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Saturday, May 13, 2017

Fit & proper: Tackling neurological disorders

Shakir Husain 

don't receive the attention they deserve. They get overshadowed by cancers and heart disease, even though they affect millions worldwide. These are the diseases of the central and peripheral nervous system affecting the brain, spinal cord, cranial nerves, peripheral nerves, nerve roots, autonomic nervous system, neuromuscular junction, and muscles; and the disorders include epilepsy, alzheimer's disease, dementia, stroke, migraine among  other headache disorders, along with multiple sclerosis, Parkinson's disease.
According to WHO, more than six million people die of stroke each year, over 50 million have epilepsy, 47.5 million people have dementia (Alzheimer's disease is the most common cause of dementia) and the prevalence of migraine is more than 10 per cent worldwide.

Compared to other therapeutic fields, neurological diseases are under-researched. However, thanks to the revolution in our understanding of the human genome, the grasp over the way the brain functions, and also the overwhelming complexity of illnesses that afflict the brain, is getting better every day. The fact that the need is so dire is making more scientists and companies dip their hands into the fresh science.
For example, 'Humanity' based in Cambridge is one such startup working in the field. They are using yeast, the microbes to study how misfolded proteins in the brain cause Alzheimer's, Lou Gehrig's disease and Parkinson's, and to create drugs based on that knowledge.
The industry is in midst of a dramatic reversal, with investors willing to pour money into firms that are developing drugs for psychiatric illnesses. Looking at the ongoing work, it seems that new medicines for severe depression, psychosis and schizophrenia could reach the market within the next few years. 
Transformational work is already underway. For example, in 2004 researchers at the National Institutes of found out that a brain receptor called N-methyl-D-aspartate (NMDA), which is key to forming memories, was also involved in depression. Around the same time, a researcher at Yale found  that ketamine, a widely used anesthetic, can block NMDA.
Extensive work is on to translate this knowledge into an effective drug. A nose-spray derivative of the drug is now entering late-stage trials; a pill is also being worked on. Similarly, an experimental drug, Sage-547, that blocks haywire electrical signals from jumping across nerve synapses in the brain and central nervous system, is being viewed as a great hope for controlling seizures in people.
However, all these are just a start to the changes scientists and pharma companies hope to bring about in the way we battle brain related disease. The intent is to end the hit-and-miss approach that is generally followed while prescribing medicines for similar conditions, and to move to a system that is based on what is biologically wrong with the patient.

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