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Similarly, the restoration of neurotrophic support, whether through exogenous administration, gene therapy, or immune-mediated modulation, illustrates a growing sophistication in therapeutic design, although questions regarding long-term efficacy, immune tolerance, and BBB penetration remain unresolved

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Conflicting evidence links chronic levodopa therapy in patients with Parkinson disease to an increased risk of symptomatic vitamin B12 deficiency, perhaps because carbidopa metabolism through the catechol-O-methyl transferase pathway may deplete vitamin B12-dependent cofactors (204

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