PCa cells absorb these lactates through the MCT1 on their surface, further triggering the nuclear translocation of PKM2, which acts as a transcription factor participating in and activating OXPHOS [59], changing the intracellular NAD+/NADH ratio, and then enhancing mitochondrial activity in PCa cells through the SIRT1—PGC-1α pathway. Here, PPARGC1A is linked to posterior cortical atrophy.