Move Together to End Parkinson’s Disease: World Brain Day 2020 in Pakistan

By Dr. Abdul Malik- MD

The World Federation of Neurology (WFN) promotes brain health through its education, skills development, and advocacy activities. Since 2014, the WFN has organized dedicated awareness drives in all the WFN member countries around the globe.

Abdul Malik

The WFN, in collaboration with the International Parkinson’s and Movement Disorder Society, declared the sixth World Brain Day this year, dedicated to the awareness for Parkinson’s disease, which is a neurodegenerative brain disease that affects the mind, movement, and almost all aspects of brain function.

We in Pakistan, along with numerous other global organizations, joined again this year with this campaign to support the WFN in advocating for improved patient care, education, and additional research for those living with Parkinson’s disease and their caregivers.

The Neurology Awareness and Research Foundation (NARF) organized countrywide activities to mark the sixth World Brain Day, with the theme of moving together to end Parkinson’s disease. Parkinson’s disease affects people of all ages, including one in 100 people over the age of 60. The prevalence of this disease is on the rise, making our actions today vital to improving the lives of those who have been and will be diagnosed, particularly during this global health crisis.

Keeping in view the COVID-19 pandemic, our organized activities in Pakistan (online through Zoom and Facebook) became regional and even global activities as our participants were just not from Pakistan; they were from India, Bangladesh, the UAE, the U.S., the U.K., Canada, and different other parts of the Europe.

These awareness activities were more focused on social media like Twitter, Facebook, and WhatsApp. We also organized patient welfare activities by organizing two free Parkinson’s clinics on July 19 and July 24, adopting all standard operating procedures regarding the patients’ and medical staff’s safety. The services provided during these free clinics included not only free consultation from a neurologist, but also free services from a physiotherapist, speech therapist, and neuropsychologist.

We prepared awareness flyers in the Urdu language about Parkinson’s for the general public; this material was in simple, pictorial form about the signs, symptoms, treatment, and rehabilitative awareness of Parkinson’s disease and was distributed in 500 clinics across the country. Month-long Facebook as well as Twitter activities were executed with key messages given by the WFN and translated into the local language. World Brain Day posters were placed in almost all of the major institutes and departments of neurology in Pakistan.

We prepared a NARF Exercise Diary in the Urdu language with illustrative pictures to inform Parkinson’s patients about the importance of exercise as well as to motivate them to do these exercises at home. The diary comprises exercises involving all four limbs and trunk, including standing and sitting postures with facial exercises; speech exercise and speech therapy are also briefly described. This diary was launched in collaboration with the Pakistan Parkinson’s Society and was distributed among all neurology centers throughout Pakistan.

On July 14, NARF organized a Facebook Live public awareness session on Parkinson’s disease in the context of WBD 2020. This session was held at Aga Khan University in Karachi and was organized with the leading media group of Pakistan, Duniya. The complete proceedings of this session were published in the Daily Duniya newspaper. In this session, we had the top neurologists of the country, Prof. M. Wasay, Prof. Naila Shahbaz, and Dr. Bashir Soomro, as the participants. Besides these we had the director of the Institute of Psychology, Prof. Dr. Uzma Ali; an assistant professor and physiatrist from the Institute of Physical Medicine and Rehabilitation of DUHS, Dr. Syed Saeed Qaiser; and the editor of the Daily Duniya Karachi, Ahmed Hasan, as the panelists. Dr. Abdul Malik and Mustafa Habib Siddiqui were the moderators of this extensive awareness session, which was seen live in almost two dozen countries.

On July 22, NARF organized a Zoom webinar which was CME-accredited by the Jinnah Sindh Medical University. Principal Liaquat College of Medicine and Dentistry Prof. Dr. Rashid Naseem Khan gave opening remarks. The educational talk in context of the theme of World Brain Day was given by Dr. Abdul Malik, the rehabilitative talk was given by Dr. Farooq Rathore, and the keynote speech on the review of non-motor symptoms with recent advances in Parkinson’s management was given from Canada by the Dr. Abdul Qayyum Rana. A large number of undergraduate students, postgraduate trainees, and faculty members attended this interactive academic session.

The awareness activities were not only covered in national and local newspapers but also in the electronic media. Almost a half dozen leading newspapers and magazines published articles on Parkinson’s disease.

In short, keeping in view the COVID-19 pandemic, a comprehensive advocacy campaign for Parkinson’s disease awareness was executed on the occasion of this year’s World Brain Day 2020 from Pakistan as a member of the WFN. •

Dr. Abdul Malik- MD, MHD (Denmark), DCN, PGDN,MBA, General Secretary of NARF Pakistan, Associate Professor of Neurology, Liaquat College of Medicine & Dentistry, Karachi, Pakistan

Call for Papers

Gustavo Roman

By Gustavo Roman, MD

I have recently been appointed editor-in-chief of a new ELSEVIER online publication, Cerebral Circulation – Cognition and Behavior. The goal is to publish papers dealing with the arterial, venous, CSF, and glymphatic circulation and cognitive or behavioral aspects. Areas such as the vasculopathy of COVID-19 and the frontal arterial spin labeling (ASL) changes induced by the coronavirus as well as papers related to sleep and normal-pressure hydrocephalus are welcome and can range from case reports to comprehensive reviews.

