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Using the following methods, individual studies were categorized as having low, high or unclear risk of bias: i) Low risk of bias (plausible bias unlikely to markedly alter the findings) if the risk of bias was low in all domains

Intranasal treatment (via a nasal spray) of B12 is also available through a prescription (Andrs, 2018)

Over-activation of NMDARs leads to calcium overload of postsynaptic neurons, inducing excitatory toxicity, neuronal apoptosis, and neurodegeneration

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