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Thus, -butyrobetaine is an intermediate metabolite generated during the endogenous biosynthesis of l-carnitine and serves as its immediate precursor 27,28

Therefore, we evaluated the serum level of neurofilament light-chain (NF-L), as this has been validated as a biomarker for neurodegenerative diseases, disease progression, survival and death of large myelinated neurons, including motor neurons 41

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