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These differences could be explained by the study design (retrospective observational study vs prospective randomized trial), selection bias (subjects from the real-world clinical practice are less selected than those included in a clinical trial), drug compliance (subjects enrolled in a clinical trial perform several on site evaluation in which compliance is verified by tablets accounting, while in clinical practice this is not done)

The major pathway to supply the brain energy is oxidative metabolism, which can produce adenosine triphosphate (ATP) through an electron transport chain and reactive oxygen species (ROS) in mitochondria

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doi: 10.3389/fimmu.2022.903526 81 YooJ

The illustration in Figure 2