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inhalational made little difference in POCD at 3 months, but some data suggests that light depth of anesthesia (avoiding too deep anesthesia, as measured by BIS monitors) is associated with less POCD, possibly because overly deep anesthesia can cause more hypotension and hypoxia which injure mitochondria

By providing the body with active methylcobalamin, you force the remethylation pathway to regain its normal, healthy activity

Mitochondria contain active DNA methyltransferase (mtDNMT1) as well as TET family demethylases (TET1, TET2), which regulate the balance between 5-methylcytosine (5mC) and 5-hydroxymethylcytosine (5hmC) [15, 35]

Mol Neurobiol 57(5):2314

The limited volume that the nasal cavity can accommodate, approximately 100-200 microliters per nostril without runoff, means that higher concentrations deliver more peptide per spray