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More recent studies using VMAT2 and DA transporter radiotracers, which are more sensitive to early abnormalities than 18 F-DOPA PET, have estimated the initial decline in dopaminergic pre-synaptic activity to be up to 17 years before diagnosis

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For BDNF transcriptomic endpoints, endotoxin testing below 0.25 EU per mg is additionally relevant, since lipopolysaccharide contamination will independently drive neurotrophin and cytokine expression