Improving and Accelerating Therapeutic Development for Nervous System Disorders


Book Description

Improving and Accelerating Therapeutic Development for Nervous System Disorders is the summary of a workshop convened by the IOM Forum on Neuroscience and Nervous System Disorders to examine opportunities to accelerate early phases of drug development for nervous system drug discovery. Workshop participants discussed challenges in neuroscience research for enabling faster entry of potential treatments into first-in-human trials, explored how new and emerging tools and technologies may improve the efficiency of research, and considered mechanisms to facilitate a more effective and efficient development pipeline. There are several challenges to the current drug development pipeline for nervous system disorders. The fundamental etiology and pathophysiology of many nervous system disorders are unknown and the brain is inaccessible to study, making it difficult to develop accurate models. Patient heterogeneity is high, disease pathology can occur years to decades before becoming clinically apparent, and diagnostic and treatment biomarkers are lacking. In addition, the lack of validated targets, limitations related to the predictive validity of animal models - the extent to which the model predicts clinical efficacy - and regulatory barriers can also impede translation and drug development for nervous system disorders. Improving and Accelerating Therapeutic Development for Nervous System Disorders identifies avenues for moving directly from cellular models to human trials, minimizing the need for animal models to test efficacy, and discusses the potential benefits and risks of such an approach. This report is a timely discussion of opportunities to improve early drug development with a focus toward preclinical trials.




Disease Control Priorities, Third Edition (Volume 4)


Book Description

Mental, neurological, and substance use disorders are common, highly disabling, and associated with significant premature mortality. The impact of these disorders on the social and economic well-being of individuals, families, and societies is large, growing, and underestimated. Despite this burden, these disorders have been systematically neglected, particularly in low- and middle-income countries, with pitifully small contributions to scaling up cost-effective prevention and treatment strategies. Systematically compiling the substantial existing knowledge to address this inequity is the central goal of this volume. This evidence-base can help policy makers in resource-constrained settings as they prioritize programs and interventions to address these disorders.




Disease and Mortality in Sub-Saharan Africa


Book Description

Current data and trends in morbidity and mortality for the sub-Saharan Region as presented in this new edition reflect the heavy toll that HIV/AIDS has had on health indicators, leading to either a stalling or reversal of the gains made, not just for communicable disorders, but for cancers, as well as mental and neurological disorders.




Neurological Disorders


Book Description

This single-volume reference covers the natural course, treatment, and management of all neurological diseases affecting the brain, spinal cord nerves and muscles. This comprehensive text reference seeks to assist physicians with treatment by providing an easy-to-use compendium covering the treatment and management of all neurological diseases along with details on the natural course of these diseases. Organized for ease of use and quick reference, each chapter presents a neurological disorder or key symptoms and systematically discusses the clinical syndrome and differential diagnosis, natural course, principles of therapy, and practical management of each. Covers wide range of neurological conditions and potential treatments, including the evidence for and against each treatment Describes the spontaneous course of neurological diseases along with discussion of the management of different stages and variants of a disorder Presents special situations and exceptional cases in which alternative therapies should be considered




Improving the Utility and Translation of Animal Models for Nervous System Disorders


Book Description

Nervous system diseases and disorders are highly prevalent and substantially contribute to the overall disease burden. Despite significant information provided by the use of animal models in the understanding of the biology of nervous system disorders and the development of therapeutics; limitations have also been identified. Treatment options that are high in efficacy and low in side effects are still lacking for many diseases and, in some cases are nonexistent. A particular problem in drug development is the high rate of attrition in Phase II and III clinical trials. Why do many therapeutics show promise in preclinical animal models but then fail to elicit predicted effects when tested in humans? On March 28 and 29, 2012, the Institute of Medicine Forum on Neuroscience and Nervous System Disorders convened the workshop "Improving Translation of Animal Models for Nervous System Disorders" to discuss potential opportunities for maximizing the translation of new therapies from animal models to clinical practice. The primary focus of the workshop was to examine mechanisms for increasing the efficiency of translational neuroscience research through discussions about how and when to use animal models most effectively and then best approaches for the interpretation of the data collected. Specifically, the workshop objectives were to: discuss key issues that contribute to poor translation of animal models in nervous system disorders, examine case studies that highlight successes and failures in the development and application of animal models, consider strategies to increase the scientific rigor of preclinical efficacy testing, explore the benefits and challenges to developing standardized animal and behavioral models. Improving the Utility and Translation of Animal Models for Nervous System Disorders: Workshop Summary also identifies methods to facilitate development of corresponding animal and clinical endpoints, indentifies methods that would maximize bidirectional translation between basic and clinical research and determines the next steps that will be critical for improvement of the development and testing of animal models of disorders of the nervous system.




