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In the CNS, thiamine deficiency can lead to Wernickes encephalopathy, characterized by nystagmus, ophthalmoplegia, mental status changes, and unsteady stance and gait, due to apoptotic cell death in sensitive brain areas, mainly areas with high metabolic requirement, causing symmetrically distributed lesions among structures such as the third and fourth ventricles, besides dorsomedial thalamus (, , )

Kikuchi AM, Tanabe A, Iwahori Y

Additional preclinical work describes interaction with the nitric oxide system and upregulation of growth hormone receptor in tendon fibroblasts

They must not be used for clinical, diagnostic, or therapeutic applications