Neurological Treatments: Current Approaches and Emerging Innovations

Francesco Carla^*

Clinical-Based Human Research Department, College of Osteopathic Medicine, United States

*Corresponding Author: Francesco Carla, Clinical-Based Human Research Department, College of Osteopathic Medicine, United States, E-mail: Francesco_cl@gmail.com

Abstract

Neurological disorders are among the leading causes of disability and death globally, encompassing conditions such as stroke, epilepsy, Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, and migraine. The field of neurological treatments is dynamic, integrating pharmacological, surgical, rehabilitative, and neuromodulatory strategies. This article provides an overview of key neurological disorders and their treatments, emphasizing the mechanisms, effectiveness, and limitations of current therapies. It also highlights recent advances such as gene therapy, neurostimulation, stem cell treatment, and artificial intelligence (AI) in diagnostics and personalized medicine. Despite notable progress, challenges such as accessibility, treatment resistance, and ethical concerns persist. Ongoing research and technological integration continue to reshape the future of neurology toward more precise, effective, and patient-centered care.

Keywords: Neurology; Neurological treatments; Neurodegenerative disease; Brain disorders; Neuromodulation; Gene therapy; Stroke; Epilepsy; Parkinson’s; Alzheimer's

Introduction

Neurological diseases affect hundreds of millions of people worldwide, posing a substantial burden on healthcare systems and societies. These disorders impact the central and peripheral nervous systems and often result in chronic disability, cognitive decline, and diminished quality of life [1]. Common conditions include stroke, epilepsy, Parkinson’s disease, multiple sclerosis (MS), migraine, and dementias such as Alzheimer’s disease.

Historically, the treatment of neurological disorders was limited by incomplete understanding of brain function. However, advances in neuroimaging, molecular biology, and neurotechnology have revolutionized the field, allowing for early diagnosis and targeted interventions. This article examines various modalities used in treating neurological conditions, recent innovations, and the challenges that remain.

Pharmacological Therapies

Antiepileptic Drugs (AEDs)

AEDs such as valproic acid, carbamazepine, and levetiracetam are used to control seizures by stabilizing neuronal activity. Newer drugs like lamotrigine and topiramate offer better tolerability, though approximately 30% of patients remain drug-resistant.

Dopaminergic Therapies for Parkinson’s Disease

Parkinson’s disease (PD) is primarily treated with levodopa, which replenishes dopamine levels. Adjunctive therapies include dopamine agonists, MAO-B inhibitors, and COMT inhibitors. Long-term use may lead to motor complications like dyskinesias [2].

Cholinesterase Inhibitors in Alzheimer’s Disease

Drugs like donepezil, rivastigmine, and galantamine temporarily improve symptoms in Alzheimer’s by increasing acetylcholine levels. However, they do not halt disease progression.

Immunomodulatory Agents in Multiple Sclerosis

MS treatment involves immunosuppressants and immunomodulators like interferon-beta, glatiramer acetate, natalizumab, and fingolimod. These agents reduce relapse rates and delay disability progression.

Surgical and Interventional Treatments

Deep Brain Stimulation (DBS)

DBS is used in Parkinson’s disease, essential tremor, and dystonia. Electrodes implanted in brain regions (e.g., subthalamic nucleus) deliver electrical pulses that modulate neural circuits, improving motor symptoms.

Surgical Resection for Epilepsy

In drug-resistant epilepsy, resective surgery removes the seizure focus, often in the temporal lobe. Success rates vary but can offer seizure freedom in up to 70% of cases [3].

Mechanical Thrombectomy for Stroke

Ischemic strokes caused by large vessel occlusions can be treated via endovascular thrombectomy. When combined with thrombolytics (e.g., tPA), it significantly improves outcomes if performed within a defined time window.

Vagus Nerve Stimulation (VNS)

Used in refractory epilepsy and depression, VNS involves electrical stimulation of the vagus nerve to regulate brain activity. While not curative, it can reduce seizure frequency and improve mood.

Rehabilitative and Supportive Therapies

Neurorehabilitation

Stroke and traumatic brain injury patients benefit from physical therapy, occupational therapy, and speech-language therapy. Neuroplasticity—the brain’s ability to reorganize—underpins recovery.

Cognitive Rehabilitation

In Alzheimer’s and post-stroke cognitive impairment, structured tasks and memory exercises can support functional independence [4].

Psychological and Social Support

Mood disorders are common in neurological illness. Psychotherapy, counseling, and social services are essential in holistic care.

Emerging Therapies and Innovations

Gene Therapy

Gene therapy introduces, modifies, or silences genes to treat diseases:

SMA (spinal muscular atrophy): Zolgensma (onasemnogeneabeparvovec) delivers functional SMN1 gene.

Investigational therapies target Parkinson’s, ALS, and Huntington’s disease.

Stem Cell Therapy

Stem cells aim to replace damaged neurons or support repair. Clinical trials are underway for stroke, MS, and PD, though long-term efficacy and safety remain under study.

Targeted Monoclonal Antibodies

Alzheimer’s disease: Anti-amyloid antibodies like aducanumab and lecanemab show potential in reducing amyloid plaques [5], though with controversy regarding clinical benefit.

Migraine: CGRP antagonists (e.g., erenumab) have transformed prophylactic treatment.

Neurostimulation and Closed-Loop Systems

Newer devices integrate real-time feedback to optimize stimulation. Responsive neurostimulation (RNS) is used in epilepsy, adjusting output based on detected activity.

Artificial Intelligence and Precision Medicine

AI enhances early diagnosis, image interpretation, and treatment personalization. Precision medicine tailors therapies to genetic and molecular profiles, increasing efficacy and minimizing side effects.

Challenges in Neurological Treatment

Access and Cost

Advanced treatments like gene therapy and DBS are expensive and not widely available, especially in low-income regions.

Treatment Resistance

Many patients do not respond adequately to existing therapies, underscoring the need for new drugs and individualized approaches.

Side Effects and Complications

Neurological drugs often have CNS-related side effects: sedation, dizziness, cognitive impairment, or motor fluctuations.

Ethical and Regulatory Issues

Gene editing and neuroenhancement raise ethical questions regarding consent, long-term consequences, and equity.

The Future of Neurological Treatment

The future lies in neurotechnology, genomic medicine, and early intervention. Promising areas include:

Brain-computer interfaces (BCIs) for communication and control in paralysis.

Biomarkers for early detection of neurodegenerative diseases.

Combination therapies that target multiple disease mechanisms.

Interdisciplinary collaboration among neuroscientists, engineers, clinicians, and ethicists will be key to translating innovation into effective care.

Conclusion

Neurological treatments have evolved remarkably, offering hope and improved quality of life for millions. From classic pharmacological agents to cutting-edge gene therapy and AI-driven diagnostics, the landscape of neurology is dynamic and promising. Nevertheless, persistent challenges like access disparities, resistance to treatment, and ethical dilemmas must be addressed through research, policy, and education. With ongoing innovation and a patient-centered approach, the future of neurology holds immense potential to transform lives.

Refernces

1. World Health Organization (WHO) (2006)Neurological disorders: public health challenges.

2. Stovner LJ, (2018) Global burden of neurological disorders: The Global Burden of Disease Study 2016. The Lancet Neurology 17: 877–897.

3. Kalia LV, Lang AE (2015) Parkinson's disease. The Lancet 386: 896–912.

4. Fitzsimons CP (2020) Gene therapy for neurological disorders: progress and prospects. Nature Reviews Neurology, 16: 509–525.

5. Beniczky S (2022) Artificial intelligence and machine learning in epilepsy: A scoping review. Epilepsia 63: 6–17.