SPAST and hereditary spastic paraplegia: Others sign, though very variable and not indicative of HSP (da Graça et al., 2018), include hydrocephalus in SPG1 and SPG4 patients; leukoencephalopathy, a much more evident feature in Merzbacher disease but also present in SPG2; multifocal areas of T2 white matter hyperintensities, sometimes resembling multiple sclerosis, in SPG5 and SPG35; basal ganglia iron deposition appearing hypointense on T2, T2,* or Susceptibility Weighted Images (SWI) in SPG28, SPG35, and SPG43; basal ganglia abnormalities in SPG7 with cerebellar atrophy.