Moreover, voxel-based analysis in neuroimaging also showed global reduction of generalized fractional anisotropy (GFA) in the cerebral white matter innervating cortical regions, including prefrontal, parietal and temporal cortex, suggesting impaired microstructural integrity in fibers and restricted cerebral hypometabolism for diffuse cognitive deficits in SPG11-related HSP-TCC [31–33]. Here, SPG11 is linked to Cognitive impairment.