Large study of SPG7 HSP

Many new findings emerge


A large study of 60 people with SPG7 HSP has found 70% have complex HSP and 30% have pure HSP. Ataxia was observed in about 60%. 14 new mutations were identified in the study, and for the first time with SPG7, a correlation between genotype (specific genetic mutation) and phenotype (type and extent of HSP symptoms) was found.

Spastic paraplegia type 7 is an autosomal recessive neurodegenerative disorder mainly characterized by progressive bilateral lower limb spasticity and referred to as a form of hereditary spastic paraplegia. Additional disease features may also be observed as part of a more complex phenotype.


Many different mutations have already been identified, but no genotype-phenotype correlations have been found so far. From a total of almost 800 patients referred for testing, we identified 60 patients with mutations in the SPG7 gene. We identified 14 previously unreported mutations and detected a high recurrence rate of several earlier reported mutations.


We were able to collect detailed clinical data for 49 patients, who were ranked based on a pure versus complex phenotype, ataxia versus no ataxia and missense versus null mutations. A generally complex phenotype occurred in 69% of all patients and was associated with a younger age at onset (trend with P = 0.07). Ataxia was observed in 57% of all patients. We found that null mutations were associated with the co-occurrence of cerebellar ataxia (trend with P = 0.06). The c.1409 G > A (p.Arg470Gln) mutation, which was found homozygously in two sibs, was associated with a specific complex phenotype that included predominant visual loss due to optical nerve atrophy. Neuropathology in one of these cases showed severe degeneration of the optic system, with less severe degeneration of the ascending tracts of the spinal cord and cerebellum. Other disease features encountered in this cohort included cervical dystonia, vertical gaze palsy, ptosis and severe intellectual disability.


In this large Dutch cohort, we seem to have identified the first genotype-phenotype correlation in spastic paraplegia type 7 by observing an association between the cerebellar phenotype of spastic paraplegia type 7 and SPG7 null alleles. An overlapping phenotypic presentation with its biological counterpart AFG3L2, which when mutated causes spinocerebellar ataxia type 28, is apparent and possibly suggests that abnormal levels of the SPG7 protein impact the function of the mitochondrial ATPases associated with diverse cellular activities-protease complex (formed by SPG7 and AFG3L2) in the cerebellum. In addition, a missense mutation in exon 10 resulted in predominant optical nerve atrophy, which might suggest deleterious interactions of this SPG7 variant with its substrate OPA1, the mutated gene product in optic atrophy type 1. Functional studies are required to further investigate these interactions.

SOURCE: Brain. 2012 Oct;135(Pt 10):2994-3004. doi: 10.1093/brain/aws224. Epub 2012 Sep 10. PMID: 22964162 [PubMed – in process]

Genotype-phenotype correlations in spastic paraplegia type 7: a study in a large Dutch cohort.

van Gassen KL, van der Heijden CD, de Bot ST, den Dunnen WF, van den Berg LH, Verschuuren-Bemelmans CC, Kremer HP, Veldink JH, Kamsteeg EJ, Scheffer H, van de Warrenburg BP.

Department of Human Genetics, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands. [email protected].


  1. Hi,

    In 2018 I was diagnosed with HSP SPG 7. Since that time the condition has deteriorated. I find that my ability to walk, what were relatively long distances, has worsened. Initially I was diagnosed with Asymmetric Cerebellar Ataxia nearly thirty years ago. Though after attending The Brain and Mind Institute since around 2011 I was encouraged to take Genetic testing, hence the change in diagnosis. Recently I have noticed that my speech is developing a slur, which, as I have relied on my voice, having performed on stage, and broadcast on community radio and I am currently an active participant at Toastmasters has affected. The Speech therapist at Concord Hospital has been very helpful and encouraging. It is at that same hospital that I have been seeing a physiotherapist who is also looking after me well.

    My question is, Are there any other steps that I might take to assist in slowing down the progression of this disease?

    Thankyou for taking the time to read this email.

    I forgot to say that I am a young 75 year old.


    1. Tim,
      I too have recently been diagnosed with HSP-7 and in similar condition and looking for clinical study. I’ve been told that there are no research going on in Mass for HSP, but know there are studies in Germany, Sweden and England. I’m 72 and have always been active. Are you from Concord, NH or CONCORD, MA?

  2. I would be interested to take part in a study.
    I was first diagnosed with idiopathic Parkinson’s in 2012 and since 2012 I have been taking sinemet.

    Following genetic testing as part of the 1,000 genome project I was re-diagnosed as HSP type 7.

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