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An experimental study that showed that systemic metabolic changes can modulate firing of nociceptors in the spinal trigeminal nucleus

Combined enzyme deficiencies of -ketoacid dehydrogenase complexes pyruvate dehydrogenase complex, BCKDC and ketoglutarate dehydrogenase complexes have been observed due to genetic changes in human E3 [44] resulting in lactic acidemias and maple syrup urine disease [45-47]