The mind is a powerhouse for all aspects of our life. Watching a loved one lose the ability to think, respond or communicate because of neurological injuries or disorders can be a painful experience. But advancements in neuroscience are building hope for the future of neurology, neuropsychiatry and neuropsychology.
Breakthroughs in dementia
One of the most exciting advancements in neuroscience has been the work focused on dementia. Dr. Claire McGrath is a senior neuropsychologist with Bancroft and says that progressive research has led to earlier diagnoses for her patients.
“With dementia, a person or their family will notice something that doesn’t align with typical behaviors. Maybe there’s memory loss, or unusual thinking,” explains McGrath. “Dementia first develops with subtle changes, and research in neuropsychology is helping identify early habits. We want to identify thinking as early as possible. There are some medications in research that could slow down cognitive decline, and we’re noticing that research is pointing to things that can reduce symptoms around dementia.”
“For a long time treatment for dementia was mediocre at best, focused mainly on mitigation and comfort,” adds Dr. Russell Abrams, neurologist and founding member of Relievus. “But there’s ongoing research and breakthroughs in dementia as well as in Parkinson’s disease. That includes new treatments and drugs on the horizon. While they aren’t FDA approved yet, it’s more exciting than ever to see these things in the works.”
Dr. Steven Bromley a neurologist and founder of the South Jersey MS Center at Bromley Neurology, says existing treatments are also being repurposed to further advance these exciting changes. “Although not new, antibody infusions have now been successfully applied to the treatment of Alzheimer’s disease,” he says. “The FDA recently approved the use of a monoclonal antibody called Aduhelm to treat Alzheimer’s. While this revolutionary approach remains controversial because of potential side effects, it is a huge step forward in managing a common and devastating condition where there have been only a few limited medications with modest effects.”
A treatment-focused future
An essential goal for physicians and specialists across neuroscience is to reduce medication overuse, reducing the need for chemical-based medicinal treatment in the process.
“Medication overuse is one of the underlying conditions we often see in our patients,” says Abrams. “That includes prescriptions, but the ones that are the most overused include over-the-counter medications like Tylenol and Motrin.”
Bromley says that he sees trends developing for the future that can reshape the way we approach neuroscience overall. “The latest advances in neuropsychiatry are driven by the need to depend less on chemical-based medications to treat conditions and symptoms,” he says.
The FDA recently approved a medication-resistant treatment for major depression caled transcranial magnetic stimulation (TMS), which is driving that research forward. The state-of-the-art treatment is a painless, non-invasive therapy designed for people with chronic treatment-resistant illness. A standard treatment takes minutes, requires a number of sessions to maintain the effect, is medication free and allows one to continue with normal activities immediately after being treated.
“TMS is essentially a focused and powerful magnet applied to very specific locations on the head and repetitively pulsed in a specific way to stimulate underlying cortex and invoke a positive shift in underlying histochemistry,” says Bromley. “It has been found—in controlled trials—to be able to help 40% of patients who fail medications.”
McGrath says that neuropsychology is another valuable step in identifying non-chemical treatments. “There is so much research out there that is really exciting,” she says. “We’ll are able to recommend psychotherapy or psychiatric evaluations as well as behavioral changes like exercise or diet, and treatment for sleep to resolve sleep apnea.”
Some treatments in neuroscience already exist in each patient. “Another major advancement includes the use of biological infusion therapies, where human proteins (antibodies) are given intravenously to target a process in the body and help a disease state,” explains Bromley.
“Over the past three to four years research has come up with different mechanisms to effectively treat headaches and migraines in particular,” echoes Abrams. “There are several new classes of medicinal monochromal antibodies featured in three new medications. This includes once-a-month injections that have tremendously improved our ability to treat migraine headaches.”
One of the keys to neuroscience’s advancements has been addressing patients for their individual needs vs. a one-size-fits-all approach. McGrath says that Bancroft has made huge advancements in the study of diversity for treatment.
“We are making strides in developing appropriate norms to understand how diversity impacts inclusivity in our research,” she says. “Neuropsychology evaluates people and looks at scores on their tests and compares that to people who are similar to them. Traditionally those tests were developed on mostly white people, or would include other races and group everyone together without understanding the subtle differences that exist. Our tests are much more complex now and allow for us to understand [varied] backgrounds. It allows us to understand things like race, gender, education and age without grouping people into one space.”
It’s diversity that allows Abrams and the team at Relievus to better understand how neurology impacts pain management and the treatment of headaches, as well as diseases like dementia. “We try to monitor individual symptoms to understand individual patients,” he says.
“Something like headaches fall into a number of subtypes, so these advancements in neurological treatments allow us to focus on the whole patient.”
“This can all sound so scary,” McGrath says. “But we’re able to use these neurological advancements to understand the path forward and recognize symptoms earlier.”
As this area of medicine continues to evolve and area providers have access to these modern tools and therapies, patient outcomes are improving and there’s real optimism that momentum will only carry forward into the future.
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Published and copyrighted in South Jersey Magazine, Volume 18, Issue 7 (July 2021)
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