Hereditary spastic paraplegias (HSPs) are a group of neurological disorders with progressive spasticity and weakness of the lower limbs, likely a result of distal axonopathy in the corticospinal tract. Hereditary spastic paraplegias have been classified as pure or complicated on the basis of the absence or presence of associated clinical features, such as cognitive dysfunction, ataxia, and peripheral neuropathy.
1 With nearly 75 distinct loci and more than 50 disease genes identified to date, the genetics of HSPs provide an opportunity for unraveling the requirements for corticospinal tract axon integrity and identifying convergent themes at the cellular level. The most common presentation of HSP is pure adult-onset autosomal dominant (AD-HSP).
2 Mutations in
SPAST (SPG4; OMIM #182601),
3ATL1 (SPG3A; OMIM #182600),
4 and
REEP1 (SPG31; OMIM #610250)
5 account for almost 60% of AD-HSPs overall.
6 The localization of the encoded proteins to the endoplasmic reticulum (ER), where proteins interact with one another and shape the tubular network, suggests that abnormalities in ER morphogenesis may be a common pathogenic theme.
7,8 Which myriad functions of these proteins in the ER are most relevant for the pathogenesis of HSP remains an unanswered question.