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Abstract
<p class="first" id="d37944356e72">Insulin is a peptide secreted by the pancreas and
plays an important role in the regulation
of glucose metabolism in peripheral tissues. Although the role of insulin in the periphery
is well understood, less is known about its multifactorial role in the brain. However,
emerging evidence from human and animal studies indicate that insulin influences cerebral
bioenergetics, enhances synaptic viability and dendritic spine formation, and increases
turnover of neurotransmitters, such as dopamine. Insulin also has a role in proteostasis,
influencing clearance of the amyloid β peptide and phosphorylation of tau, which are
hallmarks of Alzheimer's disease. Insulin also modulates vascular function through
effects on vasoreactivity, lipid metabolism, and inflammation. Through these multiple
pathways, insulin dysregulation could contribute to neurodegeneration. Thus, new approaches
to restore cerebral insulin function that could offer therapeutic benefit to adults
with Alzheimer's disease, vascular cognitive impairment, or related disorders are
being investigated.
</p>