Gaps Between Aims and Achievements in Therapeutic Modification of Neuronal Damage ("Neuroprotection")

Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics
Heinz WiendlStefan Schwab

Abstract

The term "neuroprotection" is often misused, overused, or misunderstood. A reasonable definition of neuroprotection refers to the preservation of "neuronal structure and/or function." Although our knowledge about the cellular and molecular mechanisms of neurodegeneration has expanded, experimental systems and animal models that mimic the process or allow translation into clinical success remain limited. This editorial discusses reasons for this gap and strategies to close it. Experimental models can only mirror certain aspects of disease mechanisms in humans. Therefore, findings in these models need to be linked with patient data to improve real-life relevance. Successful neuroprotection depends on finding the right "window of opportunity" which varies from very short (stroke) to very long (Alzheimer's disease), necessitating the need to focus on strategies for very early disease recognition. This need challenges the strategies to be chosen, trial approaches and methodologies, and the allocation of resources. Additionally, outcome measures are often not well suited to assess neuroprotection. To this end, surrogate measures, including biomarkers, are useful endpoints to demonstrate evidence of target directed therapeutic utility...Continue Reading

References

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Dec 25, 2002·Neurobiology of Aging·Heiko BraakEva Braak
Jun 17, 2010·Nature Reviews. Neurology·Orhan AktasHans-Peter Hartung
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Nov 30, 2011·Frontiers in Neurology·Stacey E Seidl, Judith A Potashkin
Jun 16, 2012·Clinical & Experimental Ophthalmology·Robert J CassonIvan Goldberg
Jan 16, 2014·Annual Review of Medicine·Shein-Chung Chow
May 30, 2014·Neurology·Fred D LublinChris H Polman
Jul 26, 2014·Stroke; a Journal of Cerebral Circulation·Ulrich Dirnagl
Nov 12, 2014·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Jesse M CedarbaumMarc K Walton
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Mar 17, 2015·Lancet Neurology·Anthony FeinsteinAlbert C Lo
Mar 17, 2015·Lancet Neurology·Daniel OntanedaJeremy Chataway

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Citations

Jul 1, 2015·Acta Neuropathologica·Bernd C Kieseier, Heinz Wiendl
Jan 24, 2017·The International Journal of Neuroscience·Hongxing ZhouSheng Tan
Jul 28, 2016·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Athanasios LourbopoulosNikolaus Plesnila
Jul 29, 2017·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Wei Yang, Wulf Paschen
Jan 1, 2019·Experimental Physiology·Justin D SprickCaroline A Rickards
Oct 13, 2017·Translational Neurodegeneration·Jeffrey Cummings
Aug 17, 2016·Alzheimer's & Dementia : Translational Research & Clinical Interventions·Jeffrey CummingsGaram Lee
Jun 6, 2021·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·Rebecca FerrisiFrancesca Gado

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