Navigating the Neurodegenerative Crisis: A Multifaceted Approach

Overtaking more established issues like cancer and heart disease, neurological problems have become a major worldwide health concern. From neurodevelopmental disorders and late-life dementia to recently discovered illnesses like post-COVID-19 cognitive impairment, the range of these conditions has greatly expanded. A 65% increase since 1990, brain illnesses, which include mental health, neurological, and cerebrovascular diseases, accounted for nearly 15% of worldwide health loss in 2021. Due to the extreme lack of access to specialized neurological care, this growing burden is especially noticeable in low- and middle-income nations. To make matters worse, diseases like diabetic neuropathy and neurological consequences from COVID-19 are becoming more prevalent. The predicted rise in mental health problems and other neurological illnesses presents a serious danger to both individual well-being and global health systems as the world's population ages and lifestyle variables raise risk.[1] [2]

Approach towards mitigation of neurological disease burden

A multimodal approach that incorporates prevention lifestyle modifications, early detection and diagnosis, therapeutic and non-pharmacological therapy, public health initiatives, and international collaborations to reduce this burden. By combining these approaches, neurodegenerative diseases may be lessened and the lives of individuals affected and their loved ones may be improved. Consortia and networks have been established as organizations such as the European Brain Research Institute (EBRI) and the Alzheimer Diseases Neuroimaging Initiative (ADNI) bring together researchers from various countries to share resources, data, and methods. International conferences and workshops are thought to be very beneficial for information sharing and capacity building. At these gatherings, researchers can share their research, talk about new trends, and collaborate. Through training programs that assist capacity building, researchers in low- and middle-income countries can acquire the skills and information necessary to conduct high-quality research. The Alzheimer Association is the major NGO addressing this issue since it finances independent researchers globally through its International Research Grant Program and hosts yearly meetings centered around the topic. At the moment, the Association has approximately $430 million invested in more than 1,110 ongoing projects across six continents and 56 countries. For further progress in lowering the global burden of diseases, legislation and ethical issues must be harmonized. Standards of ethics do ethical behavior, which includes informed permission and data protection, is necessary to maintain public support for research and to foster confidence. Clinical trials can be streamlined and drug development accelerated by regulatory harmonization, which unifies national laws. [3]

Cognitive Assessment: A Closer Look

A major global health concern is the increasing incidence of cognitive decline, which is mostly caused by AD and associated dementias. The absence of standardized cognitive testing procedures impedes early detection and prompt intervention, even if early diagnosis presents chances for preparation, support, and even research participation. We can enhance early diagnosis of cognitive impairment, improve management techniques, and ultimately improve the quality of life for those who are impacted by these disorders by funding research and creating testing protocols that are optimized. Early detection of cognitive abnormalities is essential due to the profound effects dementia has on both individuals and families. Although medical professionals are essential to this process, early detection is hampered by certain obstacles. These include the possibility of false positives, a lack of standardized testing procedures, and a lack of understanding of the significance of early evaluation. However, early detection is becoming more and more important as research advances and new treatment options appear. We can enhance the quality of life for people with dementia and their families by tackling these issues and encouraging early evaluation.

NIH-NIA is supporting research to create and validate brief, user-friendly tests that can be included into conventional clinical care in order to address the dearth of standardized cognitive evaluation instruments. In order to find instruments that can reliably evaluate cognitive decline in a short amount of time, the DetectCID collaboration is experimenting with a number of methods, such as pen-and-paper examinations, gait evaluations, and digital platforms. Researchers are also working to create culturally sensitive and accessible tools for a variety of populations. While the INCLUDE Project is looking into biomarkers and modified assessment tools for individuals with Down syndrome, the Multicultural Community Dementia Screening project is testing an online assessment tool among different individuals. Additionally, researchers are investigating cutting-edge digital methods to track cognitive shifts in day-to-day living. The CART program uses a network of digital devices to monitor activity and health indicators, while the Mobile Monitoring of Cognitive Change initiative is creating cognitive tests that can be taken on smartphones. NIH hopes to improve early identification of cognitive impairment, increase access to care, and eventually improve the quality of life for people with dementia and their families by promoting these research activities. [4]

