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Implications of insulin in cognitive performance. Once an insulin receptor is activated, phosphorylation of the insulin receptor substrate (IRS) is triggered. Then, phosphoinositide 3-kinase (PI3K) and phosphoinositide-dependent protein kinase-1 (PDK-1) are activated, resulting in the activation of protein kinase B (Akt). Activated Akt promotes several downstream cascades and influences synaptic plasticity as well as mitochondrial dysfunction.
