Introduction
EGCG benefits are claimed on nearly every green tea supplement sold, and almost none of those claims comes from human trials. Most of what you read goes back to laboratory work on cells rather than to people who swallowed a capsule. The compound is real, the chemistry is real, and the absorption problem is real as well. I will show you what researchers have measured in people and how little of an oral dose reaches your bloodstream. You will also see why the one change that raises absorption is the change regulators warn against. Knowing both halves lets you judge a green tea product on evidence rather than packaging.
What Is EGCG? A Closer Look at Green Tea's Main Catechin
EGCG is short for epigallocatechin-3-gallate, the most abundant catechin in green tea. Catechins are a family of plant polyphenols (i.e., protective compounds that plants make in their leaves, seeds, and skins). Green tea, black tea, and oolong tea all come from the same plant, Camellia sinensis, and processing is what separates them. Green tea leaves are steamed or pan-fried soon after picking. That step inactivates the enzymes that would otherwise oxidize catechins into larger compounds. Green tea leaf therefore carries the highest monomeric catechin content of the three teas (Oketch-Rabah et al., 2020).
Chemists describe EGCG as an ester of epigallocatechin and gallic acid, with a molecular weight of 458 grams per mole (Krupkova et al., 2016). The molecule carries a cluster of hydroxyl groups, and those groups are what give it antioxidant behavior in a test tube. The same groups make EGCG unstable because they react readily with oxygen. Dry green tea leaf runs roughly ten percent catechins by weight, or eight to fifteen grams per hundred grams (Krupkova et al., 2016). EGCG makes up the largest share of that fraction, reported at 50 to 80 percent of total catechins (Pervin et al., 2019).
A cup of green tea gives you a modest amount. One hundred milliliters brewed from a single gram of leaf carries about 67 milligrams of total catechins. Roughly 30 of those milligrams arrive as EGCG (Pervin et al., 2019). Anyone asking what is EGCG is therefore asking about the one compound that most green tea research has chased. I want you to hold that number in mind because the supplement doses studied in trials run far higher.
EGCG Benefits Backed by Science and the Concentration Gap
EGCG benefits reported in the laboratory are genuine findings about cells, and that is exactly the problem. Most cell studies apply EGCG at 5 to 200 micromolar, which is where the effects on signaling pathways appear (Gan et al., 2018). Those same authors state plainly that such concentrations are not biologically relevant, since poor absorption keeps intracellular EGCG extremely low (Gan et al., 2018). Only 0.1 to 1.1 percent of an orally administered dose reaches systemic circulation in humans (Krupkova et al., 2016). The maximum concentration reported in human plasma after oral intake is about 1 micromolar (Krupkova et al., 2016). Read those two figures next to each other and the gap between the petri dish and the person is obvious. Inflammatory signaling is the pathway most often proposed for green tea catechins, and I have written separately in another article about inflammation and brain health.
I also want to be direct about the literature you will find if you search this compound. The vast majority of EGCG research sits in oncology, and reviews of it run to thousands of pages. None of that work belongs in an article about a dietary supplement. A supplement cannot legally be described as treating, preventing, managing, or mitigating any disease, and I will not gesture at one either. I will not borrow a cancer finding to sell you anything, and a page that does so has told you what it is. Every finding I report below comes from research on healthy people or on ordinary physiology.
Human trials of green tea catechins in ordinary adults are fewer than the marketing suggests, and the recent ones are sobering. A cluster-randomized, placebo-controlled trial gave 613 milligrams of catechin daily to older adults for 24 weeks (Makizako et al., 2026). Participants were 78 community-dwelling adults aged 60 and older who perceived themselves as weak or slow. In the intent-to-treat analysis of those older adults, no significant differences appeared in physical performance tests or muscle mass (Makizako et al., 2026). One secondary measure moved, namely the percentage change in knee extension strength over 24 weeks. I report the null primary result first because that is the honest order, and most pages quoting this trial reverse it.
Cognitive trials tell a similar story. Investigators randomized 99 older adults to 2 grams of matcha or placebo daily for 12 months (Uchida et al., 2024). Sixty-four of those participants had subjective cognitive decline and 35 had mild cognitive impairment. The primary outcomes in those older adults, a cognitive screening score and a daily-living score, showed no significant change (Uchida et al., 2024). A measure of emotional perception did improve, and sleep quality showed a non-significant trend in those same older adults. Observational work looks friendlier at first glance. A meta-analysis of 18 studies covering 58,929 participants found green tea drinking inversely associated with cognitive impairment (Zhou et al., 2026). Those same authors reported the association in Asian populations and no such association in European populations.
