Named Lectures at the World Congress of Neurology (WCN)

By Peter J. Koehler

Giving names to lectures has been a general phenomenon in various fields of society, including the humanities and sciences, since at least over 100 years ago. These may be public lectures or lectures presented for members of an association. Through the years, the World Federation of Neurology (WFN) started a tradition of named lectures at the WFN’s World Congress of Neurology (WCN) and one may wonder, who were the people behind these names. What did they do to become well-known within the neurological community? In this article, I will provide biographical sketches of these persons.

Victor and Clara Soriano Award Lectures and the Soriano Lecture of the Fulton Society Symposium

John Farquhar Fulton (courtesy Wellcome Institute)

With respect to the Soriano lectures, the WFN webpage mentions that “The Fulton Society, Victor and Clara Soriano, and the Soriano Lectureship, are endowed lectures presented at the World Congresses of Neurology.”1 So let us first discuss John Farquhar Fulton (1899-1960) and then come back to the Sorianos. Born the son of ophthalmologist John Farquhar Fulton and Edith Stanley Wheaton in St. Paul (Minnesota),2 John Jr. graduated at Harvard with the degree of Bachelor of Science magna cum laude in 1921. He went to Oxford, England, receiving a BA with first class honors in physiology (Oxford). In 1923, he had married Lucia Pickering Wheatland, who was descending from a rich family in Salem, Massachusetts. The marriage remained childless.

John worked in the laboratory of the famous neurophysiologist and Nobel laureate (1932) Charles Scott Sherrington (1857-1952) and published a 644-page monograph Muscular Contraction and the Reflex Control of Movement in 1926. With a Doctor of Philosophy degree, he returned to Harvard, where he was awarded his MD, magna cum laude (1927). He spent a year at the Peter Bent Brigham Hospital in Boston with neurosurgeon Harvey Cushing, and they became life-long friends. He went to Sherrington’s laboratory for another period, and in 1930, he was appointed Sterling Professor at Yale University, the youngest at the University, establishing the first U.S. primate physiology laboratory. His contribution to functional localization in the cerebral cortex is of paramount importance. The combination of his training in physiology under Sherrington and clinical medicine, including his training under Cushing, later resulted in the book Physiology of the Nervous System (1938), which was translated into at least six languages. He attracted neurologists, neurosurgeons, and physiologists from the U.S. as well as from abroad.

In cooperation with Johannes G. Dusser de Barenne (1885-1940), he founded the Journal of Neurophysiology (1938). During the war, Fulton worked in the field of aviation physiology. His interest in the history of science culminated in one of the greatest collections of the history of medicine in the world at Yale and in a biography of Harvey Cushing (1946). In 1951, Fulton became professor of the history of medicine at the new homonymic department, a decision in which his hard working and health may have played a role. He acquired Cushing’s book collection and became editor of Journal of the History of Medicine and Allied Sciences.3,4

Victor Soriano (from World Neurology, May 14th, 2018)

Victor Soriano (1909-2005) was one of the many fellows of Fulton at Yale University. With his wife Clara, he was among the founders of the Fulton Society, perhaps inspired by the Harvey Cushing Society5 and the Osler Society,6 and started the Fulton Society Symposium, including the Soriano Lecture, at the World Congress of Neurology in New Delhi in 1989.7

Born from Jewish parents on the Mediterranean isle Rhodes, when it was still belonging to the Ottoman Empire, but becoming an Italian possession in 1912, the family emigrated to Montevideo, Uruguay, when he was 9 months old. Therefore, he considered himself Turkish, Italian, which is not quite correct, and Uruguayan. His father, a respected tailor, founded the Sephardic synagogue of Montevideo. Victor received his MD in 1934 and had been particularly interested in the physician Américo Ricaldoni’s (1867-1928) teaching in clinical neurology. Founded in 1926, Soriano became neurologist at the Instituto de Neurología of Montevideo in 1935, and in 1937, a new professor was appointed to succeed Ricaldoni, notably Alejandro Schroeder (1890-1954), who had trained at various German and French hospitals and institutes. Soriano taught neurology and worked at several hospitals and institutes in Montevideo. He was appointed assistant professor of medicine in 1943.

In the meantime, he had married Clara, also known as Clarita Benzecry, in 1939. She supported and encouraged his work in several social and medical activities. When Victor founded the Uruguayan Committee of Friends of the Weizmann Institute of Israel, she organized meetings at their home. Moreover, she hosted weekly scientific, literary, and musical events. Supported by the Rockefeller Foundation, Soriano stayed with Fulton at Yale in 1945 and with Hiram Houston Merritt Jr. (1902-1979) at the Montefiore Hospital affiliated to Columbia University in 1947. From 1948 on and accompanied by Clarita, he attended all American Neurological Association (ANA) meetings as well as a number of World Congresses of Neurology (WCNs). The year following Fulton’s death, at the Rome meeting of 1961, Soriano and Giuseppe Moruzzi (1910-1986), who had discovered the ARAS (ascending reticular arousing system) and its relation to sleep and waking with Horace W. Magoun (1907-1991) in the 1940s, founded the Fulton Society. The society was commended to organize a special symposium at meetings of the ANA and the WCN. Selected researchers of neuroscience were to present lectures on the advances of research in the nervous system. In 1987, the Sorianos decided to become sponsor of a lectureship at the ANA meetings. The WFN has two types of lectures associated with the Sorianos, including the one mentioned above at the Fulton Society Symposium (Soriano Lecture) and the other named Victor and Clara Soriano Award Lecture.8 The lecturers through the years can be found at Soriano Award Lectures and include Nobel Prize winners Rita Levi-Montalcini (1909-2012), Stanley B. Prusiner (born 1942), and Bert Sakmann (born 1942). More information on Soriano can be found in the May 2018 issue of World Neurology.

The Richard L. and Mary Masland Lecture

Richard L. Masland (Courtesy NLM Digital Collections, Public Domain

Richard Lambert Masland (1910-2003) was born the son of a textile executive in Philadelphia. He received his Bachelor’s degree from Haverford College and his MD from the University of Pennsylvania. During WWII, he was in charge of altitude flight training for flight surgeons at the School of Aviation Medicine in San Antonio, Texas. In 1947, he certified for neurology and psychiatry. He worked as a neurologist at Bowman Gray School of Medicine in Winston Salem, North Carolina. He had a special interest in the origin of mental retardation and tried to find ways to decrease its prevalence. He joined the National Association for Retarded Children, and his research results were published in the book Mental Subnormality: Biological, Psychological, and Cultural Factors (1958), of which he was first author. These achievements resulted in his recruitment as assistant director (1957) and director (1959) of the National Institute of Neurologic Diseases and Blindness (NINDB) of the NIH, where he worked until 1968.

