Neuroprotective vs. Neurostimulating Management Options for Amytrophic Lateral Sclerosis. A Multiple Trial Based Comparison

Inhaltsverzeichnis (Table of Contents)

• TITTLE PAGE
• ACKNOWLEDGEMENT(s)
• TABLE OF CONTENT(S)
• ABBREVIATION(s)
• ABSTRACT
• CHAPTER 1: GENERAL INTRODUCTION
  • Dissertation Methodology
  • Aims and Objectives
  • Introduction
• CHAPTER 2: MAJOR NEURO-PROTECTIVE METHODS
  • Literature Review on Controlled Trial of Riluzole in Amyotrophic Lateral Sclerosis
    • Introduction
    • Material and Methods
    • Randomization and Criteria
    • Figures
    • Results
  • Literature Review on Clinical trial with ceftriaxone in amyotrophic lateral sclerosis
    • Introduction
    • Material and Methods
    • Randomization and Criteria
    • Figures
    • Results
  • Literature Review on Randomised, Double-Blind, Placebo-Controlled, Study of Safety and Efficacy of Dexpramipexole in Subjects with ALS
    • Introduction
    • Material and Methods
    • Randomization and Criteria
    • Figures
    • Results
  • Literature Review on Efficacy and Safety of MCI-186 Edaravone
    • Introduction
    • Material and Methods
    • Randomization and Criteria
    • Figures
    • Results
• CHAPTER 3: MAJOR NEURO-STIMULATIVE METHODS
  • Literature Review on CY4031-VITALITY-ALS (TIRASEMTIV)
    • Introduction
    • Material and Methods
    • Randomization and Criteria
    • Figures
    • Results
  • Literature Review on Multi-Centre, Randomised Controlled Study of NeuRx® Diaphragm Pacing System™ In Participants with A LS
    • Introduction
    • Material and Methods
    • Randomization and Criteria
    • Figures
    • Results
  • Literature Review on Repetitive Transcranial Magnetic Stimulation (rTMS) in ALS
    • Introduction
    • Material and Methods
    • Randomization and Criteria
    • Figures
    • Results
• CHAPTER 4: CRITICAL ANALYSIS
• CHAPTER 5: CONCLUSIONS and FUTURE SCOPES
  • Conclusions
  • Future Scope
• CHAPTER 6: REFERENCES

Zielsetzung und Themenschwerpunkte (Objectives and Key Themes)

This dissertation explores the various management options for Amyotrophic Lateral Sclerosis (ALS) in a comparative manner, aiming to evaluate the effectiveness of different strategies, both individually and in combination, to find the most sustainable and suitable choice for ALS patients (PALS). The primary objective is to analyze neuroprotective versus neurostimulating approaches as solitary or combined therapies for PALS.

• Evaluation of major therapeutic options for ALS in a comparative manner.
• Analysis of the efficacy of neuroprotective and neurostimulating methods for ALS.
• Exploration of the effectiveness of combined therapeutic approaches.
• Assessment of the potential for future research and development of new management options.
• Proposal of a new therapeutic classification system for ALS, “TOS-ALS”, which categorizes treatment options into neuroprotective and neurostimulating methods.

Zusammenfassung der Kapitel (Chapter Summaries)

Chapter 1 provides a general introduction to ALS, covering its clinical presentation, pathophysiology, and current standard of care. It also introduces the dissertation's unique perspective, focusing on a new binary classification system for ALS management.

Chapter 2 evaluates four neuroprotective medications: Riluzole, Ceftriaxone, Dexpramipexole, and Edaravone. Each section delves into the rationale for using the drug, its mechanism of action, and the results of relevant clinical trials.

Chapter 3 focuses on neurostimulating approaches, exploring the potential of Tirasemtiv, Diaphragmatic Stimulation, and Repetitive Transcranial Magnetic Stimulation (rTMS). The chapter examines the clinical rationale, trial designs, and outcomes associated with these methods.

Chapter 4 provides a critical analysis of the reviewed research on neuroprotective and neurostimulating treatments for ALS. This section evaluates the strengths and limitations of each study, highlighting the challenges in determining the efficacy and safety of various therapeutic options.

Schlüsselwörter (Keywords)

Key terms and concepts addressed in this dissertation include: amyotrophic lateral sclerosis (ALS), motor neuron disease (MND), neuroprotective methods, neurostimulating methods, Riluzole, Ceftriaxone, Dexpramipexole, Edaravone, Tirasemtiv, diaphragm pacing system (DPS), repetitive transcranial magnetic stimulation (rTMS), glutamate excitotoxicity, free radical scavenging, mitochondrial dysfunction, clinical trials, therapeutic classification system, TOS-ALS.