One recent finding does sit close to my own interests. A GRADE-assessed meta-analysis of nine randomized controlled trials examined green tea extract and substrate use in exercising adults (Khalilkhaneh et al., 2026). Fat oxidation during exercise rose by 0.2 grams per minute across those trials in adults (Khalilkhaneh et al., 2026). Carbohydrate oxidation after exercise fell by 0.16 grams per minute, while carbohydrate oxidation during exercise did not change significantly. The authors rated the certainty of that evidence as low to high, which is a wide range and belongs in any summary. Two tenths of a gram per minute is a real measurement and a small one, and I would not build a purchase around it.
EGCG Foods, Green Tea Extract, and Supplement Forms
Form determines how much of the compound you swallow, and EGCG benefits cannot exceed what you absorb. EGCG foods are a brief list, since brewed green tea is the main dietary source most people have. Matcha is the same leaf ground whole, so that you swallow the powder rather than an infusion. That difference matters because a matcha serving delivers the insoluble fraction of the leaf as well. The trial above used 2 grams of matcha powder daily in older adults, which is a realistic kitchen amount (Uchida et al., 2024). White tea and oolong tea contribute smaller amounts, and black tea contributes least of all.
Green tea extract is the concentrated form, and it is where the dose questions and the safety questions both begin. Extracts vary enormously in catechin profile depending on how they were manufactured (Oketch-Rabah et al., 2020). Analytical work makes that point concrete. Researchers quantified methylxanthines in seven commercial green tea supplements and found caffeine ranging from 0.37 to 12.13 milligrams per capsule (Paliu et al., 2026). Theobromine ran from 0.07 to 3.59 milligrams and theophylline from 0.05 to 0.83 milligrams across those same seven products (Paliu et al., 2026). A thirty-fold spread between products on one measured compound tells you how little a category label settles. I examine what decaffeination takes out of the leaf alongside the caffeine in decaffeinated green tea extract.
Stability is the other half of the forms question, and it drives most formulation work in this field. EGCG in solution is reasonably stable at pH 2.0 to 5.5 and unstable in alkaline conditions (Krupkova et al., 2016). The upper small intestine, where most absorption happens, runs alkaline. A solution of EGCG at pH 9 degraded completely within one day (Krupkova et al., 2016). The same solution at pH 3 still measured 90 percent of its starting concentration on day 28. Encapsulating EGCG in nanocarriers raises its measured stability in laboratory testing, which is why so many delivery systems exist (Granja et al., 2017). Researchers have prepared EGCG-loaded liposomes from phosphatidylcholine and tested their uptake in murine microglial cells in culture (Cheng et al., 2021).
My own EGCG supplement from Dr Lewis Nutrition® is built on that reasoning, and I will describe it plainly rather than sell it. The actives are encapsulated in an all-natural liposome by my manufacturing partner's patent-pending process, and the material is made as a powder first. That powder is pressed into a tablet, and the extract is decaffeinated and standardized to 94 percent EGCG. A three-tablet serving carries 30 milligrams of that extract plus an 800 milligram liposomal blend. The blend is dextrose, dicalcium phosphate, phosphatidylcholine, sunflower lecithin, and beta cyclodextrin. Two of those carrier ingredients belong to the same phospholipid class used in published liposome research. Cold-pressed phospholipids are worth understanding on their own terms, and a dedicated article on sunflower lecithin covers that ingredient in full. The carrier outweighs the extract by more than twenty-five to one, which is what encapsulation costs in mass. Rice fiber and a rice extract blend finish the panel, which sits in full on the EGCG product page.
Now the limit, and it is the most important passage in this section. No head-to-head human trial has compared my tablet against a conventional green tea extract. I searched the published literature for a human pharmacokinetic study of any liposomal EGCG formulation and could not locate one. Every liposomal EGCG study I found was conducted in cell culture or in animals. Until a crossover trial in people exists, an absorption claim for this tablet is not mine to make, and not anyone else's either. Human liposomal trials do exist for curcumin, and I examine how fragile their numbers are in liposomal curcumin.
