(A and B) Brain MRI demonstrating symmetric, caudate-predominant striatal volume loss with ex vacuo dilatation of the frontal horns (A, T1-weighted axial; B, T2-weighted axial). No T2 signal abnormality, mineralization, or putaminal involvement is present. (C and D) Transmission electron micrographs of control (C) and patient (D) skin fibroblasts. Yellow dashed circles in D mark enlarged vacuolar structures consistent with stalled autolysosomes, absent in control cells. Scale bars: 1 μm. (E) Representative immunoblots for p62/SQSTM1, LC3B (LC3-I and LC3-II), and β-actin (loading control) in control and patient fibroblasts. (F) Quantification of p62 protein levels normalized to β-actin (n = 3 biological replicates). *P < 0.05, unpaired t test. (G) Quantification of the LC3-II/LC3-I ratio (n = 3 biological replicates). *P < 0.05, unpaired t test. Data presented as violin plots with individual data points.