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After 12 weeks, the researchers noted that the group receiving L-carnitine did indeed show improvements in fatigue, with the most significant improvements seen in brain fatigue. The most significant results were in those younger than 50, those over the age of 50 with high levels of free T3, and those who had hypothyroidism due to a thyroidectomy (who were taking relatively high doses of thyroid hormone)
Think of it as taking a naturally occurring signaling molecule and engineering a version that specifically targets brain receptors rather than peripheral tissues

Multiple lesions can be seen

[DOI] [PubMed] [Google Scholar] 409.Gold E.B., Wells C., Rasor M.O