Other genes such as ATRX (Alpha Thalassemia/Mental Retardation Syndrome X-linked), PIWIL1 (Piwi Like RNA-Mediated Gene Silencing 1), and CPEB1 (Cytoplasmic Polyadenylation Element Binding Protein 1) are involved in germ cell maturation and meiosis, processes that may be disrupted in the context of TDS [61,62]. This evidence concerns the gene PIWIL1 and alpha thalassemia-X-linked intellectual disability syndrome.