This is indeed a Causal Argument: the author presents a curious fact and then concludes some causal interpretation of what happened.
CURIOUS FACT:
Why did the stroke patients whose nerve cells got worse even after the stroke also have the highest levels of glutamate in their blood?
AUTHOR'S CAUSAL INTERPRETATION:
Glutamate was causing the nerve cells to get worse (glutamate is a cause of long-term brain damage)
What's the author's evidence for this interpretation?
If glutamate leaks from damaged or oxygen-starved nerve cells, it can kill surrounding nerve cells.
Our two pronged prephrase for causal arguments:
1. Is there some OTHER WAY to explain the curious fact?
2. How plausible is the AUTHOR'S WAY of explaining it?
When we're strengthening, we'd either want to rule out some other way to explain the curious fact, or we'd want to bolster the AUTHOR'S WAY of explaining it
If we ask ourselves whether there is some other way to explain why the patients with continuing nerve cell damage were also the patients with the highest levels of glutamate, we can consider the usual suspects:
REVERSE CAUSALITY? Instead of the high glutamate leading to deteriorating nerve cells, maybe deteriorating nerve cells led to high glutamate. We'd like an answer that said "when nerve cells deteriorate, they do NOT emit glutamate"
THIRD FACTOR? Maybe there's some other factor that causes people to have high glutamate in their blood stream that ALSO causes people to have longer than average damage from strokes. Say, for example, that drinking lots of white wine causes high glutamate in the blood and causes nerve cells to be especially punished by strokes. Maybe the stroke patients with the long lasting nerve damage were just heavy white wine drinkers, and that's why they also had lots of glutamate in their blood. We'd like any answer ruling out that sort of story.
The most typical answer for boosting plausibility of the author's story is a covariance "control group" answer: we'd like an answer that said "when the glutamate went back to normal levels, the nerve cell deterioration stopped".
(C) does seem to rule out the possibility that the long-term nerve cell damage was caused by any other neurotransmitter that leaked out (although it's not like we KNOW that a neurotransmitter is causing the damage, so ruling out the possibility of some other neurotransmitter causing the damage isn't especially crucial)
(D) rules out the possibility that glutamate is high in the blood for some other reason. (i.e. there's no third factor, like the white wine example, that could cause glutamate). Conditionally, this says "If you see glutamate in the blood, then it leaked from damaged or oxygen-starved nerve cells". We could chain this new idea to the conditional we saw in the argument:
gluta in blood -> leaked from damaged nerve cells -> kills surrounding cells
Since we found glutamate in the blood of these patients, we know from this chain that the glutamate could be killing surrounding nerve cells.
This ends up ruling out other sources of glutamate and triggering a conditional chain that greatly increases the plausibility of the author's story.
Ultimately, I think the takeaway for this problem is more about the conditional logic premise than the causal argument template.
Strengthen and Weaken very rarely use conditional logic. But if we see some, it's important. We know that gluta can kill nerve cells IF it leaks from damaged cells.
Okay, but do we know for these stroke patients that the gluta in their blood leaked from damaged cells?
We do not. So choice (D) triggers that conditional, which allows the author to say that "gluta was killing surrounding cells".
To see another example of a Strengthen question in which the correct answer essentially functions by "activating a conditional" that the author assumes is being triggered, check out this one:
https://www.manhattanprep.com/lsat/foru ... -t678.html