Talking heads - European Commission health research

Brain model
In total, EU funds and in-kind resources of the pharmaceutical industry worth some €24m and €35m, respectively, have been combined to set up projects that enable further progress in brain research.
Ruxandra Draghia-Akli & Philippe Cupers
The European Commission's Ruxandra Draghia-Akli and Philippe Cupers offer their views on why neuroscience research is necessary at EU level...

The human brain remains essential as the source of our intellectual capacities and emotional behaviour, as well as enabling us to interact socially. To understand how the brain works is one of the greatest challenges in science.

Any malfunction of the brain risks affecting our wellbeing and personality, and the burden of brain disorders and diseases on our society is significant. A total of 260 million European citizens are likely to experience some form of brain related disorders in the central or peripheral nervous system. In 2010 alone, the cost of brain disorders in EU member states and associated countries was estimated to be around the €800bn mark.1 As a result of Europe's ageing population and the associated increase of neuro-degenerative diseases, such as Alzheimer's and Parkinson's, these numbers are set to rise in the near future.

Modern brain research can capitalise on the tremendous scientific progress made in holistic 'omics' research, medical imaging, neuroinformatics and nanotechnologies. However, it is complex and requires a multidisciplinary approach that includes clinical investigation, anatomy, genetics, cell biology, physiology, behavioural sciences, imaging, bio-informatics and healthcare management. Generating more knowledge and establishing new paradigms is the way forward, but the resources needed to make progress are scarce. Several pharmaceutical companies have with-drawn from neurosciences during the last few years, shying away from conducting research in an area that is complex and expensive, requires long lead times to develop new compounds and targets, and entails higher risks to fail than other business areas and hence promises lower returns on investment.

To compensate for these effects, the EU's 7th Framework Programme (FP7) is now giving greater priority to brain research to enable further progress in the field. Collaborative research projects involving top experts from Europe and beyond lead to coordinated work across various disciplines, greatly facilitating the development of new diagnostic tools, therapies and more personalised treatment for brain diseases. Greater EU involvement in brain research also sends a strong signal to the industry to re-invest in this area .

Brain research in FP7
Since its origin in 2007, FP7 has dedicated some €1.2bn to brain related research using a variety of funding mechanisms to address specific needs, such as collaborative research, frontier research, public private partnerships and mobility programmes. About one-quarter of this budget supported frontier research under the direction of the European Research Council, reflecting the importance of a better understanding of brain functions and processes. However, the biggest budget share – some €500m – was supported by the so-called Cooperation programme, the part of FP7 dedicated to collaborative research, under the 'health' heading.

This money is used to support international multidisciplinary research projects that help us to:
• Better understand the integrated structure and dynamics of the brain;
• Study brain diseases and identify new diagnostics, therapies and regenerative or restorative therapeutic approaches;
• Improve the management of brain diseases, ie provide better healthcare at lower cost.

These projects include a wide range of research topics such as stroke, spinal cord repair, mental retardation, neuron-glia interactions, brain coding, vision, learning and memory, synaptic processing, and blood brain barrier. However, the two main priorities addressed are neurodegenerative diseases and mental health.

Support for research on neurodegenerative diseases
The growing threat of neurodegenerative diseases is reflected in the decision to invest some €320m of EU funds into research in this area, which is more than ever before. It is a significant resource that enables us to find better responses to diseases such as memory loss in dementia, Parkinson's and Alzheimer's diseases, amyotrophic lateral sclerosis, neuroinflammation in neurodegenerative diseases, retinal degeneration, or paediatric dementia. A key focus is Alzheimer's, with some €100m dedicated to this disease alone.

In addition to funding class-leading international neurodegenerative disease research, the EU plays an important role in coordinating national efforts in this area. The EU's push to set up the member states-led Joint Programming Initiative on Neurodegenerative Diseases (JPND), in particular Alzheimer's, is a case in point. This is the first initiative of its kind – designed to address the grand challenges facing EU society in the coming years, considered beyond the scope and resources of any one country to tackle. Presented on 7th February, the JPND research strategy sets out the common vision of the 25 European countries involved, and will guide their research activity and investments in the field of neurodegenerative diseases over the coming decade in Europe. Four new projects are expected to start soon under the JPND umbrella to address Alzheimer's, Parkinson's, Creutzfeldt-Jakob and amyotrophic lateral sclerosis. The commitment of each JPND member, including the provision of an adequate level of resources, and the establishment of synergies with the European Commission, will be crucial ingredients to the continued success of this new initiative.

