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At present, we know that both enzymes are found not only in the liver, but also in the muscle, intestine, kidney, and brain

2019 Jul;127:e1127-e1131

TMAO causes vascular dysfunction and hypertension, two important risk factors for ischemic stroke [77]

But its also part of a bigger system: the balance between free carnitine, acylcarnitines, and acyl-CoA, a trade-off game that helps regulate how different substrates are handled inside the cell

While there is no evidence of common structural or functional brain alterations in PAIS, probably due to its heterogeneous origin and lack of conceptualization, ME/CFS has been extensively studied with MRI (magnetic resonance imaging), as recently reviewed by Nelson et al

PMID 18272931