Overview

• PET scans using a novel [68Ga]Ga-NOTA-insulin tracer and a six-spray nasal device demonstrated safe and effective delivery of intranasal insulin to 11 brain regions involved in memory and cognition.
• Cognitively normal adults exhibited higher overall uptake and longer retention of insulin compared with those with mild cognitive impairment, who showed faster initial absorption followed by more rapid clearance.
• Uptake in women correlated with cardiovascular health markers and was inversely associated with ptau217 levels, highlighting potential biomarker-driven dosing strategies.
• The procedure was well tolerated, with only two participants reporting mild headaches that resolved within 24 hours.
• Wake Forest and Aptar Pharma will launch larger trials over the next 12–18 months to explore how vascular health, amyloid burden and sex differences affect brain insulin delivery and guide personalized treatment.