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Although recently emerged cerebrospinal fluid (CSF) -synuclein seed amplification assays have demonstrated high sensitivity and specificity in identifying PD patients 1 , reliable peripheral fluid biomarkers for PD are currently lacking

Given the illegal nature of AAS use in many settings and the ethical impossibility of conducting long-term interventional studies with supraphysiological androgen doses in humans, a substantial proportion of cases likely remain unreported, and the true prevalence of this phenomenon may be underestimated in the existing literature

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