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Due to the rapid desensitization of 4 2 nAChRs, when exposed to sustained low concentrations of nicotine, the GABAergic drive gradually diminishes over time, thereby relieving inhibition on dopaminergic neurons and ultimately enhancing their excitability

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The longer participants took Metformin the increased risk of Vitamin B12 deficiency and neuropathy symptoms

Urinalysis for organic acids retrospectively confirmed the diagnosis