Brain health: Pathway to primary prevention of neurodegenerative disorders of environmental origin

Peter S. Spencer, Shala Ghaderi Berntsson, Alain Buguet, Patricia Butterfield, Donald B. Calne, Susan M. Calne, Santiago Giménez-Roldán, Jacques Hugon, Sahiba Kahlon, Glen E. Kisby, Emmeline Lagrange, Anne Marie E. Landtblom, Albert C. Ludolph, Peter B. Nunn, Valerie S. Palmer, Jacques Reis, Gustavo C. Román, Jussi O.T. Sipilä, Scott S. Spencer, Raquel Valdes AnguesJean Paul Vernoux, Momoko Yabushita

Research output: Contribution to journalArticlepeer-review

Abstract

While rising global rates of neurodegenerative disease encourage early diagnosis and therapeutic intervention to block clinical expression (secondary prevention), a more powerful approach is to identify and remove environmental factors that trigger long-latencybrain disease (primary prevention) by acting on a susceptible genotype or acting alone. The latter is illustrated by the post-World War II decline and disappearance of Amyotrophic Lateral Sclerosis and Parkinsonism-Dementia Complex (ALS/PDC), a prototypical often-familial neurodegenerative disease formerly present in very high incidence on the island of Guam. Lessons learned from 75 years of investigation on the etiology of ALS/PDC include: the importance of focusing field research on the disease epicenter and patients with early-onset disease; soliciting exposure history from patients, family, and community to guide multidisciplinary biomedical investigation; recognition that disease phenotype may vary with exposure history, and that familial brain disease may have a primarily environmental origin. Furthermore, removal from exposure to the environmental trigger effects primary disease prevention.

Original languageEnglish (US)
Article number123340
JournalJournal of the Neurological Sciences
Volume468
DOIs
StatePublished - Jan 15 2025

Keywords

  • Alzheimer's disease
  • Amyotrophic lateral sclerosis
  • Disease clusters
  • Lifetime exposome
  • Parkinson's disease

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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