Chronic hyperammonemia can also cause neuroinflammatory reactions (Rodrigo et al., 2010; Hernández-Rabaza et al., 2016; Balzano et al., 2020) Injecting extracellular vesicles of hyperammonemic rats into the control group causes neuroinflammatory reactions and dyskinesia (Izquierdo-Altarejos et al., 2020) The use of anti-TNFa therapy, which does not pass the BBB, prevents the neuroinflammatory responses induced by hyperammonemia (Balzano et al., 2020). This evidence concerns the gene TNF and Hyperammonemia.