He led a landmark study on the causes of birth defects, notably the National Collaborative Perinatal Project, a study of pregnancy and child development (1959-1966). It was designed to study risk factors in pregnancy for cerebral palsy and included over 50,000 pregnant women and their children through age 7. It led to over 400 scientific articles and dozens of books and monographs, in which factors like smoking and rubella virus could be associated with mental retardation.

In 1968, Masland became chairman of neurology at the College of Physicians and Surgeons of Columbia University. He directed the Neurologic Service at the Neurological Institute of New York at the Presbyterian Hospital. Neurologist Lewis P. Rowland (1925-2017) said “The residents were very fond of him. They called him the ‘white rabbit’ for his prematurely white hair and for his scurrying around.”9

Masland served as president of the American Epilepsy Society and of the WFN (1981-1989). In the latter position he was instrumental in changing the newsletter into a scientific journal (Journal of the Neurological Sciences). He was married to Mary Wootton of Englewood, a speech and language pathologist, with whom he had four children.10 He published many articles and received various awards, including the Award of Merit from the National Association for Retarded Children, which was presented to him by President John F. Kennedy in 1963.

Dr. Bhim S. Singhal Lecture11

Bhim Sen Singhal (Public Domain CCA 3.0)

Born in Mount Abu (in Rajasthan, north-west India) in 1933, Bhimsen Sen Singhal studied medicine, receiving his MD in 1956, and trained for neurology in Mumbai at the Grand Medical College under professor Noshir H. Wadia (1925-2016). He continued his training at the University College of London (UCL) Queen Square Institute of Neurology and became MRCP (Edinburgh, 1960) and MRCP (London, 1961).

Upon his return to India in 1962, he worked at the department of neurology at Grant Medical College and Sir. J. J. Group of Hospitals, where he became professor and chairman of the department. He was also active at the Bombay Hospital Institute of Medical Sciences in Mumbai. In 1991, he retired from the Grant Medical College, but continued his activities at the Bombay Hospital Institute. He trained many neurologists and published numerous articles and book chapters. He was interested in particular in multiple sclerosis,12 myasthenia gravis,13 and Parkinson’s disease. Singhal and co-workers described the entity of megalencephalic leukodystrophy (1996), especially prevalent in the Agarwal (anglicized term for Agrawal) community.14 In 2004, with international collaboration, he was one of the authors of a report in which the identification of its gene defect was described.15

Singhal served for many national and international organizations, including the Neurological Society of India, of which he was president in 1986, and the WFN as regional director. He was honored with a number of prestigious national awards, including the Padma Shri. This is awarded annually on India’s Republic Day and is the fourth-highest civilian award of the country. The award was not only a recognition for his clinical and academic work, but also his efforts through non-profit national foundations. An example of the latter was his initiative to establish the Neurology Foundation in 1998, to improve knowledge and provide assistance in patient care. This includes financial assistance for medical treatment, rehabilitation therapies for children and adults from low socio-economic areas, community outreach, and support for professional organizations such as the Multiple Sclerosis Society of India and the Indian Epilepsy Association. The foundation also started biennial Neurology Update conferences that became very popular. In 2001, Singhal founded the Parkinson’s Disease and Movement Disorder Society (PDMDS), an all-India “Registered Charity Society.” This is a nonprofit charitable organization that supports patients and their caregivers and is also active in the rehabilitation of patients. He is honored by two lectureships, notably one at the WCN and the other at the Indian Academy of Neurology

Dr. Singhal is married to Dr. Asha Singhal, who is an obstetrician and gynecologist. Like her husband, she has devoted her life to underprivileged people. They have a son, who is a stroke neurologist at the Massachusetts General Hospital, and a daughter, who is a professor of medicine (hematology and oncology) in Chicago.

Bharucha Lecture16,17,18

Eddie Bharucha (from World Neurology, May 14th, 2018)

Eddie Phiroz Bharucha (1916-2017) was born in a privileged family. His father Phiroz C. Bharucha (1882-1952) was a physician in Bombay (the present Mumbai) and his mother Bachha descended from a business family in Karachi. Eddie’s mother died when he was 2 years old, and he was educated mainly by an English governess. He studied medicine in Bombay and London, after which he became Honorary Physician in Medicine at the King Edward Memorial and Seth G S Medical College (KEM) Hospital in Bombay (1945).

In the 1949-1952 period, he trained for neurology at the National Hospital for Nervous Diseases (Queen Square) in London that had been amalgamated with the Maida Vale Hospital in 1948. In this period, he also spent some time at Columbia University in New York (with Houston H. Merritt Jr.) and Boston City Hospital (with Derek Denny Brown (1901-1981)). When he returned to India and the KEM Hospital, he was the first neurologist in Bombay19 and in cooperation with neurosurgeon Ramchandra G. Ginde (1912-1974), who trained with Wilder Penfield (1891-1976) in Montreal, started a department of neurology and neurosurgery, with 12 beds each (1953). Bharuch also worked at the Bombay Hospital, which is a large private hospital that became a teaching hospital.

Eddie married pediatrician Dr. Piloo (Kohiyar) Bharucha in 1947 and together they practiced multidisciplinary care in pediatric neurology.20 They treated children with poliomyelitis and cerebral palsy at the Children’s Orthopedic Hospital. With respect to his research and publications, he was active in stroke, infections, nutritional and toxic (for instance, lathyrism) disorders, and epilepsy. He was a member of the editorial board of Vinken’s & Bruyn’s Handbook of Clinical Neurology from 1973. He was considered an empathic physician with an important sense for social responsibility for the underprivileged. He invested personal financial means for the purchase of an EEG machine and the import of D-penicillamine (to treat Wilson’s disease). Piloo and Eddie had three sons.

Eddie Bharucha held several positions in India and received the Dhanvantari Award for his outstanding contributions to medical sciences (1991). He was elected president of the Neurological Society of India (1956),20 vice president of the WFN (1969-1973), and president of the World Congress of Neurology in New Delhi, 1989. He was honorary member of several organizations, including the ANA. During the last 20 years of his life, he suffered from severe visual handicap. In anticipation of his decreasing vision, he read journal texts onto a Dictaphone so that he could later listen to the contents. With respect to his character, one of his sons, the neurologist Nadir Bharucha wrote, “He did not seek positions of power or prestige, was unconcerned about material remuneration, and perennially radiated good cheer, kindness, and caring.”16 The Bharucha family, students, and friends established the Eddie & Piloo Bharucha Fund for lectures to be held during World Congresses of Neurology.

