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Hashimoto’s Stages In a 2014 article, Wiersinga and colleagues identified 5 stages of Hashimoto’s
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4.2 Neuronal energy deficiency and cognitive decline Mitochondrial dysfunction and insufficient energy supply in the central nervous system may lead to inadequate ATP production, which in turn may affect neuronal synaptic transmission efficiency and excitability, particularly impairing the function of high-energy-demand brain regions such as the prefrontal cortex, hippocampus, and basal ganglia (158, 159)
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