Moving Beyond Palliative Care
Neurodegenerative diseases are an increasingly significant public health challenge.
8.1 million people in the United States live with neurodegenerative disease, including 6.9 million with Alzheimer’s dementia, and 1 million people with Parkinson’s disease.
Because these diseases are strongly associated with aging, their prevalence is expected to rise substantially.
Americans with Alzheimer’s dementia are projected to reach 13 million by 2050 without major therapeutic advances.
70 million people worldwide live with neurodegenerative disease, with 60–70% of those cases attributed to Alzheimer’s disease.
The worldwide economic burden of Alzheimer’s disease and related dementias was $2.8 trillion in 2019 and is projected to grow to roughly $4.7 trillion by 2030.
Clinical treatment of neurodegenerative diseases has not kept pace with advances in basic and translational research. This is largely because therapeutic development has remained predominantly brain-centric.
Pharmaceutical strategies have traditionally emphasized reductionist approaches aimed at discrete molecular targets such as receptors, enzymes, or ion channels to achieve specific pharmacodynamic effects.
Improvements in clinical outcomes will require broader integration of contemporary research showing that neurodegenerative conditions involve complex, multisystem dysregulation and often include a prolonged preclinical or asymptomatic phase.
Until such integrative approaches are translated into effective interventions, a diagnosis of a neurodegenerative disorder will continue to signal a progressive, ultimately fatal condition for which current therapies remain largely palliative.
A New Strategy
Modeling the Brain as a Biomechanical System
Contemporary research including the 2012 discovery of the glymphatic system has provided a new framework to understand brain health.
The human brain can be modeled as a self-regulating, biomechanical system analogous to a graphics processing unit (GPU). In this framework, the brain functions as the central processing architecture, while the vascular system provides the essential power supply, delivering oxygen and glucose required for sustained neuronal metabolism. The glymphatic system operates as the thermal regulation and waste-clearance network, maintaining ionic balance and preventing the accumulation of neurotoxic metabolites.
When vascular perfusion is compromised, neuronal energy metabolism declines, leading to reduced synaptic efficiency and impaired cognitive output. Likewise, dysfunction of the glymphatic system diminishes metabolic clearance, resulting in neuroinflammation and cellular stress which is comparable to thermal overload in an electronic processor.
Collectively, these failures reduce the brain’s computational throughput, manifesting as cognitive impairment and disrupted neuronal signaling or innervation. These symptoms are the hallmarks of neurodegeneration.
Conversely, when the biomechanical system functions properly, the brain maintains homeostasis.
Homeostatic Brain Health
Dysregulation of the brain’s biomechanical system is a complex, multifactorial pathogenesis. Homeostatic modification and optimization necessitates an integrative therapeutic paradigm. Effective interventions require coordinated modulation across molecular, cellular, and musculoskeletal (MSK) levels.
5 Pillars of Neurodegeneration Centered on Pathophysiological Dysfunction
This framework identifies five core, interconnected pathophysiological pillars through which homeostatic dysfunction contributes to neurodegenerative pathogenesis.
It integrates anatomical, mechanical, vascular, immune, and metabolic consequences.
Clinical Relevance
The 5 Pillar framework is a mechanistic model for:
- Understanding idiopathic or atypical neurodegeneration with brainstem features
- Evaluating chronic subclinical musculoskeletal dysfunction in early-stage neurodegeneration
- Informing therapeutic strategies targeting alignment, drainage, and inflammation
CerebroLab
A Multimodal Process
Achieving homeostatic brain health will depend on coordinated efforts in neurology, vascular biology, immunology, endocrinology, orthopedics, and regenerative medicine.
CerebroLab is an AI-driven platform that aggregates, curates, and analyzes peer-reviewed research and clinical evidence across neurology, vascular biology, immunology, endocrinology, orthopedics, and regenerative medicine. The platform is designed to facilitate integrative analysis across these domains within the 5 Pillar framework, which is not routinely incorporated into conventional diagnostic or clinical care models.
Aggregation of this research will stimulate progress in diagnostics and therapeutics while offering personalized education and information for homeostatic brain health and complex neurodegenerative symptoms.
CerebroLab collects anonymized diagnostic data from its user base to build a rich data set for researchers.
A real time feedback loop between patients, researchers and clinicians creates an ecosystem where innovation can accelerate.