The Melvin D. Yahr Lecture 22,23,24

Melvin D. Yahr (Courtesy Mount Sinai School of Medicine) see Melvin D Yahr – The Lancet]

Melvin D. Yahr (1917-2004) was born in New York City as the youngest of six children. His parents were orthodox Jewish immigrants from Austria-Hungary. His father was a baker. Melvin studied medicine, receiving his MD from New York University College of Medicine in 1943. Interrupted by military services, he specialized in neuropsychiatry and neurology at various New York hospitals during the following next six years. He married Felice Yahr, with whom he had four daughters. He worked at the College of Physicians and Surgeons, Columbia University, where he became H. Houston Merritt professor of neurology (1973) and at Mount Sinai School of Medicine (City University of New York), where he was professor and chair (1973-1992).

He created the first U.S. multidisciplinary center for research in Parkinson’s disease and related disorders, which he later took to Mount Sinai. He played a role in the training of over 100 neurologists. His name and that of the Canadian neurologist Margaret May Hoehn (1930-2005), who was associate professor at Columbia University at the time, were eponymized by the Hoehn and Yahr scale for determining the severity of Parkinson’s disease.25 The article was referred to in the following way: “Their work established that the average age of onset of PD [Parkinson’s disease] was in the sixth decade (ie, between ages 50-59 years), described a broad spectrum of rates of progression, established that PD was associated with an increased mortality rate, and concluded that there were no treatments that affected life expectancy”.23 Yahr was (co-) author of over 300 articles, including the first double-blind levodopa study (1969).26 He served at a number of U.S. Advisory Committees and held positions at various neurological organizations and congresses, including the ANA (president) and the WFN. From 1963, Parkinson’s disease became his main research subject.

He took the initiative to establish the Research Committee on Extrapyramidal Disorders of the WFN (1959) and chaired the Research Group (1972-2001). It transformed into the International Association of Parkinsonism and Related Disorders.27 He was member of the Editorial Boards of several journals, including the Archives of Neurology (now known as JAMA Neurology). He became honorary member of several national neurological societies. In one of the obituaries, he was described as follows: “His, with very few sentences precisely described situations, analyses and thoughts, which he performed in a dark, sometimes rough appearing lingo and often with a mischievous but wise facial expression, eyes only a wee bit open, will be unforgettable to everyone who got acquainted to Melvin Yahr”.24

Conclusion

The persons described in this article were hard working neurologists, with the exception of Fulton, who became an experimental neurophysiologist and historian of medicine. Several, if not all, of their wives, some of whom being physicians themselves, contributed to their success. Whereas the Soriano, Singhal, and Bharucha Lectures were founded by the respective families (and friends), the Richard L. and Mary Masland Lecture and the Melvin D. Yahr Lecture were sponsored by the World Neurology Foundation (U.S. based) that was created in 1999. Another difference perhaps is that next to scientific, social efforts may have been a more important part of the careers and subsequent initiatives of Soriano, Singhal, and Bharucha. In contrast, scientific achievements may have been the more important motivation for the founding of the Masland and Yahr Lectures. •

 

References and Footnotes

  1. See Soriano Award Lectures; accessed December 17th, 2022
  2. Gariepy TP. John Farquhar Fulton and the History of Science Society. Isis 1999;90:S7-27.
  3. Davey LM. Obituary. John Farquhar Fulton, 1899-1960. J Neurosurg. 1960;17:1119-23.
  4. Igual MM. John F. Fulton (1899-1960): neurophysiologist, bibliophile, and historian. His relationship with Spain. Neurosci Hist  2019;7:62-76.
  5. It became American Association of Neurological Surgeons (AANS) in 1967; see Introduction (aans.org); accessed December 17th, 2022.
  6. In fact there are several Osler Societies, including the American Osler Society dedicated to the history of medicine and the William Osler Society of Australia & New Zealand.
  7. For a list of lecturers since the foundation see Soriano Award Lectures.
  8. An important source for the information in this biographical sketch is Victor Soriano.
  9. Oransky I. Obituary: Richard L Masland. Lancet 2004;363:663.
  10. Pedley TA, Rowland LP. In Memoriam: Richard Lambert Masland, MD (1910-2003). Neurology 2004;62:1056-7.
  11. This article is partly based on: Meshram C. Padma Shri for Dr. Bhimsen Singhal. World Neurology 2022, May 15th.
  12. See for instance Singhal BS, Advani H. Multiple sclerosis in India: An overview. Ann Indian Acad Neurol. 2015 Sep;18(Suppl 1):S2-5.
  13. Singhal BS, Bhatia NS, Umesh T, Menon S. Myasthenia gravis: a study from India. Neurol India. 2008;56:352-5.
  14. Singhal BS, Gursahani RD, Udani VP, Biniwale AA. Megalencephalic leukodystrophy in an Asian Indian ethnic group. Pediatr Neurol. 1996;14:291-6.
  15. Gorospe JR, Singhal BS, Kainu T, Wu F, Stephan D, Trent J, Hoffman EP, Naidu S. Indian Agarwal megalencephalic leukodystrophy with cysts is caused by a common MLC1 mutation. Neurology. 2004;62:878-82.
  16. Bharucha N. Eddie Phiroz Bharucha. World Neurology 2018, May 14th.
  17. Shah P, Seshia S. Dr. Eddie P. Bharucha (December 28, 1916–December 14, 2017). Ann Indian Acad Neurol 2018;21:91-2.
  18. Shah PU, Saxena VS. Dr. Eddie Phiroze Bharucha (December 28, 1916–December 14, 2017). Int J Epilepsy 2018;5:53-5.
  19. Poser CM, Crawford Poser J. Neurology in the developing world. Brain 2006;129:1624-9.
  20. Bharucha, 2018.
  21. Culebras A. Named Lectures at the World Congress of Neurology. Neurology 2005;65:31-2a.
  22. Charatan F. Melvin Yahr. Neurologist who revolutionised the treatment of Parkinson’s disease. BMJ 2004;328:290.
  23. Oransky I. Melvin D. Yarh. Lancet 2004;363:903.
  24. Riederer PF, Hirsch E, Youdim MB, Calne DB. A tribute for Prof. Dr. Melvin D. Yahr, M.D. (1917-2004). J Neural Transm (Vienna). 2004;111:1205-8.
  25. Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology 1967;17:427-42.
  26. Yahr MD, Duvoisin RC, Schear MJ, Barrett RE, Hoehn MM. Treatment of parkinsonism with levodopa. Arch Neurol 1969;21:343-54.

27.       See About IAPRD – IAPRD 2023 (iaprd-world-congress.com); accessed December 26th, 2022.

Growing the African Neurological and Scientific Workforce

Spreading the reach of neurology across the continent.

By Augustina Charway-Felli and Amadou Gallo Diop

Photos from the biannual francophone contest November 2022, in Abidjan, Cote d’Ivoire, involving 10 new African professors of neurology and three psychiatrists

Nov. 12, 2022, marked the end of the biennial Francophone contest of the headquarters of the African and Malagasy Council for Higher Education (Conseil Africain et Malgache pour l’Enseignement Superieur [CAMES]). Congratulations to the 10 new African professors of neurology (and three psychiatrists) who were successful at the contest that concluded in Abidjan in Cote d’Ivoire.

