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Neurodegenerative diseases (NDs) are characterized by slow progression and late detection, seriously compromising the efficiency of treatments. The presence of the blood-brain barrier (BBB) significantly impairs conventional therapies. More recently, extracellular vesicles (EVs) have emerged as promising drug delivery systems for brain-targeted therapies due to their ability to cross the BBB and their combination of low immunogenicity, high biocompatibility, and delivery efficiency. EVs play a vital role in intercellular communication, transporting nucleic acids, lipids, and proteins between cells, which are crucial for modulating cellular functions, immune responses, and neuroprotection. They have also demonstrated considerable therapeutic potential by mitigating neuroinflammation, reducing neuronal damage, and alleviating cognitive deficits in preclinical models of NDs. This review discusses various applications of EVs in the treatment of NDs, challenges they present as a delivery vehicle, and future research directions and regulatory considerations in advancing EV-based therapies for neurodegenerative disorders.
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