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These are the same brain (GIP) pathways that are connected to nicotine addiction

J., Lucini, L., Jothiramshekar, S

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In the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced in vivo model of Parkinsons disease, activated microglia were found to express Shh, and most neural cells, except oligodendrocytes, responded to microglia-derived Shh in MPTP-treated substantia nigra [42]

The AAFP notes that the CPT Editorial Panel revised E/M guidelines in 2021 and expanded changes in 2023

The neuroprogressive nature of major depressive disorder: pathways to disease evolution and resistance, and therapeutic implications