## 3 Results
### Micronutrient Supplementation in AD  
A growing body of evidence suggests that, in addition to \(\omega\)-3 FAs, E, C, and B group vitamins, choline, uridine, and other micronutrients may play a role in AD progression [55; 56]. Consequently, several studies have focused on the potential to enhance the structures and functions of synapses and neurons [57; 58]. Table 4 reports the main characteristics of the reviewed RCTs regarding micronutrient supplementation in AD. Souvenaid is a dietary supplement with a patented formulation (Fortasyn Connect(tm)) [59] that contains a combination of \(\omega\)-3 FA (DHA and EPA), uridine monophosphate, choline, phospholipids, selenium, B, C, and E vitamins, and folic acid, useful to improve synapse formation and activities and correlated to cognitive functions and decline [60; 61; 62]. Several studies have been conducted to evaluate the impact of administering 125 mL of this oral formulation once daily on AD progression, each with different primary endpoints. Analyzing the results of three RCTs, [PERSON] et al. [63] found that 12 to 24 weeks of supplementation with Souvenaid significantly increased the plasma and/or erythrocyte levels of several micronutrients recognized to be decreased in AD patients, such as uridine, choline, selenium, folate, vitamins B6, B12, and E, and DHA and EPA (all, \(p<0.001\)), thus supporting the associated beneficial effects on AD management [63]. Some evidence suggests that the patient body mass index (BMI) may play a crucial role in the manifestation of the therapeutic effects of the supplement. Indeed, a secondary analysis of RCTs, conducted by [PERSON] et al. [64], showed that BMI was a significant factor in response to Souvenaid treatment (\(p=0.05\)). Stratifying the study population according to mean BMI (26.2 kg/m\({}^{2}\)), an improvement in activities assessed by the \"Alzheimer's Disease Cooperative Study-Activities of Daily Living (ADCS-ADL) scale\" was reported in the low BMI subgroup compared to the placebo (\(p=0.04\)), while the higher BMI subgroup showed no improvement. These data suggest that a lower BMI may be associated with the beneficial effects of Souvenaid [64]. [PERSON] et al. [61; 65; 66] conducted three studies to test the tolerability and efficacy of Souvenaid in AD patients. They found no significant differences in synaptic function, as assessed by the analysis of cerebral glucose metabolism using 18F-fluorodeoxyglucose ([18F] FDG) positron emission tomography (PET), between the placebo group and the group treated with Souvenaid for 24 weeks [61]. However, a significant improvement in the \"delayed verbal recall\" task (\(p=0.021\)) was observed in patients who received the supplementation [65]. Moreover, based on the \"Neuropsychological Test Battery (NTB)\", [PERSON] et al. [66] reported a significant enhancement in the cognitive activity of patients who received supplementation compared to the control group (\(p=0.023\)) [66]. On the contrary, [PERSON] et al. [67] found no significant difference in NTB scores between the group that received the supplement and the control group (\(p=0.166\)), although differences were observed in hippocampal atrophy and AD progression. Similarly, [PERSON] et al. [68] found a comparable cognitive decline, as assessed by the \"ADAS-cog\", with no statistically significant differences between the two groups, highlighting the ineffectiveness of the Souvenaid treatment in patients with mild-to-moderate AD [68]. With regard to the tolerability of Souvenaid, the study conducted by [PERSON] et al. [69] showed that, even with high treatment adherence (\(\geq\)95%), the adverse events (AEs) reported were generally mild and not always related to supplements [69]. [PERSON] et al. and [PERSON] et al. [70; 71] investigated the impact of nutritional supplements containing micronutrients on weight variation in patients, yielding contrasting results. [PERSON] et al.