A silent epidemic is spreading through the Czech Republic. By 2035, it could affect one in three people
There is a worldwide increase in the incidence of neurological and especially neurodegenerative diseases. According to experts at the National Institute…
There is a worldwide increase in the incidence of neurological and especially neurodegenerative diseases. According to experts at the National Institute for Neurological Research (NEUR-IN), brain disease affects one in three people. By 2035, the number of people with dementia will double. The health and economic impact on society will be enormous. On 13 March 2025, representatives of NEUR-IN, scientific research institutions, hospitals, ministries, universities, patient organisations and the pharmaceutical industry spoke about the alarming data, mitigating the negative impact, the need for early diagnosis and modern treatment methods for neurodegenerative diseases in the Chamber of Deputies of the Parliament of the Czech Republic.
“I am very pleased to be able to take over the patronage of the NEUR-IN roundtable, where we will learn about the latest findings in the field of research, early diagnosis and treatment of neurodegenerative diseases. All three pillars of this programme will be presented today by leading experts from the Czech Republic. We are all very pleased that the life expectancy of our population is increasing. Unfortunately, however, there is no increase in healthy life expectancy, which has been stagnating for a long time. I consider this to be a major challenge for the health sector in our country. I believe that NEUR-IN can make a significant contribution to this challenge.” Says MUDr. Romana Bělohlávková, Member of the Committee on Health, Chairwoman of the Subcommittee on Public Health, Epidemiology and Prevention, Chamber of Deputies of the Parliament of the Czech Republic.
Prof. Ladislav Dušek, Director of the Institute of Health Information and Statistics of the Czech Republic, presented current data from the social area, including financial expenditures for public health insurance. “Care for the growing numbers of neurological and neurodegenerative diseases represents a very important segment of health and social services. We are now newly able to assess the impact on both types of services as we have inter-agency linked data. This burden will increase significantly in the coming years due to the ageing population. If we take dementia and Alzheimer’s disease as an example, then we must prepare for an increase from around 165 000 patients today to more than 230 260 000 after 2040. This is not just about the elderly at the end of life; these diseases start to increase significantly from the age of 60.”
The number of deaths due to brain diseases has increased by almost 40%, points out Prof. Milan Brázdil, scientific director of the National Institute for Neurological Research. One of the main causes is the ageing of the population, as the risk of stroke or Alzheimer’s and Parkinson’s disease increases significantly with age. “We need to strengthen the development of new and more effective treatment options, focusing on early diagnosis and prevention. We also need to ensure sustainable and effective communication between researchers, doctors, the public, patients and, on the other hand, public authorities or healthcare providers and payers. These are the main topics of today’s public discussion and the main goals of the National Institute for Neurological Research,” adds Milan Brázdil.
Due to the increase in the incidence of neurodegenerative diseases, whose causes and development have not yet been fully explained and for which there is no preventive or causal treatment, the National Institute for Neurological Research (NEUR-IN) was established in July 2022. Eleven institutions from across the country are collaborating.
The main coordinator of NEUR-IN is St. Anne’s University Hospital in Brno. In addition to the Brno platform, the other main institutions are 1. and the 2nd Faculty of Medicine of Charles University, and other institutions including the Czech Academy of Sciences, CTU and BUT are also involved. The Institute’s project was created under the Exceles programme on the basis of the call of the National Recovery Plan.
“I am glad that today we can present the results of our work to the public, including modern and effective treatment methods that can significantly improve the quality of life of patients. Neurological diseases are the second most common cause of death and a major factor in the years of life lost when a patient cannot lead a full life because of their disease. In addition, the epidemic increases the risk of a future increase in neurodegenerative diseases, similar to what happened after the Spanish flu in the 1920s. The state must be prepared for such threats. The NEUR-IN is a key capacity for risk analysis and the development of a national plan to address such crises. Unlike individual research projects initiated by single science teams, NEUR-IN enables coordinated solutions to challenges critical to the entire nation, which is its greatest asset.” explains Prof. Robert Jech, Deputy Director and Chairman of the NEUR-IN Scientific Board, Head of the Department of Neurology at the 1st Faculty of Medicine of Charles University and the General University Hospital in Prague (1st Faculty of Medicine of Charles University and the University Hospital in Prague).
The main mission of NEUR-IN is to connect, improve and modernize neurological research in the Czech Republic and to systematically search for breakthroughs in the brain and nervous system. The research teams primarily focus on three pillars/areas of neurodegeneration – motor control disorders, mental disorders and neurodevelopmental disorders.
Modern and effective treatment options for some neurological diseases, such as movement disorders, epilepsy and Parkinson’s disease, include deep brain stimulation. In Parkinson’s disease, it dramatically suppresses stiffness, slowness and tremors.
“The treatment consists of permanent electrical stimulation of selected nuclei deep in the brain. A thin stimulation electrode is inserted into the selected nucleus on each side of the head through a small hole in the skull and connected subcutaneously to a programmable neurostimulator placed in the subcutaneous region of the chest with a connecting cable. With this treatment, patients regain control of their own movements, which for many of them is a major breakthrough in regaining self-sufficiency and improving their quality of life,” explains Professor Robert Jech.
Parkinson’s disease is one of the fastest growing diseases in the population, even in middle-aged people under 50. The disease is characterized by a long phase when pathological processes in the organism are detectable, but typical manifestations are not yet expressed. The key task of basic and clinical research is to find such persons in the population and to discover procedures that will lead to slowing down or stopping the neurodegenerative process.