Neuronal Networks in Brain Function, CNS Disorders, and Therapeutics


Book Description

Neuronal Networks in Brain Function, CNS Disorders, and Therapeutics, edited by two leaders in the field, offers a current and complete review of what we know about neural networks. How the brain accomplishes many of its more complex tasks can only be understood via study of neuronal network control and network interactions. Large networks can undergo major functional changes, resulting in substantially different brain function and affecting everything from learning to the potential for epilepsy. With chapters authored by experts in each topic, this book advances the understanding of: - How the brain carries out important tasks via networks - How these networks interact in normal brain function - Major mechanisms that control network function - The interaction of the normal networks to produce more complex behaviors - How brain disorders can result from abnormal interactions - How therapy of disorders can be advanced through this network approach This book will benefit neuroscience researchers and graduate students with an interest in networks, as well as clinicians in neuroscience, pharmacology, and psychiatry dealing with neurobiological disorders. - Utilizes perspectives and tools from various neuroscience subdisciplines (cellular, systems, physiologic), making the volume broadly relevant - Chapters explore normal network function and control mechanisms, with an eye to improving therapies for brain disorders - Reflects predominant disciplinary shift from an anatomical to a functional perspective of the brain - Edited work with chapters authored by leaders in the field around the globe – the broadest, most expert coverage available




Modern CNS Drug Discovery


Book Description

This textbook provides a comprehensive overview of the currently used concepts, approaches and technologies in the discovery and development of new treatments for the full spectrum of disorders of the central nervous system. It guides the reader through all essential steps, from finding an innovative idea, to the registration of a new drug. Divided into four sections, the book starts by presenting a broad perspective on current approaches in central nervous system (CNS) drug discovery. The second section addresses the generation of ideas for the identification of targets and novel treatment strategies; covers core functions in early discovery, and provides an example of a novel treatment paradigm: brain stimulation. The third section highlights strategies and technologies in translational CNS drug discovery. In an effort to bridge the gap between discovery and clinical development, it also covers brain imaging, EEG and cognitive testing approaches. The fourth section extensively discusses the clinical phase of drug development, covering the basics of early clinical testing for psychopharmacological drugs. The book’s final chapter addresses the registration for newly developed drugs. Written by experts from academia and industry, the book covers important basics and best practices, as well as recent developments in drug discovery. Offering in-depth insights into the world of drug development, it represents essential reading for early researchers who want to prepare for a career in drug discovery in academia or industry.