Support for research on mental health
EU support for research into mental health reflects the principles of the 'European Pact for Mental Health and WellBeing';2,3includes preclinical and clinical research on schizophrenia, depression, stress and anxiety, addiction, obsessive and compulsive disorders, and autism; and has been worth more than €150m since 2007. A significant investment of €23m was made to set up, via the projects EU-GEI and OPTIMISE, a new European large-scale schizophrenia platform that allows researchers to identify the genetic, clinical and environmental factors involved in the emergence of schizophrenia. It is also a major step forward in relation to the optimised treatment and management of the condition.

Other remarkable projects in this areas include the MOODINFLAME – investigating the relationship between mood disorders and inflammation – and in the area of public health research, three complementary projects on suicide prevention: OSPI-EUROPE, SEYLE and WE-STAY. Finally, an international consortium of renowned mental health experts has joined forces in the ROAMER project to assess the state of play in mental health research, identify opportunities and gaps, and propose a roadmap for the future direction of mental health research in Europe.

Coordination of national research activities
Besides the JPND initiative, the EU supports a number of so-called European Research Area Networks to better link and coordinate national and regional research activities in Europe. In relation to brain research, NEURON and NEURON II helped to make important progress in the field, and resulted in a €40m investment to investigate and innovate in the areas of neurodegenerative disease, mental disorder and cerebrovascular disease. In NEURON II, 18 national funding agencies from 13 countries have recently published a joint call for project proposals to encourage and fund research on 'Novel Methods and Approaches towards the Understanding of Brain Diseases'.

Looking beyond Europe, we must not forget to mention the International Initiative for Traumatic Brain Injury Research, a programme level cooperation between the EU, the US (National Instituted of Neurological Disorders and Stroke), Canada (Canadian Institute of Health Research) and any country that may join in the future. Launched in October 2011, the initiative is set to play a major role in the development of harmonised clinical guidelines and the identification of the most effective clinical interventions for different types of brain injuries and patient histories.

Support by the IMI Joint Undertaking
Finally, brain research in Europe benefits from the Innovative Medicines Initiative (IMI), a €2bn public private partnership with the pharmaceutical industry to support research and modernise drug development in collaboration with academic researchers, patient organisations and regulatory agencies. IMI includes a strong brain research component, with particular emphasis on neurodegenerative diseases, mental health (depression, schizophrenia and autism) and pain research. For instance, the PharmaCog project works to predict cognitive properties of new drug candidates for neurodegenerative diseases in early clinical development, while NEWMEDS develops tools and tests to determine the efficacy of drug candidates for depression and schizophrenia at early stages of their development.

In total, EU funds and in-kind resources of the pharmaceutical industry worth some €24m and €35m, respectively, have been combined to set up projects that enable further progress in brain research. The commitments that the pharmaceutical industry has taken under the IMI umbrella are an encouraging sign at a time when companies have a tendency to abandon their research work on the central nervous system.

Outlook
Brain research is a real opportunity for modern biomedical sciences and healthcare management. It promises great benefits for all of us; for our societies and economies on the whole. However, it is also a significant challenge, requiring high levels of investment and cooperation between all of the players involved. The FP7 deploys financial resources unmatched by any previous research framework programme to stay ahead of the game. These resources are used in a variety of ways, similar to a toolbox that offers different implements for different needs.

For the 2014-2020 period, brain research could be expected to be a part of the 'Health, demographic change and well-being' area of the next research and innovation framework programme 'Horizon 2020', as proposed by the European Commission. However, other priorities of Horizon 2020 may also become relevant for brain research and neurodegenerative diseases in general. Many details remain to be confirmed, and will become clearer during the course of this year. Just like other research areas, it seems to be a matter of expanding and improving many of the approaches that have been successfully tested and worked in the past, as well as pioneering new and innovative ways of working.

The Commission's idea of organising a 'Month of the Brain' in May 2013 is certainly an encouraging sign. If this idea works successfully, it may well mark a turning point and bring our understanding of the need to invest into brain research to a different level.


1 Gustavsson et al (2011), Cost of disorders of the brain in Europe 2010, European Neuropsychopharmacology 21, 718-779
2 ec.europa.eu/health/ph_determinants/life_style/mental/docs/pact_en.pdf
3 www.europarl.europa.eu/sides/getDoc.do?pubRef=-//EP//TEXT+TA+P6-TA-2009-0063+0+DOC+XML+V0//EN


This article first appeared on publicservice.co.uk: Talking heads.

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