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doi: 10.1590/s1807-59322011000800016

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The gut microbiota, a complex and dynamic microbial ecosystem primarily residing in the colon and distal small intestine, is considered a key determinant of EC biotransformation

It has the longest clinical track record of this group, used in parts of Europe and Asia for cognitive decline, mild cognitive impairment, and stroke recovery, with trials reporting cognitive benefit in impaired populations.9 Note the population: the case for Cerebrolysin is strongest in deficit states, which is consistent with Giurgea's original observation that nootropic effects show up most clearly under disturbed neural metabolism aging, hypoxia, injury rather than in an already-optimized 30-year-old