The Brain: an intractable, attractive and very human problem to solve

1. Why this, why now, why me

In 2018 in a discussion with a psychiatrist, I was shocked to learn that antidepressants help around 20 extra people out of every 100 to notice some improvement over depression [1]. When I asked how could that be possible, he responded “There are categories of drugs with 15% efficacy so these are more effective!”.

While I appreciated the humor, I was left with a sobering realization: there is a lot of suffering and disease for which current medicine is moving very slowly, if at all. Major depressive disorder (MDD) can bring life to a halt. People with MDD experience a lack of pleasure, a lack of initiative, and a lethargy so profound that it can be said to deprive them of their humanity. It’s also not insignificant. MDD has a lifetime prevalence of 5-17% and is twice as likely to occur in women as in men.

Around a couple of years earlier, I came across an even worse category of disease. My grandmother had started showing the first signs of dementia, a disease that has subsequently made her life hard, and our communication with her very difficult.

Seeing dementia up close made me realize how helpless we are. There is no known treatment for it and like most other neurodegenerative diseases its prevalence will only keep on growing.

On a personal level, if dementia is running through the family, one is undoubtedly going to wonder: Am I going to get it? This is a responsible question to ask because your posterior probability, your actual chance of being diagnosed with it in your lifetime, is 2x increased.

But also collectively, we are more likely to be afflicted as a society by neurodegenerative diseases as we grow older.

• Alzheimer's disease, the most common neurodegenerative disease, is expected to double from 46 million in 2020 to 150 million in 2050 [3].

• Parkinson's disease, the second most common, is expected to double from 6.1 million in 2020 to 12.2 million in 2050 [4].

The burden on our society, healthcare, financial, and government systems will be unbearable.

Depression steals life and Neurodegenerative diseases deplete it. Their commonality? Both are diseases of the brain [or at least this is how they look at first sight]. Their other commonality? We, as a society, have not figured out a way to combat them effectively.

This is an imminent problem with grave consequences. But it is also an “attractive” problem for some, myself included.

Our brightest minds spent a decade building consumerist offerings, but there has been disproportionately little progress in science, deep tech, and health sciences. In 2021, for the first time in a long time, the average lifespan in the USA decreased [5].

But there’s actually quite a lot to be optimistic about assuming action is taken which is the focus of this publication. Advances in genetics, brain imaging, artificial intelligence as well as operational aspects of healthcare like telemedicine, remote testing, and social, such as the growing citizen science movement, are all reasons to believe a Cambrian explosion of intelligence in space is about to emerge.

I have been reading on the topic for a while now. For some time I have been wondering: “Why would I write anything, I am not a Doctor, a researcher, or a scientist in the field”. Then I considered a couple of points that made me decide to start this:

• The intelligence of naiveté. There is a good chance that applying an informed naiveté might be useful both for experts and laymen as well. New ideas come from cross-pollination and since the topic is dear to me, objections built on knowledge that can be helpful to the community are welcome.

• I am a computer scientist & product-minded founder. I have spent quite a lot of time thinking about how to a) measure things that are hard to measure b) remove signal to noise and c) make hard things easy so as to gain wide adoption and appeal. In my circles, I am not a rare creature but in this case, perhaps here I can provide a different perspective. My background in scaling R&D-based consumer healthcare and my data-first approach could be helpful in combining ideas to benefit the public.

2. Who is this for?

The news shared here won’t be purely academic but rather pieces of a puzzle aiming to put together an action plan first by broadening our understanding of where we are in brain health overall and further examining what we can do on the individual, corporate and social level.

Who are you? You are someone that is interested in brain health. You might be interested in optimizing your health and performance, you might have seen a close one bear the load of such a condition, you might be wondering how to assess your own risk or you could be a researcher, founder, or investor who wants to understand the space better and seek like-minded people.

If that is the case subscribe to get a practical, data-backed view of what is going on in the space, where things are going, and what we can do. You will learn about new medical devices, health protocols, prevention, and diagnostics as well as social dynamics, market trends, and business insights.

You should expect to be armed with the latest prevention techniques, a deep understanding of new innovations, and the ability to weigh the cost-benefit of new drugs in the space. By the end of this publication, you should have all the data yours truly could dig up, delivered simplified so that you make improvements in your own health or start a company in the space and help more people. [p.s this is obviously not medical advice :)].

You should expect a post every couple of weeks but I don’t intend to maintain a steady pace. Sometimes I will write more, sometimes less.

Brain Origami. Plastic and hard.

Resources

1. Patrias K, Wendling D. Depression: How effective are antidepressants? In: Bookshelf. Bethesda (MD): National Library of Medicine (US); 2022. https://www.ncbi.nlm.nih.gov/books/NBK361016/

2. Patrias K, Wendling D. Major Depressive Disorder. In: Bookshelf. Bethesda (MD): National Library of Medicine (US); 2022. https://www.ncbi.nlm.nih.gov/books/NBK559078/

3. Ikram MA, Khan MM, Khan AA, et al. A comprehensive review of Alzheimer’s disease: Causes and Treatment. J Alzheimers Dis. 2022;80(2):493-515. doi:10.3233/JAD-210978

4. Chen H, Zhang B, Zhang Y, et al. The emerging evidence of a Parkinson Epidemic. J Parkinsons Dis. 2021;11(4):1003-1014. doi:10.3233/JPD-210713

5. Heron M, Murphy SL, Kochanek KD, et al. Mortality in the United States, 2021. NCHS Data Brief. 2022;456:1-8. doi:10.15620/NCHSBR456

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