Treatment option various CNS neurological diseases

Cognitive assessment is essential for managing various CNS neurological diseases, including neurodegenerative conditions like AD, Parkinson diseases (PD), and Huntington's diseases (HD); cerebrovascular disorders such as stroke and traumatic brain injury; brain tumors; autoimmune diseases like multiple sclerosis (MS); & infections like meningitis and encephalitis. While there's no cure for many neurodegenerative diseases, pharmacological interventions, such as cholinesterase inhibitors and dopamine agonists, can help manage symptoms. Emerging disease-modifying therapies target specific disease mechanisms, with recent FDA approvals for lecanemab and donanemab. Non-pharmacological interventions like cognitive rehabilitation, occupational therapy, speech-language therapy, physical therapy, and psychosocial support complement pharmacological treatments. By combining comprehensive cognitive assessment with tailored treatment strategies, healthcare professionals can optimize the management of CNS neurological diseases and improve the quality of life for affected individuals. [5]

Neurology market is anticipated sustained growth

The size of the worldwide neurology market was assessed at USD 3.32 billion in 2023 and is expected to grow at a compound annual growth rate (CAGR) of 7.60% from 2023 to 2032, reaching approximately USD 6.42 billion.

Figure with the expected global neurology market size from 2022-2032 ($USD Billion)

North America led the neurological condition market in 2022, accounting for around 41% of worldwide sales. The Asia-Pacific area, on the other hand, is anticipated to grow at the quickest CAGR between 2023 and 2032, indicating that it is ready for substantial expansion. Neurodegenerative illnesses had a significant market share of about 59% in 2022 when compared to other disease types. In the meantime, it is projected that the neurovascular diseases segment would rise rapidly, with CAGR of 9.1% throughout the projection period. In terms of procedures, in 2022, multiple sclerosis had around 36% of the market. With a 69% share, the adult group dominated the end-user market. Finally, with over 48% of the market share in 2022, diagnostic centers were the main end users. [6] 

In conclusion, a major threat to public health is the growing prevalence of neurological diseases worldwide, including neurodegenerative diseases and mental health issues. A diversified strategy is necessary to overcome this challenge. Prevention, early identification, cutting-edge treatments, and supportive care should all be included in this strategy. To improve our comprehension and treatment of these complex illnesses, international cooperation, research financing, and policy measures are essential. Millions of people and their families around the world can live better lives if neurological health is given priority.

References:

1. WHO, News - Over 1 in 3 people affected by neurological conditions, the leading cause of illness and disability worldwide. Accessed on 24 November, 2024

URL: https://www.who.int/news/item/14-03-2024-over-1-in-3-people-affected-by-neurological-conditions--the-leading-cause-of-illness-and-disability-worldwide

2. Lei J, Gillespie K. Projected Global Burden of Brain Disorders through 2050 (P7-15.001). Neurology [Internet]. 2024 Apr 9;102(17_supplement_1).

URL : https://doi.org/10.1212/wnl.0000000000205009

3. Research solution, The Importance of Trust in Scientific Research. Published on May 11, 2023; accessed on: November 24, 2024

URL: https://www.researchsolutions.com/blog/the-importance-of-trust-in-scientific-research

4. NIA, Cognitive Assessment Considerations: Understanding the Evidence. Reviewed on: December 8, 2023; Accessed on: November 24, 2024

URL:https://www.nia.nih.gov/health/cognitive-assessment-considerations-understanding-evidence

5. Palanisamy CP, Pei J, Alugoju P, Anthikapalli NVA, Jayaraman S, Veeraraghavan VP, Gopathy S, Roy JR, Janaki CS, Thalamati D, Mironescu M, Luo Q, Miao Y, Chai Y, Long Q. New strategies of neurodegenerative disease treatment with extracellular vesicles (EVs) derived from mesenchymal stem cells (MSCs). Theranostics. 2023 Jul 16;13(12):4138-4165.

6. Biospace, Neurology Market Expected to Witness Sustained Growth. Published on: April 2, 2024; Accessed on: November 24, 2024

URL: https://www.biospace.com/neurology-market-expected-to-witness-sustained-growth#:~:text=The%20market%20for%20neurology%2Drelated,of%20neurological%20disorders%2C%20increasing%20aging

About the author

Shruti Talashi

boasts a dual mastery of lab research and writing. Her doctoral study outcome as M.Phil in biomedical science while studying breast cancer and an extraordinary masters degrees dissertation work on exploring role of Gal-lectin in cancer metastasis fuels her extensive research interests. She has gained few publication in journals. Bridging the science-public gap is her passion, aided by expertise in diverse techniques. From oncology to antibiotic/drugs production, she's led and managed complex projects, even clinical trials. Now, as a freelance Content Coordinator for Sinoexpo Pharmasource.com, her industry knowledge shines through valuable insights on cutting-edge topics like GMP, QbD, and biofoundry.