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As a result, pyridoxine deficiency can lead to relevant neuropsychiatric manifestations, such as reduced neurotransmitter synthesis, depression, epilepsy, premature aging of neurons, paresthesias, cerebrovascular diseases, cognitive impairment and carpal tunnel syndrome (1618, 20, 58) In contrast, pyridoxine may have therapeutic potential for treating depression or aggressive behavior, since pyridoxine plays a crucial role in the tryptophan-serotonin pathway (61, 62)