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Hereditary spastic paraplegia 31(SPG31)

MedGen UID:
377858
Concept ID:
C1853247
Disease or Syndrome
Synonyms: Spastic Paraplegia 31; Spastic paraplegia 31, autosomal dominant
SNOMED CT: Autosomal dominant spastic paraplegia type 31 (763068005)
Modes of inheritance:
Autosomal dominant inheritance
MedGen UID:
141047
Concept ID:
C0443147
Intellectual Product
Source: Orphanet
A mode of inheritance that is observed for traits related to a gene encoded on one of the autosomes (i.e., the human chromosomes 1-22) in which a trait manifests in heterozygotes. In the context of medical genetics, an autosomal dominant disorder is caused when a single copy of the mutant allele is present. Males and females are affected equally, and can both transmit the disorder with a risk of 50% for each child of inheriting the mutant allele.
 
Gene (location): REEP1 (2p11.2)
 
Monarch Initiative: MONDO:0012453
OMIM®: 610250
Orphanet: ORPHA101011

Definition

Spastic paraplegia-31 (SPG31) is an autosomal dominant neurologic disorder characterized primarily by spasticity of the lower limbs, resulting in gait abnormalities and muscle weakness. There is a bimodal age at onset with a peak in the second and fourth decades of life. Most affected individuals have a 'pure' form of the disorder with gait difficulties and hyperreflexia of the lower limbs. However, there is phenotypic heterogeneity, and some patients have a 'complex' form of the disorder with additional signs and symptoms, such as peripheral neuropathy, cerebellar ataxia, postural tremor, or urinary symptoms. The disorder is slowly progressive, and there is intrafamilial variability and incomplete penetrance (summary by Goizet et al., 2011 and Toft et al., 2019). For a general phenotypic description and a discussion of genetic heterogeneity of autosomal dominant spastic paraplegia, see SPG3A (182600). [from OMIM]

Additional description

From MedlinePlus Genetics
The first signs and symptoms of spastic paraplegia type 31 usually appear before age 20 or after age 30. An early feature is difficulty walking due to spasticity and weakness, which typically affect both legs equally. People with spastic paraplegia type 31 can also experience progressive muscle wasting (amyotrophy) in the lower limbs, exaggerated reflexes (hyperreflexia), a decreased ability to feel vibrations, reduced bladder control, and high-arched feet (pes cavus). As the condition progresses, some individuals require walking support.

Spastic paraplegia type 31 is one of a group of genetic disorders known as hereditary spastic paraplegias. These disorders are characterized by progressive muscle stiffness (spasticity) and the development of paralysis of the lower limbs (paraplegia) caused by degeneration of nerve cells that trigger muscle movement (motor neurons). Hereditary spastic paraplegias are divided into two types: pure and complicated. The pure types involve only the lower limbs, while the complicated types also involve the upper limbs and other areas of the body, including the brain. Spastic paraplegia type 31 is usually a pure hereditary spastic paraplegia, although a few complicated cases have been reported.  https://medlineplus.gov/genetics/condition/spastic-paraplegia-type-31

