About this Research Topic

Background

Multimorbidity is oftendefined as the coexistence of two or more medical conditions in a single individual, and may include either transient or long-term physical, infectious, and mental diseases. It affects at least 50 million people in the European Union and large numbers in low- and middle-income countries. Common disease clusters may be related with age, ethnicity, income and sex, and data on coexisting medical conditions are often difficult to interpret. A barrier to the development of effective treatment for multimorbidities is that clinical trials usually aim at isolated nosological entities, and often exclude patients with multiple conditions. Interactions between medications make clinical guidelines designed for single disease potentially harmful for patients with multiple diseases. Systemic multimorbidity is highly prevalent in older people, and a growing concern due to the progressive increase in human longevity. The current proposal is aimed at Multimorbidity in the context of Neurodegenerative Disorders, a particular subject that combines the general aspects above with the difficulties in dealing with many neurological conditions.

Multimorbidity frequently includes Neurodegenerative Diseases. Most of the latter are incapacitating, incurable and refractory to palliative treatments. Differential diagnosis is often difficult, especially in low- and middle-income countries due to the paucity of novel methods such as advanced imaging techniques. There is evidence that people who have both a mental and physical health condition have a worse outcome than those who just have physical health problems. Knowledge on multimorbidity in the context of neurodegeneration is sparse, especially at early stages when pathogenesis may propagate at subclinical levels. Nonetheless, increasing numbers of studies report relatively high proportions of comorbidities previously undetected in patients diagnosed with a single neurological disease.

Attention to such data is required for the effective treatment of neurodegenerative disorders. Current discrepancies among clinical trials, as well as variable response to certain treatments may be due to heterogeneous cohorts of target patients, especially at preclinical stages of one or more aggravating conditions. For example, variable pathologic outcomes may arise from the progressive leading edge of congruent subclinical changes, beyond areas of the brain bearing manifest pathogenic conditions. Therefore, the development of novel treatments to comorbid conditions affecting the Nervous System depend on adequate basic and preclinical models, as well as clinical studies properly designed to account for distinct stages of each condition.

The present collection aims at covering from basic research to clinical and neuropathological studies, to instigate novel approaches to multimorbidity in the context of neurodegenerative disease. We encourage authors to submit either Original articles, as well as Reviews of specific subjects. Advances in this field are in need to provide a firm basis for the development of new and more effective treatments.

• In vitro experimental models of mutimorbidities including at least one neurodegenerative condition
• In vivo experimental models of mutimorbidities including at least one neurodegenerative condition
• Epidemiological studies of multimorbidity including neurodegenerative diseases.
• Clinical studies of multimorbidities containing at least one neurodegenerative condition.
• Neuropathological studies of multimorbidity in the nervous system of patients with former single disease diagnostics.

Keywords: Neurodegeneration, Comorbidity, Multimorbidity, Non-communicable diseases, Infection, Neurodegenerative Diseases

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