Outcomes and clinical implications of intranasal insulin on cognition in humans: A systematic review and meta-analysis.
<h4>Background</h4>Aberrant brain insulin signaling has been posited to lie at the crossroads of several metabolic and cognitive disorders. Intranasal insulin (INI) is a non-invasive approach that allows investigation and modulation of insulin signaling in the brain while limiting periph...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2023-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0286887 |
| _version_ | 1797788293666963456 |
|---|---|
| author | Sally Wu Nicolette Stogios Margaret Hahn Janani Navagnanavel Zahra Emami Araba Chintoh Philip Gerretsen Ariel Graff-Guerrero Tarek K Rajji Gary Remington Sri Mahavir Agarwal |
| author_facet | Sally Wu Nicolette Stogios Margaret Hahn Janani Navagnanavel Zahra Emami Araba Chintoh Philip Gerretsen Ariel Graff-Guerrero Tarek K Rajji Gary Remington Sri Mahavir Agarwal |
| author_sort | Sally Wu |
| collection | DOAJ |
| description | <h4>Background</h4>Aberrant brain insulin signaling has been posited to lie at the crossroads of several metabolic and cognitive disorders. Intranasal insulin (INI) is a non-invasive approach that allows investigation and modulation of insulin signaling in the brain while limiting peripheral side effects.<h4>Objectives</h4>The objective of this systematic review and meta-analysis is to evaluate the effects of INI on cognition in diverse patient populations and healthy individuals.<h4>Methods</h4>MEDLINE, EMBASE, PsycINFO, and Cochrane CENTRAL were systematically searched from 2000 to July 2021. Eligible studies were randomized controlled trials that studied the effects of INI on cognition. Two independent reviewers determined study eligibility and extracted relevant descriptive and outcome data.<h4>Results</h4>Twenty-nine studies (pooled N = 1,726) in healthy individuals as well as those with Alzheimer's disease (AD)/mild cognitive impairment (MCI), mental health disorders, metabolic disorders, among others, were included in the quantitative meta-analysis. Patients with AD/MCI treated with INI were more likely to show an improvement in global cognition (SMD = 0.22, 95% CI: 0.05-0.38 p = <0.00001, N = 12 studies). Among studies with healthy individuals and other patient populations, no significant effects of INI were found for global cognition.<h4>Conclusions</h4>This review demonstrates that INI may be associated with pro-cognitive benefits for global cognition, specifically for individuals with AD/MCI. Further studies are required to better understand the neurobiological mechanisms and differences in etiology to dissect the intrinsic and extrinsic factors contributing to the treatment response of INI. |
| first_indexed | 2024-03-13T01:34:30Z |
| format | Article |
| id | doaj.art-fb023491a11c4b5e9310532291a31547 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-03-13T01:34:30Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-fb023491a11c4b5e9310532291a315472023-07-04T05:32:06ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01186e028688710.1371/journal.pone.0286887Outcomes and clinical implications of intranasal insulin on cognition in humans: A systematic review and meta-analysis.Sally WuNicolette StogiosMargaret HahnJanani NavagnanavelZahra EmamiAraba ChintohPhilip GerretsenAriel Graff-GuerreroTarek K RajjiGary RemingtonSri Mahavir Agarwal<h4>Background</h4>Aberrant brain insulin signaling has been posited to lie at the crossroads of several metabolic and cognitive disorders. Intranasal insulin (INI) is a non-invasive approach that allows investigation and modulation of insulin signaling in the brain while limiting peripheral side effects.<h4>Objectives</h4>The objective of this systematic review and meta-analysis is to evaluate the effects of INI on cognition in diverse patient populations and healthy individuals.<h4>Methods</h4>MEDLINE, EMBASE, PsycINFO, and Cochrane CENTRAL were systematically searched from 2000 to July 2021. Eligible studies were randomized controlled trials that studied the effects of INI on cognition. Two independent reviewers determined study eligibility and extracted relevant descriptive and outcome data.<h4>Results</h4>Twenty-nine studies (pooled N = 1,726) in healthy individuals as well as those with Alzheimer's disease (AD)/mild cognitive impairment (MCI), mental health disorders, metabolic disorders, among others, were included in the quantitative meta-analysis. Patients with AD/MCI treated with INI were more likely to show an improvement in global cognition (SMD = 0.22, 95% CI: 0.05-0.38 p = <0.00001, N = 12 studies). Among studies with healthy individuals and other patient populations, no significant effects of INI were found for global cognition.<h4>Conclusions</h4>This review demonstrates that INI may be associated with pro-cognitive benefits for global cognition, specifically for individuals with AD/MCI. Further studies are required to better understand the neurobiological mechanisms and differences in etiology to dissect the intrinsic and extrinsic factors contributing to the treatment response of INI.https://doi.org/10.1371/journal.pone.0286887 |
| spellingShingle | Sally Wu Nicolette Stogios Margaret Hahn Janani Navagnanavel Zahra Emami Araba Chintoh Philip Gerretsen Ariel Graff-Guerrero Tarek K Rajji Gary Remington Sri Mahavir Agarwal Outcomes and clinical implications of intranasal insulin on cognition in humans: A systematic review and meta-analysis. PLoS ONE |
| title | Outcomes and clinical implications of intranasal insulin on cognition in humans: A systematic review and meta-analysis. |
| title_full | Outcomes and clinical implications of intranasal insulin on cognition in humans: A systematic review and meta-analysis. |
| title_fullStr | Outcomes and clinical implications of intranasal insulin on cognition in humans: A systematic review and meta-analysis. |
| title_full_unstemmed | Outcomes and clinical implications of intranasal insulin on cognition in humans: A systematic review and meta-analysis. |
| title_short | Outcomes and clinical implications of intranasal insulin on cognition in humans: A systematic review and meta-analysis. |
| title_sort | outcomes and clinical implications of intranasal insulin on cognition in humans a systematic review and meta analysis |
| url | https://doi.org/10.1371/journal.pone.0286887 |
| work_keys_str_mv | AT sallywu outcomesandclinicalimplicationsofintranasalinsulinoncognitioninhumansasystematicreviewandmetaanalysis AT nicolettestogios outcomesandclinicalimplicationsofintranasalinsulinoncognitioninhumansasystematicreviewandmetaanalysis AT margarethahn outcomesandclinicalimplicationsofintranasalinsulinoncognitioninhumansasystematicreviewandmetaanalysis AT jananinavagnanavel outcomesandclinicalimplicationsofintranasalinsulinoncognitioninhumansasystematicreviewandmetaanalysis AT zahraemami outcomesandclinicalimplicationsofintranasalinsulinoncognitioninhumansasystematicreviewandmetaanalysis AT arabachintoh outcomesandclinicalimplicationsofintranasalinsulinoncognitioninhumansasystematicreviewandmetaanalysis AT philipgerretsen outcomesandclinicalimplicationsofintranasalinsulinoncognitioninhumansasystematicreviewandmetaanalysis AT arielgraffguerrero outcomesandclinicalimplicationsofintranasalinsulinoncognitioninhumansasystematicreviewandmetaanalysis AT tarekkrajji outcomesandclinicalimplicationsofintranasalinsulinoncognitioninhumansasystematicreviewandmetaanalysis AT garyremington outcomesandclinicalimplicationsofintranasalinsulinoncognitioninhumansasystematicreviewandmetaanalysis AT srimahaviragarwal outcomesandclinicalimplicationsofintranasalinsulinoncognitioninhumansasystematicreviewandmetaanalysis |