神经系统疾病饮食干预:从"脑先/体先"到代谢-表观-免疫-肠-脑轴整合模型OA

Neurological disorders represent a major and growing global health burden,for which conventional pharmacotherapies often have limited efficacy and notable side effects.Dietary intervention has thus gained prominence as a viable,non-invasive,and accessible adjunctive strategy.This review proposed a novel integra-tive framework to decipher the multisystem mechanisms of diet.We posited that dietary influences converge through two interconnected pathways:a direct central modulation of the intracerebral metabolism-epigenome-immunity network,and a peripheral-to-central signaling route via the gut-brain axis.This article tried to come up with a first synthesis of the"brain-first"and"body-first"etiological models with the systemic metabo-lism-epigenome-immunity network and gut-brain axis mechanisms,constructing a unified paradigm that bridges central and peripheral pathophysiology.Grounded in this framework,we critically evaluated the roles of specific dietary components(e.g.,polyphenols,ω-3 fatty acids,pre/probiotics)and holistic dietary patterns(e.g.,Mediterranean diet,ketogenic diet,intermittent fasting),elucidating their distinct yet complementary sites of action within the proposed network.We further identified persistent challenges in mechanistic delinea-tion,protocol standardization and personalization of interventions.Looking forward,we highlighted the trans-formative potential of multi-omics technologies,precision nutrition,and interdisciplinary convergence in translating this integrated model into tailored,evidence-based dietary strategies.This theoretical synthesis not only offers a cohesive lens via which to understand the pleiotropic actions of diet in neurology but also pro-vides a foundational road-map for advancing personalized nutritional neuroscience from bench to bedside.