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Intranasal Insulin for Alzheimer’s Disease

Authors: Manfred Hallschmid;

Intranasal Insulin for Alzheimer’s Disease

Abstract

Brain insulin signaling contributes to memory function and might be a viable target in the prevention and treatment of memory impairments including Alzheimer's disease. This short narrative review explores the potential of central nervous system (CNS) insulin administration via the intranasal pathway to improve memory performance in health and disease, with a focus on the most recent results. Proof-of-concept studies and (pilot) clinical trials in individuals with mild cognitive impairment or Alzheimer's disease indicate that acute and prolonged intranasal insulin administration enhances memory performance, and suggest that brain insulin resistance is a pathophysiological factor in Alzheimer's disease with or without concomitant metabolic dysfunction. Intranasally administered insulin is assumed to trigger improvements in synaptic plasticity and regional glucose uptake as well as alleviations of Alzheimer's disease neuropathology; additional contributions of changes in hypothalamus-pituitary-adrenocortical axis activity and sleep-related mechanisms are discussed. While intranasal insulin delivery has been conclusively demonstrated to be effective and safe, the recent outcomes of large-scale clinical studies underline the need for further investigations, which might also yield new insights into sex differences in the response to intranasal insulin and contribute to the optimization of delivery devices to grasp the full potential of intranasal insulin for Alzheimer's disease.

Country
Germany
Keywords

Insulin/administration ; Neurology ; Female [MeSH] ; Hypoglycemic Agents/pharmacology [MeSH] ; Administration, Intranasal [MeSH] ; Alzheimer Disease/physiopathology [MeSH] ; Brain/drug effects [MeSH] ; Humans [MeSH] ; Alzheimer Disease/drug therapy [MeSH] ; Review Article ; Psychopharmacology ; Animals [MeSH] ; Memory/drug effects [MeSH] ; Brain/physiopathology [MeSH] ; Male [MeSH] ; Cognitive Dysfunction/physiopathology [MeSH] ; Insulin Resistance [MeSH] ; Psychiatry ; Neurosciences ; Hypoglycemic Agents/administration ; Sex Factors [MeSH] ; Insulin/pharmacology [MeSH] ; Cognitive Dysfunction/drug therapy [MeSH] ; Pharmacotherapy, Male, Brain, Review Article, Sex Factors, Alzheimer Disease, Memory, Animals, Humans, Hypoglycemic Agents, Insulin, Cognitive Dysfunction, Female, Insulin Resistance, Administration, Intranasal

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
127
Top 1%
Top 10%
Top 1%
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