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Metabolism is also slower in patients with hepatic dysfunction

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While this can reliably be measured in peripheral blood and relates to SMA type, SMN protein levels do not predict severity of motor function, and it remains to be determined if this reflects what is happening in motor systems [126, 127]

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Hence, common physical and psychological stressors might initiate the emetic cascade by stimulating dysfunctional hypothalamic neurons, characterized by high intrinsic energy demands, and consequently activating the autonomic nervous system and HPA axis with CRF release