Neuroprotection: Present and future

The treatment of brain diseases (regardless of the latter's neurological or psychiatric expression) is based on either preventive, symptomatic or etiopathogenic approaches. The frequent observation of neuronal death during brain disease initially prompted researchers to favour neuroprotection for the etiopathogenic approach. The repeated failure to develop reliable neuroprotective agents has prompted emergence of the concept of “disease modifyer”. The disease modifyer concept (based essentially on clinical endpoints) enables us to envisage the broader application of etiopathogenic treatments by freeing ourselves of the need to demonstrate a cellular mechanism of action. The formalization of disease modification prompts several lines of thought, which are developed in the present article.