Advances in the regulation of bone metabolism by central nuclei: a new perspective on the brain-bone axis

The convergence of neuroscience and bone biology has led to the profound conceptualization of the "brain-bone axis," revealing the intricate connection between the central nervous system and bone metabolism. Central nuclei, defined as structures composed of neurons with similar functions, play a pivotal role in the regulation of bone metabolism. Research has demonstrated that central nuclei can modulate bone metabolism either directly via nerve fiber projections or indirectly through neuroendocrine pathways. Despite significant progress, the precise mechanisms by which central nuclei regulate bone metabolism and the collaborative communication networks among these nuclei remain poorly understood. This review systematically summarizes recent advances in central nuclei across the entire brain that regulate bone metabolism and their complex mechanisms. Moreover, it discusses current challenges and potential future research directions in the field. The ultimate aim is to provide novel insights for developing neuromodulatory therapeutic strategies against bone metabolic disorders.