SCA4 ZFHX3

Disease ID
SCA4
Gene ID
ZFHX3
Updated
Oct 20, 2025
v2.12.0
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Disease

SCA
Name
Spinocerebellar ataxia 4
Inheritance
Autosomal dominant
Description
Spinocerebellar ataxia type 4 (SCA4) is a very rare progressive subtype of type I autosomal dominant cerebellar ataxia (ADCA type I) characterized by ataxia with sensory neuropathy (adapted from Mondo)1 .
Prevalence
Observed in Swedish individuals: 2 original kindreds and 3 additional families2 ; common ancestral allele has been identified3 .
Age of Onset(Typical)Years12  6537  56
Age of Onset Details
Typical: 37- 56; Range: 12 - 654,5 .

Locus

Details
Disease-causing expansions range from 46 repeats5 to 74 repeats6 . Possible anticipation in disease7,6 ; intermediate alleles may correspond to premutations5 . Most unaffected individuals had 21 motifs, but benign alleles range from 14-26 repeats6 .
Mechanism
GoF?
Potential RNA-mediated gain of function mechanism theorized8
Year
20236
Location in Gene
Coding, Last Exon (exon number is transcript dependent)
Gene Strand

Alleles

Ref. Motif
GCC
Pathogenic (ref.)
GCC
Pathogenic (gene)
CGG
BenignIntermediatePathogenicUnits14  2627  4546  74

References

Direct supporting references for info on this page.

1
Ontology Lookup Service (OLS)
mondo:0010847
3
The ZFHX3 GGC Repeat Expansion Underlying Spinocerebellar Ataxia Type 4 has a Common Ancestral Founder.
Zhongbo,Chen, Pilar,Alvarez Jerez, Claire,Anderson, Martin,Paucar, Jasmaine,Lee, Daniel,Nilsson, Hannah,Macpherson, Annarita,Scardamaglia, Kylie,Montgomery, John,Hardy, Andrew B,Singleton, Arianna,Tucci, Katherine D,Mathews, Ying-Hui,Fu, Martin,Engvall, José,Laffita-Mesa, Inger,Nennesmo, Anna,Wedell, Louis J,Ptáček, Cornelis,Blauwendraat, Emil K,Gustavsson, Per,Svenningsson, Mina,Ryten, Henry,Houlden
Movement disorders : official journal of the Movement Disorder Society · 2024-12-05
pmid:39635987
5
Spinocerebellar ataxia type 4 is caused by a GGC expansion in the ZFHX3 gene and is associated with prominent dysautonomia and motor neuron signs.
Martin,Paucar, Daniel,Nilsson, Martin,Engvall, José,Laffita-Mesa, Cilla,Söderhäll, Mikael,Skorpil, Christer,Halldin, Patrik,Fazio, Kristina,Lagerstedt-Robinson, Göran,Solders, Maria,Angeria, Andrea,Varrone, Mårten,Risling, Hong,Jiao, Inger,Nennesmo, Anna,Wedell, Per,Svenningsson
Journal of internal medicine · 2024-07-07
pmid:38973251
6
Exonic trinucleotide repeat expansions in ZFHX3 cause spinocerebellar ataxia type 4: A poly-glycine disease.
Joel,Wallenius, Efthymia,Kafantari, Emma,Jhaveri, Sorina,Gorcenco, Adam,Ameur, Christin,Karremo, Sigurd,Dobloug, Kristina,Karrman, Tom,de Koning, Andreea,Ilinca, Maria,Landqvist Waldö, Andreas,Arvidsson, Staffan,Persson, Elisabet,Englund, Hans,Ehrencrona, Andreas,Puschmann
American journal of human genetics · 2023-11-29
pmid:38035881
7
Adaptive Long-Read Sequencing Reveals GGC Repeat Expansion in ZFHX3 Associated with Spinocerebellar Ataxia Type 4.
Zhongbo,Chen, Emil K,Gustavsson, Hannah,Macpherson, Claire,Anderson, Chris,Clarkson, Clarissa,Rocca, Eleanor,Self, Pilar,Alvarez Jerez, Annarita,Scardamaglia, David,Pellerin, Kylie,Montgomery, Jasmaine,Lee, Delia,Gagliardi, Huihui,Luo, John,Hardy, James,Polke, Andrew B,Singleton, Cornelis,Blauwendraat, Katherine D,Mathews, Arianna,Tucci, Ying-Hui,Fu, Henry,Houlden, Mina,Ryten, Louis J,Ptáček
Movement disorders : official journal of the Movement Disorder Society · 2024-01-10
pmid:38197134
8
Sequence composition changes in short tandem repeats: heterogeneity, detection, mechanisms and clinical implications.
Indhu-Shree,Rajan-Babu, Egor,Dolzhenko, Michael A,Eberle, Jan M,Friedman
Nature reviews. Genetics · 2024-03-11
pmid:38467784

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)

