hereditary spastic paraplegia 39 PNPLA6-related spastic paraplegia with or without ataxia https://github.com/monarch-initiative/mondo/issues/5527 GARD:0026063 MONDO:0100149 An autosomal recessive, multisystem condition caused by pathogenic variants of the PNPLA6 gene that characterized by peripheral neuropathy, cognitive impairment, lower limb spasticity, muscle weakness, and reduced vibration sense. Additional clinical features may include cerebellar ataxia, hypogonadism, growth hormone deficiency, and hypothyroidism.