“…In other words, dystonia was also observed in patients with small expansions, 27,33,36,37 and parkinsonism and chorea were also present in patients with large expansions 4,30,38‐41 . ATX‐ TBP patients with parkinsonism showed, in some cases, a phenotype resembling typical PD with response to dopaminergic therapy and, in other cases, a clinical picture indistinguishable from multiple system atrophy (MSA‐C or MSA‐P) with partial or no response to dopaminergic therapy and, in some, characteristic imaging findings of MSA, such as the hyperintense putaminal rim or the hot cross bun sign 13,32,33,39,42‐46 . Dopaminergic single‐photon emission computed tomography/positron emission tomography imaging studies demonstrated presynaptic and postsynaptic dopaminergic deficits involving the nigrostriatal pathway.…”