AP4B1 encodes the β4 subunit of the heterotetrameric AP-4 adaptor protein complex, which mediates intracellular vesicle trafficking of membrane proteins and is required for the correct sorting of AP-4 cargo out of the trans-Golgi network in neurons (PMID:22290197, PMID:24781758, PMID:29193663). Loss of AP4B1 causes the autophagy-related cargo ATG9A to be mislocalized from a generalized cytoplasmic distribution into the trans-Golgi network, with concomitant upregulation of ATG9A protein across tissues, defining ATG9A as an AP-4 cargo that depends on AP4B1 for export from the TGN (PMID:36632189). This trafficking defect translates into neuronal pathology: AP4B1-null animals accumulate calbindin-positive axonal spheroids at Purkinje cell projections in the deep cerebellar nuclei (PMID:36632189), and loss of ap4b1 shortens spinal motor neuron axons, implicating the complex in axonal development and integrity (PMID:40267240). Biallelic loss-of-function mutations in AP4B1, including a splice-disrupting intronic variant, cause the spastic paraplegia/intellectual disability disorder SPG47 (PMID:22290197, PMID:24781758, PMID:29193663, PMID:34927723). AAV9-mediated restoration of AP4B1 in knockout mice reverses ATG9A mislocalization, spheroid accumulation, brain anatomical defects, and motor dysfunction, establishing AP4B1 loss as causally responsible for the molecular and organismal phenotypes (PMID:39358605).