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In skeletal muscle, L-Carnitine supplementation has also been shown to inhibit caspases, involved in the apoptotic process, and decrease levels of Tumor Necrosis Factor (TNF-) [64]

However, this effect is dependent on a specific astrocyte to neuron ratio

Smith, D.A

Nano Today, 55 , 102147

Therefore, the potential for adaptation means that the initial benefits of VNS might not always persist undiminished longterm without parameter changes
