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A form of hereditary spastic paraplegia characterized by either a pure phenotype of slowly progressive spastic paraplegia of the lower extremities with bladder dysfunction and pes cavus or a complex presentation with additional manifestations including cerebellar signs, nystagmus, distal or generalized muscle atrophy and cognitive impairment. Age of onset is highly variable, ranging from early childhood to adulthood. White matter hyperintensity and cerebellar and spinal cord atrophy may be noted, on brain magnetic resonance imaging, in some patients.
Features include always present findings: Spastic gait, Lower limb spasticity, and Overactive reflexes (hyperreflexia); and very common findings: Impaired vibration sensation in the lower limbs, Lower limb muscle weakness, and Babinski sign. 26 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Brain and nerves | 10 | Spastic gait, Lower limb spasticity, Difficulty with thinking and memory (cognitive impairment) |
Arms and legs | 8 | Impaired vibration sensation in the lower limbs, Lower limb spasticity, Lower limb muscle weakness |
Eyes | 3 | Cataract, Nystagmus, Damage to the optic nerve (optic atrophy) |
Muscles | 3 | Lower limb muscle weakness, Upper limb muscle weakness, Damage to the optic nerve (optic atrophy) |
Bones and joints | 2 | Sideways curvature of the spine (scoliosis), Postural tremor |
Kidneys and urinary system | 1 | Urinary incontinence |
Digestive system | 1 | Abnormal cholesterol levels (abnormal circulating cholesterol concentration) |
Ears | 1 | Inner ear hearing loss (sensorineural hearing impairment) |
Age of onset: middle age.
CYP7B1 encodes cytochrome P450 family 7 subfamily B member 1 (506 aa). A cytochrome P450 monooxygenase involved in the metabolism of endogenous oxysterols and steroid hormones, including neurosteroids. Highest expression in Cells Cultured fibroblasts (12.4 TPM) and Cells EBV-transformed lymphocytes (9.7 TPM).
Hereditary spastic paraplegia 5A is associated with mutations in the CYP7B1 gene on chromosome 8.
The CYP7B1 protein participates in Cytochrome P450 (CYP7B1 based) pathway.
CYP7B1 is classified as a druggable target (Cytochrome P450, Druggable Genome, and Enzyme categories) with score 7.0.
Genetic testing for CYP7B1 is available. Testing is considered confirmatory for diagnosis.
Biomarker and diagnostic research for hereditary spastic paraplegia 5A has been reported in the published literature.
Phenotype severity distribution: 3 always present features, 3 very common features, 4 common features.
Estimated prevalence: <1 in 1,000,000 (VERY_RARE).
No clinical trials have been registered for hereditary spastic paraplegia 5A.
107 publications have been identified in PubMed for hereditary spastic paraplegia 5A. Research spans Basic Science / Preclinical (28%), Case Report / Case Series (22%), and Review / Meta-Analysis (20%).
Research Type | Count | % of Total |
|---|---|---|
Laboratory research | 30 | 28% |
Patient case studies | 24 | 22% |
Research summaries | 21 | 20% |
Disease patterns and progression | 14 | 13% |
New treatment approaches | 8 | 7% |
Testing and diagnosis research | 6 | 6% |
Other research | 3 | 3% |
Clinical study results | 1 | 1% |
Ziegler M (2026). [PMID: 42154535](https://pubmed.ncbi.nlm.nih.gov/42154535/). *JCI Insight*. [Gene Therapy / Novel Therapeutics]
Esener Z (2026). [PMID: 41808431](https://pubmed.ncbi.nlm.nih.gov/41808431/). *Int J Dev Neurosci*. [Review / Meta-Analysis]
Gillesse EH (2026). [PMID: 41656397](https://pubmed.ncbi.nlm.nih.gov/41656397/). *Neurogenetics*. [Case Report / Case Series]
Santangelo S (2026). [PMID: 41836058](https://pubmed.ncbi.nlm.nih.gov/41836058/). *Frontiers in genetics*. [Gene Therapy / Novel Therapeutics]
Dulski J (2026). [PMID: 40873038](https://pubmed.ncbi.nlm.nih.gov/40873038/). *HGG advances*. [Basic Science / Preclinical]
Lin PY (2026). [PMID: 40518753](https://pubmed.ncbi.nlm.nih.gov/40518753/). *Acta Neurol Taiwan*. [Epidemiology / Natural History]
Satolli S (2026). [PMID: 41493653](https://pubmed.ncbi.nlm.nih.gov/41493653/). *Neurol Sci*. [Review / Meta-Analysis]
Akarsu Ş (2026). [PMID: 41797006](https://pubmed.ncbi.nlm.nih.gov/41797006/). *J Neurochem*. [Basic Science / Preclinical]
Israr S (2026). [PMID: 40856587](https://pubmed.ncbi.nlm.nih.gov/40856587/). *J Child Neurol*. [Review / Meta-Analysis]
Esmaeil Lashgarian H (2026). [PMID: 41625348](https://pubmed.ncbi.nlm.nih.gov/41625348/). *Iran J Med Sci*. [Case Report / Case Series]
Data assembled from 6 of 12 sources · Last updated Sep 20, 2026, 7:00 AM UTC
Online Mendelian Inheritance in Man
European rare disease database
Genetic and Rare Diseases Info Center