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Recent clinical trial failures, difficult diagnosis, uncertain etiology, and lack of curative therapies prompted us to re-examine other hypotheses of neurodegenerative pathogenesis. Recent reports establish that mitochondrial and calcium dysregulation occur early in many neurodegenerative diseases (NDDs), including Alzheimer's disease, Parkinson\u2019s disease, Huntington's disease, and others. However, causal molecular evidence of mitochondrial and metabolic contributions to pathogenesis remains insufficient. Here we summarize the data supporting the hypothesis that mitochondrial and metabolic dysfunction result from diverse etiologies of neuropathology. We provide a current and comprehensive review of the literature and interpret that defective mitochondrial metabolism is upstream and primary to protein aggregation and other dogmatic hypotheses of NDDs. Finally, we identify gaps in knowledge and propose therapeutic modulation of\n                    <jats:sub>m<\/jats:sub>\n                    Ca\n                    <jats:sup>2+<\/jats:sup>\n                    exchange and mitochondrial function to alleviate metabolic impairments and treat NDDs.\n                  <\/jats:p>","DOI":"10.1186\/s40478-021-01224-4","type":"journal-article","created":{"date-parts":[[2021,7,7]],"date-time":"2021-07-07T07:02:53Z","timestamp":1625641373000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":85,"title":["Reappraisal of metabolic dysfunction in neurodegeneration: Focus on mitochondrial function and calcium signaling"],"prefix":"10.1186","volume":"9","author":[{"given":"Pooja","family":"Jadiya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne F.","family":"Garbincius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3925-2224","authenticated-orcid":false,"given":"John W.","family":"Elrod","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,7,7]]},"reference":[{"key":"1224_CR1","doi-asserted-by":"crossref","unstructured":"Kety SS (1957) The general metabolism of the brain in vivo. 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