Tiny Messengers, Big Impact: The Role of Endogenous Extracellular Vesicles in Neurological Diseases

Extracellular Vesicles (EVs) are membrane-enclosed structures released by cells, encapsulating bioactive molecules such as proteins, lipids, and nucleic acids. They play a pivotal role in intercellular communication and have emerged as critical mediators in both physiological and pathological processes, particularly in neurological diseases. This review summarizes the current knowledge of endogenous EVs in neurological diseases, including cerebrovascular disorders, neurodegenerative diseases, autoimmune disorders, epilepsy, trauma, and cancer. We highlight their role in disease progression, their potential as biomarkers, and their therapeutic implications, while identifying critical gaps such as exosome biogenesis, selective cargo loading, and recipient cell specificity that warrant further research. By addressing these gaps, future studies can better harness the potential of exosomes in diagnosing and treating neurological diseases.