The first ranked candidate, Prof. Medinatou Atoukè Agbetou, from Benin, coincidentally benefited from a sponsored one-year epileptology training fellowship in Dakar, Senegal, at the World Federation of Neurology (WFN) accredited neurology department of Universitaire Cheikh Anta Diop (Cheikh Anta Diop University-UCAD) three years prior.

Photos from the biannual francophone contest November 2022, in Abidjan, Cote d’Ivoire, involving 10 new African professors of neurology and three psychiatrists

Other individuals and countries represented were: Maouli Fall and Ndiaga Matar Gaye from Senegal; Kokou Mensah Guinhouya (Togo); Seybou Hassane (Mali); Lompo Labodi and Anselme Dabilgou (Burkina Faso); Ghislain Armel Mpandzou and Prince Eliot Gallieni Sounga Bandzouzi (Congo); and Emmanuel Yangatimbi (Central African Republic).

CAMES is the coordinating body for higher education and research systems in francophone Africa. It serves also as the accreditation body for various degrees (Bachelor’s, Master’s, Doctorates, etc.) in its member countries. The UCAD Neurology Department has a longstanding tradition of training in neurology for trainees across French-speaking Africa and several of the above-mentioned successful candidates have their roots in this department.

Though a seemingly small number of new professors, these individuals now serve to continue sharing knowledge and training new cadres in neurology and build on the foundation set by the likes of Michel Dumas, Amadou Gallo Diop, Riadh Gouider, and Therese Sonan, to name a few. Examples of similar growth of neurological departments and local training of neurologists are plentiful across other parts of the continent in luso- and anglophone countries. The African Academy of Neurology (AFAN) is proud of all these efforts and will continue to support individual, country, and regional efforts to build up the neurological workforce with internal resources and reduce the brain drain that is threatening the African Continent. •

Augustina Charway-Felli is president of the African Academy of Neurology. Amadou Gallo Diop is head of the department of neurology at Cheikh Anta Diop University, Dakar, Senegal, and is past trustee of the WFN.

Dementia Prevention: Can We Do Better?

By Vladimir Hachinski, MD, DSc, FRCPC, FRSC

Note from the Editors: This photo is of Prof. Hachinski being awarded the Potemkin prize (sometimes referred to as the “Nobel Prize of Alzheimer’s research”) at the American Brain Foundation gala at the 2022 AAN Annual Meeting in Seattle, Washington. Andi Potamkin, the grandaughter of Luba and Victor Potemkin, who endowed the Potemkin Prize in 1988, is shown presenting the award to Prof. Hachinski.

The publication of the results of lecanemab for the treatment of early Alzheimer’s disease has generated hype, hope, and questions. Questions include:

Can we do better in dementia prevention than finding a “silver bullet” drug?

Are we doing enough to stem the rising wave of neurological disorders that are now the leading causes of disability adjusted life years (DALY), particularly stroke and dementia, that account for 62% of these?1

Although the absolute numbers of stroke and dementia cases continue to rise in most countries, the stroke cases per thousand have declined in 165 of 209 countries. Dementia has proven more intractable; only 18 out of 204 countries have had a decline in incidence.2 What accounts for the decreased incidence in these countries? What are we doing right? Looks like a great opportunity to find out and begin preventing some dementias systematically.

However, so far the bulk of funds and efforts have been to find an effective drug against dementia. The clinical trials have yielded equivocal results. Part of the reason lies in the concomitant multiple causes of dementia in older adults that result in Alzheimer’s disease. In older adults, it is not a disease, but a syndrome of up to eight different pathologies.3 To date only one drug, lecanemab, might have some minimal effect in the early stages of Alzheimer’s disease.”4 However, it will probably cost tens of thousands of dollars, it requires the inconvenience and costs of intravenous infusions, and carries the risk of brain edema and hemorrhage. Nevertheless, the search to find drugs for specific etiologies needs to go on, so that at some point in the future we can target the different causes that lead to dementia. But what do we do in the meantime?

One encouraging development has been the FINGER study, showing that intensive lifestyle management can slow cognitive progression in persons at risk of dementia.5 This approach has now been expanded to a series of similar studies in several countries.6 This is promising and deserves testing in different settings and populations. Limitations include the considerable resources required to implement the extensive interventions and the fact that it targets only a fragment of a given population.

The WHO’s Global Action Plan7 is more comprehensive and advocates a life course approach. It provides excellent information, but little on motivation and less on implementation, this being up to the governments of the member countries. Some countries have national dementia plans, but most focus on caring for those afflicted, with little funding left for prevention.

The news is more encouraging in smaller jurisdictions. The province of Ontario, Canada, introduced a stroke strategy associated with a 32% decrease in the incidence of stroke and 7% of dementia over 12 years.8 We now are trying to find out what accounts for the decline. We are using a comprehensive approach, including environmental, socioeconomic, and individual risk and protective factors, customized, focusing on the most promising targets and assuring that it is cost effective, to justify the investment.9

We consider it important to carry out prevention at the level of “actionable units.” This means a group or population that has a sense of community. In our case, it will be a health region comprising 525,000 inhabitants. Moreover, we will target stroke, heart disease, and dementia together10 around a positive message of “brain health for all, now” and work through the leaders of government, businesses, labor, voluntary organizations, and with the help of the Heart and Stroke Foundation of Canada, Hypertension Canada, and the Alzheimer Society of Canada.

Prevention remains the best way to stem the tide of stroke, heart disease, and dementia, but we have to foster new approaches such as the comprehensive, customized, cost effective (The Triple C) approach, to complement the current ones. We can, we must, we will do better in dementia prevention; millions of brains depend on it. •

Vladimir Hachinski is past president of the World Federation of Neurology and the 2022 recipient of the Potamkin Prize.

