Approximately one million people in Italy suffer from degenerative neurological diseases. The most common and known are Parkinson’s, Alzheimer’s and Amyotrophic Lateral Sclerosis (ALS).
Generally, degenerative neurological diseases occur in adulthood and at full capacity. They are characterized by the early loss of nerve cells, the neurons, in some specific areas of the nervous system. This loss may remain confined to a limited portion of the brain or spread and generalize to larger areas.
What are the symptoms?
The symptoms vary, depending on the degenerative neurological disease. For example, Parkinson‘s disease, which affects about 300,000 people in Italy alone, initially affects the areas of motor control and then, in some cases, also affects the nerves that control internal organs and cognitive function (refer to the film “Awakenings” with Robin Williams). Alzheimer‘s disease initially affects the areas of memory and then affects almost the entire cerebral cortex. Finally, ALS (sadly known among footballers) affects about 500,000 people in Italy and leads to a progressive paralysis of all muscles, with a fatal outcome within three-to-five years from the onset of symptoms.
Precision Neurology
These degenerative neurological diseases, like many others, include a multiplicity of forms. That is, two people who have been diagnosed with Parkinson’s disease may demonstrate a different form of the disease that should be matched with an appropriate therapy. Thanks to modern technology, which also includes genetic analyses and neuroradiology, it’s now possible to carry out more in-depth investigations that allow for the sub-typing of Parkinson’s and other neurodegenerative diseases. This brings us to Precision Medicine; in this case Precision Neurology, through which a personalized therapy should be developed for each patient.
What are the advantages?
These can be explained with an example. Since the symptoms of most degenerative neurological diseases are very similar, the initial clinical picture could lead to an overly generalized or even incorrect diagnosis, thus starting a therapy regimen that is not appropriate for the patient, and thus wasting very valuable time.
With modern technologies, such as genomic analysis, it is possible to identify (with certainty) the genetic components that are at the core of the pathology, and then identify and develop targeted therapies that, sometimes, are simple vitamin supplements that can slow down the progress of the disease.
What are the risks?
The only obvious risk is the excessive fragmentation of the disease which could lead to very high costs for the development of personalized therapies for each individual patient. This is a risk that I personally believe the Italian Health System should run; however, putting itself in a position to meet the costs that may arise. The question therefore is not “if it can be done” but rather “how can it be done?”.
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