EGCG Dosage and the Fasting Question
Dose is where EGCG benefits either become plausible or stay theoretical. EGCG dosage has no recommended intake because EGCG is not an essential nutrient. What exists instead is a range of amounts that have been studied and a range that appear on labels. Product labels catalogued in a federal supplement database span 45 to 1,575 milligrams of EGCG per day (Oketch-Rabah et al., 2020). Clinical trials have used 400, 800, and 1,200 milligram single doses in healthy volunteers (Chow et al., 2005). Anyone shopping in this category is choosing among numbers that differ by more than thirtyfold.
My own product contains an amount of EGCG below the bottom of that range, and I want you to see the number. Three tablets supply 30 milligrams of extract standardized to 94 percent EGCG, which works out to roughly 28 milligrams of EGCG. A 100-milliliter cup of green tea brewed from one gram of leaf supplies about the same amount (Pervin et al., 2019). Every human trial cited in this article used between 400 and 1,200 milligrams, so none of those results transfers to my label. My label directs you to take three tablets with water daily, and I am giving you the number so you can compare it yourself.
The dosing condition changes the result more than most people realize. Thirty healthy volunteers took a single dose of a decaffeinated green tea catechin mixture (Chow et al., 2005). Each dose was taken either after an overnight fast or with a light breakfast of muffins and water. Each participant crossed over to the opposite condition after a one-week washout, which makes the comparison a within-person one. Average maximum plasma concentration of free EGCG rose more than 3.5-fold in the fasting condition in those healthy volunteers (Chow et al., 2005). Those authors concluded that greater oral bioavailability of free catechins is achieved by dosing on an empty stomach.
Hold that conclusion next to the next section and you will see the problem. The United States Pharmacopeia expert panel identified fasted dosing as a factor contributing to liver injury (Oketch-Rabah et al., 2020). The mechanism they name is the one Chow measured, namely increased absorption on an empty stomach. More compound in circulation means more of it arriving at liver cells, which is exactly where the concern sits. Two authoritative groups looked at the same pharmacokinetics and arrived at opposite instructions. I follow the safety instruction rather than the absorption one, and I have held that position for years.
Timing beyond the meal question has been tested directly and did not separate the groups. Forty-five adults aged 65 and older drank green tea in the morning, midday, or evening for eight weeks (Fuke et al., 2026). Glucose, glycated hemoglobin, body weight, and fat mass fell across all three timing groups in those older adults (Fuke et al., 2026). Muscle mass rose across all three groups as well. No untreated control group was included, so those within-group changes cannot be attributed to the green tea alone. Peak plasma EGCG arrives one to two hours after an oral dose in healthy subjects (Mereles & Hunstein, 2011). The elimination half-life runs about 3.4 hours, so the compound does not accumulate across the day.
One more fact belongs in any dosing discussion, and almost no product page mentions it. Most of an oral EGCG dose never enters the blood intact in people, and substantial quantities pass into the large intestine (Mereles & Hunstein, 2011). Gut bacteria break it down into ring-fission metabolites, and those metabolites are detectable in plasma and urine in humans (Pervin et al., 2019). Your microbial community is therefore part of your dose, which is not something a label can control. Gut microbes deciding what a nutrient becomes is a theme running through my article discussing the gut brain connection.
Is EGCG Bad for You? EGCG Side Effects and the Liver
One organ accounts for nearly all of the documented EGCG side effects, and that evidence belongs at the front. The United States Pharmacopeia convened an expert panel to review the hepatotoxicity of green tea extracts (Oketch-Rabah et al., 2020). That panel examined animal studies, clinical trials, and published case reports together. The panel identified 75 published cases of liver injury in 51 reports, and analyzed the 35 involving single-ingredient products. Expert reviewers judged 29 of those 35 cases to be probably, highly likely, or definitely related to green tea extract (Oketch-Rabah et al., 2020). Case reports associated liver injury with EGCG intakes from roughly 140 to 1,000 milligrams per day.
