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In acid sphingomyelinase knock-out mice, which mimic a neurovisceral acid sphingomyelinase deficiency (ASMD) characterized by cellular accumulation of sphingomyelin, the effects of a choline-free diet decreased the activation of liver macrophages and microglia, but it did not significantly alter sphingomyelin levels due to compensatory mechanisms involving methionine metabolism (101)

Serum nicotinamide adenine dinucleotide levels through disease course in multiple sclerosis

Rare meta-analyses performed (only four), with only up to three studies included in the analyses, also confirmed positive effects (but only in pairwise meta-analyses, not in network meta-analyses) (220223)