Locus FRDA FXN

Disease ID
FRDA
Gene ID
FXN
Updated
Jul 15, 2026
v2.24.0
Other gene loci
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Disease

Name Friedreich ataxia
Inheritance
Description
Friedreich ataxia (FRDA) is an autosomal recessive neurodegenerative disorder characterized by progressive gait and limb ataxia with associated limb muscle weakness, absent lower limb reflexes, extensor plantar responses, dysarthria, and decreased vibratory sense and proprioception. Onset is usually in the first or second decade, before the end of puberty .
Prevalence
1 50,000
1/50,000, : Known carrier frequency 1000/100,000; observed 421/100,000. Most common inherited ataxia in Europe, the Middle East, India, and North Africa; not documented in Southeast Asia, in sub-Saharan Africa, or among Native Americans .
Age of Onset Age of Onset(Typical)Years2  8010  15
Typical: 10-15; Range: 2-80 .
HPO Terms
Association
Mendelian

Locus

Details
96% of FA patients have biallelic GAA expansions in intron 1 (compared to compound heterozygous with another mutation type), in which the reference allele is conventionally 5-33 repeats . Intermediate alleles (34-55) are associated with premutations, but may lead to disease as exact pathogenicity/penetrance thresholds have not been demarcated. Dysphagia is highly prevalent and progressive, . The expanded repeats can be interrupted with GAAGAG, GAAGGA, or GAAGAAAA sequences, leading to differential phenotypes . Allele size is correlated with disease severity and inversely correlated to age of onset . ~20% of patients carry an expanded composite (GAA-GGA) allele with large tracts of tandem GGA triplets near the 5' end of the repeat (median ~44, range 22-342), with further minor interruptions occurring in ~10% of cases .
Mechanism
LoF
Loss of function via transcriptional silencing, .
Detection
RP-PCR and long-range PCR have been used to detect expansions [@pmid:35595154]. Standard long-range PCR and RP-PCR poorly amplify GC rich expanded composite (GAA-GGA) alleles and fail to detect proximal FXN deletions, so affected individuals may be misclassified as homozygous for expansions, though composite alleles are recovered through the addition of 7-deaza-dGTP [@pmid:41432640]. Long-read sequencing has sized large alleles and resolved sequence organization, including proximal deletions [@pmid:35595154; @pmid:41432640].
Year
1996
Location in Gene
Intron 1
Gene Strand

Alleles

Ref. Motif
GAA
Ranges BenignIntermediatePathogenicUnits5  3334  5556  1,700
Benign (ref.)
Benign (gene)
Pathogenic (ref.)
AAG
Pathogenic (gene)
AAG
Unknown (ref.)
Unknown (gene)
Interruption (ref.)
Interruption (gene)

gnomAD

References

Direct supporting references for info on this page.

2
Profiling of Short-Tandem-Repeat Disease Alleles in 12,632 Human Whole Genomes.
Haibao,Tang, Ewen F,Kirkness, Christoph,Lippert, William H,Biggs, Martin,Fabani, Ernesto,Guzman, Smriti,Ramakrishnan, Victor,Lavrenko, Boyko,Kakaradov, Claire,Hou, Barry,Hicks, David,Heckerman, Franz J,Och, C Thomas,Caskey, J Craig,Venter, Amalio,Telenti
American journal of human genetics · 2017-11-02
pmid:29100084
5
Sequence variation in GAA repeat expansions may cause differential phenotype display in Friedreich's ataxia.
D O,McDaniel, B,Keats, V V,Vedanarayanan, S H,Subramony
Movement disorders : official journal of the Movement Disorder Society · 2001-11-01
pmid:11748752
6
Clinical and genetic abnormalities in patients with Friedreich's ataxia.
A,Dürr, M,Cossee, Y,Agid, V,Campuzano, C,Mignard, C,Penet, J L,Mandel, A,Brice, M,Koenig
The New England journal of medicine · 1996-10-17
pmid:8815938
7
Unrecognized high prevalence of expanded composite repeats in Friedreich ataxia.
Morgan C,Devore, Christina,Lam, Graham,Wiley, Courtney C,Park, David R,Lynch, Sanjay I,Bidichandani
Human molecular genetics · 2026-02-10
pmid:41432640
8
Diseases of unstable repeat expansion: mechanisms and common principles.
Jennifer R,Gatchel, Huda Y,Zoghbi
Nature reviews. Genetics · 2005-10-01
pmid:16205714
9
Clinical and neuroimaging review of triplet repeat diseases.
Ryo,Kurokawa, Mariko,Kurokawa, Akihiko,Mitsutake, Moto,Nakaya, Akira,Baba, Yasuhiro,Nakata, Toshio,Moritani, Osamu,Abe
Japanese journal of radiology · 2022-09-28
pmid:36169768
10
Friedreich's ataxia: autosomal recessive disease caused by an intronic GAA triplet repeat expansion.
V,Campuzano, L,Montermini, M D,Moltò, L,Pianese, M,Cossée, F,Cavalcanti, E,Monros, F,Rodius, F,Duclos, A,Monticelli, F,Zara, J,Cañizares, H,Koutnikova, S I,Bidichandani, C,Gellera, A,Brice, P,Trouillas, G,De Michele, A,Filla, R,De Frutos, F,Palau, P I,Patel, S,Di Donato, J L,Mandel, S,Cocozza, M,Koenig, M,Pandolfo
Science (New York, N.Y.) · 1996-03-08
pmid:8596916

Additional Literature

Additional literature related to this locus.