“We want to find a way to cure Parkinson’s before it breaks out. At the moment, we can diagnose a patient at risk of Parkinson’s, but not prevent the disease from developing. And we want to change that. To help us diagnose the disease before it manifests itself. We want to find out which indicators are the most sensitive, how to detect and prevent the disease in the best, fastest, best quality, cheapest and most painless way,” says the head of the first pillar of NEUR-IN doc. Petr Dušek from the 1st Medical Faculty of Charles University and the University Hospital in Prague.
To slow the global progression of Parkinson’s disease, NEUR-IN scientists are trying to detect it in its earliest stages. For example, with a unique mobile app that can detect the onset of the disease after just a few minutes of a call.
“We are mainly concerned with the development of methods for diagnosing the so-called prodromal stage of Parkinson’s disease, when pathological processes in the body are detectable, but the disease is not yet manifested by classical symptoms. Our team from the Faculty of Electrical Engineering at the CTU was the first in the world to demonstrate that speech disorders can be detected already at this stage, and moreover, quite passively – by analysing speech during ordinary telephone calls – and thus very accurately identify people at risk of Parkinson’s disease. Our research to date has shown that it is enough to make a correct assessment if a person calls for approximately 18 minutes, which corresponds to, for example, nine short calls with friends or family,” explains Associate Professor Petr Dušek.
Typical of Parkinson’s is impaired speech melody, loudness and intelligibility. In the later stages of the disease, these difficulties are clearly audible. At the beginning, however, the changes may be only very subtle – but even these can be reliably detected by the NEUR-IN application scientists. They have already successfully tested the app on dozens of patients and are currently working on further development of the software. Especially in different types of mobile devices and also speech analysis in other languages.
The second pillar of NEUR-IN deals with brain neurodegeneration with dementia. There are now about 150,000 people with dementia in the Czech Republic. Of these, approximately 90 thousand have Alzheimer’s disease and 25-30 thousand have dementia with Lewy bodies. The latter is manifested by significant fluctuations in cognitive functions over time, visual hallucinations, slowing of movements and muscle rigidity, and sleep disorder characterised by movements in sleep and crying out in sleep.
“Research in Pillar 2 is primarily concerned with finding early non-invasive and widely available diagnostic indicators of different types of dementia. This includes basic research and discovery of new molecules for the treatment of certain subgroups of patients, as well as clinical research in the field of non-invasive current stimulation techniques to influence brain function,” explains Prof. Irena Rektorová, coordinator of the second pillar of NEUR-IN, project leader for the Faculty of Medicine and the coordinator of the Neuroscience Programme at CEITEC Masaryk University.
Predictions show that the number of people suffering from dementia will double by 2035, which will have a huge negative economic and social impact. Although Lewy body dementia is the second most common degenerative dementia, unlike Alzheimer’s disease, it is not diagnosed early and correctly.
“Within the NEUR-IN project, we had the opportunity to create and follow a unique group of individuals with mild cognitive impairment with Lewy bodies, i.e. at an early stage of the disease, on the basis of a simple questionnaire and subsequent non-invasive examination of the participants,” describes Prof. Irena Rektorová. “We have succeeded in discovering markers for accurate assessment of mobility, cognitive function and sleep.”
Another research direction within the second pillar of NEUR-IN is the evaluation of proteins from blood plasma, which will not only help to diagnose the pathology and therefore the type of neurodegeneration and disease activity, but may also be an important source of information for the development of new molecules for treatment.
NEUR-IN Pillar II scientists have been able to establish collaborations with a number of excellent world centres and have been awarded prestigious European projects. Another plan is to collaborate with the European Academy of Neurology on dementia prevention and the “brain health” campaign.
The third research pillar of NEUR-IN focuses on disorders of the developing brain – so-called neurodevelopmental diseases. This group includes not only the common and well-known autism spectrum disorders (ASD) or ADHD, but also developmental epileptic encephalopathies, intellectual disabilities and developmental dysphasia.
“Over the last thirty years, the incidence of these diseases has doubled in the population and the number of children with autism has increased tenfold. The societal impact is therefore huge – the total direct and indirect costs of lifelong care for neurodevelopmental diseases and epilepsy are higher than the sum of the costs of diabetes and cerebrovascular diseases,” says Prof. Vladimír Komárek from NEUR-IN, the Department of Child Neurology, 2nd Faculty of Medicine, Charles University Hospital and Motol University Hospital, and the EPIREC Epileptology Centre.
It is not without significance that children with neurodevelopmental disorders suffer more often and earlier from neurodegenerative diseases in adulthood and are therefore candidates for early diagnosis and possible preventive therapy.
“Since there is currently no causal treatment for these diseases, the key to tackling this creeping epidemic is the translational link between basic and clinical research within EPIREC, from the molecular and genetic level through laboratory models to personalised treatment with tailored drugs or gene therapy,” explains Prof. Vladimír Komárek. “The concentrated collaboration of research institutes from all over the Czech Republic within NEUR-IN, linked to top neuroscience centres abroad, brings not only hope for our patients and their families, but also economic benefits for society as a whole.”
The NEUR-IN Round Table entitled “Silent Epidemic – Dramatic Rise of Neurological and Neurodegenerative Diseases in the Czech Republic” was held on 13 March 2025 in the Chamber of Deputies of the Parliament of the Czech Republic under the auspices of MUDr. Romana Bělohlávková, Member of the Committee on Health, Chair of the Subcommittee on Public Health, Epidemiology and Prevention, MUDr. Tom Philippe, Vice-Chairman of the Health Committee and MUDr. Vít Kaňkovský, Chairman of the Social Policy Committee, in cooperation with the Czech Neurological Society ČLS JEP, the Society of Child Neurology ČLS JEP, the Czech League Against Epilepsy ČLS JEP and the National Institute for Research on the Socioeconomic Impact of Diseases and Systemic Risks (SYRI).