 

References

  1. Avan A, Hachinski V. Stroke and dementia, leading causes of neurological disability and death, potential for prevention. Alzheimers Dement. 2021 Jun;17(6):1072-1076. Epub 2021 May 31. PMID: 34057294. DOI: 10.1002/alz.12340
  2. Avan A, Hachinski V. Global, regional, and national trends of dementia incidence and risk factors, 1990-2019: A Global Burden of Disease study. Alzheimers Dement. 2022 Aug 31. doi: 10.1002/alz.12764. Online ahead of print.PMID: 36044376
  3. Boyle PA, Yu L, Wilson RS, Leurgans SE, Schneider JA, Bennett DA. Person-specific contribution of neuropathologies to cognitive loss in old age. Ann Neurol. 2018 Jan;83(1):74-83. doi: 10.1002/ana.25123. Epub 2018 Jan 14. PMID: 29244218 Free PMC article.
  4. van Dyck CH, Swanson CJ, Aisen P, Bateman RJ, Chen C, Gee M, Kanekiyo M et al. Lecanemab in Early Alzheimer’s Disease. November 29, 2022. DOI: 10.1056/NEJMoa2212948
  5. Ngandu T, Lehtisalo J, Solomon A, et al. A 2-year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): A randomised controlled trial. The Lancet 2015;385:2255-2263
  6. Kivipelto M, Mangialasche F, Snyder HM, et al. World-Wide FINGERS network: a global approach to risk reduction and prevention of dementia. Alzheimers Dement. 2020;16:1078-1094.
  7. WHO Global Action Plan. https://www.who.int/publications/i/item/global-action-plan-on-the-public-health-response-to-dementia-2017—2025
  8. Sposato LA, Kapral MK, Wu J, Gill SS, Hackam DG, Cipriano LE, Hachinski V. Declining incidence of stroke and dementia: Coincidence or prevention opportunity? JAMA Neurol. 2015;72:1529-1531
  9. Hachinski V, Dementia Prevention Initiative. The comprehensive, customized, cost-effective approach (CCCAP) to prevention of dementia Alzheimers Dement. 2022 Feb 1. doi: 10.1002/alz.12586. Online ahead of print. PMID: 35103397. DOI: 10.1002/alz.12586
  10. Hachinski V. Brain Health-Curbing Stroke, Heart Disease, and Dementia: The 2020 Wartenberg Lecture. Neurology. 2021 Aug 10;97(6):273-279. Epub 2021 Apr 21. PMID: 33883239 DOI: 10.1212/WNL.0000000000012103

My Experience at the Medical University of Graz, Austria

By Seblewongel Asmare Seyoum

The neurology department building at Medical University of Graz.

I had the chance to participate in the department visit program of Austria 2022, which was organized in collaboration between the Austrian Neurological Society (OEGN) and the WFN.  I stayed for four weeks in the beautiful and historic city of Graz, Austria. I had a lot of experiences and exposure during my stay.

On my first day, I met with a welcoming secretary of the department, Michaela Schweiger, who gave me a tour of the department and the hospital compound to familiarize me with the property as soon as possible. She also introduced me to Prof. Christian Enzinger, and we had a brief discussion about how to spend the four weeks in the department. I was assigned to the neurointensive care unit and started to work on the same day.  At the unit, I met a team of specialists who are hard-working and dedicated. I joined them in every activity, including rounds, case discussions, and bedside procedures. I appreciated how the patients get quality and scientific care.

Prof. Christian Enzinger and the general neurology ward team.

In my second week, I joined the stroke unit team. I met different stroke specialists who are expert both in clinical and research activities. We did rounds and discussed each clinical case. We also discussed some published articles. The team also introduced me to the radiology department, and I was able to see some neurointerventional procedures in the operation room, such as aneurysm coiling, diagnostic digital subtraction angiography, and other procedures.

I spent the third week rotating at different outpatient clinics. I got to see many different cases and up-to-date management. I had the chance to see many new drugs being used and procedures being done routinely like EEG, NCS/EMG, and nerve ultrasound. It was the best week since I got to meet many experienced doctors and discuss each case in detail.

On my last week, I stayed in the general neurology ward, where I got to see some cases that I don’t usually see in my country.  Meanwhile, the international office of the university was able to arrange a guided city tour and intercultural get-together, which allowed me to connect with many other students and doctors who come from different countries.

Overall, my stay was pleasant and overwhelming with all the new hospital setup, the culture, and the weather too. I did all to get the best out of my stay. It motivated me to take and implement all the experience I gained to my country and to pursue more in my neurology career. One of the challenges I faced was the language barrier, but the staff was so helpful to translate and discuss in English.

As a recommendation, it would be great if these observership programs were available for more neurologists and if more fellowship programs are open to supporting the physicians and the society at large.

Last but not least, I would like to thank all the staff of the department of neurology at the Medical University of Graz, the Austrian Neurological Society (OEGN), and the WFN for giving me this great opportunity. •

Seblewongel Asmare Seyoum is a a neurologist at Bahir Dar University in Ethiopia.

My visit to Innsbruck Hospital, Austria

Stimulating and eye-opening! If I were to neatly describe my experience at Innsbruck Hospital in Austria, this would be it.

Neurology consultants at Innsbruck Medical University Hospital. (Left to right) Bettina Pfausler, Heena Narotam Jeena, and Martin Sojer.

I am deeply indebted to the World Federation of Neurology and Austrian Neurology Society for providing me with the opportunity to take part in this African Initiative project. My gratitude extends to Sophia Huppmann (social secretary of the Austrian Neurology Society) for tirelessly coordinating the logistics of my stay and to the consultant neurologists Michael Knoflach, Martin Sojer, and Bettina Pfausler for their hospitality and for ensuring I gain the most from my time in and out of the hospital in Innsbruck. Lastly, to my home institution of Tygerberg Hospital and my colleagues, thank you for affording me the time away from work in order to pursue this opportunity.

From the moment I peered through the aeroplane window upon our descent into Salzburg, marveling at the view of the rolling green hills, snow-capped Alps, and scattered village-like dwellings, I knew a unique and enriching experience was about to unfold.

I landed the evening in Salzburg and took the train to Innsbruck the next morning. It did not take me long to realize that I was, for all intents and purposes, functionally aphasic and that my German needed some work. I invested more time into learning the language, and on my first morning at the hospital could thankfully access some basic necessities with ease: “ein große americano, bitte!” (one large americano, please!).

The Innsbruck Medical University.

Every morning I would kit up and brace the refreshing cold air as I walked a short distance of 1 km to get to the hospital. The neurology division at the hospital consists of four wards (stroke unit, general neurology, epilepsy, and intensive care unit).

I spent my first two weeks in the stroke unit, where I was exposed to a multitude of stroke cases. I witnessed impressive door-to-needle times and had first-hand exposure to the day-to-day running of the unit. I quickly realized that access to direct oral anticoagulants and administration of intravenous heparin was easily accessible and formed part of standard practice; warfarin is not routinely used. MRI brain and Doppler of the neck vessels is the investigation of choice for stroke aetiology workup, and this is sometimes followed by angiography and FDG-PET, where indicated. The European guidelines are followed when evaluating the ultrasonography findings to make a decision with regards to management.

The health care worker to patient ratio is impressive, and access to diagnostic tests is readily available. An electronic recordkeeping system, which instantly uploads test results, diagnostic images, and patient notes, is used. Each staff member is equipped with a mobile telephone to use for communication within the hospital, as well as to contact external hospitals and patient family members. Each ward has a secretary who is responsible for arranging the relevant diagnostic tests as well as assisting with administration related to patient care.

