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Functional instability involves neuromuscular deficits including impaired proprioception, delayed muscle reaction times, and poor motor control that persist even when mechanical structures appear intact

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Symptoms are typically worst at night and with sustained gripping (steering wheel, phone)

Cutting-edge experimental techniques in humans and translational model mice, combined with large-scale longitudinal studies, have enabled detailed analysis of the complex interactions between the CNS and the peripheral immune system

This omission limits pharmacological context, hinders potency normalization across studies, and constrains the prioritization of peptide leads for translational development [177, 178]