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These inconsistencies may reflect the differences in study methodologies and the need for more rigorous clinical trials with standardized endpoints and larger sample sizes

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With breach of the blood-brain barrier, immune cells infiltration as well as extravasation of blood-borne molecules such as fibronectin triggers, together with the death of oligodendrocytes, degeneration and transection of axons and starts a multicellular inflammatory response associated with reactive astro- and microgliosis