Nordic Life Science 1
I T IS HARD TO DETERMINE if the field of central
nervous system (CNS) disease treatment is entering a “new era” of definitive breakthroughs or incremental advancements. At times it seems like a Cambrian explosion of innovation, but at other times there are disappointing setbacks. On 31 January 2024, Biogen pulled its once-encouraging Alzheimer’s drug, Aduhelm, from the market. A combination of both corporate and regulatory missteps, as well as milquetoast efficacy, doomed Aduhelm to a year of bleak sales and controversy, but just a week before the market withdrawal a potential breakthrough was announced. Researchers at the School of Engineering and Applied Sciences, University of Pennsylvania, announced promising results modeling mRNA delivery across the blood brain barrier using lipid nanoparticles (Han et al., Nano Lett, 2024). Easing the ability to cross the blood brain barrier opens a possible floodgate of previously unavailable brain treatments. AI is a rapidly advancing field of study Despite the brain and the CNS system being, “The last organ system where many aspects of our understanding of the underlying biology of disease remain uncertain," as previous FDA Commissioner Scott Gottlieb once said (PharmaVoice, September 2018), the pace of understanding, treatment options, and creative approaches to CNS research is nothing short of dizzying. Benedict C. Albensi, PhD, BCMAS, CRQM, Professor and Chair of the Department of Pharmaceutical Sciences at Nova Southeastern University in Florida, whose lab focuses on mitochondrial dysfunction and sex differences in Alzheimer’s disease, sees interesting potential in several areas of CNS disease treatments. “The application of AI [artificial intelligence] to diagnostics, particularly with respect to magnetic resonance imaging [MRI], is a rapidly advancing field of study. It’s proven to be very effective for breast cancer and now we’re seeing benefits in CNS as well,” he says. Few regions are as rife with CNS disease study and new treatments as the Nordics, and this also includes applying AI. For example, the Danish Research Centre for Magnetic Resonance and the University of Oslo’s Center for Lifespan Changes in Brain and Cognition are applying AI to neuroimaging data for various purposes, such as identifying brain biomarkers for early detection of CNS diseases. Non-pharmacological approaches, such as electrical and magnetic stimulation, have also shown value in CNS. Deep brain stimulation (DBS), which works by administering direct electrical pulses to different parts of the brain, is making 78 | NORDICLIFESCIENCE.ORG Benedict C. Albensi, Professor and Chair of the Department of Pharmaceutical Sciences at Nova Southeastern University strides in the treatment of CNS diseases such as epilepsy, Parkinson's, and dystonia (a movement disorder), among many others. DBS is likely to progress more rapidly due to ongoing advancements and applications of AI, Dr. Albensi predicts. In the Nordics, Sweden’s Karolinska University Hospital, a global leader in DBS, applies innovative combinations of MRI and electrophysiological data to increase target and circuit specificity, as well as reduction of DBS side effects. Brain-Computer Interface A significant indicator of CNS disease treatment progress came on the same day as the Biogen Aduhelm announcement. Elon Musk’s Neuralink company announced that its brain-computer interface (BCI) device was implanted in its first human subject implant since FDA IND clearance in May 2023. BCI is poised to expand not only due to anticipated advancements in AI, but because it is expected to be used for another large market: gaming and entertainment. In CNS treatment, BCI has the potential to address spinal cord injuries by facilitating communication between brain signals and devices such as prosthetic limbs, wheelchairs and perhaps recover some degree of motor function itself. SCIENCE // HOT TOPIC