Potential overlap between HSP and MS

New mutation in SPG7 implicated


A new mutation has been found in two siblings for SPG7 HSP, with overlap occurring between primary progressive Multiple Sclerosis (PPMS) and HSP.



Primary progressive multiple sclerosis (PPMS) presents with clinical signs of slowly progressive long tract dysfunction that can overlap with neurodegenerative disorders, such as hereditary spastic paraplegia (HSP).

Herein, we present two siblings in whom we have identified a novel mutation in the paraplegin (SPG7) gene. The proband, a 49-year-old woman, presented with a five-year history of progressive spastic paraparesis and ataxia. Brain MRI showed mild cerebellar atrophy. The genetic study revealed a homozygous mutation in the SPG7 gene that led to the diagnosis of HSP. Four years previously, the younger brother had complained of slowly progressive spastic-ataxic gait that started one year before; MRI had disclosed multiple areas of white matter hyperintensity with contrast enhancement.

A diagnosis of active PPMS was made, and the patient started Disease-Modifying Therapy with further clinical and radiological stability. Once a genetic diagnosis was achieved in his sister, the patient underwent SPG7 testing, which disclosed the same mutation. Whether MS is a mimicry of HSP or it represents “double trouble” condition in this patient, it remains undetermined.

SOURCE: Mult Scler Relat Disord. 2020 Jun 14;44:102302. doi: 10.1016/j.msard.2020.102302. Online ahead of print. PMID: 32570181 Copyright © 2020 Elsevier B.V. All rights reserved.

A new paraplegin mutation in a patient with primary progressive multiple sclerosis

Angelo Bellinvia 1Luisa Pastò 2Claudia Niccolai 3Alessandra Tessa 4Riccardo Carrai 5Cristiana Martinelli 5Marco Moretti 6Maria Pia Amato 7Filippo Maria Santorelli 4Sandro Sorbi 7Sabrina Matà 8

1 Department of NEUROFARBA, Section Neurosciences, University of Firenze, Firenze, Italy.

2 Department of Neurological Rehabilitation, AOU Careggi, Firenze, Italy.

3 IRCCS Don Carlo Gnocchi, Firenze, Italy.

4 Molecular Medicine for Neurodegenerative and Neuromuscular Diseases Unit, IRCCS Fondazione Stella Maris, Pisa, Italy.

5 Department of Neurophysiopathology, AOU Careggi, Firenze, Italy.

6 Department of Neuroradiology, AOU Careggi, Firenze, Italy.

7 Department of NEUROFARBA, Section Neurosciences, University of Firenze, Firenze, Italy; IRCCS Don Carlo Gnocchi, Firenze, Italy.

8 Department of Neurology, AOU Careggi, Largo Palagi 1, Firenze 50139, Italy. Electronic address: [email protected].



1 comment

  1. This is an exciting article. I was diagnosed with SPG7 complex in 2017 & recently, after an MRI, I was told I also have MS. So very interesting

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