Repeat-associated ataxias in a German patient cohort analysed by targeted parallel long-read sequencing.
Hannes,Erdmann, Annalisa,Schaub, Morghan C,Lucas, Veronika,Scholz, Anna,Benet-Pages, Kerstin,Becker, Christine,Dineiger, Veronika,Mayer, Inga,van Buren, Eva,Breithausen, Karl,Akbari, Isabell,Cordts, Mayra,Sauer, Christine,Schneider, Rosanna,Krakowsky, Franziska,Schnabel, Konstanze,Dunker, Lena,Fabritius, Johannes,Gerb, Denis,Grabova, Ken,Möhwald, Marius,Näher, Karoline,Steinmetz, Franziska,Thiessen, Alexander,Jäck, Christiane,Schneider-Gold, Simone,Zittel, Christina,Petersen, Isolde,Schreyer, Larissa,Mämecke, Sibylle,Wilfling, Gilbert,Wunderlich, David,Brenner, Yorck,Hellenbroich, Kirsten,Muhle, Tessa,Huchtemann, Inga,Claus, Thomas,Klopstock, Michael,Strupp, Johannes,Levin, Günter,Höglinger, Doreen,Huppert, Sandra,Becker-Bense, Filipp,Filippopulos, Fabian,Kilpert, Elsa,Leitão, Sabine,Kaya, Christel,Depienne, Florian,Schöberl, Teresa,Neuhann, Elke,Holinski-Feder, Andreas,Zwergal, Angela,Abicht
Brain : a journal of neurology · 2025-09-03
pmid:40898875
Feasibility of long-read sequencing to identify molecular alterations in an Indonesian cohort of locally advanced to advanced nasopharyngeal cancer.
,Handoko, Marlinda,Adham, Lisnawati,Rachmadi, Demak Lumban,Tobing, ,Asmarinah, ,Fadilah, Wei,Dai, Anne Wing Mui,Lee, Soehartati A,Gondhowiardjo
Scientific reports · 2025-07-01
pmid:40594369
Diagnostic yield and limitations of whole-genome sequencing for hereditary cerebellar ataxia.
Wai Yan,Yau, Roisin,Sullivan, Emer,O'Connor, David,Pellerin, Michael H,Parkinson, Paola,Giunti, Marie-Josée,Dicaire, Matt C,Danzi, Stephan,Züchner, Bernard,Brais, Nicholas W,Wood, Henry,Houlden, Jana,Vandrovcova
Brain communications · 2025-05-17
pmid:40488180
Identification of GGC Repeat Expansions in ZFHX3 among Chilean Movement Disorder Patients.
Paula,Saffie-Awad, Abraham,Moller, Kensuke,Daida, Pilar,Alvarez Jerez, Zhongbo,Chen, Zachary B,Anderson, Mariam,Isayan, Kimberly,Paquette, Sophia B,Gibson, Madison,Fulcher, Abigail,Miano-Burkhardt, Laksh,Malik, Breeana,Baker, Paige,Jarreau, Henry,Houlden, Mina,Ryten, Bida,Gu, Mark J P,Chaisson, Danny E,Miller, Pedro,Chaná-Cuevas, Cornelis,Blauwendraat, Andrew B,Singleton, Kimberley J,Billingsley
Movement disorders : official journal of the Movement Disorder Society · 2025-06-03
pmid:40459184
Identification of GGC Repeat Expansions in
Paula,Saffie-Awad, Abraham,Moller, Kensuke,Daida, Pilar Alvarez,Jerez, Zhongbo,Chen, Zachary B,Anderson, Mariam,Isayan, Kimberly,Paquette, Sophia B,Gibson, Madison,Fulcher, Abigail,Miano-Burkhardt, Laksh,Malik, Breeana,Baker, Paige,Jarreau, Henry,Houlden, Mina,Ryten, Bida,Gu, Mark Jp,Chaisson, Danny E,Miller, Pedro,Chaná-Cuevas, Cornelis,Blauwendraat, Andrew B,Singleton, Kimberley J,Billingsley
medRxiv : the preprint server for health sciences · 2025-03-19
pmid:40166539
Repeat length in spinocerebellar ataxia type 4 (SCA4) predicts age at onset and disease severity.
Andreas,Dalski, Martje G,Pauly, Henrike,Hanssen, Johann,Hagenah, Yorck,Hellenbroich, Christian,Schmidt, Jassemien,Strohschehn, Malte,Spielmann, Christine,Zühlke, Norbert,Brüggemann
Journal of neurology · 2024-08-02
pmid:39095619
A GGC-repeat expansion in ZFHX3 encoding polyglycine causes spinocerebellar ataxia type 4 and impairs autophagy.
Karla P,Figueroa, Caspar,Gross, Elena,Buena-Atienza, Sharan,Paul, Mandi,Gandelman, Naseebullah,Kakar, Marc,Sturm, Nicolas,Casadei, Jakob,Admard, Joohyun,Park, Christine,Zühlke, Yorck,Hellenbroich, Jelena,Pozojevic, Saranya,Balachandran, Kristian,Händler, Simone,Zittel, Dagmar,Timmann, Friedrich,Erdlenbruch, Laura,Herrmann, Thomas,Feindt, Martin,Zenker, Thomas,Klopstock, Claudia,Dufke, Daniel R,Scoles, Arnulf,Koeppen, Malte,Spielmann, Olaf,Riess, Stephan,Ossowski, Tobias B,Haack, Stefan M,Pulst
Nature genetics · 2024-04-29
pmid:38684900
FGF14 GAA repeat expansion and ZFHX3 GGC repeat expansion in clinically diagnosed multiple system atrophy patients.
Masaaki,Matsushima, Hiroaki,Yaguchi, Eriko,Koshimizu, Akihiko,Kudo, Shinichi,Shirai, Takeshi,Matsuoka, Shigehisa,Ura, Atsushi,Kawashima, Toshiyuki,Fukazawa, Satoko,Miyatake, Naomichi,Matsumoto, Ichiro,Yabe
Journal of neurology · 2024-03-12
pmid:38472396
Unraveling the genetic landscape of undiagnosed cerebellar ataxia in Brazilian patients.
Luiz Eduardo,Novis, Shahryar,Alavi, David,Pellerin, Marcus Vinicius,Della Coleta, Salmo,Raskin, Mariana,Spitz, Andrea,Cortese, Henry,Houlden, Helio Afonso,Teive
Parkinsonism & related disorders · 2023-12-20
pmid:38145611