Hereditary Spastic Paraplegia in Alberta: Lessons from a Well‐Defined Cohort Including the Indigenous Population
Bibliographic record
Abstract
BACKGROUND: Hereditary spastic paraplegias (HSP) are rare disorders sharing common features of leg spasticity with gait impairment. Simple and complex forms are recognized; over 50% of cases remain unsolved genetically. Little is known about the genetics of HSP among Indigenous Peoples. OBJECTIVES: To describe clinical, radiological, and genetic features of HSP in Alberta, Canada, and evaluate genetic variability among ethnic groups. METHODS: Patients with HSP were recruited between 2012 and 2021, and enrolled in an observational study. Genetic testing through research and/or clinical laboratories was performed. RESULTS: 100 patients from 86 Albertan families were enrolled. Overall prevalence was 2.3 per 100,000, with 2.8 per 100,000 in the Indigenous population. Forty-eight families (56%) were found to have pathogenic variants in 17 genes, including SPAST (29.2%), SPG7 (20.8%), SPG11 (8.3%), CAPN1 (6.3%), and SACS (6.3%). 58% of families had complex HSP. 36/66 White (European) families, 5/8 Indigenous families, 4/8 Asian families and 2/3 Middle Eastern families were confirmed with a genetic diagnosis. One Black (African) family was enrolled and tested positive for PI4KA. In Indigenous families, pathogenic variants were found in CTNNB1, SACS, SPG7, and SYNE1. Abnormalities of brain MRI were more frequently observed in patients with SACS, SPG7, SPG11, and ANO10. CONCLUSIONS: This study details findings in HSP patients in Alberta and is the first study to examine prevalence and types of HSP in the Indigenous Peoples of Alberta. It highlights the need for familiarity with the phenotypes and genotypes in the different ethnic populations in Alberta.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.034 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".