Neurodegenerative diseases

Neurodegenerative diseases, like Parkinson’s disease, Alzheimer’s disease, Multiple Sclerosis and many other neurological conditions, are considered highly multifactorial complex diseases harboured with numerous interactions between genetic, molecular, psychological, environmental, dietary and other intrinsic and extrinsic factors that need a holistic approach to treat. Many stakeholders are calling for fundamental changes especially in the tailoring of medical treatment to the individual characteristics, needs and preferences. We need to move away from systems that are dominated and controlled by medical speciality to integrated systems that consider and treat patients holistically. Biomarkers that have prognostic value for survival would be of value for decision-making and planning of care. Technological developments have led to the discovery of many agents in biofluids neurophysiological measures and neuroimaging biomarkers for neurological diseases. These discoveries have led to progress in the management of neurodegenerative diseases. For example, the treatment of neurodegenerative diseases with monoclonal antibodies, like in the case of Multiple Sclerosis, could be considered a significant step towards targeted therapy. However, once again, a percentage of patients remain uncontrolled and the disease in many others continues to progress. As a result, there is an urgent need to find and validate biomarkers to timely and accurately diagnose disease and predict disease progression. Furthermore, investigators are becoming interested in how “disease modification” of neurological diseases could be detected using a variety of biomarkers. By using high power computerized systems and developing dense networks, by feeding integrated neural networks and deep learning algorithms with carefully collected detailed demographic, epidemiological, clinical, therapeutic, laboratory, image, genetic, epigenetic, environmental and numerous other thoroughly described and diligently followed and maintained data we can manage to succeed in (i) understanding the pathophysiology, (ii) developing early detection and/or monitoring biomarkers, and (iii) designing and trying personalised therapeutic intervention leading to cost-effective management with minimal side effects. The Cyprus Institute of Neurology and Genetics follows up thousands of neurodegenerative disease patients, whose files contain a wealth of such data, which upon patient consent, can be used to facilitate a better understanding of “the person of the disease” and guide us towards better and more effective personalized medical service delivery.