Hereditary Spastic Paraplegia
Gene: GSN
ESHG 2026
20 individuals from large multigeneration French family presenting with spastic ataxia onset ~40yrs leading to death ~50yrs. Neuropathological analysis on tissue showed predominant motoneuron pathology in the spinal cord, loss of Purkinje cells, and gelsolin mislocalisation, but no amyloid deposits in spinal cord. Linkage and LR WGS identified a rare heterozygous missense variant in the GSN gene (H174N).
GSN encodes Gelsolin, a calcium-activated F-actin severing and capping protein with six gelsolin-like domains critical for cytoskeletal dynamics. Protein modeling predicted impaired actin binding for the variant in the G2 domain of gelsolin. Actin stress fibres were reduced and thinner in patient-derived fibroblasts. Migration assays showed impaired motility in both patient-derived fibroblasts and HeLa cells expressing mutant GSN. Transcriptome profiling of isogenic iPSC-derived neural progenitors revealed a marked decrease in the expression of the brain-enriched actin isoform (ACTG1) and alterations in cytoskeleton-related genes.
3 additional individuals identified with same phenotype with functional studies pending.
NB: Pathogenic variants in GSN known to cause Finnish-type gelsolin amyloidosis (typically affecting D163 amino acid).Created: 18 Aug 2026, 2:20 p.m. | Last Modified: 18 Aug 2026, 2:20 p.m.
Panel Version: 2.478
Mode of inheritance
MONOALLELIC, autosomal or pseudoautosomal, NOT imprinted
Phenotypes
Spastic ataxia, MONDO:0017845, GSN-related
Gene: gsn has been classified as Red List (Low Evidence).
Publications for gene: GSN were set to 2176164; 28139293
Phenotypes for gene: GSN were changed from Spastic ataxia, MONDO:0017845, GSN-related to Spastic ataxia, MONDO:0017845, GSN-related
Mode of inheritance for gene: GSN was changed from MONOALLELIC, autosomal or pseudoautosomal, NOT imprinted to MONOALLELIC, autosomal or pseudoautosomal, NOT imprinted
Mode of inheritance for gene: GSN was changed from BOTH monoallelic and biallelic (but BIALLELIC mutations cause a more SEVERE disease form), autosomal or pseudoautosomal to MONOALLELIC, autosomal or pseudoautosomal, NOT imprinted
Phenotypes for gene: GSN were changed from Amyloidosis, Finnish type, MIM# 105120; Spastic ataxia, MONDO:0017845, GSN-related to Spastic ataxia, MONDO:0017845, GSN-related
Gene: gsn has been classified as Red List (Low Evidence).
gene: GSN was added gene: GSN was added to Hereditary Spastic Paraplegia. Sources: Expert Review Green,Victorian Clinical Genetics Services Mode of inheritance for gene: GSN was set to BOTH monoallelic and biallelic (but BIALLELIC mutations cause a more SEVERE disease form), autosomal or pseudoautosomal Publications for gene: GSN were set to 2176164; 28139293 Phenotypes for gene: GSN were set to Amyloidosis, Finnish type, MIM# 105120; Spastic ataxia, MONDO:0017845, GSN-related