View of Innsbruck from the top of Arzler Alm in Innsbruck.

I also spent time in the outpatient department and was exposed to various specialised clinics such as the Huntington’s clinic, ataxia clinic, Parkinson’s clinic, and botulinum toxin clinic. The Medical Emergency Department was another favorite place of mine to visit. Here, I would join the neurology resident and consultant as they attended to various neurological cases, including headache, backache, seizures, and strokes, to name but a few examples.

My last two weeks were spent in the neurology intensive care unit. The team of consultants managing the unit are neurointensivists, and residents spend part of their training time learning to manage critically ill neurological patients. These patients may, however, also have multiorgan involvement and co-management with other disciplines.

All in all, my experience at the Innsbruck Medical University Hospital has been excellent. The partial language barrier has been to my benefit — I was forced to really look at the patients, their body language, and clinical signs and listen to the prosody of their speech in order to gain an understanding of their impairments. In neurology, we can learn so much through observing our patients. I trust that the exposure to a broad spectrum of neurological disease will prove to be beneficial to my future practice in the field. Furthermore, the opportunity for personal growth which this experience has afforded me is far-reaching.

As the adage goes, all good things must come to an end. I look forward to the next part of my journey where I am able to offer greater insight and expertise into the management of patients with neurological disorders. The relationships that have been fostered with experts in the field are invaluable, and we are already exploring avenues with which to facilitate continuous education, research, and collaboration in the near future. Ending my stay with a stimulating and engaging meeting with Prof. Wolfgang Grisold, WFN president, has reawakened the advocate inside me and reminded me that kindness and humility are the highest accolades to strive toward. •

Heena Narotam Jeena is a registrar in the division of neurology at Tygerberg Hospital/University of Stellenbosch in Cape Town, South Africa.

Austrian Neurology Department in Salzburg

Visit for a young Nigerian neurologist: a generosity beyond measure

By Daniel Ekhaeyouno Ezuduemoih

Dr. Ezuduemoih with Marco Medina, WFN co-opted trustee, and Wolfgang Grisold, WFN president in Dr. Grisold’s office in Vienna.

Taking an academic voyage in medicine as a student and then a resident in neurology in a densely populated country like Nigeria with a teeming number of patients with neurological diseases has come with its own two sides of the same coin: one with knowledge-based learning driven by experienced teachers in a technology disadvantaged setting, where some neurological diseases are attributed to cultural causes for want of a better explanation. Honing one’s clinical skills in this setting and the desire to continuously improve oneself quickly became a non-negotiable requirement. Learning was made worthwhile by being blessed and mentored by seasoned tutors whom themselves have extensive clinical experience from many years of practice.

My training center, Lagos University Teaching Hospital, designed the neurology residency to accommodate a variety of seminar presentations, didactic sessions, and learning opportunities. Despite these opportunities for learning, the urge to see how things are done in a more advanced setting sprang from a deep-seated craving yearning for fulfillment. I applied as soon as a position for a department visit to the Austrian Neurology Department became available, so I could see how the system works. Fortunately, I was selected.

On arrival in Vienna, I boarded a train to Salzburg, where I would start my posting cum observership the next day in the neurology department of the Christian Doppler Clinic with my designated mentor, Prof. Eugen Trinka, a pleasant, joyful, and highly regarded epileptologist. Dr. Giorgi Kuchukhidze and the department’s secretary, Christa Muller were on hand to welcome me the next morning. They walked me through the paperwork and showed me around Salzburg’s facilities and the surrounding areas.

I was more than thrilled to be able to participate in daily morning reviews of patients from the prior day’s call duty. Dr. Bosque Pilar, a Spanish PhD student in epilepsy, was always willing to translate German into English for me. Every morning, I looked forward to this meeting not only for its rich educational substance but also for the show of genuine patient empathy. Everyone welcomed me with open arms. I witnessed timeliness, orderliness, team spirit, and astute attention to duty in all ages. Doctors, nurses, and other support staff worked well together.

Dr. Susanne Grinzinger, who specialized in NCS and EMG, and her resident, Dr. Bernadette Wigand, would take turns explaining the fundamentals of NCS and EMG to me during nerve conduction and electromyography sessions, and they made the process seamless. On weekends, she would give me textbooks to study NCS and EMG. My gratitude is indeed beyond words.

Drs. Markus Leitinger, Kalss Gudrun, Fabio Rossini, and other staff members of the epilepsy unit assisted me. I witnessed first-hand the use of video electroencephalography to monitor patients and received instructions on how the procedure operates and guidance on EEG interpretations. I would get explanations from Dr. Leitinger, who had a specialty in evoked potentials, on the concept and how to interpret this in a clinical setting.

Dr. Ezuduemoih with Marco Medina, WFN co-opted trustee, and Wolfgang Grisold, WFN president.

The acute stroke unit served as an example of the benefits of teamwork and the blending of various disciplines. Here, all patients were connected to centrally transmitting monitors, allowing for the monitoring of all patients from one place. Dr. Slaven Pikija showed me around various departments, including the emergency room, where paramedics and community doctors at the ambulance unit would communicate the patient’s condition and diagnosis to the hospital over an intercom. I also took note of the triage processes, which assigned each patient to a unit based on their state of consciousness and potential diagnoses. The point-of-care services provided here were excellent. We also briefly visited the well-equipped Neurorehabilitation Center built to meet every individual patient’s needs.

Finally, I am grateful for the mentorship of my teachers at the neurology unit at Lagos University Teaching Hospital, Professors Frank Ojini, Njideka Okubadejo, and Drs. Oluwadamilola Ojo, Osigwe Agabi, and my immediate senior colleague, Dr. Uchechi Agulunna.

Maya Angelou sums up my experience with the words: “This is a wonderful day. I have never seen this one before.” Indeed, it was an exceptional exposure to kindness beyond limits and the Austrian Neurological Society’s desire to make the world a better place. I have truly never seen it before. Thank you, the Austrian Neurological Society, I am forever grateful! Thank you, the World Federation of Neurology for your selflessness. The world is certainly a better place because of you all.

Ich schlafe jeden Tag und träume von deiner Freundlichkeit, die Tiefe meiner Dankbarkeit ist unbeschreiblich.  Danke nochmal. •

 

Daniel Ekhaeyouno Ezuduemoih, MBBS (Benin), MWACP (Intl Med) is a senior registrar in the neurology unit at Lagos University Teaching Hospital in Nigeria.

Program at the Universitätsklinikum Leipzig, Germany

By Prisca-Rolande Bassolé

Prisca-Rolande Bassolé

I am Dr. Prisca-Rolande Bassolé, neurologist from Dakar, Senegal. I would like to thank the World Federation of Neurology and the German Neurological Society for giving me this great opportunity to visit the department of neurology, Nov. 21-Dec. 16, 2022, at Universitätsklinikum Leipzig.

