TGFB1 and Leigh syndrome: The use of rolipram, an inhibitor of PDE4, not only significantly inhibited PDE4 activity but also suppressed the expression of Col I/III, fibronectin, and TGF-β1, indicating that rolipram may exert an antifibrotic effect in LFH by inhibiting PDE4 activity.[73] Rolipram attenuates fibroblast activity and suppresses proliferation and differentiation.[74] Additionally, it has neuroprotective properties and may exert antiallodynic effects.[75,76] These findings are crucial for the treatment of lower limb neurological symptoms of LSS.