Diseases of the Nervous System


Book Description

The study of the brain continues to expand at a rapid pace providing fascinating insights into the basic mechanisms underlying nervous system illnesses. New tools, ranging from genome sequencing to non-invasive imaging, and research fueled by public and private investment in biomedical research has been transformative in our understanding of nervous system diseases and has led to an explosion of published primary research articles. Diseases of the Nervous System, Second Edition, summarizes the current state of basic and clinical knowledge for the most common neurological and neuropsychiatric conditions. In a systematic progression, each chapter covers either a single disease or a group of related disorders ranging from static insults to primary and secondary progressive neurodegenerative diseases, neurodevelopmental illnesses, illnesses resulting from nervous system infection and neuropsychiatric conditions. Chapters follow a common format and are stand-alone units, each covering disease history, clinical presentation, disease mechanisms and treatment protocols. Dr. Sontheimer also includes two chapters which discuss common concepts shared among the disorders and how new findings are being translated from the bench to the bedside. In a final chapter, he explains the most commonly used neuroscience jargon. The chapters address controversial issues in current day neuroscience research including translational research, drug discovery, ethical issues, and the promises of personalized medicine. This new edition features new chapters on Pain and Addiction to highlight the growing opioid crisis and the ethical issue of prescriptions drug abuse. This book provides an introduction for course adoption and an introductory tutorial for students, scholars, researchers and medical professionals interested in learning the state of the art concerning our understanding and treatment of diseases of the nervous system. Each chapter includes suggested further readings and/or journal club recommendations. - 2016 PROSE Award winner of the Best Textbook Award in Biological and Life Sciences - Provides a focused tutorial introduction to the core diseases of the nervous system - Includes comprehensive introductions to Stroke, Epilepsy, Alzheimer's Disease, Parkinson's Disease, Huntington's Disease, ALS, Head and Spinal Cord Trauma, Multiple Sclerosis, Brain Tumors, Depression, Schizophrenia and many other diseases of the nervous system - Covers more than 40 diseases from the foundational science to the best treatment protocols - Includes discussions of translational research, drug discovery, personalized medicine, ethics, and neuroscience - New Edition features two new chapters on Pain and Addiction




The Modern Treatment of Nervous and Mental Diseases


Book Description

This volume, devoted to the treatment of nervous and mental diseases, is designed to meet the needs which the rapid advances in knowledge of neurology and psychiatry have created. The nervous system is here regarded as a whole and as inclusive of the mind, and it is maintained that disturbances of any and all of its functions, mental as well as physical, are proper subjects for therapeutics. The present work lays emphasis upon the psychical side of life as being worth quite as much consideration as the physical. It sets forth doctrines of nervous and mental hygiene, reconstructive factors in social organization as applied to human ills, and endeavors to present a broad front to the pessimistic nihilism in therapeutics that has been too long current in these fields, because the doctor's eyes have been too closely focused on the individual examples and results of human accidents. Neurology and psychiatry offer the widest possible opportunities for preventive medicine as well as for therapeutic optimism. The program here presented is essentially therapeutic. Planned as it has been on a broad scale, the more practical issues confronting the clinician have, nevertheless, been fully met. The editors have sacrificed philosophical views for more definite guideposts wherever, in the present state of our knowledge, such a course seemed wiser. (PsycINFO Database Record (c) 2005 APA, all rights reserved).




Functional Neurologic Disorders


Book Description

Functional Neurologic Disorders, the latest volume in the Handbook of Clinical Neurology series, summarizes state-of-the-art research findings and clinical practice on this class of disorders at the interface between neurology and psychiatry. This 51-chapter volume offers an historical introduction, chapters on epidemiology and pathophysiolology, a large section on the clinical features of different type of functional neurologic symptoms and disorders (including functional movement disorders, non-epileptic seizures, dizziness, vision, hearing, speech and cognitive symptoms), and then concluding with approaches to therapy. This group of internationally acclaimed experts in neurology, psychiatry, and neuroscience represent a broad spectrum of areas of expertise, chosen for their ability to write clearly and concisely with an eye toward a clinical audience. This HCN volume sets a new landmark standard for a comprehensive, multi-authored work dealing with functional neurologic disorders (also described as psychogenic, dissociative or conversion disorders). - Offers a comprehensive interdisciplinary approach for the care of patients with functional disorders seen in neurologic practice, leading to more efficient prevention, management, and treatment - Provides a synthesis of research efforts incorporating clinical, brain imaging and neurophysiological studies - Fills an existing gap between traditional neurology and traditional psychiatry - Contents include coverage of history, epidemiology, clinical presentations, and therapy - Edited work with chapters authored by leaders in the field, the broadest, most expert coverage available