Schieving et al. (2019) pointed that the majority of patients (22/27, 81%) with de novo variants have an extremely early onset (<10 years) of the disease and that the complex types exhibited more severe neurological symptoms than in familial cases. Another study reconfirmed that de novo variants in SPAST usually lead to a severe and complex form of HSP (Mo et al., 2022). However, this finding is inapplicable to our patient, and the association between genotype (truncating variant arisen de novo) and phenotype (age of onset and the form of HSP) may require further investigation. Here, SPAST is linked to hereditary spastic paraplegia.