In the previous column, we briefly discussed fragile X syndrome. Here, we expand on this developmental disorder because it introduces key aspects of synaptic plasticity that are the focus of several future columns. Fragile X syndrome is the most common form of inherited mental retardation. Its clinical symptoms include moderate to severe mental retardation, macroorchidism, and behavioral symptoms that include hyperactivity, gaze aversion, and stereotypies. A fragile site on the X chromosome was discovered in 1969, when magnified views of X chromosomes from affected individuals suggested that a section at the end of the chromosome had separated from the rest of the chromosome. The explanation for the fragile site came with the cloning and characterization of the fragile X mental retardation 1 gene (FMR1) in 1991. Gene sequencing indicates that a portion of the gene is dramatically expanded, with sometimes 1,000 to 2,000 new nucleotides found in affected individuals. The new sequence is of a particular sort: the repeat of the three nucleotides cytosine, guanine, and guanine (called a CGG repeat). The expansion is located immediately adjacent to the regulatory portion of the gene, termed the promoter, and interferes with normal transcription of the gene. The net effect is that little if any message is produced, and little if any protein is translated. The gene is effectively silenced. All humans have a small number of CGG repeats at this site, with between 5 and 50 repeats normally present throughout the population. This short repeated sequence does not interfere with transcription. However, the repeat expands to between 50 and 200 repeats in some individuals. Why this happens is not yet understood, but when it occurs, the repeated element expands in the next generation. Individuals with the initial expansion of 200 repeats are carriers, who were initially thought to be affected only mildly, if at all. However, more recent studies show that carriers often develop fragile X tremor ataxia syndrome characterized by gait ataxia, tremor on the onset of movements, as well as milder cognitive and neurological symptoms. Fragile X syndrome is the second disorder in which an
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