The most frequent HSP was SPG4 (100 patients, 26%) among all HSP patients, followed by SPG31 (14 patients, 3.7%), SPG3A (13 patients, 3.4%), SPG11 (10 patients, 2.6%), and SPG10 (six patients, 1.6%). Here, ATL1 is linked to hereditary spastic paraplegia.