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Furthermore, exendin-4 can stimulate the cyclic adenosine monophosphate/protein kinase A (cAMP-PKA) pathway by activating GLP-1R, which then increases the level of non-phosphorylated -catenin to stimulate the Wnt/-catenin/NeuroD1 pathway and inhibits the activity of GSK-3, ultimately decreasing the hyperphosphorylation of AD-associated tau proteins regulated by GSK-3 (Reich and Hlscher, 2022)