Fluctuating clinical presentations resembling neurological dysfunction may arise in the absence of primary neurodegenerative pathology. This perspective proposes that systemic conditions affecting metabolic stability can induce a state of energy instability, leading to multi-system dysregulation.This work presents an initial conceptual framework in which interactions between mitochondrial energy availability (ATP), autonomic regulation, and endocrine function generate dynamic and reversible symptoms. From an evolutionary perspective, such responses reflect adaptive prioritization of survival over reproduction and higher-order functions under energetic constraint.This contribution is intended as an exploratory and hypothesis-generating starting point, aimed at stimulating broader discussion and future empirical investigation.
Benedetta Bernardini (2026) studied this question.