Introduction:Cerebellar Ataxia, Neuropathy and Vestibular Areflexia Syndrome (CANVAS) is an autosomal recessive neurodegenerative disease characterized by adult onset and slowly progressive sensory neuropathy, cerebellar dysfunction, and vestibular impairment. In most cases, the disease is caused by biallelic (AAGGG)nrepeat expansions in the second intron of the Replication Factor Complex subunit 1 (RFC1). However, a small number of cases with typical CANVAS do not carry the common biallelic repeat expansion. The objective of this study was to expands the genotypic spectrum of CANVAS by identifying point mutations inRFC1coding region associated with this condition.Methods:Fifteen individuals diagnosed with CANVAS and carrying only one heterozygous (AAGGG)nexpansion inRFC1underwent WGS or WES to test for the presence of a second variant inRFC1or other unrelated gene. To assess the impact of truncating variants onRFC1expression we tested the level of RFC1 transcript and protein on patients’ derived cell lines.Results:We identified seven patients from five unrelated families with clinically defined CANVAS carrying a heterozygous (AAGGG)nexpansion together with a second truncating variantin transinRFC1, which included: c.1267C>T (p.Arg423Ter), c.1739_1740del (p.Lys580SerfsTer9), c.2191del (p.Gly731GlufsTer6) and c.2876del (p.Pro959GlnfsTer24). Patient fibroblasts containing the c.1267C>T (p.Arg423Ter) or c.2876del (p.Pro959GlnfsTer24) variants demonstrated nonsense-mediated mRNA decay and reduced RFC1 transcript and protein.Discussion:Our report expands the genotype spectrum of RFC1 disease. FullRFC1sequencing is recommended in cases affected by typical CANVAS and carrying monoallelic (AAGGG)nexpansions. Also, it sheds further light on the pathogenesis of RFC1 CANVAS as it supports the existence of a loss of function mechanism underlying this complex neurodegenerative condition.