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While research on neurodegenerative pathology is robust, it remains inflexibly based within a mechanistic biomedical space. The influence of chronic inflammation relating to previous repetitive head trauma, peripheral inflammation, cardiovascular disease, obesity and the metabolic syndrome (diabetes and glucose metabolism) are clearly validated as predisposing to senile atrophy as well as to neurodegenerative conditions such as Alzheimer’s disease, Parkinson’s disease and Motor Neuron Disease (ALS). However the driving influence of mind state-generated chronic inflammation as revealed in the science of psychoneuro-immunology (PNI) is all but totally excluded from the existing research.

I would suggest that confined wholly to the mechanistic biomedical space and disregarding the subjective influence of mind states renders the research incomplete. Mind states such as meaninglessness, joylessness, a perception of personal irrelevance coupled with degrees of anxiety, predispose to chronic inflammation which compromises neurogenesis and neuroplasticity, resulting in atrophy and impaired function. Perhaps the athlete who had experienced multiple head blows in the course of his/her career devolves into a state of meaninglessness and personal irrelevance upon retirement and it is in fact the mind state which predisposes more significantly to the chronic inflammation that precipitates the emergence of ALS?

I contend that the mechanistic biomedical model is incomplete and unless elements of the biopsychosocial dynamic are incorporated into our enquiry of neurodegenerative pathology, both a comprehensive understanding as well as appropriate interventions will remain elusive.