“…Hyperexpression of PM alleles is associated with specific disorders, including fragile X premature ovarian insufficiency (FXPOI; OMIM #311360), a condition associated with menopause in women aged <40 years ( Sullivan et al, 2011 ; Sherman et al, 2014 ), and fragile X-associated tremor/ataxia syndrome, a neurodegenerative disorder (FXTAS; OMIM #300623) that affects PM carriers, mostly men over the age of 50 years, with clinical manifestations such as action tremors, gait ataxia, Parkinsonism, and cognitive decline ( Hagerman and Hagerman, 2016 ). In model systems, hyperexpression of riboCGG repeats in the PM range leads to defects in cell development and cell toxicity ( Hagerman, 2012 ; Hagerman et al, 2018 ; Bhat et al, 2021 ). Unlike FM alleles, PM alleles alter RNA-processing mechanisms, which may be related to unusual secondary structures formed by DNA strands and RNA containing CGG and antisense CCG repeats ( Zhao and Usdin, 2021 ).…”