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SAM is additionally required for phosphatidylcholine synthesis, which is abundant in neuronal membranes and is crucial for synaptogenesis and neurite outgrowth ( Vitamin B12 is a cofactor for the enzyme methylmalonyl-CoA mutase, which converts methylmalonyl-CoA to succinyl-CoA, a crucial step in fatty acid metabolism (73)

In experimental settings, this has been associated with improved cell survival, migration, and wound-healing activity