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How to Progress in the Field of Neuroprotection and -Rehabilitation: A look at the Good, the Bad and the Better

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Neuroscience is a research field where current knowledge has not yet led to a fundamental understanding of the organ’s complex functions. In the areas of neuroprotection and rehabilitation, however, progress is strongly needed for people suffering from brain damage and neurodegenerative diseases who ...

Neuroscience is a research field where current knowledge has not yet led to a fundamental understanding of the organ’s complex functions. In the areas of neuroprotection and rehabilitation, however, progress is strongly needed for people suffering from brain damage and neurodegenerative diseases who desperately need effective treatments. Having this in mind and considering the efforts put into this research field, the progress has been very slow. For example, many treatments that showed promise in animal models of stroke and TBI have failed to produce beneficial effects in clinical trials. The failure of many compounds to reproduce their promising effects in a patient population has created a discussion about possible shortcomings of both clinical trial designs and outcomes measures, and of current animal models and procedures used in the evaluation of potential new therapies. Although in recent years standards have been increasingly implemented for studies in humans, this may have improved the reliability of measures rather than validity and value of those measures. In general, central points of consideration include methodological issues and protocols to evaluate damage, neuroprotection, and rehabilitation. Also, more fundamental issues need to be addressed, including: 1) what should be measured to document deficits and recovery, 2) what is the relation between preserved morphology and functional outcome, and 3) how to avoid over-interpretations and over-simplifications of the resulting data. We would therefore like to stimulate a discussion about methodological short-comings of procedures, protocols and analyses in the field of brain damage, protection and rehabilitation as well as a discussion about questionable fundamental scientific paradigms that are currently driving research in this field.
The purpose of this Research Topic is to determine if there are authors who wish to discuss advances and limitations of currently used (experimental) procedures in the field of neuroprotection and -rehabilitation. We welcome investigators to share their knowledge about how to select appropriate parameters for translating the concepts of brain plasticity, protection and rehabilitation into meaningful scientific measures, to provide insights into possible limitations of specific quantification methods, or to discuss new views and basic concepts and questioning old ones. By this, we would like to facilitate a critical discussion about “the Good, the Bad and the Better” in the field of brain damage and neurodegenerative diseases:

The Good:
- Defining the paradigmatic challenges to the neuroscience of plasticity and repair as we go forward
- Consideration of often neglected factors like age, sex, gene expression, and epigenetic regulation
- New promising methodological approaches
- Transition from correlative to causal analysis
- Identifying valid and reliable prognostic outcome parameters

The Bad
- Peer-review-induced mediocrity
- Empty Reductionism of complex brain (dys-)function to structural parameters
- Biased experimental concepts
- Funding issues that shape how the science is conducted.
- Inadequate outcomes measures in clinical trials.

The Better
- Critical assessment of used techniques and data analysis, including statistics
- Analysis and interpretation of contradictory results
- Increasing the translational value of pre-clinical animal models for better clinical application
- Questioning of “generally accepted” interpretations of widely used outcome parameters
- Validation of rating scales and timing of assessments in human studies
- Support for non-commercial treatment strategies
- Multi-target approaches
- Clinical trial desig


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