NBEA (neurobeachin) is a scaffolding protein that anchors protein kinase A (PKA) regulatory subunits to cellular membranes and organelles, facilitating kinase positioning at specific subcellular locations. 1 At GABAergic synapses, NBEA interacts with the postsynaptic anchor protein gephyrin and regulates GABAA receptor internalization through PKA-dependent mechanisms, thereby modulating inhibitory synaptic strength. 1 NBEA functions in synapse organization and trafficking of ion channels, with its DUF1088 domain being critical for proper neuronal function. 2 NBEA is established as a neurodevelopmental disorder (NDD) gene, with de novo variants identified in 24 patients presenting primarily with early-onset generalized epilepsy characterized by myoclonic and atonic seizure types, often manifesting within the first few years of life. 3 Loss-of-function variants in NBEA result in altered neuronal trafficking and cell fate determination. 2 Beyond neurological disease, NBEA genetic variation predicts individual responsiveness to GLP-1 receptor agonist weight-loss therapy, with specific genetic scores associated with significantly higher likelihood of substantial weight loss on liraglutide and semaglutide. 4 Additionally, circular RNA derived from NBEA (circ-Nbea) participates in diabetic encephalopathy pathogenesis through microRNA-128-3p sponging mechanisms. 5