Raw PubMed search results
(All PubMed results returned by searching for this gene, tandem repeats, and disease, in medline format)

Dysregulation of sphingolipid-metabolizing enzymes in Friedreich's ataxia:
Zenouska,Ramchunder, Ester,Kalef-Ezra, Saqlain,Suleman, Fred Jonathan,Edzeamey, Sandor,Szunyogh, Owen,Gittins, Natalia,Castro Mena, Richard,Wade-Martins, Adamo,Valle, Charareh,Pourzand, Sara,Anjomani Virmouni
iScience · 2026-06-22
pmid:42383006
Frataxin deficiency drives cardiac dysfunction and transcriptional dysregulation in Friedreich ataxia iPSC model.
Jarmon G,Lees, Haoxiang,Zhang, Lebei,Jiao, Anne M,Kong, Ren Jie,Phang, Li,Li, Nan,Su, Sebastian,Bass-Stringer, Hei-Yi H,Woo, Anthony S,Mukhtar, Alice,Pébay, Mirella,Dottori, Louise,Corben, Martin,Delatycki, Roger,Peverill, Stephen,Wilcox, Jarny,Choi, Jeffrey M,Pullin, Davis,McCarthy, Jill S,Napierala, Marek,Napierala, Shiang Y,Lim
Cell death & disease · 2026-06-23
pmid:42331777
Assessing airway clearance dysfunction in Friedreich's ataxia: A focus on peak cough flow.
Barbara K,Smith, Mackenzi A,Coker, Cristina,Liberati, Blake P,Meyer, Samantha,Norman, Jessica,Ehrbar, Carmen,Leon-Astudillo, Sub,Subramony, Manuela,Corti
Journal of neuromuscular diseases · 2026-06-08
pmid:42253100
Compound Heterozygote Friedreich Ataxia Patients With Covert Proximal FXN Gene Deletions.
Michael P,Lazaropoulos, Morgan C,Devore, Christina,Lam, Courtney,Park, Sanjay,Bidichandani, David R,Lynch
Annals of clinical and translational neurology · 2026-06-02
pmid:42227166
Therapeutic activity of a hematopoietic stem cell-delivered cell-penetrating frataxin in Friedreich's ataxia models.
Jeffrey,Pido-Lopez, Shefta E,Moula, Enas,Shaban, Konstantinos,Stamatiou, Bethan J,Critchley, Thomas E,Whittaker, Stina,Svensson, Sara,Anjomani-Virmouni, Ester,Kalef-Ezra, Lucinda,Carr, Jane,Hassel, Adrian J,Thrasher, Manju A,Kurian, Ian A,Blair, Teerapat,Rojsajjakul, Giorgia,Santilli, Arturo,Sala
Cell reports. Medicine · 2026-05-13
pmid:42134333
Genome-wide detection and clinical prioritization of tandem repeat outliers using long-read sequencing.
Sophia B,Gibson, Nikhita,Damaraju, J Gus,Gustafson, Elsa V,Balton, Sirisak,Chanprasert, Ian A,Glass, Martha,Horike-Pyne, Runjun D,Kumar, Kathleen A,Leppig, Chris,Lundberg, Jane,Ranchalis, Elisabeth A,Rosenthal, Andrew K,Solomon, Andrew B,Stergachis, Mark,Wener, Gail P,Jarvik, Elizabeth E,Blue, Katrina M,Dipple, Harriet,Dashnow, Lea M,Starita, Danny E,Miller
medRxiv : the preprint server for health sciences · 2026-05-01
pmid:42094143
The TRKB Agonist 7,8-dihydroxyflavone Alleviates DNA Damage and Apoptosis in a Neuronal Cell Model of Friedreich's Ataxia.
Jorge,Galán-Cruz, Andrés,Vicente-Acosta, Frida,Loría, Javier,Díaz-Nido, Saúl,Herranz-Martín
Molecular neurobiology · 2026-04-22
pmid:42018061
Longitudinal analysis shows GAA1 length and baseline clinical status as robust predictors of progression in Friedreich ataxia.
Leire,Manrique, Francisco,Martínez-Dubarbie, Ana L,Pelayo-Negro, Natalia,Benitez-Calle, María Victoria,Sanchez-Pelaez, Daniel,Cota-Gonzalez, Ruben,Loza, Raquel,Martinez-Díaz, Juan,Irure-Ventura, Coro,Sanchez-Quintana, Ivelisse,Sanchez, Antoni,Matilla-Dueñas, Jon,Infante
Journal of neurology · 2026-04-09
pmid:41954755
Peripheral frataxin levels govern long-term clinical progression in Friedreich ataxia.
Christian,Rummey, Ian A,Blair, Clementina,Mesaros, Teerapat,Rojsajjakul, Yina,Dong, George,Wilmot, Theresa,Zesiewicz, Kathy,Mathews, Joseph C,Hoyle, Lauren,Seeberger, Louise A,Corben, Martin Bruce,Delatycki, Richard S,Finkel, Richard H,Roxburgh, Antoine,Duquette, Grace,Yoon, Christopher M,Gomez, S H,Subramony, Susan,Perlman, Shana,Mccormack, David R,Lynch
BMJ neurology open · 2026-03-23
pmid:41919005