FMR1 gene therapy restores activity-driven inhibition and prevents audiogenic seizures in Fmr1-/y mice

Fragile X syndrome (FXS) is a neurodevelopmental disorder associated with auditory hypersensitivity, circuit hyperexcitability, and seizures. Whether re-expression of the FMR1 gene and encoded Fragile X Messenger Ribonucleoprotein (FMRP) can restore sensory circuit dysfunction remains unclear. Here, we show that a viral AAV-FMR1 vector rescues audiogenic seizures in the Fmr1-/y mouse model after both neonatal and adult delivery, indicating that auditory circuit dysfunction remains reversible. Local re-expression in the inferior colliculus (IC) is sufficient to reduce seizure susceptibility, identifying this region as a key site of FMRP-dependent circuit regulation. In the IC, Translating Ribosome Affinity Purification and RNA-seq (TRAP-seq) profiling reveals impaired induction of sound-evoked translation programs in Fmr1-/y neurons, including those regulated by transcription factor Npas4. AAV-FMR1 restores a WT-like molecular response and normalizes unbalanced sound-evoked activation of VGLUT2+ excitatory neurons over VGAT+ inhibitory neurons in Fmr1-/y IC. Together, these findings indicate altered translation of Npas4 in response to sound impairs recruitment of inhibition in the Fmr1-/y IC, and this can be reversed with AAV-FMR1 administration. Moreover, the rescue of seizures after adult administration of AAV-FMR1 supports a gene therapy approach for FXS. HighlightsO_LITRAP-seq reveals impaired activity-driven translation in Fmr1-/y inferior colliculus (IC) C_LIO_LIDeficient Npas4 induction reduces evoked inhibition in Fmr1-/y IC C_LIO_LIAAV9-FMR1 gene therapy normalizes translation and excitatory/inhibitory balance in Fmr1-/y IC C_LIO_LIAAV9-FMR1 gene therapy prevents audiogenic seizures in Fmr1-/y mice when administered neonatally or in adulthood C_LI