MicroRNAs (miRNAs) have emerged as key regulators of neuroplasticity, influencing essential processes such as neurogenesis, synaptogenesis, and neuroinflammatory responses. This review provides a comprehensive overview of the general roles of miRNAs in neuroplasticity and synthesizes recent insights from both preclinical and clinical studies, including transcriptomic analyses and miRNA profiling, to elucidate the molecular mechanisms by which these miRNAs modulate neuronal function. We have examined specific miRNAs, such as miR-132, miR-124, miR-134, miR-135 and miR-146a, and their roles in synaptic remodeling, neuronal differentiation, and regulation of neuroinflammation. Furthermore, we have explored the therapeutic potential of targeting these miRNAs in neurodegenerative diseases, with a focus on Alzheimer’s disease and Parkinson’s disease. The review highlights the novelty of miRNA-based interventions and innovative therapeutic delivery strategies, such as exosome-based systems, and lipid nanoparticles. Despite promising results in animal models, clinical translation remains limited due to challenges in delivery systems, off-target effects, and the need for validated biomarkers. Therefore, further studies, especially longitudinal trials in humans, are essential to advance the clinical utility of miRNA-targeted therapies in neurology.
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