Although women scored better in the North Star Assessment for Dysferlinopathy (NSAD) at baseline,9 they simultaneously showed higher fat content in several muscles measured through MRI13,14 Although current findings offer insight into certain aspects of disease progression, contradictions and persistent knowledge gaps highlight the complexity of LGMDR2 and the need for further research to fully understand its natural history. This evidence concerns the gene DYSF and neuromuscular disease caused by qualitative or quantitative defects of dysferlin.