VPS53 gene is associated with a new phenotype of complicated hereditary spastic paraparesis

  • Moran Hausman-KedemEmail author
  • Shay Ben-Shachar
  • Shay Menascu
  • Karen Geva
  • Liora Sagie
  • Aviva Fattal-Valevski
Original Article


Hereditary spastic paraparesis (HSP) is a progressive neurodegenerative disorder, characterized by progressive lower limb weakness and spasticity. Multiple genes are associated with both the pure and complicated HSP types. Our study is aimed at seeking for novel genetic basis of HSP in a family with two affected siblings. Genetic analysis using whole exome sequencing was conducted in a family quartet with two female siblings, who presented with complicated HSP featuring slowly progressive paraparesis, mild-moderate intellectual disability, normal head circumference (HC), and normal magnetic resonance imaging (MRI). A homozygous pathogenic variant was identified in both siblings in the VPS53 gene (c.2084A>G: c.2084A>G, p.Gln695Arg). This gene acts as a component of the Golgi-associated retrograde protein (GARP) complex that is involved, among others, in intracellular cholesterol transport and sphingolipid homeostasis in lysosomes and was previously associated with progressive cerebello-cerebral atrophy (PCCA) type 2. This is the first description of the VPS53 gene as a cause of autosomal recessive complicated HSP. Lysosomal dysfunction as a result of impaired cholesterol trafficking can explain the neurodegenerative processes responsible for the HSP. Our finding expands the phenotype of VPS53-related disease and warrants the addition of VPS53 analysis to the genetic investigation in patients with autosomal recessive HSP. The exact role of GARP complex in neurodegenerative processes should be further elucidated.


Hereditary spastic paraparesis Hereditary spastic paraplegia VPS53 PCCA type 2 



Hereditary spastic paraparesis


Progressive cerebello-cerebral atrophy


Golgi-associated retrograde protein


Head circumference


Magnetic resonance imaging


Magnetic resonance spectroscopy


Intellectual disability


Attention deficit hyperactivity disorder


Chromosomal microarray analysis


Whole exome sequencing



Irina Opincariu is thanked for editorial assistance. We would like to express our sincere gratitude to the patients and their family.

Financial disclosures

The study received the Bircher-Benner Grant for Preventative Medicine from the Sackler Faculty of Medicine, Tel Aviv University.

Compliance with ethical standards

All study protocols were reviewed and approved by the Institutional Review Board at the Tel Aviv Sourasky Medical Center.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Pediatric Neurology Institute, Dana-Dwek Children’s HospitalTel Aviv Sourasky Medical CenterTel AvivIsrael
  2. 2.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
  3. 3.Genetic InstituteTel Aviv Sourasky Medical CenterTel AvivIsrael
  4. 4.Multiple Sclerosis CenterSheba Medical CenterTel HaShomerIsrael

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