What Goes Inside Neurologists’ Brain

The brain with all its myriad complexities has perplexed and fascinated mankind since time immemorial. With the advances in Neuroscience over the last few decades, a lot of these mysteries of the mind have been solved. However, what is that Neurologists themselves prefer in terms of content, discussions, and debates. Delving deep into this specialty and deciphering therapy trends sums up the essence of this write-up.

In this article, we will briefly touch upon insights for Neurology as an overall specialty with a focus on migraine management. For this analysis, we have looked at data pertaining to a 8-month period between May to December 2020 on the MedSynapse platform considering both geographies – Middle East and South East Asia.

Neurology Content Publication and HCP Discussion Patterns

With over 80 content pieces published in Neurology, HCPs have predominantly engaged on the topics of Stroke (19%), Neuro-degenerative Disorders (15%), Multiple Sclerosis (11%), Headaches (8%) and Epilepsy (8%) [Figure 1]. These 80 contents resulted in 326 discussions on the platform revolving mainly around the subjects of treatment guidelines (13%), digital health (11%) and diagnostic imaging studies – CT & MRI (14%) [Figure 2].

However, before coming to any sort of consensus, it is important to look at the presented information through the right lens. For example, World Stroke Day is celebrated every year in October and there generally tend to be an uptick in stroke related discussions during this month. The festive month of December sometimes causes a decrease in publications and engagement of HCPs [Figure 3]. Analysing monthly and seasonal trends, therefore, would enable us in making much more objective assessments of visualized patterns, some of which may not be quite apparent at first glance.

Geographical influence plays a significant role in this space as well. Based on local and cultural differences, online behaviours vary accordingly. In addition, topics like headaches are quite broad and consist of several categories and sub-types each with its own specific features be it migraines, cluster headaches, tension headaches, etc. We need to examine areas where we require additional information so that relevant data can be extracted and analysed in totality. No information can be looked at in isolation, or else we run the risk of coming to erroneous conclusions.

Another aspect that also has a bearing on content engagement and discussions is the ripple effect created by already published content. One content acts a catalyst for subsequent ones, triggering more activity around a particular topic. Therefore, understanding content landscape is pertinent in pinpointing the precise reason for a particular peak or trough. What this also means is that regularly publishing high quality, credible, unbiased, and scientifically sound content in any specific area would result in increased organic publications and discussions on the same as well. As time progresses, HCP generated content (as opposed to editorial or sponsored sources) contributes to a major portion of platform publications in a particular therapy area which is a clear indication that the community is truly thriving and self-sustaining [Figure 4].

Keywords in Neurology and Online HCP Search Behavior

The top keywords specifically with respect to neurological conditions, therapy and management include the following [Figure 5].

Neurological Conditions

1. Stroke
2. Dementia
3. Multiple Sclerosis
4. Migraine
5. Seizures

Therapy and Management

1. Safety
2. Prevention
3. Efficacy
4. Guidelines
5. Diagnosis

Other Recurring Keywords: Telemedicine, effects of COVID on the brain, ALS, gait disorders, tremors, vertigo, Parkinson’s disease, and tumours.

The global pandemic raging on for well over a year now has had a huge impact in terms of HCPs looking for information on effects of the disease on the brain, virtual patient consultations and planning elective procedures and dealing with chronic disorders. Recent research findings hinting at long term neurological and psychiatric implications of COVID in long haulers would only fuel search patterns in this direction. Hence, being cognizant of the context becomes imperative while distilling out findings and sifting through outliers.

Migraine Content: Publications, Discussions & Trends

Although overall Neurology content experienced a dip in the month of December, number of migraine content was among the highest in the given period with similar numbers in June (Migraine Awareness Month) as well [Figure 6]. HCP generated content has accounted for 58% of total migraine related publications [Figure 7].

Migraine Content: Sentiment Analysis

Most of the Neurologists have a positive outlook about Migraine management given that the primary treatment objectives are met, with significant emphasis on the following [Figure 8].

1. Reducing frequency and intensity of attacks
2. Lowering disability and functional impairment
3. Prevention of disease progression (acute to chronic)
4. Avoiding structural changes in the brain

Nevertheless, HCPs have expressed quite a few concerns and challenges as well regarding the treatment of migraine. The negative sentiment is primarily with reference to the following [Figure 8].

1. Undesirable cardiovascular effects of triptans
2. High cost CGRP class of molecules used for mainly resistant cases
3. Overuse and abuse of analgesic by patients
4. Subjectivity of pain and accurate measurement of the same

Migraine Content: Opinion on Novel Treatment Modalities

Some of the more recently launched molecules for migraine discussed during the given period have been Rimegepant, Fremanezumab and Galcezenumab.

1. Rimegepant – HCPs are of the opinion that it does not have vasoconstrictive effects. However, they do feel that further studies are required in comparison with traditional migraine medication for the management of acute migraine.
2. Fremanezumab – Neurologists have agreed that it does help reduce number of migraine attacks and is metabolized in a manner that results in fewer side effects in treated patients.
3. Galcezenumab – Doctors have shared their experience of good tolerability of the drug among patient resulting in better adherence to treatment and lower rate of discontinuations.
4. Verbatim comments and queries by treating physicians (beyond the scope of this article) provide the closest to reality assessment in terms of receptiveness and acceptability of availability treatment options and the need for newer ones.

Note: Details provided in this article refer to only a basic level analysis to provide a glimpse of MedSynapse capabilities, solutions, and offerings. For more in-depth insights relevant to your molecule/brand/therapy area, please reach out to our team with your business requirements.

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