Clinical features

From HPO
Urinary urgency
MedGen UID:
39315
Concept ID:
C0085606
Finding
Urge incontinence is the strong, sudden need to urinate.
Ankle clonus
MedGen UID:
68672
Concept ID:
C0238651
Finding
Clonus is an involuntary tendon reflex that causes repeated flexion and extension of the foot. Ankle clonus is tested by rapidly flexing the foot upward.
Pes cavus
MedGen UID:
675590
Concept ID:
C0728829
Congenital Abnormality
An increase in height of the medial longitudinal arch of the foot that does not flatten on weight bearing (i.e., a distinctly hollow form of the sole of the foot when it is bearing weight).
Lower limb muscle weakness
MedGen UID:
324478
Concept ID:
C1836296
Finding
Weakness of the muscles of the legs.
Dysphagia
MedGen UID:
41440
Concept ID:
C0011168
Disease or Syndrome
Difficulty in swallowing.
Dysarthria
MedGen UID:
8510
Concept ID:
C0013362
Mental or Behavioral Dysfunction
Dysarthric speech is a general description referring to a neurological speech disorder characterized by poor articulation. Depending on the involved neurological structures, dysarthria may be further classified as spastic, flaccid, ataxic, hyperkinetic and hypokinetic, or mixed.
Babinski sign
MedGen UID:
19708
Concept ID:
C0034935
Finding
Upturning of the big toe (and sometimes fanning of the other toes) in response to stimulation of the sole of the foot. If the Babinski sign is present it can indicate damage to the corticospinal tract.
Spastic paraplegia
MedGen UID:
20882
Concept ID:
C0037772
Disease or Syndrome
Spasticity and weakness of the leg and hip muscles.
Hyperreflexia
MedGen UID:
57738
Concept ID:
C0151889
Finding
Hyperreflexia is the presence of hyperactive stretch reflexes of the muscles.
Spastic gait
MedGen UID:
115907
Concept ID:
C0231687
Finding
Spasticity is manifested by increased stretch reflex which is intensified with movement velocity. This results in excessive and inappropriate muscle activation which can contribute to muscle hypertonia. Spastic gait is characterized by manifestations such as muscle hypertonia, stiff knee, and circumduction of the leg.
Lower limb spasticity
MedGen UID:
220865
Concept ID:
C1271100
Finding
Spasticity (velocity-dependent increase in tonic stretch reflexes with increased muscle tone and hyperexcitable tendon reflexes) in the muscles of the lower limbs, hips, and pelvis
Distal sensory impairment
MedGen UID:
335722
Concept ID:
C1847584
Finding
An abnormal reduction in sensation in the distal portions of the extremities.
Muscular atrophy
MedGen UID:
892680
Concept ID:
C0541794
Pathologic Function
The presence of skeletal muscular atrophy (which is also known as amyotrophy).
Distal amyotrophy
MedGen UID:
338530
Concept ID:
C1848736
Disease or Syndrome
Muscular atrophy affecting muscles in the distal portions of the extremities.

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVHereditary spastic paraplegia 31
Follow this link to review classifications for Hereditary spastic paraplegia 31 in Orphanet.

Professional guidelines

PubMed

Beetz C, Schüle R, Deconinck T, Tran-Viet KN, Zhu H, Kremer BP, Frints SG, van Zelst-Stams WA, Byrne P, Otto S, Nygren AO, Baets J, Smets K, Ceulemans B, Dan B, Nagan N, Kassubek J, Klimpe S, Klopstock T, Stolze H, Smeets HJ, Schrander-Stumpel CT, Hutchinson M, van de Warrenburg BP, Braastad C, Deufel T, Pericak-Vance M, Schöls L, de Jonghe P, Züchner S
Brain 2008 Apr;131(Pt 4):1078-86. Epub 2008 Mar 5 doi: 10.1093/brain/awn026. PMID: 18321925Free PMC Article

Recent clinical studies

Etiology

de Boer EMJ, de Vries BS, Pennings M, Kamsteeg EJ, Veldink JH, van den Berg LH, van Es MA
J Neurol 2023 Aug;270(8):3970-3980. Epub 2023 May 3 doi: 10.1007/s00415-023-11746-7. PMID: 37133535Free PMC Article
Fereshtehnejad SM, Saleh PA, Oliveira LM, Patel N, Bhowmick S, Saranza G, Kalia LV
Neurol Sci 2023 Mar;44(3):947-959. Epub 2022 Nov 28 doi: 10.1007/s10072-022-06516-8. PMID: 36441344Free PMC Article
Morsy H, Benkirane M, Cali E, Rocca C, Zhelcheska K, Cipriani V, Galanaki E, Maroofian R, Efthymiou S, Murphy D, O'Driscoll M, Suri M, Banka S, Clayton-Smith J, Wright T, Redman M, Bassetti JA, Nizon M, Cogne B, Jamra RA, Bartolomaeus T, Heruth M, Krey I, Gburek-Augustat J, Wieczorek D, Gattermann F, Mcentagart M, Goldenberg A, Guyant-Marechal L, Garcia-Moreno H, Giunti P, Chabrol B, Bacrot S, Buissonnière R, Magry V, Gowda VK, Srinivasan VM, Melegh B, Szabó A, Sümegi K, Cossée M, Ziff M, Butterfield R, Hunt D, Bird-Lieberman G, Hanna M, Koenig M, Stankewich M, Vandrovcova J, Houlden H; Genomics England Research Consortium
Genet Med 2023 Jan;25(1):76-89. Epub 2022 Nov 4 doi: 10.1016/j.gim.2022.09.013. PMID: 36331550Free PMC Article
Zouvelou V, Yubero D, Apostolakopoulou L, Kokkinou E, Bilanakis M, Dalivigka Z, Nikas I, Kollia E, Perez-Dueñas B, Macaya A, Marcé-Grau A, Voutetakis A, Anagnostopoulou K, Kekou K, Sofocleus C, Veltra D, Kokkinis X, Fryssira H, Torres RJ, Amstrong J, Santorelli FM, Artuch R, Pons R
Eur J Paediatr Neurol 2019 May;23(3):427-437. Epub 2019 Feb 14 doi: 10.1016/j.ejpn.2019.02.001. PMID: 30799092
Roşulescu E, Stănoiu C, Buteică E, Stănoiu B, Burada F, Zăvăleanu M
Rom J Morphol Embryol 2009;50(2):299-303. PMID: 19434327

