Evidence mapPaperPMID 39874739Full record

ReviewAutonomic neuroscience : basic & clinical2025

Abnormal cardiovascular control during exercise: Role of insulin resistance in the brain.

Juan A Estrada, Amane Hori, Ayumi Fukazawa, Rie Ishizawa, Norio Hotta, Han-Kyul Kim, Scott A Smith, Masaki Mizuno

Abstract readReview
In one paragraph

Review in Autonomic neuroscience : basic & clinical, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Juan A EstradaDepartments of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
Amane HoriDepartments of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; Japan Society for the Promotion of Science, Tokyo 102-0083, Japan; College of Life and Health Sciences, Chubu University, Kasugai 487-8501, Japan.
Ayumi FukazawaDepartments of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; Japan Society for the Promotion of Science, Tokyo 102-0083, Japan.
Rie IshizawaFaculty of Sports and Life Science, National Institute of Fitness and Sports in KANOYA, Kagoshima 891-2393, Japan.
Norio HottaCollege of Life and Health Sciences, Chubu University, Kasugai 487-8501, Japan.
Han-Kyul KimDepartments of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
Scott A SmithDepartments of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
Masaki MizunoDepartments of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA. Electronic address: masaki.mizuno@utsouthwestern.edu.

Funding

NHLBI NIH HHS R01 HL151632
6 · The paper itself

Abstract

During exercise circulatory adjustments to meet oxygen demands are mediated by multiple autonomic mechanisms, the skeletal muscle exercise pressor reflex (EPR), the baroreflex (BR), and by feedforward signals from central command neurons in higher brain centers. Insulin resistance in peripheral tissues includes sensitization of skeletal muscle afferents by hyperinsulinemia which is in part responsible for the abnormally heightened EPR function observed in diabetic animal models and patients. However, the role of insulin signaling within the central nervous system (CNS) is receiving increased attention as a potential therapeutic intervention in diseases with underlying insulin resistance. This review will highlight recent advances in our understanding of how insulin resistance induces changes in central signaling. The alterations in central insulin signaling produce aberrant cardiovascular responses to exercise. In particular, we will discuss the role of insulin signaling within the medullary cardiovascular control nuclei. The nucleus tractus solitarius (NTS) and rostral ventrolateral medulla (RVLM) are key nuclei where insulin has been demonstrated to modulate cardiovascular reflexes. The first locus of integration for the EPR, BR and central command is the NTS which is high in neurons expressing insulin receptors (IRs). The IRs on these neurons are well positioned to modulate cardiovascular responses to exercise. Additionally, the differences in IR density and presence of receptor isoforms enable specificity and diversity of insulin actions within the CNS. Therefore, non-invasive delivery of insulin into the CNS may be an effective means of normalizing cardiovascular responses to exercise in patients with insulin resistance.

Indexed as

BrainCardiovascular Physiological PhenomenaCardiovascular SystemExerciseInsulin ResistanceAnimalsBaroreflexHumansInsulinInsulinBlood pressureCentral nervous systemExercise pressor reflexInsulin receptorInsulin resistanceNTSType 2 diabetes mellitus

Identifiers

PMID39874739
PMCPMC12379054

What Socratic holds

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Registered trials

None linked

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.