34Machado-Joseph disease (MJD/SCA3) is the most common form of dominantly inherited ataxia 35 worldwide. The disorder is caused by an expanded CAG repeat in the ATXN3 gene. Past studies 36 have revealed that the length of the expansion partly explains the disease age at onset (AO) 37 variability of MJD, which is confirmed in this study. Using a total of 786 MJD patients from five 38 different geographical origins, a genome-wide association study (GWAS) was conducted to 39 identify additional AO modifying factors that could explain some of the residual AO variability. 40 We identified nine suggestively associated loci (P < 1 × 10 −5 ). These loci were enriched for genes 41 involved in vesicle transport, olfactory signaling, and synaptic pathways. Furthermore, 42 associations between AO and the TRIM29 and RAG genes suggests that DNA repair mechanisms 43 might be implicated in MJD pathogenesis. Our study demonstrates the existence of several 44 additional genetic factors, along with CAG expansion, that may lead to a better understanding of 45 the genotype-phenotype correlation in MJD. 46 Keywords 47 65 collaborative studies are required to identify genetic modifiers in MJD, as well as replicate the 66 findings of such studies [8]. 67 Previously, Genetic Modifiers of Huntington's Disease (GeM-HD) Consortium carried out a GWA 68 approach of HD individuals to reveal genetic modifiers of AO in HD [9,10]. A total of eleven [9]69 and fourteen loci [10] were found to be associated with residual age at HD onset. In the present 70