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Given expected heterogeneity, random-effects models using restricted maximum likelihood estimation with KnappHartung adjustments were applied, and implemented in RevMan and metafor (R)

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However, these treatments do not address the underlying causes of myelin loss or promote true repair 5

The cause affects which treatment works best Medical history: Existing conditions, medications, and allergies that may interact Treatment goals: Whether the patient wants overall brightening, spot reduction, or both This step is what separates a safe, effective outcome from a disappointing or harmful one