Recent human and experimental studies demonstrate that central insulin resistance disrupts brain energy metabolism, promotes neuroinflammation, impairs synaptic plasticity, and alters neuronal network stability. These mechanisms contribute to disease onset and progression in Alzheimer's disease, Parkinson's disease, epilepsy, and mood disorders. Advances in neuroimaging, cerebrospinal fluid biomarkers, and molecular profiling have strengthened the link between impaired insulin signaling and cognitive, behavioral, and affective dysfunction. In parallel, emerging evidence suggests that dietary patterns, energy restriction, ketogenesis, and lifestyle interventions can partially restore insulin sensitivity, improve metabolic flexibility, and mitigate neurobiological vulnerability. Insulin resistance should be regarded not merely as a comorbid metabolic condition, but as an active disease-modifying factor in a broad spectrum of neurological disorders. Targeting insulin signaling pathways through personalized nutritional and metabolic interventions represents a promising, modifiable strategy for prevention and adjunctive management. Future research integrating metabolic phenotyping with neurological outcomes will be essential to translate these insights into clinical practice.
Atar et al. (Sat,) studied this question.