The expansion size of our patient presenting at age 28 years was smaller compared with that of other patients in this cohort who developed disease later in life, which is in keeping with some previous reports showing weak or lack of correlation between age at onset and expansion size.1,7,9 This observation suggests that additional yet unknown factors may modify age at onset in GAA-FGF14 ataxia. Here, FGF14 is linked to cerebellar ataxia.