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In AD-GTPCHD patients, disease onset is typically during the first decade of life (mainly between 3 to 9 years of age), although very rarely patients may present with dystonia and/or developmental delay in the first 1218 months [33, 34]

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The consequences for positive tests include: Disqualification from competition Loss of medals and records Suspension from sport (potentially years) Stripped sponsorships and endorsements Permanent career damage Trace amounts -- even levels far below what would provide any performance benefit -- can still trigger positive tests and sanctions