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Under optimal conditions, follow-up visits were scheduled every 3 months during the first year (34)

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Additionally, tyrosines play an important role in aSyn-vesicle binding while nitration impairs this interaction (making the charge more negative at the N-terminal domain, or causing a conformational change when the C-terminal domain is nitrated) thereby increasing the amount of aSyn in a random coil or beta-sheet conformation and thus shifting equilibrium toward oligomer formation 105,106,109

Acknowledgements We would like to thank all the participants for their dedicated contribution in the study

Jaipakdee S, Prasongwatana V, Premgamone A, Reungjui S, Tosukhowong P, Tungsanga K,

Additionally, further exploration of the role of topiramate in modulating this pathway, particularly its dose-dependent effects, is necessary