I was warmly welcomed since I arrived at the airport by Prof. Joseph Classen, department head, who introduced me to the staff the first day. He arranged weekly rotational visits for me.

Week 1: Stroke and neurointensive care unit

During my first week, I had the opportunity to attend the twice-daily rounds.  I was able to observe the quality of the multidisciplinary medical and nursing care of patients who had undergone thrombolysis, who were awaiting further examinations or who were being investigated for the etiological diagnosis of acute paroxysmal neurological symptoms. I especially remember the clinico-electrophysiological management in the context of the diagnosis of a very acute onset of Guillain-Barre Syndrome, which was thus able to benefit from plasmapheresis.

Left to right: Prof. Joseph Classen (Head of Department), Prof. Petra Baum, Dr. Prisca-Rolande Bassolé, Prof. Dorothée Saur, Dr. Caroline Awiss, Dr. Daniela M. V. Kuenheim, and Dr. Christoph Mühlberg.

Week 2 and 4: Functional Diagnosis Unit

In my two-weeks of observation in this unit, I had the opportunity to observe Doppler and Duplex sonography of intra- and extra-cranial arteries. I also observed the exciting botulinum toxin injection sessions. I took part in the rewarding sessions of discussion and interpretation of neurophysiological tests (EP, EEG, EMG, and nerve conduction). I also attended consultation on movement disorders, and I had the great opportunity to attend a deep brain stimulation surgery. I particularly enjoyed my time in this unit. Prof. Petra Baum gives her time for each member of her team and is patient and didactic. Thanks to Prof. Baum and all members of her team (Daniela, Caroline, Clément, and Christoph).

Week 3: Emergency room (ER)

During my stay in the ER, I was particularly impressed by the implementation of the “Time is Brain” theory. I saw how acute stroke is managed from arrival to treatment with thrombolysis or thrombectomy. Neurologists and nurses in the ER are well organized and coordinated with the radiology and stroke units. I have also seen the management of other acute and paroxysmal neurological disorders. What really impressed me about this unit was the fluidity of information regarding the arrival of new patients and the resulting speed of care but also the higher age of patients with acute cerebrovascular events compared to my country. This is probably due to the youthfulness of our population and the negative lifestyle changes. I would like to thank Dr. Hannes, who despite the urgency of the place, found the time to explain each procedure to me.

I also had time to visit the city of Leipzig

This department visit program was a wonderful exchange of experiences and practices and an opportunity to create an academic network for future cooperation.

I will especially try to improve the practice of clinical neurophysiology in my department with all that I have learned. I will also try, with the support of the head of my department and all faculty members, to draw the attention of the political health authorities to the importance and necessity of setting up the conditions for acute stroke management.

Finally, I would like to thank Herwig-Landry who arranged my visit, and Mrs. Tetzlaff who helped me a lot with all administrative procedures during my stay.

Thanks to all the staff at Universitätsklinikum-Leipzig for their hospitality during my rotation at different units. •

Prisca-Rolande Bassolé is Associate Lecturer in Neurology at Fann Teaching Hospital in Dakar, Senegal.

World Brain Day 2023: Brain Health and Disability

The WFN, global regions, and the World Federation of Neurorehabilitation

By Tissa Wijeratne, David Dodick, Steven Lewis, and Wolfgang Grisold

Key Message

  • World Brain Day (WBD) 2023 jointly with the global regions and World Federation of Neurorehabilitation (WFNR).
  • Spread the news on Brain Health and Disability, World Brain Day 2023 campaign in your community, hospital, village, and city-region.
  • Follow us on the WFN website and social media.
  • Six regional societies: American Academy of Neurology (AAN), African Academy of Neurology (AFAN), Asian and Oceanian Association of Neurology (AOAN), European Academy of Neurology (EAN), Pan-American Federation of Neurological Societies (PAFNS), and the Pan Arab Union of Neurological Societies (PAUNS) will lead regional activities on brain health and disability.

The WFN World Brain Day (WBD) was launched in 2014. Since then, the WFN, jointly with other international societies such as International League Against Epilepsy, World Stroke Organization, the International Headache Society, and the Movement Disorders Society selects a topic with a view to drive home the importance of brain health and promoting better neurological care globally. (https://wfneurology.org/world-brain-day-past-years)

For 2023, the WFN selected Brain Health and Disability, continuing our efforts to drive awareness for brain health, and also aligning with the WHO efforts to fight disability worldwide. Disability can be prevented, rehabilitated, and also needs to be under neurological care in chronic and chronic progressive diseases.

The aim of WBD 2023 is to alert not only its member societies, but also the public on the critical neurological issues issue of disability. The organizing committee will represent the global regions, and we partner with the WFNR..

Member societies of the WFN will receive a toolkit, which includes templates for press releases and educational PowerPoint presentation sets to assist in their local WBD activities and to advocate for brain health and disability. Local press conferences, press coverages (such as print, electronic, radio, TV, YouTube channels) are strongly encouraged to reach the public.

Please join the World Brain Day 2023 campaign for Brain Health and Disability, as this is an important priority.

Correspondence: Prof. Tissa Wijeratne, Chair, Neurology, Western Health, Melbourne, St Albans, Victoria,3021, Australia; Co-Chair, World Brain Day 2023. World Federation of Neurology, Tissa.Wijeratne@wfneurology.org •

Tissa Wijeratne and David Dodick are Co-Chairs of World Brain Day for the WFN. Steven Lewis is Secretary General of the WFN and Wolfgang Grisold is President of the WFN.

The Tournament of Minds at the World Congresses of Neurology

By Richard Stark

Richard Stark

The Tournament of Minds has been a well-loved component of the world Congress of Neurology since 2001.

The inaugural tournament  was held in London in 2001. This set the tone for future events. The idea behind the tournament was to produce a series of questions on neurological topics with an entertaining as well as educational element. Member societies were invited to enter a national representative team of four neurologists. The initial tournament was hotly contested over elimination, semi-final, and final rounds.

A similar format was put in place for the Sydney 2005 WCN. These first two tournaments were composed by the host society on each occasion without formal input from the WFN office and the sessions were chaired by the local committee members who had been involved in producing the questions.

Photo montage from the Tournament of Minds at WCN 2019 in Dubai.

With the success of the tournament in 2001 and 2005, it was decided that there should be a formal structure and a WFN tournament committee was established. This was initially chaired by Raad Shakir. In the 2009 WCN in Bangkok, the tournament questions were produced by the local Thai organizing committee as they had been by the UK and Australia in earlier tournaments. However, on this occasion, the questions were reviewed and edited by the WFN tournament committee in consultation with the local committee and chairmanship of the sessions was shared between WFN and local contributors, resulting in a professional and even smoother production.

