TOGARAM1 is a ciliary protein essential for regulating axonemal microtubule dynamics and ciliogenesis. As a member of the Crescerin family with TOG (TOG array regulator) domains, TOGARAM1 promotes microtubule polymerization and overcomes growth inhibition imposed by interacting ciliary tip proteins CEP104 and CSPP1, enabling slow and processive microtubule elongation characteristic of axonemal dynamics 1. TOGARAM1 regulates ciliary microtubule post-translational modifications, including acetylation and polyglutamylation, and controls cilium length 2. Dysfunction of TOGARAM1 causes Joubert syndrome 37, a recessive neurodevelopmental ciliopathy characterized by hindbrain malformation, resulting from reduced ciliary stability and decreased axonemal protein modifications 2. TOGARAM1 mutations also associate with neural tube closure defects; knockout mice display abnormal cilia, reduced sonic hedgehog signaling, and spina bifida, indicating critical roles in early neural development 3. Patient-derived fibroblasts with TOGARAM1 dysfunction show aberrant ciliary resorption and cold-induced depolymerization 2. Recent proteomic analysis identified TOGARAM1 among proteins with sex-specific associations in Alzheimer's disease cognitive trajectories, suggesting potential roles beyond ciliary function, though mechanistic details require further investigation 4.