This review critically evaluates the experimental, epidemiological, and mechanistic evidence linking early-life metabolic and environmental insults with the establishment of latent vulnerability and proposes that this status may remain clinically silent for decades until activated by aging and cumulative stressors, ultimately leading to neurodegeneration.
Abstract
Several neurodevelopmental disorders and neurodegenerative diseases share common pathogenic mechanisms that unfold across the lifespan, blurring the distinction between the two nosological entities. Environmental factors, particularly those shaping metabolic health during critical developmental time windows, have emerged as key modulators of long-term brain liabilities. This review critically evaluates the experimental, epidemiological, and mechanistic evidence linking early-life metabolic and environmental insults with the establishment of latent vulnerability. We propose that this status may remain clinically silent for decades until activated by aging and cumulative stressors, ultimately leading to neurodegeneration. Specifically, we analyze how early metabolic alterations disrupt mitochondrial function, redox signaling, synaptogenesis, and glial programming, particularly in microglia, thereby shaping long-term neuroinflammatory tone and dysfunctional neural circuit maturation. The review highlights the role of the α7 nicotinic acetylcholine receptor (α7nAChR) as a strategic molecular bridge onto which metabolic and inflammatory signals converge. We further discuss how early dysregulatory stressors manifest later in life as dysmetabolism, vascular impairment, and defective energy sensing, all of which accelerate neurodegenerative pathophysiological processes. This life-course perspective reframes these disorders as a continuum and highlights critical prophylactic and/or therapeutic opportunities through early nutritional, metabolic, and environmental interventions.
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BACKGROUND
Neuroepigenetics studies the molecular mechanisms that regulate gene expression in the nervous system without altering the DNA sequence. The environmental exposome has emerged as a key factor influencing neuronal plasticity and brain homeostasis, contributing to vulnerability to neurodegeneration.
REVIEW S...
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It is demonstrated that mitochondrial impairment precedes classical neuropathological hallmarks, thereby positioning mitochondrial dysfunction as a primary driver rather than a secondary consequence of neurodegeneration, and critically evaluates the translational landscape of mitochondria-targeted interventions.
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Overall, this review makes a case for integrative, pathway-based therapeutic models, and multiple approaches may facilitate for drug development, biomarker identification and patient management in Alzheimer's disease.
This review integrates multidisciplinary evidence to elucidate the mechanism and emphasizes environmental risk mitigation and translational strategies to reduce disease burden and promote lifelong brain resilience.
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