The overall aim of the CTNR is to identify and target resilience mechanisms in neurodegeneration to implement innovative therapeutic concepts for primary and secondary neurodegenerative processes.

Resilience, in this context, is understood as an integrated concept for physical, cognitive and psycho-social resistance against neurodegenerative insults and/or their impacts. The concept thus ranges from neuroprotective and neuroregenerative factors on the molecular and cell biology level and cognitive and physical resources on the patient level to psycho-social and health system aspects on the population level.

The detailed knowledge of these resilience factors provides new perspectives for disease-modifying therapeutic interventions in primary and secondary neurodegeneration. The CTNR is organized into three tightly connected topics to lead to a qualitative leap in three dimensions:

1. Strong focus on mechanisms of resilience und their interplay with neurodegenerative processes to overcome the current standstill in the development of causative treatments for major neurodegenerative diseases.
2. Adoption of the concept of precision medicine to neurodegenerative disease care to establish predictors for cerebral resilience in primary and secondary neurodegeneration in humans.
3. Adoption of continuous bi-directional translation pathways where patient centeredness and patient-relevance and sustainability for the care system are the guiding principles for the development of new treatments and preventions for neurodegenerative insults.

Ad I. Mechanisms of resilience and their interplay with neurodegenerative processes

This topic is established in various research groups of the theoretical and clinical departments of the University Medical Centre Rostock in strong cooperation with engineer-science institutes of the University of Rostock. This strong connection of biomedical research and engineering science is exemplarily demonstrated by the Collaborative Research Centre (CRC) 1270 “Electrically Active Implants (ELAINE)”. A strong focus of the Rostock neuroscience community is the research on cell and animal models of neurodegenerative diseases with a clear focus on molecular and cellular mechanisms of resilience of neurons and their systems. The CTNR focuses on rare and mostly monogenetic neurodegenerative diseases, such as Amyotrophic Lateralsclerosis (ALS), Niemann-Pick disease and neuronal ceroid-lipofuscinosis (NCL) and on application-oriented animal models of Parkinson’s disease. 

Ad II. Precision medicine to establish predictors for cerebral resilience in primary and secondary neurodegeneration in humans

One key topic of the Rostock site of the German Centre for Neurodegenerative diseases (DZNE) is the development of imaging and biochemical biomarkers of neurodegenerative diseases and potential resilience markers. As an internationally unique selling point for Rostock, the whole developmental pipeline of such markers from multimodal animal imaging, functional imaging in small clinical cohorts to populations-based approaches in primary care settings is established in Rostock. Through the integration into large multicentre studies, such as the European DTI Study in Dementia, the European ADNI study, the European Huntington disease network, the German networks on ALS/FTD and Parkinson’s disease together with the cohort studies of the DZNE, Rostock’s neuroscience research is integrated into national and international networks with high visibility and the possibility of fast and targeted recruitment of patient populations. The joint work offers a strong link to fundamental and applied research in computer and cognitive science to develop information and communication technology based measures of human behaviour and function to monitor the course of neurodegenerative diseases and detect intervention effects on physical and functional patient-centred outcomes. 

Ad III. Adoption of continuous bi-directional translation pathways for development of new treatments and preventions in neurodegenerative diseases

The competence not only in basic science-oriented research in cell and animal models of neurodegenerative diseases as outlined above, but also a strong expertise in clinical research ensures the continuous bi-directional translational process to overcome current translational roadblocks in the development of novel therapeutic interventions. In this context, intervention is seen as a broad concept integrating all treatment approaching to strengthen physical, cognitive and psycho-social resistance against neurodegenerative insults and/or their impacts. The development of dementia assistance systems is one key topic of the Department Ageing of the Individual and of Society at the Interdisciplinary Faculty of the University of Rostock. In addition, the clinical members within the CTNR (clinical departments and the DZNE) are already conducting more than 30 mono- and multicentre trials in parallel, including investigator-initiated trials (IITs) according to the AMG in various indications such as dementias, movement disorders and motor neuron diseases, which together form a strong basis for the overall aim of the CTNR, namely to implement innovative therapeutic concepts for primary and secondary neurodegenerative processes.