A similar format continued through the WCNs of 2011 in Marrakesh, 2013 in Vienna, 2015 in Santiago, 2017 in Kyoto, and 2019 in Dubai. In all cases, local organizing committees produced marvelous sets of questions with a significant local flavor. The senior contributors would in most cases join the WFN tournament committee for subsequent congresses adding their acquired experience and wisdom to make a process even better. When Raad Shakir became president of WFN in 2013, he handed chairmanship of the Tournament committee to Richard Stark who in turn has handed it on to Nicholas Davies for 2021 and 2023.

In 2021, the pandemic resulted in the conference being held as a virtual event rather than in person in Rome. This produced organizational challenges in running the tournament, but these were overcome. The host society from Italy again produced the questions which gave the tournament a local flavor. One consequence of these challenges was that it would be difficult to get a truly national team together in a single room to engage in the virtual tournament, as often team members would come from a range of different cities within a nation. It was therefore decided to open the tournament to departmental teams, and this proved highly successful.

The plan for Montréal in 2023 is that the tournament will be held both in person and virtually and once again departmental teams will be encouraged to participate. We are looking forward to welcoming teams from around the world.

I have been involved in the Tournament since 2001 (as a participant) and since 2005 as a contributor and chair. Throughout this time, I have been amazed and gratified to see the talent and knowledge that has been displayed by all contestants, many of them early in their careers, from all parts of the world: It is truly uplifting to see and makes one strongly optimistic about the future of neurology. •

Richard Stark is treasurer of the WFN and past chair of the WCN tournament committee.

President’s Column

Grisold

This year’s Council of Delegates meeting occurred in Amsterdam, just before the ECTRIMS Congress. The meeting was held at the excellent RAI facilities and was preceded by a one-day seminar-like trustee meeting, which was the first in-person meeting of the trustees in a long time. All trustees attended the meeting. However, Prof. Guy Rouleau attended virtually, as he was being awarded the prestigious Gairdner award in Canada at the time. All of us at WFN congratulate him on this award.

In total, 60 people attended the Council of Delegates (CoD), 20 in person, three of whom were delegates. This confirmed the need for future CoD meetings to be hybrid. The WFN trustees recommended and the members approved, a change in wording to the articles of association to ensure that future meetings can be held electronically without ambiguity. Trends show that traveling is still limited and costly since the pandemic, and with visa restrictions, it can be difficult to arrange. The WFN leadership hopes this meeting format will allow more people to participate in future CoD meetings.

The meeting was opened with a minute of silence for Jun Kimura, Ettore Beghi, and all those who served the WFN and are not with us any longer.

The president’s, first vice president’s, and treasurer’s reports were well received. They were followed by reports from each trustee and several committee chairs, which provided an overview of the present state of WFN activities.

A key highlight of the meeting was the election results. Prof Steven Lewis (U.S.) was elected secretary general, taking office from Jan. 1, 2023, and Prof. Chandrashekhar Meshram (India) was elected as a trustee. Both have long experience with the WFN and are motivated and eager to participate in further WFN developments.

The WCN site visit team in Montreal. From left to right: Maya Smith, Steven Lewis, Wolfgang Grisold, Anne-Louise Lafontaine, Marcel Dekker, Steven Peters, Guy Rouleau, Karine Garneau

The terms of two co-opted trustees, Riadh Gouider (Tunisia) and Marco Medina (Honduras) ended. The WFN leadership is grateful for their work and input. The co-opted trustees came from Africa (Pan-Arab Region), Asia, and Latin America, which has meant that the WFN has benefitted from a wide de facto regional representation. I am happy to report that both Prof. Medina and Prof. Gouider have agreed to be co-opted again for an additional term.

The WFN will continue to seek a wide geographic diversity on the Board of Trustees. In addition, quarterly meetings are planned with the leadership of the regions (AAN, EAN, AFAN, PAUNS, PAFNS, and AOAN) to ensure wide regional influence in WFN.

IGAP

The Intersectoral Global Action Plan (IGAP) and its implementation worldwide is of much interest and was emphasized during the CoD. Alla Guekht reported on this and the importance of the WFN’s cooperation with the WHO.

In a follow-up WHO meeting on IGAP, the WFN and ILAE were asked to provide joint proposals to the WHO on implementation. A small working group consisting of Helen Cross, ILAE president; Julie Hall, ILAE executive director; Kimberly Karlshoej, WFN strategy and program director; and me have created a general statement and are working on a series of joint webinars to introduce important elements of IGAP to member societies and the wider public.

Site visit team inside the congress center, in the large multipurpose hall.

WFN has agreed to fund the WHO’s Brain Health Unit to employ a consultant for one year to work on the implementation of IGAP and to develop an implementation toolkit. The trustees are convinced that supporting WHO in this activity is crucial.

In summary, IGAP’s 10-year timeline aims to implement neurology at country-level. It is an ambitious project and a unique opportunity for neurology and neurologists with benefits for patients and carers. We will continue to keep WFN Member Societies informed about progress.

Member Societies

The AFAN Congress and the Regional Teaching Course were financially supported by the WFN. In addition, the trustees have participated in several meetings. For example, we attended and had joint meetings with the World Stroke Organization in Singapore; the Mexican Academy of Neurology, León; and the Indian Academy of Neurology as well as the AOAN in Delhi. I was honored to give the Dr. Gilberto Gomez Memorial Lecture at the Philippine Neurological Association Annual Convention and was on the panel for the launch of the Optimizing Brain Health Across the Life Course: WHO position paper.

The WFN appreciates every opportunity to participate in and contribute to WFN member societies’ meetings. All regular communication between the WFN and our member societies is valued, and we believe it helps to improve brain health and quality neurology.

Educational Activities

The Palais des congrès de Montréal at night.

The educational activities of the WFN continue, and the Education Committee and several subcommittees have been appointed. Current priorities are creating a core curriculum, a practical global neurology training blueprint, addressing the minimal required knowledge, clinical and technical skills, and overall competencies for neurologists, while recognizing regional variations in resources, funding, and spectrum of diseases. The needs of faculty, trainers, and the structure of the teaching facility will be included.

WFN has also appointed a Young Neurologist Subcommittee. At the World Congress in Montreal, the subcommittee is hosting two sessions created for other young neurologists. It is the strong wish of the WFN to inspire and empower young neurologists in their education around the globe.

eLearning

The WFN and AFAN will continue the highly successful eLearning Day next year, and WFN plans a joint AFAN and International Headache Society eLearning Day on headaches in 2023.

World Congress

Organizing the World Congress of Neurology is an enormous task. In September, we did the first site visit to the excellent facilities with the engaged local team. We look forward to seeing you all in Montréal in October 2023. •

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