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This perspective is often supported by neuroimaging studies (e.g., BOLD-fMRI) that report a mismatch between increases in glucose utilization (CMRglc) and oxygen consumption (CMRO) during brain activation

Given the progressive nature of the disorder, disease pathogenesis is mainly triggered by continual processes such as geometric accumulation of oxidative radicals brought about by cellular inclusions and mitochondrial dysfunction 8,9,10

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248 By increasing intracellular NAD + concentrations, these compounds enhance SIRT1 activity, therefore supporting energy metabolism, reducing oxidative stress, and suppressing inflammation

5-Amino-1MQ, by contrast, works over a longer arc: NNMT inhibition builds gradually over days to weeks, with NAD+ levels peaking after consistent daily dosing for 710 days