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Meta-analysis provided a pooled SMD of 0.46 (95% CI: 0.360.57), in the presence of low heterogeneity (I 2 = 21.3%), affirming a consistent protective effect (Certainty GRADE: Moderate) (Figure 5)

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TDP-43 exhibits rhythmic expression, and its knockdown disrupts circadian behavior, alters the expression of core clock genes including BMAL1, CLOCK, CRY1, and PER2, and weakens cognition and balancing abilities in mice (Gu et al., 2025)

(2020) reported elevated levels of Cyanobacteria and Proteobacteria in SPS exposed male rats