More news from the 49 ° congress of neurology: headache in treatment / early diagnosis and new therapies against mental decay

(by Nicola Simonetti) Headache. It is estimated that at least 26 million people suffer from headache in Italy, that is almost one in two people. A widespread problem, therefore, that does not spare anyone, including children and that the WHO considers one of the worst diseases in terms of disability experienced by the young adult patient and is positioned at the 3 place among all; the challenge of the future will be to overcome this discomfort and overcome this record. We are on the right path.

“Thanks to the introduction of new specific biotherapies we are about to witness .. says prof. Fabio Frediani, Director of UOC Neurology and Stroke Unit, “San Carlo Borromeo” Hospital in Milan - at a significant turning point for migraine patients. The new drugs are specific antibodies that block the activity of CGRP, a protein responsible for the explosion of the migraine attack, with a cost / benefit ratio that has no equal in the Italian panorama: they are characterized by considerable efficacy in the face of a excellent tolerability, with fewer side effects than placebo. Furthermore, the method of administration is completely new: only one injection per month for three months with a strong impact on improving adherence to therapy.

There are all the prerequisites for a second significant change for migraine patients. After the era of triptans, molecules designed and developed following the discovery of the trigeminovascular system as the central nucleus of the pathogenic moment, even these drugs - continues Frediani - have a specific target, which accounts for the remarkable effectiveness seen in the experimental phase. Above all, they promise a new way of treating the migraine patient. Today, migraine sufferers no longer think it possible to propose a drug "borrowed" from other diseases. For years the therapeutic offer has abandoned the old drugs, now obsolete and poorly tolerated for too many side effects, to turn to new strategies. A clear example is the various neurostimulation techniques or the use of botulinum toxin for chronic forms, or the search for new supplements that privilege the "do no harm" to "do good". Today, finally, even in the pharmacological field we are witnessing a real revolution, and not just for the characteristics of the molecule. Even the methods of administration are completely new: one injection per month for three months, which unquestionably favors a better adherence to therapy, a basic condition for the result of the treatment itself and to encourage the patient never to give up.

News, today, are the evaluation methods (we no longer refer to the sterile count of days with or without pain) that have made us recover a holistic vision at the center of which is the quality of life and the functional capacity of the individual, but also to the same treatments, enriched with training and educational aspects and behavioral indications capable of modifying diets and lifestyles. That is, the patient, the main protagonist of his own life, to whom he, with the adoption of new rules and innovative therapies: a significant change, a real transformation of the disease. The future challenge - assures Frediani - will be to overcome this discomfort, bringing down the migraine from this sad podium.

Women. According to the Gema study (Gender & Migraine) of the Research Center on Health and Social Care Management (Cergas) presented, on October 30, in Rome, two out of three migraine sufferers are women and the condition affects their working life and socially more heavily than that of men.

Italian women suffering from migraines are four million compared to two million men). They lose more days of work (16,8 the year against the 13,6 of the males) and days of social life (26,4 against 20) and are more subject to the phenomenon of presentism, or to days when they present themselves at work in uneasiness ( 51,6 days against 35,6). Because of a lower income than the males, however, they spend less for diagnosis and treatment (1.132 euro a year against 1.824) and report a loss of lower profitability.

The annual cost of migraine is, for each woman, 4.352 euro in addition to 464 euro spent to buy drugs not supported by the NHS.

In particular, for health services, 1,100 euro; loss of productivity 1.524 (25%), for formal assistance 236 (5%), informal 1.492 (34%).

DEMENZA - Menacing horoscope: the number of people diagnosed with dementia, within 2050, will triple, going from the current 46,8 million to 131,5 million and every year, 9,9 million new cases will be 1 each 3 seconds. These are the data - said the prof. Carlo Ferrarese of the University of Milan-Bicocca, at the 49 ° National Congress of the Italian Society of Neurology - of the Global Impact of Dementia.

A reassuring sign is that, by acting in the initial stages of memory decline ("mild cognitive decline or Mild Cognitive Learning"), some drugs, proven effective in blocking the biological mechanisms of the disease could slow down the progression to overt dementia, because they are .

Today, diagnostic techniques such as Positron Emission Tomography (PET) allow to establish, with the administration of a tracer that binds the beta amyloid protein (it destroys the neurons and begins to accumulate in the brain even decades before the first signs of dementia) - specifies Ferrarese - a risk of developing Alzheimer's disease before the onset of severe cognitive deficits and make it therefore feasible to launch preventative therapeutic strategies. The latter are based on molecules that determine a reduction in the production of beta-amyloid, whose accumulation causes the disease, with drugs that block the enzymes that produce it (beta-secretase) or, alternatively, with antibodies capable of even determining the progressive disappearance of beta-amyloid already present in the brain tissue. These antibodies, produced in the laboratory and administered subcutaneously or intravenously, are able to penetrate the brain and remove the protein before the dangerous accumulation.

More news from the 49 ° congress of neurology: headache in treatment / early diagnosis and new therapies against mental decay

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