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It has the longest clinical track record of this group, used in parts of Europe and Asia for cognitive decline, mild cognitive impairment, and stroke recovery, with trials reporting cognitive benefit in impaired populations.9 Note the population: the case for Cerebrolysin is strongest in deficit states, which is consistent with Giurgea's original observation that nootropic effects show up most clearly under disturbed neural metabolism aging, hypoxia, injury rather than in an already-optimized 30-year-old

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Estrogen therapy is known to have a protective role against neurodevelopmental disorders and glutamate-induced neurotoxicity via the mTOR pathway [125]

Differences in diagnosis accuracy, inflammatory load, sleep, metabolic health, and biomechanics can make the same therapy look powerful in one person and ineffective in another

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