DNA icon

Hereditary Spastic Paraplegia via the ATP2B4 (PMCA4) Gene

Summary and Pricing

Test Method

Exome Sequencing with CNV Detection
Test Code Test Copy GenesTest CPT Code Gene CPT Codes Copy CPT Codes Base Price
ATP2B4 81479 81479,81479 $990
Test Code Test Copy Genes Test CPT Code Gene CPT Codes Copy CPT Code Base Price
4355ATP2B481479 81479,81479 $990 Order Options and Pricing

An additional 25% charge will be applied to STAT orders. STAT orders are prioritized throughout the testing process.

Click here for costs to reflex to whole PGxome (if original test is on PGxome Sequencing platform).

Click here for costs to reflex to whole PGnome (if original test is on PGnome Sequencing platform).

Turnaround Time

3 weeks on average for standard orders or 2 weeks on average for STAT orders.

Please note: Once the testing process begins, an Estimated Report Date (ERD) range will be displayed in the portal. This is the most accurate prediction of when your report will be complete and may differ from the average TAT published on our website. About 85% of our tests will be reported within or before the ERD range. We will notify you of significant delays or holds which will impact the ERD. Learn more about turnaround times here.

Targeted Testing

For ordering sequencing of targeted known variants, go to our Targeted Variants page.


Genetic Counselors


  • Greg Fischer, PhD

Clinical Features and Genetics

Clinical Features

Hereditary Spastic Paraplegia (HSP) is a group of clinically and genetically diverse diseases, characterized by spasticity (rigid muscles) and lower extremity weakness (Fink 2014; Hensiek et al. 2015). To date, more than 70 forms of HSP have been described (Tesson et al. 2015). In a two-generation Chinese family with 6 members (4 were symptomatic and 2 were asymptomatic), Li et al. reported a form of autosomal dominant HSP (Li et al. 2014). Affected individuals in this family developed progressive spastic paraplegia since teenage or mid-30s. They manifested weakness in hip and knee flexion, and downgoing plantar responses. The disease seems to be a “pure” type, as the patients’ upper limbs remained unaffected and no cognitive dysfunction was involved (Li et al. 2014).


Based on the Chinese family studied, the disease is inherited in an autosomal dominant manner. By whole exome sequencing, Li et al. identified a missense variant (c.803G>A, p.Arg268Gln) in the Plasma Membrane Calcium ATPase gene (PMCA4, also known as ATP2B4) (Li et al. 2014). This is the only pathogenic variant identified so far in the ATP2B4 gene (Human Gene Mutation Database). ATP2B4 is involved in calcium homeostasis (Kunert-Keil et al. 2014), and the p.Arg268Gln pathogenic variant in ATP2B4 may cause delay in intracellular calcium extrusion (Ho et al. 2015).

Clinical Sensitivity - Sequencing with CNV PGxome

It is difficult to estimate the clinical sensitivity of this test due to the lack of large cohort studies. The only reported pathogenic variant, c.803G>A, is detectable by sequencing.

Testing Strategy

This test provides full coverage of all coding exons of the ATP2B4 gene plus 10 bases of flanking noncoding DNA in all available transcripts along with other non-coding regions in which pathogenic variants have been identified at PreventionGenetics or reported elsewhere. We define full coverage as >20X NGS reads or Sanger sequencing. PGnome panels typically provide slightly increased coverage over the PGxome equivalent. PGnome sequencing panels have the added benefit of additional analysis and reporting of deep intronic regions (where applicable).

Dependent on the sequencing backbone selected for this testing, discounted reflex testing to any other similar backbone-based test is available (i.e., PGxome panel to whole PGxome; PGnome panel to whole PGnome).

Indications for Test

Family members of patients with ATP2B4-HSP mutations are candidates of this test. Patients with clinical symptoms consistent with autosomal dominant HSP may consider this test.


Official Gene Symbol OMIM ID
ATP2B4 108732
Inheritance Abbreviation
Autosomal Dominant AD
Autosomal Recessive AR
X-Linked XL
Mitochondrial MT


Name Inheritance OMIM ID


  • Fink J.K. 2014. Seminars in Neurology. 34: 293-305. PubMed ID: 25192507
  • Hensiek A. et al. 2015. Journal of Neurology. 262: 1601-12. PubMed ID: 25480570
  • Ho Philip W.L. 2015. Brain and Behavior. 5: e00321. PubMed ID: 25798335
  • Human Gene Mutation Database (Bio-base).
  • Kunert-Keil C.H. et al. 2014. Journal of Physiology and Pharmacology. 65: 317-24. PubMed ID: 24781740
  • Li M. et al. 2014. Plos One. 9: e104790. PubMed ID: 25119969
  • Tesson C. et al. 2015. Human Genetics. 134: 511-38. PubMed ID: 25758904


Ordering Options

We offer several options when ordering sequencing tests. For more information on these options, see our Ordering Instructions page. To view available options, click on the Order Options button within the test description.

myPrevent - Online Ordering

  • The test can be added to your online orders in the Summary and Pricing section.
  • Once the test has been added log in to myPrevent to fill out an online requisition form.
  • PGnome sequencing panels can be ordered via the myPrevent portal only at this time.

Requisition Form

  • A completed requisition form must accompany all specimens.
  • Billing information along with specimen and shipping instructions are within the requisition form.
  • All testing must be ordered by a qualified healthcare provider.

For Requisition Forms, visit our Forms page

If ordering a Duo or Trio test, the proband and all comparator samples are required to initiate testing. If we do not receive all required samples for the test ordered within 21 days, we will convert the order to the most effective testing strategy with the samples available. Prior authorization and/or billing in place may be impacted by a change in test code.

Specimen Types

Specimen Requirements and Shipping Details

PGxome (Exome) Sequencing Panel

PGnome (Genome) Sequencing Panel

loading Loading... ×


An error has occurred while calculating the price. Please try again or contact us for assistance.

View Ordering Instructions

1) Select Test Method (Platform)

1) Select Test Type

2) Select Additional Test Options

No Additional Test Options are available for this test.

Note: acceptable specimen types are whole blood and DNA from whole blood only.
Total Price: loading
Patient Prompt Pay Price: loading
A patient prompt pay discount is available if payment is made by the patient and received prior to the time of reporting.
Show Patient Prompt Pay Price
Copy Text to Clipboard