The strongest human evidence in that review came from a randomized, placebo-controlled trial running twelve months. Investigators analyzed 1,021 postmenopausal women who had normal baseline liver enzymes (Oketch-Rabah et al., 2020). Of those women, 513 took green tea extract supplying 800 milligrams of EGCG daily and 508 took placebo. Serum ALT rose by 5.4 units per liter and AST by 3.8 units per liter in those women, both significantly above placebo. Moderate or severe liver function abnormalities appeared in 26 of the treated women, which is 5.1 percent of that arm. The odds ratio for developing liver function abnormalities was 7.0 compared with placebo in those postmenopausal women (Oketch-Rabah et al., 2020).
Several further details in that review deserve your attention. Some women in that trial developed liver injury, improved after stopping, and redeveloped it faster on resuming (Oketch-Rabah et al., 2020). A separate multiphase study of a green tea catechin mixture in patients was halted at its second phase (Oketch-Rabah et al., 2020). Five of seven treated patients with multiple sclerosis had developed abnormal liver tests. The United States Food and Drug Administration declined to permit further human studies of that mixture under fasting conditions. High mortality observed in fasted dogs was the stated reason (Oketch-Rabah et al., 2020). Anyone weighing an empty-stomach dosing strategy should sit with that last sentence for a moment.
The panel's conclusion took the form of a labeling requirement rather than a ban. Four instructions now appear in the relevant monograph (Oketch-Rabah et al., 2020). First, do not take the product on an empty stomach. Second, take it with food. Third, do not use it if you have a liver problem. Fourth, discontinue use and consult a healthcare practitioner if you develop symptoms of liver trouble, such as abdominal pain, dark urine, or jaundice.
Frequency belongs in this picture as well. Millions of people have taken green tea extract since the early 2000s. Only hundreds of liver injury cases have been reported in that time (Oketch-Rabah et al., 2020). Low frequency is different from low importance, and the panel declined to set a safe dose at all. Susceptibility appears idiosyncratic, and genetic factors are the leading explanation offered for it. A recent review of clinical trials argues for genotyping participants on catechin-metabolizing enzymes to help interpret liver biomarkers (Ferrari & Naponelli, 2025).
Two further EGCG side effects are worth naming. Phenolic compounds including EGCG inhibit iron absorption in humans in a dose-dependent manner (Mereles & Hunstein, 2011). That matters if your own iron status is already marginal. Mild and transient nausea appeared in some healthy volunteers, most often at the 1,200 milligram fasted dose (Chow et al., 2005). Reporting what a supplement cannot do is a discipline I apply throughout my article on best supplements for memory loss. If you take prescription medication, ask your own clinician before adding any concentrated botanical extract to your routine.
What Is EGCG Good For? How I Read the Evidence
EGCG benefits, read honestly, come down to a short and useful list. First, green tea is a pleasant, low-calorie source of polyphenols, and drinking it daily is a reasonable habit for most adults. Second, green tea extract raised fat oxidation during exercise in adults by a small, measured margin (Khalilkhaneh et al., 2026). Third, pooled observational cohorts link green tea drinking to lower odds of cognitive impairment (Zhou et al., 2026). That association held in Asian populations and did not hold in European ones. Fourth, the compound is heavily studied, which is a reason to watch the field rather than to buy anything today.
Four things I could put on that page are things I refuse to put there, and here is why. Calling my liposome the most bioavailable form on the market would require a head-to-head trial, and none exists. Printing an absorption multiple next to my tablet would mean borrowing a number measured on somebody else's material. Telling you that EGCG reaches your brain in a meaningful amount would misstate what the measurements show. Brain concentrations ran about 0.01 micromolar in male Sprague-Dawley rats, and transfer into brain tissue itself was not established (Pervin et al., 2019). Ranking my tablet above a competitor would require a study comparing them, and no such study has been published.
My EGCG tablet and Daily Brain Care are two distinct products with two different purposes. The brain formula contains no green tea catechins at all. Tart cherry supplies part of its polyphenol content, and that fruit has its own article on tart cherry. Treating the two as one line of evidence would be the easiest sale I could make and the least honest one. I would rather you bought neither than bought either for a reason I invented.
I have eaten a whole-food, plant-based diet since 1999. Decades of consistent bodybuilding without drugs left me skeptical of any product promising what consistent training already delivers. Decaffeination matters to me for that reason since I do not want a stimulant load riding along with a polyphenol. Stimulant-free options deserve their own treatment, which they get in best caffeine-free brain supplement.
