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We conducted a phase 1 study to verify the feasibility and safety of A-dopamine titration in patients with PD and LDRCs, followed by a randomized, controlled, open-label, crossover, phase 2 study of 1 month of A-dopamine versus 1 month of optimized oral antiparkinsonian therapy (Extended Data Fig

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Some insurers require documented trial of oral supplementation before approving injections, though this contradicts the pathophysiology-patients with true intrinsic factor deficiency cannot absorb oral B12 regardless of dose