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      Brain Glucose Metabolism: Integration of Energetics with Function

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      Physiological Reviews
      American Physiological Society

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          Abstract

          Glucose is the long-established, obligatory fuel for brain that fulfills many critical functions, including ATP production, oxidative stress management, and synthesis of neurotransmitters, neuromodulators, and structural components. Neuronal glucose oxidation exceeds that in astrocytes, but both rates increase in direct proportion to excitatory neurotransmission; signaling and metabolism are closely coupled at the local level. Exact details of neuron-astrocyte glutamate-glutamine cycling remain to be established, and the specific roles of glucose and lactate in the cellular energetics of these processes are debated. Glycolysis is preferentially upregulated during brain activation even though oxygen availability is sufficient (aerobic glycolysis). Three major pathways, glycolysis, pentose phosphate shunt, and glycogen turnover, contribute to utilization of glucose in excess of oxygen, and adrenergic regulation of aerobic glycolysis draws attention to astrocytic metabolism, particularly glycogen turnover, which has a high impact on the oxygen-carbohydrate mismatch. Aerobic glycolysis is proposed to be predominant in young children and specific brain regions, but re-evaluation of data is necessary. Shuttling of glucose- and glycogen-derived lactate from astrocytes to neurons during activation, neurotransmission, and memory consolidation are controversial topics for which alternative mechanisms are proposed. Nutritional therapy and vagus nerve stimulation are translational bridges from metabolism to clinical treatment of diverse brain disorders.

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          Author and article information

          Journal
          Physiological Reviews
          Physiological Reviews
          American Physiological Society
          0031-9333
          1522-1210
          January 2019
          January 2019
          : 99
          : 1
          : 949-1045
          Affiliations
          [1 ]Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, Arkansas; and Department of Cell Biology and Physiology, University of New Mexico, Albuquerque, New Mexico
          Article
          10.1152/physrev.00062.2017
          30565508
          3173a946-39e5-4dd7-bcdf-f9fde630c434
          © 2019
          History

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