Two limits remain, and both belong here rather than in small print. My label carries far less EGCG than any trial cited above, so that evidence does not transfer to it in either direction. Asserting that the small amount makes my tablet safe is a claim I am not entitled to make, so I am not making it. No human trial has tested this exact formulation, and every trial I cited tested other extracts at other doses. My background and my published research are set out on my About page for anyone who wants to check them. The clinical trial record I built my career on belongs to the polysaccharide work in Daily Brain Care. I will not lend that record to a green tea tablet.
Conclusion
EGCG benefits are easy to overstate and easy to dismiss, and neither reaction serves you well. The chemistry is genuine, the absorption is poor, and the fix for the absorption carries its own cost. If you take a high-milligram green tea extract, take it with food rather than on an empty stomach. Keep the amount moderate, and tell your clinician what you are taking. A decaffeinated, liposomal form suits that approach, and my EGCG supplement is built for it. You owe yourself a decision made on evidence, and now you have the evidence!
Frequently Asked Questions
What is EGCG?
EGCG is epigallocatechin-3-gallate, the most abundant catechin in green tea. It is an ester of epigallocatechin and gallic acid, and it makes up 50 to 80 percent of green tea catechins (Pervin et al., 2019). A cup brewed from one gram of leaf supplies roughly 30 milligrams of it (Pervin et al., 2019). Most published green tea research has focused on this single compound.
How much EGCG should I take per day?
No government body has set a recommended intake for EGCG, which is not a required nutrient. Labels catalogued in a federal database span 45 to 1,575 milligrams daily (Oketch-Rabah et al., 2020). Case reports in people have linked liver injury to intakes from roughly 140 milligrams upward (Oketch-Rabah et al., 2020). Ask your physician what amount, if any, makes sense for you.
Should I take EGCG on an empty stomach?
Absorption is higher on an empty stomach, and that is exactly why the safety guidance says not to take it that way. Free EGCG peaked more than 3.5-fold higher in fasted healthy volunteers than in fed ones (Chow et al., 2005). The relevant monograph directs users not to take these products on an empty stomach and to take them with food (Oketch-Rabah et al., 2020). I follow the safety guidance.
What are the EGCG side effects I should watch for?
Liver effects are the main concern with concentrated green tea extract. The monograph directs users to stop and consult a healthcare practitioner if symptoms of liver trouble appear (Oketch-Rabah et al., 2020). Those symptoms include abdominal pain, dark urine, or jaundice. EGCG also inhibits iron absorption in humans in a dose-dependent manner (Mereles & Hunstein, 2011). Mild, transient nausea occurred in some healthy volunteers at higher fasted doses (Chow et al., 2005).
Are EGCG benefits proven in human trials?
Cell culture supports this compound far better than human trials do. A randomized trial in 78 older adults found no significant differences in physical performance or muscle mass (Makizako et al., 2026). A 12-month randomized trial in 99 older adults found no significant change in its primary cognitive outcomes (Uchida et al., 2024). A meta-analysis of randomized trials did find a minor increase in fat oxidation during exercise in adults (Khalilkhaneh et al., 2026). I would call the human evidence real but modest.
