COVID-19 and neurological research: potential impact and needs
for invigoration
The COVID-19 outbreak has resulted in disruption of various preclinical
and clinical neurological researches as a result of shifting of focus on
understanding and defeating the disease. The following information will
help in developing an insight into challenges faced in carrying out
neurological research activities.
The current COVID-19 pandemic is affecting public health and economy
worldwide. This pandemic has also affected the working and management
strategies of clinical practices, healthcare centres, academics, and
research centres. The academic and research institutions, students, and
research scholars are diverging towards the online platform such as zoom
and google meet for teaching, discussing, and sharing knowledge and
ideas. In the current situation, on one side the research related to
COVID-19 is conducted at an unprecedented rate whereas on the other side
the research concerned with other fields including the CNS research is
affected adversely. It is very challenging to carry out the research
activities at an adequate pace keeping in view the present pandemic
situation.
The CNS diseases constitute more than 600 conditions and for most of
them, only symptomatic therapy is available. There is a need as well as
a wide scope for research and drug development for neurological and
neurodevelopmental disorders. The commonly growing research area in CNS
includes diseases like Alzheimer’s, Parkinson’s, autism spectrum
disorder, treatment-resistant epilepsy and multiple sclerosis, ADHD, and
depression. In recent years upward trends in CNS research have been
seen. The increased research and clinical trials require more funding
and resources. But, due to the COVID-19 pandemic, drastic changes can be
seen in the allocation of funds to different types of trials and a
sudden shift towards the COVID-19 funding is observed. Recently $14
billion is reduced from total allotted funding of $54 billion for an
autism-related project in the state of California1.
Also, the state has planned to reduce 10% of funding for public higher
education in the state. This sudden shift of the funds has raised a
serious concern for the CNS research and trials and certainly could put
pressure on the sponsors. Further recruiting patients in the CNS related
trials keeping in view the current pandemic situation is also very
challenging. Considering certain elements such as maintaining social
distancing and wearing masks to reduce the risk of COVID-19 to patients,
it is difficult for both the sponsor and the investigator to recruit the
patients and conduct the trial smoothly. Certain tests need to be done
before enrolling the patients into the trial and some of these tests
such as ADOS for autism can’t be done with masked
individuals1. So, it will again be a matter of taking
risks or increasing the time and effort of the person who recruits
patients. Similarly, the patient’s follow-up and maintaining the
timeline for taking the subsequent sample are much of consideration in
the present situation. Due to the lockdown, the patients could not come
and even after the lockdown they are afraid to come.
The reduced number of persons in research centres has also affected the
productivity and conduct of CNS research. Also, the availability of
drugs, kits, specific cell lines, and outsourcing of the test parameters
are affected adversely and need to be fixed for maintaining the
continuity of CNS research. The inter-institute collaborations for
conducting the CNS research have also affected the productivity and
conduct of CNS research as a frequent visit to other institutions and
places are restricted nowadays. Although, the exchange of ideas and
discussions is done via telecommunication still the problem lies in the
underdeveloped countries and rural areas. Our researchers, doctors, and
scientists altogether put an effort to battle the COVID-19 pandemic and
its consequences still a lot have to be done for the smooth conduct of
the CNS research and trials. Technologies have played an indispensable
role in connecting researchers all over the world and there is a need to
develop various telehealth strategies for the rapid and unhampered
conduct of the CNS trials and research. Moreover, there is a need to
reinvigorate neurological research as no new standard drug has been
approved since long in some of the CNS disorders like Autism, ADRD, etc.
These research studies could be conducted by adopting certain approaches
to avoid the spread of infection in individuals participating in
research or trials and researchers as well. Alterations in experimental
protocols are needed for the collection of endpoint assessments safely.
Otherwise, observational studies that involve direct contact must be
deferred or should only be conducted distantly if possible. There are
several interventions studies in which continuous provision of medical
care (accessible only through research trial) is necessitated, these
studies should be continued ensuring the safety of everyone involved.
For the continuation of these researches for the intervention studies,
certain guidelines have been approved by the US Food and Drug
Administration (FDA) which provides every possible information regarding
the mitigation of risk to the people involved in researches2. Further, it is the responsibility of the government
as well as the sponsors and the researchers to understand the importance
of the CNS research and other research areas and should maintain the
adequate balance between the COVID-19 research and other research areas
including neurological research.
It is concluded that the continuation of research is critical even in
COVID-19 era not only to avoid the repercussions of neglecting
neurosciences research in coming years but also to reduce the suffering
of many patients with pre-existing neurological disorders.