The brain begins to reveal secrets: “The walls began to crumble”

This one and a half kilogram machine is capable of creating the most beautiful love poem and the most brutal humanitarian massacre. How is this possible? The laboratories that are studying it say they are starting to get answers. The light begins to illuminate many shadows. Knowledge acquired over the past two decades makes us think that the line between rational and emotional is blurred. It may have been a mistake to think in terms of neurology and psychiatry, because signs that are beginning to emerge indicate that diseases such as schizophrenia and Parkinson’s disease may take root in the same or similar physical quagmire.

All this and much more was discussed by Spain’s most eminent neuroscientists at the recent International Congress of Neurosciences, held at the University of Deusto in Bilbao. EL CORREO gathered three of them to discuss the mysteries to be solved; and the state of research into Alzheimer’s, Parkinson’s, and multiple sclerosis. In medicine, as they say, the 21st century is called the century of the brain.

Multiple sclerosis is a disease that has opened the doors of the brain. The great strides made in recent decades in the study and treatment of this pathology have allowed us to begin to understand some of the mechanisms that control its functioning. “The challenge now is to understand why people suffer from this disease, which mainly affects young people, especially women,” says neuroscientist David Otagui.

The biochemist heads the neurobiology group at the Biogipuzkoa Health Research Institute. Trained at the University of the Basque Country (EHU-UPV) and specialized centers in San Francisco and New York, Otagui has focused his career on the study of multiple sclerosis, a disease that is often confused with ALS, although nothing, or very little, has to do with it attitude. In fact, his incidence of “multiplicity” is four times higher than Stephen Hawking’s and his prognosis is much better.

The disease, he explains, is the result of a failure of the immune system that attacks a fundamental component of the brain, the myelin sheath. Science gave this name to the substance that covers the “cables” (axons) through which electricity circulates and is transmitted to neurons. Understanding the cause of the pathology would allow us to repair this damage to the myelin, neuroprotect the brain, in short, restore it.

Chasing the virus

It is believed that resolving this hieroglyph will also make progress in the fight against Parkinson’s and Alzheimer’s disease. “There are several hypotheses, and the most common one suggests that the cause is an infection during adolescence caused by a virus, possibly called Epstein-Barr. But we still don’t know,” he clarifies.

Advances in recent decades have made it possible to control and delay the progression of the disease to such an extent that in most cases patients no longer find themselves in a wheelchair. On the contrary, they have begun to age, and older people are now between 65 and 70 years old.

For this reason, scientists are now looking for biomarkers in the blood that facilitate not only diagnosis, but also answers to many questions. For example, what effect do medications have on the immune system of an elderly patient? “The longer we live, the more diseases will appear,” warns David Otagi. “It’s possible,” he muses, “that new problems might even arise even if we don’t finish solving the ones we already have.” That is life.

Do you remember what happened with cancer or AIDS? For me, this is the moment when we faced Alzheimer’s disease. After a century of cold water, the door of hope opened with the advent of the first drugs against the disease. “I am convinced that in a few years it will be possible to have a menu of treatments tailored to the needs of each patient.”

These are moving words from one of Spain’s great dementia researchers. Pascual Sánchez Juan, scientific director of the Foundation for Research Centers for Neurological Diseases (CIEN), part of the Carlos III Institute of Health network. He arrived at this institution three years ago from the Valdecilla Cantabria Hospital, where he directed the cognitive impairment unit and participated in numerous national and international studies on cognitive impairment.

A recent neuroscience summit held in Bilbao sparked a debate that divided the scientific community. New Alzheimer’s drugs – one awaiting approval in the US and two in Europe – are the first to reduce the effects of two proteins that the disease accumulates in the brain, beta-amyloid and tau. As a result, they slow down its development. Promote.

Walls that are torn down

Its effectiveness is limited. But Sanchez Juan trusts them. “There are many unknowns that will only be resolved when we have more experience with the drug, but we have had nothing for 20 years,” the expert, who is also secretary of the behavior and dementia group of the Spanish Society of Neurology (SEN ). , thinks optimistically.

“This always happens with complex diseases. Most likely, these drugs will not be enough; but then they will improve and others will appear who will complement them. Laboratories, he said, are already working on “improved versions.”

To combat brain pathologies, biomarkers are needed – signals in the blood that allow them to be detected in time. Surely they exist, because everything that happens in the human body leaves its mark in the bloodstream, but they need to be detected. Perhaps when they are found, the barrier separating neurology from psychiatry will collapse forever. “It’s not that much of a difference,” he reflects. “When you analyze a patient’s brain, you find that there are signs of many, very diverse comorbidities. Character, emotions, memory, movement – everything is a product of the brain.

Parkinson’s disease is an example of how much existing knowledge about the brain has grown. “We know more and more, but we still have a way to go,” sums up neurologist Javier Ruiz Martínez, coordinator of the Biogipuzkoa neurodegenerative research group. “The day we can offer disease-modifying treatments to patients, we will be able to say we know a lot.”

Ruiz Martínez also heads the neurology department at Donostia Hospital. The research team he leads has determined that a gene once called dardarin (from the Basque word dardar, tremor) plays a critical role in the genetic causes of Parkinson’s disease.

The discovery, signed in Neuron by scientists Jordi Perez Tour, Adolfo Lopez de Munain and José Felix Marto, is not the only cause of the pathology. Other “highly varied” factors come into play, such as exposure to pesticides, lifestyle and, of course, aging. “This is a complex disease, like all diseases associated with age,” sums up Ruiz Martinez. The task he poses is even more serious. Projections show that within the next 15 or 20 years, the number of cases of the second most common neurodegenerative disease will even exceed the number of the first – Alzheimer’s disease.

Knocking on the table

Research on this movement disorder, which was identified 200 years ago by the English physician who gave it its name, has largely focused on treating symptoms. “We are in a privileged position compared to other neurodegenerative pathologies, but the ability to alleviate symptoms is nothing more than putting on a band-aid,” he compares.

Science in the face of disease is still experiencing an “exciting” moment. “We’ve spent decades analyzing in detail what happens in Parkinson’s disease. Carrying out this analysis required significant effort, which will soon bear fruit. We have such clear data about the disease that we can start working on developing specific drugs,” says the expert. “It is time for a clinical trial phase to see if everything we know can change the course of the disease,” suggests in him.

The 21st century began with brain mapping, a very ambitious international project that ultimately did not bring the desired results. Despite this, Ruiz Martinez is convinced that this will be the age of the brain. “It’s time to sit down at the table.” This day is about to come.