Reply:

We greatly appreciate Dr Mascalchi's interest in our article “Inherited Cerebellar Ataxia in Childhood: A Pattern-Recognition Approach Using Brain MRI.”¹ We agree that many cases of Friedreich ataxia (FRDA) have normal MR imaging findings at the time of diagnosis and that a visually normal cerebellum in a child with ataxia usually suggests FRDA. We also concur that volume loss and decreased fractional anisotropy by diffusion tensor imaging of the superior cerebellar peduncles and iron deposition on T2* are potential biomarkers for this disease.^2,3

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