Diagnosis

de Boer EMJ, de Vries BS, Pennings M, Kamsteeg EJ, Veldink JH, van den Berg LH, van Es MA
J Neurol 2023 Aug;270(8):3970-3980. Epub 2023 May 3 doi: 10.1007/s00415-023-11746-7. PMID: 37133535Free PMC Article
Pellerin D, Danzi MC, Wilke C, Renaud M, Fazal S, Dicaire MJ, Scriba CK, Ashton C, Yanick C, Beijer D, Rebelo A, Rocca C, Jaunmuktane Z, Sonnen JA, Larivière R, Genís D, Molina Porcel L, Choquet K, Sakalla R, Provost S, Robertson R, Allard-Chamard X, Tétreault M, Reiling SJ, Nagy S, Nishadham V, Purushottam M, Vengalil S, Bardhan M, Nalini A, Chen Z, Mathieu J, Massie R, Chalk CH, Lafontaine AL, Evoy F, Rioux MF, Ragoussis J, Boycott KM, Dubé MP, Duquette A, Houlden H, Ravenscroft G, Laing NG, Lamont PJ, Saporta MA, Schüle R, Schöls L, La Piana R, Synofzik M, Zuchner S, Brais B
N Engl J Med 2023 Jan 12;388(2):128-141. Epub 2022 Dec 14 doi: 10.1056/NEJMoa2207406. PMID: 36516086Free PMC Article
Panwala TF, Garcia-Santibanez R, Vizcarra JA, Garcia AG, Verma S
Pediatr Neurol 2022 May;130:7-13. Epub 2022 Mar 3 doi: 10.1016/j.pediatrneurol.2022.02.007. PMID: 35303589
Parodi L, Coarelli G, Stevanin G, Brice A, Durr A
Curr Opin Neurol 2018 Aug;31(4):462-471. doi: 10.1097/WCO.0000000000000585. PMID: 29847346
Coutinho P, Ruano L, Loureiro JL, Cruz VT, Barros J, Tuna A, Barbot C, Guimarães J, Alonso I, Silveira I, Sequeiros J, Marques Neves J, Serrano P, Silva MC
JAMA Neurol 2013 Jun;70(6):746-55. doi: 10.1001/jamaneurol.2013.1707. PMID: 23609960

Therapy

Ibrahim AA, Ollenschläger M, Klebe S, Schüle R, Jeschonneck N, Kellner M, Loris E, Greinwalder T, Eskofier BM, Winkler J, Gaßner H, Regensburger M
Eur J Neurol 2024 Aug;31(8):e16367. Epub 2024 Jun 10 doi: 10.1111/ene.16367. PMID: 38859620
Tu Y, Liu Y, Fan S, Weng J, Li M, Zhang F, Fu Y, Hu J
Eur J Neurol 2024 Aug;31(8):e16310. Epub 2024 Apr 23 doi: 10.1111/ene.16310. PMID: 38651515
Schöls L, Rattay TW, Martus P, Meisner C, Baets J, Fischer I, Jägle C, Fraidakis MJ, Martinuzzi A, Saute JA, Scarlato M, Antenora A, Stendel C, Höflinger P, Lourenco CM, Abreu L, Smets K, Paucar M, Deconinck T, Bis DM, Wiethoff S, Bauer P, Arnoldi A, Marques W, Jardim LB, Hauser S, Criscuolo C, Filla A, Züchner S, Bassi MT, Klopstock T, De Jonghe P, Björkhem I, Schüle R
Brain 2017 Dec 1;140(12):3112-3127. doi: 10.1093/brain/awx273. PMID: 29126212Free PMC Article
Jan MM
Pediatr Neurol 2004 Oct;31(4):298-303. doi: 10.1016/j.pediatrneurol.2004.03.017. PMID: 15464646
Westhoff B, Seller K, Wild A, Jaeger M, Krauspe R
Dev Med Child Neurol 2003 Dec;45(12):829-32. doi: 10.1017/s0012162203001531. PMID: 14667075

