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Ashwagandha affects monoaminergic systems indirectly by normalizing hyperactivity of the HPA axis and modulating GABAergic tone, which consequently enhances the balance of serotonergic and dopaminergic systems (7, 8)

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Finally, 17-hydroxysteroid dehydrogenase HSD17B1 can reduce dehydroepiandrosterone to androstenediol

Its expression is elevated in COPD lung tissue and can be activated via three pathways: CS-induced ROS activating the PI3K-AKT pathway, macrophage TCA cycle disruption leading to succinate accumulation, and the PTGES-AKT pathway (83, 84)

4.2 Stimulation protocol The stimulation protocols employed across the studies typically positioned the target electrode (anode, cathode, or sham) along the midline, 2 cm below the inion, with the lateral edges placed approximately 1 cm medial to the mastoid processes