Effects of Neurological Disorders on Bone Health

Abstract

Neurological diseases, particularly in the context of aging, have serious impacts on quality of life and can negatively affect bone health. The brain-bone axis is critically important for skeletal metabolism, sensory innervation, and endocrine cross-talk between these organs. This review discusses current evidence for the cellular and molecular mechanisms by which various neurological disease categories, including autoimmune, developmental, dementia-related, movement, neuromuscular, stroke, trauma, and psychological, impart changes in bone homeostasis and mass, as well as fracture risk. Likewise, how bone may affect neurological function is discussed. Gaining a better understanding of brain-bone interactions, particularly in patients with underlying neurological disorders, may lead to development of novel therapies and discovery of shared risk factors, as well as highlight the need for broad, whole-health clinical approaches toward treatment.

Keywords: Neurology; PTSD; bone; depression; disease; mental health; osteoporosis.

FIGURE 1

Proposed methods to improve bone health in patients with neurological disorders. There is considerable clinical evidence demonstrating negative impacts of neurological diseases on bone across many disease categories. Patients with neurological diseases exhibit decreased BMD, as well as increased risk for osteoporosis and fracture. Careful clinical monitoring, clinical intervention, and positive lifestyle changes may lead to better bone outcomes in certain subsets of neurological disease patients.