Introduction and objective:
Manganese (Mn) is an essential element in various physiological processes; however, its excessive accumulation in the human body can cause toxic effects. Mn and its compounds have found application in many industries, which significantly affects occupational and environmental exposure to Mn. In recent years, exposure to Mn has been recognized as a significant health problem due to its neurotoxicity; therefore, this narrative review addresses the topic of Mn neurotoxicity, with particular emphasis on accompanying clinical symptoms and possible mechanisms responsible for Mn toxicity.

Abbreviated description of the state of knowledge:
Mn accumulates in the brain, especially in the basal ganglia, and can cause a neurological syndrome similar to Parkinson's disease. Cognitive impairment in humans, especially children, as a result of overexposure to Mn in drinking water, has been identified in clinical trials. The accumulated Mn in the brain affects the neurotransmitter systems. Scientific literature on this topic focuses mainly on the effect of Mn on dopamine and the dopaminergic system. In addition to the dopaminergic system, Mn also affects the GABA-ergic, glutamatergic and cholinergic systems in the brain. Excessive concentration of Mn leads to oxidative stress, mitochondrial dysfunction and apoptosis.

Excessive exposure to Mn, due to its neurotoxicity, is one of the significant environmental threats to human health. Additional studies should fully elucidate the molecular mechanisms involved in Mn neurotoxicity, as well as help develop treatments for Mn-related neurodegenerative disorders.

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