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Neurodegenerative disorders a challenge to medical science
DUBAI - The brain and spinal cord are made up of about a billion neurons. For a neuron, accidental damage, whether by disease or trauma, is a one-way ticket to death. A neuron can regenerate only within certain narrow limits, unlike most other cells in the body, explains Dr Rajshekhar Garikapati, Specialist Neurologist, Zulekha Hospital, Dubai.
Nerve cell regeneration and replacement by stem cell therapy are at the cutting edge of science but progress is far from what is hoped-for.
The nervous system is affected not only by aging, but also a large number of diseases unique to it, all clubbed together under an umbrella term called “neurodegenerative disorders”.
These diseases are truly devastating, and Alzheimer disease is possibly the most well-known. Then comes Parkinson disease; another dreaded disease, possibly less so, since patients survive many years, remain cognitively intact with preserved memories, though with severely impaired ability to walk, talk and eat.
Perhaps the most dreaded condition in this group is Motor Neuron Disease; this diagnosis literally starts the countdown for its hapless victim. Weakness of the muscles of the pharynx and larynx leading to choking and death within three to five years after onset is par for the course. By that time the patient may already have become bed-bound. Possibly the cruelest aspect of this disease: the victim remains perfectly conscious, alert, and emotionally intact till the end.
These diseases are unlike cancer, stroke, heart attack, or infections. The neurons undergo a unique process of degeneration, but what initiates and perpetuates this degeneration remains a mystery to science. These diseases start on their own, progress relentlessly; no forms of therapy have been shown to halt this progression, though some drugs have “appeared to slow the progression”. Developing novel therapies for neurodegenerative disorders is a work-in-progress; some of the research in Alzheimer’s disease is truly cutting-edge.
The field attracts a lot of funding, and new drugs are constantly being added to the list. The promise of many new drugs have not been borne-out; some drugs appear very promising during drug trials, only to fade away during post-marketing phase due to either unacceptable side-effects or lack of efficacy. The tremendous cost involved in bringing a single drug to the market is a major dampener to progress.
Care-givers looking for newer modalities to improve the lives of their loved ones suffering from one of the neuro-degenerative diseases should exercise ‘cautious optimism’ when looking out for these therapies.
Dr Rajshekhar Garikapati, Specialist Neurologist, Zulekha Hospital, Dubai.
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