Moselmani M, Al Akoum M, Haddad R, Mortada F, Atieh A, Malaeb H, et al . Evaluating Neurosurgical Interventions Versus Pharmacotherapy in Treating Alzheimer’s Disease: A Comprehensive Review. Neuroscience Updates 2024; 2 (1) :53-66
URL:
http://neuroupdates.de/article-1-113-en.html
1- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon & Neuroscience Research Center, Beirut, Lebanon
2- Medical Learning Skills Academy, Beirut, Lebanon & Department of Radiology, Saint George Hospital University Medical Center, Lebanon
3- Medical Learning Skills Academy, Beirut, Lebanon & Faculty of Medicine, Université Saint-Joseph de Beyrouth, Beirut, Lebanon
4- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon & Medical Learning Skills Academy, Beirut, Lebanon
5- Medical Learning Skills Academy, Beirut, Lebanon & Rafic Hariri School of Nursing, American University of Beirut, Lebanon
Abstract: (2209 Views)
Alzheimer’s disease is defined as a progressive neurodegenerative disorder, known to mainly affect the older human population. Its prevalence is strikingly increasing raising the social and economic burden and calling for new strategies in its treatment and research. Currently, the treatment branches into two main approaches: pharmacotherapy and neurosurgical procedures. Pharmacotherapy involves the administration of drugs that either target Ach esterases known to serve for the appearance of the hallmark accumulations or pharmacological, maybe natural or synthetic, substances that counter the damage and stress highlighted in the disease’s pathophysiology. These include: acetylcholine esterase inhibitors, nanoparticles, neurotrophic and neuroprotective factors, in addition to drugs targeting the mitochondria and the associated inflammatory circuit. Neurosurgical procedures are techniques that involve direct manipulation of the central nervous system whether through invasive or non-invasive procedures. The techniques involve neuromodulation, active electrical stimulation, permeability changes in addition to administering vectors or tissue grafts. Some of the treatment neurosurgeries include: Deep Brain Stimulation (DBS), Vagus Nerve Stimulation (VNS), transcranial magnetic stimulation (rTMS), gene therapy, stem cell therapy and optogenetics. In fact, both approaches have undergone and still undergo extensive advancement to yield the safest, most effective and affordable treatment. In this review, we aim evaluate the current best available treatment approach basing our comparative analysis on four main criteria: effectiveness, safety, quality of life and cost-effectiveness. In the course of our analysis, we comprehend that pharmacotherapy is still safer, more affordable with proven good effectiveness. Neurosurgery is also promising and has a logical successful avenue in condition more clinical and translational trials are conducted to target safety and cost-effectiveness in addition to efficiency.
Type of Study:
Review Article |
Subject:
Neurodegenerative Disease Received: 2024/09/25 | Accepted: 2024/11/10 | Published: 2024/12/1
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