Targeting insulin resistance to treat cognitive impairment

Insulin is a vital hormone that performs multiple roles within the brain, including neuroprotective effects and enhancing higher cognitive processes. This chapter examines cerebral insulin and its vital role in neurological health. The chapter commences with a concise overview of brain insulin, including its precise localization and the receptors it binds to. The chapter details insulin transport across the blood-brain barrier, brain insulin production, and insulin receptors. Brain insulin resistance mechanisms are discussed in addition to their physiological effects on eating, learning, and memory. Moreover, the chapter summarizes the available preclinical and clinical evidence on the consequences of brain insulin resistance. Following this, the chapter describes the therapeutic targets for cognitive impairment, including the effects of traditional and novel antidiabetic drugs, along with cognitive behavioral therapy and exercise.