To summarize current clinical and translational evidence supporting the potential use of GLP-1 receptor agonists in neurological diseases and to evaluate their mechanisms of action.
Approach:
Key Findings:
Preclinical studies indicate GLP-1RAs can reduce neuroinflammation, oxidative stress, and support mitochondrial function.
Clinical findings in neurological disorders like Parkinson's disease have shown encouraging signals, but biomarker evidence for disease modification is still limited.
In Alzheimer's disease, clinical trials have produced mixed or negative results, reflecting variability in disease stage, patient selection, and treatment duration.
Pharmacological diversity among GLP-1RAs may influence their neurological effects.
Interpretation:
GLP-1RAs may influence neurological diseases through metabolic, inflammatory, and vascular pathways; however, their clinical role remains uncertain due to inconsistent findings.
Limitations:
Heterogeneity across neurological disease entities.
Limited randomized trials with prespecified neurological endpoints.
Variable blood-brain barrier penetration.
Outcome measures may be insensitive to gradual effects.
Conclusion:
Further studies with biomarker-informed designs and appropriate drug selection are needed to clarify the potential benefits of GLP-1RAs in neurological disorders.
