This includes loss of dendritic aborization, or branching, early in disease progression and eventual atrophy of brain tissues in later stages. SCA1 causes moderate degradation of a variety of tissues, including both hemispheres of the cerebellum, the cerebellar vermis, the pons, and the brain stem. It also causes mild atrophy in cerebral cortical tissue. A recent study also found significant atrophy of the spinal cord and flattening of the posterior column and found a correlation between cord area, CAG repeats, and SARA scores in SCA1. Central nervous system tissues, unlike that of bone, muscle, or skin, lacks mechanisms for endogenously generating and differentiating new cells and for restoring long distance patterns and connections as they are lost, so as degeneration progresses the losses are permanent. Diagnosis and evaluation
Most SCAs and other ataxic disorders are clinically heterogeneous, meaning clinical signs and symptoms are similar between diseases and distinguishing between diseases with a neurologic exam alone is difficult. In symptomatic persons, diagnosis of ataxia related disorders often requires a neurological exam, evaluation of neurological and family history, and molecular genetic testing. Absence of a family history does not exclude hereditary causes like spinocerebellar ataxia type 1 because family history may not have been collected or may be unavailable for certain individuals and new cases may originate from anticipation in an allele with a mutable number of repeats. : 2–4  To establish a diagnosis, molecular genetic testing is currently commercially available for 14 SCA types, including SCA1.
The applicant for this medicinal product is ViiV Healthcare B.V. Fostemsavir was approved for medical use in the European Union in February 2021. References
Further reading
Kozal M, Aberg J, Pialoux G, Cahn P, Thompson M, Molina JM,  et al. (March 2020). "Fostemsavir in Adults with Multidrug-Resistant HIV-1 Infection". N. Engl. J. Med. 382 (13): 1232–1243. doi:10.1056/NEJMoa1902493. PMID 32212519. External links
"Fostemsavir". Drug Information Portal. U.S. National Library of Medicine. "Fostemsavir tromethamine". Drug Information Portal. U.S. National Library of Medicine. Clinical trial number NCT02362503 for "Attachment Inhibitor Comparison in Heavily Treatment Experienced Patients" at ClinicalTrials.gov