ALZHEIMER PRECISION MEDICINE INITIATIVE
Precision Medicine (PM) in Neurology hypothesizes that an individual’s unique characteristics play a key role in both vulnerability to neurodegenerative diseases and in response to present and future therapies. The dramatic rate of failure (99.7%) of clinical trials investigating treatments with putative disease-modifying effects has suggested that the "magic bullet - one size fits all" model to develop and administrate drugs is probably unrealistic.
The main objectives of Precision Medicine for Alzheimer's disease are:
· to detect the individual’s susceptibility to Alzheimer’s Disease pathophysiological alterations
· to achieve an accurate early detection and diagnosis of Alzheimer’s Disease over the preclinical course
· to optimize patients’ assignment to treatments more likely to be beneficial with the lowest risk of adverse events
These objectives will only be accomplished through the investigation of Alzheimer’s Disease at the system-level,
Systems biology and systems neuroscience will enable to untangle the spatial and temporal AD-related dynamics across molecular-cellular pathways and brain large-scale network functional shifts, from resilience until systems failure and cognitive decline.
The implementation of a systems-scaled approach for the study of Alzheimer’s Disease and all other neurodegenerative disease will:
· provide earlier and more accurate measures of risk prediction, diagnosis, and prognosis (ideally in the preclinical phases)
· guide and support the development of treatments tailored to the single individual according to the biological make-up from (epi)genetic background to patterns of molecular pathways until brain endophenotype, i.e. pathway(s)-based therapies.
· redesign the current clinical landscape and taxonomy of neurodegenerative diseases
Precision Medicine will provide physicians with reliable tools to treat neurodegenerative diseases, including Alzheimer’s Disease, during preclinical stages preventing or at least delaying the conversion to dementia. Preventive strategies for Alzheimer’s Disease are expected to significantly reduce the burden on families and health care facilities.