References
Cheng, C.-Y., Barro, L., Tsai, S.-T., Feng, T.-W., Wu, X.-Y., Chao, C.-W., Yu, R.-S., Chin, T.-Y., & Hsieh, M. F. (2021). Epigallocatechin-3-gallate-loaded liposomes favor anti-inflammation of microglia cells and promote neuroprotection. International Journal of Molecular Sciences, 22(6), 3037. https://doi.org/10.3390/ijms22063037
Chow, H. H., Hakim, I. A., Vining, D. R., Crowell, J. A., Ranger-Moore, J., Chew, W. M., Celaya, C. A., Rodney, S. R., Hara, Y., & Alberts, D. S. (2005). Effects of dosing condition on the oral bioavailability of green tea catechins after single-dose administration of Polyphenon E in healthy individuals. Clinical Cancer Research, 11(12), 4627-4633. https://doi.org/10.1158/1078-0432.CCR-04-2549
Ferrari, E., & Naponelli, V. (2025). Catechins and human health: Breakthroughs from clinical trials. Molecules, 30(15), 3128. https://doi.org/10.3390/molecules30153128
Fuke, S., Fujihira, K., & Takahashi, M. (2026). Effects of green tea-intake timing on glucose and lipid metabolism in older adults: An 8-week randomized controlled trial. Journal of Nutrition and Metabolism, 2026, 2301278. https://doi.org/10.1155/jnme/2301278
Gan, R.-Y., Li, H.-B., Sui, Z.-Q., & Corke, H. (2018). Absorption, metabolism, anti-cancer effect and molecular targets of epigallocatechin gallate (EGCG): An updated review. Critical Reviews in Food Science and Nutrition, 58(6), 924-941. https://doi.org/10.1080/10408398.2016.1231168
Granja, A., Frias, I., Neves, A. R., Pinheiro, M., & Reis, S. (2017). Therapeutic potential of epigallocatechin gallate nanodelivery systems. BioMed Research International, 2017, 5813793. https://doi.org/10.1155/2017/5813793
Khalilkhaneh, A. H., Bidsheki, M. V., Zebari, S. M. S., Talebi, S., Mohajerani, A., & Djafarian, K. (2026). Effect of green tea extract supplementation on substrate utilization: A GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials. Nutrition Reviews, nuag025. Advance online publication. https://doi.org/10.1093/nutrit/nuag025
Krupkova, O., Ferguson, S. J., & Wuertz-Kozak, K. (2016). Stability of (-)-epigallocatechin gallate and its activity in liquid formulations and delivery systems. The Journal of Nutritional Biochemistry, 37, 1-12. https://doi.org/10.1016/j.jnutbio.2016.01.002
Makizako, H., Shiratsuchi, D., Miyake, Y., Tabira, K., Tateishi, M., Akaida, S., Nishi, H., Fukumori, M., Baba, Y., Kobayashi, M., & Takihara, T. (2026). Effects of catechin-enriched green tea combined with exercise on physical performance and muscle mass in community-dwelling older adults: A cluster-randomized, placebo-controlled trial. Archives of Gerontology and Geriatrics, 147, 106260. https://doi.org/10.1016/j.archger.2026.106260
Mereles, D., & Hunstein, W. (2011). Epigallocatechin-3-gallate (EGCG) for clinical trials: More pitfalls than promises? International Journal of Molecular Sciences, 12(9), 5592-5603. https://doi.org/10.3390/ijms12095592
Oketch-Rabah, H. A., Roe, A. L., Rider, C. V., Bonkovsky, H. L., Giancaspro, G. I., Navarro, V., Paine, M. F., Betz, J. M., Marles, R. J., Casper, S., Gurley, B., Jordan, S. A., He, K., Kapoor, M. P., Rao, T. P., Sherker, A. H., Fontana, R. J., Rossi, S., Vuppalanchi, R., ... Ko, R. (2020). United States Pharmacopeia (USP) comprehensive review of the hepatotoxicity of green tea extracts. Toxicology Reports, 7, 386-402. https://doi.org/10.1016/j.toxrep.2020.02.008
Paliu, I. A., Gherghina, F. L., Bita, A., Bica, G., Bejenaru, C., Bejenaru, L. E., Mogosanu, G. D., & Tica, A. A. (2026). Methylxanthine content in green tea supplements: UHPLC quantification, method validation, and implications for ergogenic dosing in athletes. Foods, 15(14), 2504. https://doi.org/10.3390/foods15142504
Pervin, M., Unno, K., Takagaki, A., Isemura, M., & Nakamura, Y. (2019). Function of green tea catechins in the brain: Epigallocatechin gallate and its metabolites. International Journal of Molecular Sciences, 20(15), 3630. https://doi.org/10.3390/ijms20153630
Uchida, K., Meno, K., Korenaga, T., Liu, S., Suzuki, H., Baba, Y., Tagata, C., Araki, Y., Tsunemi, S., Aso, K., Inagaki, S., Nakagawa, S., Kobayashi, M., Kakuma, T., Asada, T., Ota, M., Takihara, T., & Arai, T. (2024). Effect of matcha green tea on cognitive functions and sleep quality in older adults with cognitive decline: A randomized controlled study over 12 months. PLOS ONE, 19(8), e0309287. https://doi.org/10.1371/journal.pone.0309287
Zhou, S., Zhu, Y., Ren, N., Wu, M., & Liu, Y. (2026). The association between green tea consumption and cognitive function: A meta-analysis of current evidence. Neuroepidemiology, 60(1), 178-199. https://doi.org/10.1159/000543784
