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In view of a clear Vit B12 deficiency and/or HHcy and/or high MMA levels in a PwPD presetting with clinical signs of PN, a complete neurographic assessment and an extensive alternative-causes workup should be performed

Previously, treatment with a GIPR-antag was found to result in a hindbrain transcriptomic signature similar to GLP-1R agonism 6

1,2,6,12 Dementia-like disease, including episodes of psychosis, is thought to be associated with more severe and chronic deficiency, although supporting evidence is poor