Prognosis

Xing F, Du J
Neurol Sci 2022 Aug;43(8):4989-4996. Epub 2022 Mar 28 doi: 10.1007/s10072-022-05921-3. PMID: 35348942
Osmanovic A, Widjaja M, Förster A, Weder J, Wattjes MP, Lange I, Sarikidi A, Auber B, Raab P, Christians A, Preller M, Petri S, Weber RG
J Neurol 2020 Sep;267(9):2732-2743. Epub 2020 May 23 doi: 10.1007/s00415-020-09861-w. PMID: 32447552Free PMC Article
Loureiro JL, Brandão E, Ruano L, Brandão AF, Lopes AM, Thieleke-Matos C, Miller-Fleming L, Cruz VT, Barbosa M, Silveira I, Stevanin G, Pinto-Basto J, Sequeiros J, Alonso I, Coutinho P
JAMA Neurol 2013 Apr;70(4):481-7. doi: 10.1001/jamaneurol.2013.1956. PMID: 23400676
Jan MM
Pediatr Neurol 2004 Oct;31(4):298-303. doi: 10.1016/j.pediatrneurol.2004.03.017. PMID: 15464646
Westhoff B, Seller K, Wild A, Jaeger M, Krauspe R
Dev Med Child Neurol 2003 Dec;45(12):829-32. doi: 10.1017/s0012162203001531. PMID: 14667075

Clinical prediction guides

Salayev K, Rocca C, Kaiyrzhanov R, Guliyeva U, Guliyeva S, Mursalova A, Rahman F, Anwar N, Zafar F, Jan F, Rana N, Maqbool S; SYNAPS Study Group; QUEEN SQUARE Genomics, Efthymiou S, Houlden H
Eur J Med Genet 2022 Nov;65(11):104620. Epub 2022 Sep 16 doi: 10.1016/j.ejmg.2022.104620. PMID: 36122674
Laßmann C, Ilg W, Schneider M, Völker M, Haeufle DFB, Schüle R, Giese M, Synofzik M, Schöls L, Rattay TW
Mov Disord 2022 Dec;37(12):2417-2426. Epub 2022 Aug 29 doi: 10.1002/mds.29199. PMID: 36054444
Xing F, Du J
Neurol Sci 2022 Aug;43(8):4989-4996. Epub 2022 Mar 28 doi: 10.1007/s10072-022-05921-3. PMID: 35348942
Piermarini E, Akarsu S, Connors T, Kneussel M, Lane MA, Morfini G, Karabay A, Baas PW, Qiang L
Hum Mol Genet 2022 Jun 4;31(11):1844-1859. doi: 10.1093/hmg/ddab367. PMID: 34935948Free PMC Article
Inloes JM, Kiosses WB, Wang H, Walther TC, Farese RV Jr, Cravatt BF
Biochemistry 2018 Feb 6;57(5):827-838. Epub 2017 Dec 26 doi: 10.1021/acs.biochem.7b01028. PMID: 29278326Free PMC Article

Recent systematic reviews

Fereshtehnejad SM, Saleh PA, Oliveira LM, Patel N, Bhowmick S, Saranza G, Kalia LV
Neurol Sci 2023 Mar;44(3):947-959. Epub 2022 Nov 28 doi: 10.1007/s10072-022-06516-8. PMID: 36441344Free PMC Article
Loureiro JL, Brandão E, Ruano L, Brandão AF, Lopes AM, Thieleke-Matos C, Miller-Fleming L, Cruz VT, Barbosa M, Silveira I, Stevanin G, Pinto-Basto J, Sequeiros J, Alonso I, Coutinho P
JAMA Neurol 2013 Apr;70(4):481-7. doi: 10.1001/jamaneurol.2013.1956. PMID: 23400676

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