While pyramidal signs were almost universally present, gait/posture problems were frequently reported in most genotypes except for SPG9, SPG12, SPG28, SPG43, and SPG64. Ataxia was highly prevalent in SPG7, SPG12, SPG28, SPG43, SPG44, SPG46, SPG50, SPG52, and SPG79, among others. The gene discussed is ALDH18A1; the disease is cerebellar ataxia.