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In subjects below 70 years presarcopenia, but not sarcopenia symptoms were noted [46]

Therefore, early stages of DSPN or a painful small fiber neuropathy with or without minimal deficits can only be verified using more sophisticated tests such as thermal thresholds or skin biopsy

Importantly, the controlled nature of the GF-MKD likely reduced dietary coumarin exposure, and the observed post-intervention decline may therefore reflect both dietary restriction and altered metabolic or microbial handling of coumarin in children with ASD