Trial reportJournal of Alzheimer's disease : JAD2019
Extracellular Vesicle Biomarkers Track Cognitive Changes Following Intranasal Insulin in Alzheimer's Disease.
Trial report in Journal of Alzheimer's disease : JAD, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
46 citing papers in PubMed, 2 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- Outcomes and clinical implications of intranasal insulin on cognition in humans: A systematic review and meta-analysis.PloS one · 2023Pooled it
- Efficacy and safety of hypoglycemic drugs in improving cognitive function in patients with Alzheimer's disease and mild cognitive impairment: A systematic review and network meta-analysis.Frontiers in neurology · 2022Pooled it
- Brain responses to intermittent fasting and the healthy living diet in older adults.Cell metabolism · 2024Trial
- Neuron-derived extracellular vesicles in blood reveal effects of exercise in Alzheimer's disease.Alzheimer's research & therapy · 2023Trial
- Exploring brain insulin resistance in adults with bipolar depression using extracellular vesicles of neuronal origin.Journal of psychiatric research · 2021Trial
- Trial
- Exosomes in Alzheimer's Disease: From Pathological Mechanisms to Biomarker Potential and Therapeutic Applications.Molecular neurobiology · 2026Review
- Effect of a single exercise bout on fasting cerebral blood flow and brain insulin sensitivity in middle-aged to older adults.Experimental physiology · 2026Article
- Expanding the understanding of insulin resistance in brain and periphery.Trends in endocrinology and metabolism: TEM · 2026Review
- Characterizing longitudinal patterns of central and peripheral insulin resistance.Psychoneuroendocrinology · 2025Article
- MicroRNA cargo in neuron-derived vesicles as peripheral biomarkers of brain insulin dysregulation.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- Insulin resistance, cognition, and functional brain network topology in older adults with obesity.Scientific reports · 2025Article
- Extracellular vesicles: translational research and applications in neurology.Nature reviews. Neurology · 2025Review
- Extracellular vesicles as standard-of-care therapy: will fast-tracking the regulatory processes help achieve the goal?Regenerative medicine · 2024Review
- A Panel of miRNA Biomarkers Common to Serum and Brain-Derived Extracellular Vesicles Identified in Mouse Model of Amyotrophic Lateral Sclerosis.Molecular neurobiology · 2024Article
- Safety and efficacy of intranasal insulin in patients with Alzheimer's disease: a systematic review and meta-analysis.Journal of clinical and translational research · 2023Review
- Insulin resistance, cognition, and Alzheimer disease.Obesity (Silver Spring, Md.) · 2023Review
- Exosomes: potential diagnostic markers and drug carriers for adenomyosis.Frontiers in pharmacology · 2023Review
- Extracellular vesicles, the emerging mirrors of brain physiopathology.International journal of biological sciences · 2023Review
- Current Insights on the Use of Insulin and the Potential Use of Insulin Mimetics in Targeting Insulin Signalling in Alzheimer's Disease.International journal of molecular sciences · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundInsulin resistance is implicated in Alzheimer's disease (AD), whereas intranasal insulin is an experimental treatment in clinical trials. We previously proposed insulin signaling mediators in plasma neuronal-enriched extracellular vesicles (EVs) as biomarkers of brain insulin resistance.
objectiveWe sought to demonstrate the capacity of neuronal-enriched EV biomarkers to demonstrate target engagement in response to intranasal insulin and their ability to track treatment-associated cognitive changes in AD.
methodsWe isolated neuronal-enriched EVs from plasma samples of participants with amnestic mild cognitive impairment or probable AD involved in a 4-month duration placebo-controlled clinical trial of 20 or 40 IU intranasal insulin. We measured insulin signaling mediators as biomarkers and examined treatment-associated changes and their relationship with cognitive performance (ADAS-Cog).
resultsThere were no EV biomarker changes from baseline in any of the treatment groups. In participants treated with 20 IU insulin, EV biomarkers of insulin resistance (pS312-IRS-1, pY-IRS-1) showed strong positive correlations with ADAS-Cog changes, especially in ApoE ɛ4 non-carriers.
conclusionNeuronal EV biomarkers of insulin resistance (pS312-IRS-1, pY-IRS-1) were associated with cognitive changes in response to low dose intranasal insulin suggesting engagement of the insulin cascade in neurons of origin.
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What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.