open access
Advancing gene therapies, methods, and technologies for Parkinson’s Disease and other neurological disorders
- Brain Neurotherapy Bio, Inc., 5815 Balmoral Dr, 94619 Oakland, United States
- Department of Neurological Surgery, The Ohio State University Wexner Medical Center, N1047 Doan Hall, 410 W. 10th Ave., 43210 Columbus, United States
- Interventional Neuro Center (INC), Bródno Mazovian Hospital, Kondratowicza 8 Street, 03-242 Warsaw, Poland
open access
Abstract
Introduction. Vector-based intracerebral gene therapies are being used to treat specific neurodegenerative conditions such as Parkinson’s Disease (PD). This review presents a basis for central nervous system (CNS) gene therapy treatments of neurodegenerative diseases such as PD, as well as the need for novel skill sets and health delivery strategies within the clinical neurosciences (neurology and neurosurgery) to meet future demand for such therapies.
State of the art. Preclinical vector-based gene therapy approaches have been translated into clinical trials for PD and other neurodegenerative conditions. Unfortunately, such trials, and parallel efforts using other therapeutics, have yet to provide a breakthrough. Image-guided convection enhanced delivery (CED) optimises the parenchymal distribution of gene therapies applied within the CNS, and may ultimately provide such a breakthrough.
Clinical implications. Currently, image-guided CED and gene therapy are not part of training programmes for most neurosurgeons and neurologists. As a result, few medical centres and hospitals have sufficiently experienced teams to participate in gene transfer clinical trials for PD or other neurological conditions. If CNS gene therapies prove to be efficacious for PD and/or other conditions, the demand for such treatments will overwhelm the available number of experienced clinical neuroscience teams and treatment centres.
Future directions. Expanded indications and demand for CNS gene therapies will require a worldwide educational effort to supplement the training of clinical neuroscience practitioners. Initially, a limited number of Centres of Excellence will need to establish relevant educational training requirements and best practice for such therapeutic approaches. Advanced technologies, including robotics and artificial intelligence, are especially germane in this regard, and will expand the treatment team’s capabilities while assisting in the safe and timely care of those afflicted.
Abstract
Introduction. Vector-based intracerebral gene therapies are being used to treat specific neurodegenerative conditions such as Parkinson’s Disease (PD). This review presents a basis for central nervous system (CNS) gene therapy treatments of neurodegenerative diseases such as PD, as well as the need for novel skill sets and health delivery strategies within the clinical neurosciences (neurology and neurosurgery) to meet future demand for such therapies.
State of the art. Preclinical vector-based gene therapy approaches have been translated into clinical trials for PD and other neurodegenerative conditions. Unfortunately, such trials, and parallel efforts using other therapeutics, have yet to provide a breakthrough. Image-guided convection enhanced delivery (CED) optimises the parenchymal distribution of gene therapies applied within the CNS, and may ultimately provide such a breakthrough.
Clinical implications. Currently, image-guided CED and gene therapy are not part of training programmes for most neurosurgeons and neurologists. As a result, few medical centres and hospitals have sufficiently experienced teams to participate in gene transfer clinical trials for PD or other neurological conditions. If CNS gene therapies prove to be efficacious for PD and/or other conditions, the demand for such treatments will overwhelm the available number of experienced clinical neuroscience teams and treatment centres.
Future directions. Expanded indications and demand for CNS gene therapies will require a worldwide educational effort to supplement the training of clinical neuroscience practitioners. Initially, a limited number of Centres of Excellence will need to establish relevant educational training requirements and best practice for such therapeutic approaches. Advanced technologies, including robotics and artificial intelligence, are especially germane in this regard, and will expand the treatment team’s capabilities while assisting in the safe and timely care of those afflicted.
Keywords
gene therapy, convection-enhanced delivery, Parkinson’s Disease, clinical neuroscience education, robotics, artificial intelligence
Title
Advancing gene therapies, methods, and technologies for Parkinson’s Disease and other neurological disorders
Journal
Neurologia i Neurochirurgia Polska
Issue
Article type
Invited Review Article
Pages
220-231
Published online
2020-06-18
Page views
2034
Article views/downloads
1971
DOI
Pubmed
Bibliographic record
Neurol Neurochir Pol 2020;54(3):220-231.
Keywords
gene therapy
convection-enhanced delivery
Parkinson’s Disease
clinical neuroscience education
robotics
artificial intelligence
Authors
Massimo S. Fiandaca
Russell R. Lonser
J. Bradley Elder
Mirosław Ząbek
Krystof S. Bankiewicz