It is an age old question, when a system fails again and again to tackle the problems it needs to solve to move forward, is it better to continue with attempts at incremental change or should we blaze a new trail and adopt novel ideas aimed at taking the system in a new direction?
That is the overarching question faced in neurology and neuroscience today as it tries to tackle neurodegenerative diseases. For decades our attempts have fallen short, and to be frank, it seems the field has not yet taken to heart the lessons to be learned from our mistakes of the past.
But thankfully there is an upcoming conference designed specifically to address this issue titled Revision vs. Reconstruction: Linking Pathogenesis with Disease Modification.
I am particularly looking forward to it not only because it will be held in my home city of Toronto and that it has managed to attract a wide range of great minds in the field, but because it will be directly addressing many of the most important questions that lie at the heart of our attempts to develop disease modifying therapies for Parkinson’s disease.
- How do we properly conceptualize all the diseases that we have clumped under this single heading called Parkinson’s disease?
- How do we identify those at risk of developing one of these many diseases?
- How do we make sense of all the outliers that still fall under the classical definition of PD?
- How should we make sense of protein aggregates believed to be at the heart of neurodegenerative diseases?
- What can we learn from other relevant disease areas that have had some recent success such as Cancer and Cystic Fibrosis?
- What lessons can we take from failures to treat Alzheimer’s disease?
- Which current attempts represent our best hope for disease modification in specific subtypes of PD and how can we replicate that success in other subtypes?
- How viable will cell transplantation and other therapies in development targeting the dopamine system be?
- What insights can we gleam from recent genetic findings that might inform which targets we should prioritize?
- What are the most important takeaways from recent links found between PD and mitochondrial dysfunction, neuroinflammation and the microbiome?
- How can the natural world inform our attempts to identify relevant biomarkers of disease?
- How should we design and conduct clinical trials in this new era of disease modification and what endpoints should we use to measure success?
- How can we influence regulatory bodies to allow for more nimble and adaptive clinical trials?
These are some of most important questions that the field needs to answer. My only concern is that the organizers have bitten off more than they can chew by trying to address all of them at one conference. Regardless, it should be a very stimulating couple of days that have the potential to shape the future trajectory of Parkinson’s research. Hope to see you there.