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Although brain uptake is modest early on, tracer binding in motor cortex and brainstem increases as disease advances, mirroring human ALS neuroinflammation and expanding diagnostic reach to neuromuscular involvement (142, 146, 147)

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The pentose phosphate shunt has two phases, the oxidative phase (reactions 21 - 23), in which NADPH and pentose-5-phosphate are generated, and the non-oxidative phase (reactions 24 - 28), in which unused pentose-5-phosphate can be converted to other sugar intermediates and then returned to the glycolytic pathway as glyceraldehyde-3-phosphate and fructose-6-phosphate

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Coenzyme Q10 Although hypothyroidism leads to mitochondrial dysfunction, supplementing with other nutrients such as Coenzyme Q10, NADH, and alpha-lipoic acid have not shown consistent improvements in fatigue-related symptoms