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NI FEATURE: THE EDITORIAL DEBATE II-- PROS AND CONS
Year : 2017  |  Volume : 65  |  Issue : 5  |  Page : 968-

Muscular dystrophy: The long road ahead

Satish V Khadilkar 
 Department of Neurology, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India

Correspondence Address:
Satish V Khadilkar
110, New Wing, First Floor, Bombay Hospital, 12, New Marine Lines, Mumbai - 400 020, Maharashtra
India




How to cite this article:
Khadilkar SV. Muscular dystrophy: The long road ahead.Neurol India 2017;65:968-968


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Khadilkar SV. Muscular dystrophy: The long road ahead. Neurol India [serial online] 2017 [cited 2019 Oct 21 ];65:968-968
Available from: http://www.neurologyindia.com/text.asp?2017/65/5/968/214079


Full Text

Muscular dystrophy sufferers have to battle progressive disabilities and deterioration of quality of life. Long term medical efforts are continuing to understand this group of diseases and to find a solution to the progressive muscular weakness. Various regional and global organizations have joined hands in multicentre research into the behavior of these diseases, their pathophysiology and of late, some aspects of therapy. As a result of these efforts, a large body of information has been generated over the past few years and it is important to take an overview of what has been achieved in this field. Ram and colleagues[1] have done exactly that in their exposition of this subject in the current volume of Neurology India.

The authors systematically analyze the numbers of publications, countries of their origin and the materials of the manuscripts over a prolonged period of 25 years. Their key words cover a wide range of muscular dystrophies and include the congenital ones as well. The analysis shows that there is a steady growth of manuscripts in this field at the rate of 3.92% per year, which is steady and hence encouraging. The maximum growth seems to have occurred in the last decade, which the authors attribute to enrollment of funding agencies. An interesting aspect is the country wise distribution of the research output. As is well known, Europe has perhaps the best myology network with groups working on designated focus areas and attaining expertise in that area over periods of time. The referral systems are well organized, escalating the numbers of studied individuals. Such systems are less developed in other large regions of the world. Hence, it would be expected that the European conglomerate would lead the research output. The study, however, shows that a large output has been from the United States of America, at 35 percent of the total output. It would have been interesting to look at the breakup of the types of manuscript, basic, clinical, experimental and therapeutic, to obtain further insights into the issue.

India ranked fifteenth on the list of productivity, which is, in a way, heartening. We all realize that there is a real shortage of neurologists in our large and populous country with the work force of only a few thousand individuals. Most of them have to involve themselves in the clinical service segment, trying to fulfil the simple demands pertaining to neurological diseases. Those few who are in the research segment, have more rewarding disease options, for example, stroke or epilepsy. Very few researchers take up the field of myology; it is as yet therapeutically challenging. The field is also constrained by the requirements of laboratories and sophisticated instrumentations, which are not easy to come by in our low resource situation. Genetic advances, which form an important limb of the current research have only recently reached India and can be utilized in a limited manner. The cost is prohibitive and the implications and ramifications of the genetic diagnosis are multi-fold. On the backdrop of all this, it is indeed heartening that India has participated in the muscular dystrophy research and is at the fifteenth position.[2] We do expect and hope that over the ensuing years, more individuals in India take to this research field.

A matter of general concern is that muscular diseases are proving to be much too complex and we are not able to modify the course of these diseases in spite of so much of activity in the field. At the present time, the best results are few and are far between, to quote some of them, steroids in Duchene muscular dystrophy, sialic acid in GNE myopathy or various attempts at genetic engineering. It appears that a lot more time, resources and energy will have to be apportioned to the field of muscular dystrophies, for obtaining fruitful conclusions.

References

1Ram S. Global muscular dystrophy research: A 25-year bibliometric perspective. Neurol India 2017;65:993-1000.
2Khadilkar SV, Wagh S. Practice patterns of neurology in India: Fewer hands, more work. Neurol India 2007;55:27-30.