Central nervous system (CNS) disorders such as Parkinson’s disease, Alzheimer’s disease, mood disorders, and schizophrenia, are some of the leading causes of disability and death worldwide. Development of therapies for these conditions has lagged mainly because of the lack of understanding of the underlying neurobiology, the complexity of phenotypes, behavior, and symptoms, and a lack of clear biomarkers. Diagnosis and treatment of these disorders are hectic and require constant monitoring.
The past few years have witnessed a staggering increase in the use of digital technologies such as smartphones, wearables, and social media data to help alleviate suffering from these CNS disorders. Digital technologies can help enable patient-centric drug development through electronic data transmission from patients at home or remote locations and by capturing clinically meaningful measurements continuously in real-life situations.
Current digital technologies to treat neurological disorders
Neurological conditions like Parkinson’s and multiple sclerosis (MS) manifest itself through various physical, emotional and mental health issues, all of which affects the quality of life. For such disorders, the opportunities to use technology beneficially are numerous.
Australian-produced Parkinson’s Kinetigraph tracks the movement and gait of people with Parkinson’s through a wrist device. The wrist devices record the movements of the patients. The data can be examined by their respective healthcare professional to track the progression of the disorder, or monitor how the patients respond to changes in medication.
The app EpSMon helps people with epilepsy to monitor their health and keep track of their level of risk from seizures. Sudden Unexpected Death in Epilepsy (SUDEP) is associated with certain risk factors such as routinely getting poor sleep or being exposed to personally known seizure triggers. The app helps people check their own epilepsy against these risks, prompting them to visit a healthcare practitioner if certain risks seem high.
Assistive technologies in and around the home have also advanced to cater more to the needs of the patient. Motion sensors by the front door might prompt people suffering from dementia to lock it whilst a system of placing picture ‘tiles’ on key items around the home like keys or medication can be linked to a smartphone app. The individual can check their app to see where the phone last ‘saw’ the tile, helping the individual locate the item easily.
Communication aids are another tool which have become far more versatile with the improvement of technology. The app ‘Talking mats’ helps children and adults alike with communication difficulties. It enables them to express their views about leisure activities – not just opening up a discussion but likely prompting more activities to be considered or taken up.
Smart Brain Prosthetics usually consists of implantable wireless brain devices that are being tested as a means of relieving depression, post-traumatic stress disorder, bipolar disorder and traumatic brain injury, and restoring movement in those with severe physical limitations. These devices represent a trend towards neural engineering, which seeks to manipulate brain signals in order to treat neurological diseases and impairments.
Techniques to help aid neurological diagnosis:
Apart from digital technologies, other techniques are also underway that have the potential to detect and treat Alzheimer’s long before symptoms manifest. These techniques include “Alzheimer’s-in-a-Dish,”which features colonies of genetically manipulated human brain cells that grow in a specialized gel. Once added to the medium, the cells begin to display the two most salient hallmarks of Alzheimer’s disease: plaques and tangles.
Experimental drugs to reduce amyloid in the brain, and blood tests to determine the biomarkers for Alzheimer’s disease are also being explored. Several institutions are developing gene therapy applications to replace or “turn off” disease-causing genes in CNS disorders. Researchers are also studying the 3.3 million genes of the microbiome to identify links between gut microflora and neurological disorders. Research initiatives such as the Human Brain Project and Brain Initiative promise to yield valuable insights into the cause and progression of these diseases, as well as new opportunities for treatment.
Non-pharmaceutical, minimally invasive treatments ranging from pulses of electricity to light are being developed for the treatment of a wide range of neurological and psychiatric diseases. Electroceuticals, low-powered electrical devices placed on the skin or implanted, could be used to treat diseases ranging from depression and mood disorders to Parkinson’s disease, while low-current transcranial (through the skull) direct-current stimulation (tDCS) could be used to address chronic pain, depression and schizophrenia.
Digital technologies hold tremendous promise for helping to improve clinical care for individuals affected by CNS disorders. These technologies can also help to better understand the science and etiology behind CNS disorders, and thus accelerate therapeutic development.
Author: Parvathi Nair