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The main signaling cascade for local translation at spines requires glutamate binding to metabotropic glutamate receptors (mGluR), which triggers protein-synthesis-dependent forms of spine plasticity by activating extracellular signal-regulated kinase (ERK) or mammalian target of rapamycin (mTOR) pathways (Ebert and Greenberg, 2013)

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Almost all efficacy data come from a single research group, and independent replication of the larger-effect-size studies remains limited

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No accumulated error over months of injections