Author Response: Association of Age at Onset and First Symptoms With Disease Progression in Patients With Metachromatic Leukodystrophy

We are grateful for the interest in our article.1 Michell-Robinson and Lépine suggest that the different types of symptoms at disease onset might partly be explained by an age- or maturation-specific vulnerability of motor and cognitive brain networks, for example, their myelination. Indeed, myelination of short-range fibers happens later than of long range.2 However, this does not explain the finding in our study that a disease course with a motor onset and rapid progression can occur at all ages, including late-juvenile and adult forms.

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