SPAST and hereditary spastic paraplegia: This study also identified earlier mean age at onset in ATL1 mutated patients relative to patients with other AD HSP subtypes [SPG4 and SPG31] caused by mutations in SPAST and REEP1. Among the AR HSP subtypes included in the analysis, SPG35 showed a tendency for younger age at onset (Erfanian Omidvar et al., 2019).