile X Syndrome - drug therapy
FXTAS
Humans
Levodopa - therapeutic use
Male
Medical sciences
medications
Memory Disorders - drug therapy
Middle Aged
Nervous system (semeiology, syndromes)
Nervous system as a whole
Neurologic Examination - drug effects
Neurology
Parkinsonian Disorders - drug therapy
Serotonin Uptake Inhibitors - therapeutic use
Treatment Outcome
tremor
Tremor - drug therapy
Title Symptomatic treatment in the fragile X-associated tremor/ataxia syndrome
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