Peer review is fast and there are no publication charges. Please contact me at GCRoman@houstonmethodist.org for further details. •

Gustavo C. Roman, MD, FANA, FAAN, FACP, FRSM, Jack S. Blanton Presidential Distinguished Chair for the Study of Neurological Disease at Methodist Neurological Institute in Houston, TX, and professor of neurology at Cornell University in New York, NY, and Texas A&M College of Medicine in Bryan, TX

WFN Neuroinfection Series: A Success Story Continues

By Dr. Chandrashekhar Meshram

Chandrashekhar Meshram

The Tropical and Geographical Neurology Specialty Group of the World Federation of Neurology, in collaboration with the Forum for Indian Neurology Education (FINE), organized a neuroinfection webinar series held every Saturday from July 18 to Sept. 5. It was first educational activity of its kind by a WFN specialty group. The event was formally inaugurated by Prof. Raad Shakir, immediate past president of the WFN and chair of the WFN specialty groups, in the presence of WFN Secretary General Prof. Wolfgang Grisold. The series was dedicated to Prof. Jagjit Singh Chopra. In the last session, tribute was paid to the late Prof. Amilton Barreira, who was secretary general of the specialty group. Dr. Chandrashekhar Meshram, president of the Tropical and Geographical Neurology Specialty Group of the WFN, was the course director.

Talks were given by Hector Garcia on neurocysticercosis, by Erich Schmutzhard on cerebral malaria, by Marco Tulio Medina on Zika and other arbovirus infections, by Riadh Gouider on  neurobrucelloisis, by Serefnur Ozturk on encephalitis, by Jeremy Day on cryptococcal meningitis, by Prof. Avindra Nath on the approach to neurologic infections, and by Prof. Joseph Berger on fungal meningitis.

Interesting and challenging cases of dengue, rabies, Japanese encephalitis, leprosy, tuberculous myelitis, CJD, neurocysticercosis, amoebic encephalitis, HIV, SSPE,  neurobrucellosis, strongyloidosis, JC virus granule cell neuronopathy, cryptococcal infection in the immunocompromised host, histoplasmosis, antiphospholipid antibody syndrome, cerebral venous sinus thrombosis, aspergillosis, scrub typhus myositis, neurosyphilis, listeria encephalitis, mucormycosis, and H1N1 encephalitis were  presented and discussed during the series. The complexities in manifestations, course, and treatment in different cases were the highlights of the series. There were analytical interactions from the faculty and audience.

Sarosh Katrak, S.Prabhakar, John England, Gustavo Roman, Chris Kennard, Wolfgang Grisold, Hadi Manji, Deanna Saylor, Steven Lewis, Kiran Thakur, Davis Garcia-Azorin, B. S. Singhal, Augustina Charway-Felli, JMK Murthy, Marianna de Visser, and Jacques Reis chaired the sessions.

Participants were from different countries across the globe, and more than 1,400 delegates registered for the series. Regular participants were from India, Sri Lanka, Bangladesh, Pakistan, Brazil, Peru, Honduras, South Africa, Ghana, Kuwait, UAE, Sudan, Zambia, and the United States. Participants interacted with the faculty through question and answer sessions.

Reports of the sessions were published in Indian newspapers as part of public education activities.

Those who missed live attendance at the sessions can watch the videos on YouTube, the links to which are available on the WFN website. https://wfneurology.org/2020-09-10-wfn-fine

Second Neuroinfection Series Happening Now

Encouraged by the success of this series, the Tropical and Geographical Neurology Specialty Group, in collaboration with Indian Academy of Neurology and FINE, planned the second WFN Neuroinfection series with eight sessions that began on Sept. 26. WFN President Prof. William Carroll inaugurated this second series. Organization of the sessions rotated between Asia-Oceania,  PAFNS, the AAN ID group, Europe-EAN ID group, and the Pan Africa and Pan Arab regions. Those interested in presenting cases should contact the respective moderator for the session.

Registration is free. Link for registration can be found at: https://forms.gle/BX3xyKcztAWzLGyu6

Registered delegates will be informed about the details of the session by email before each session.

Link to join the program: https://us02web.zoom.us/j/87248087732  

Password: wfnni

Each session takes place at 1 p.m. GMT/UTC and can also be watched on YouTube.

We encourage delegates from different countries  participate and present the cases.•

 

 

International Congress on Neuromuscular Diseases (ICNMD) Went Digital for 2020

By John D. England, Wolfgang Grisold and Juan J. Vilchez

Wolfgang Grisold

John D. England, MD

John D. England, MD

The COVID-19 pandemic has disrupted almost everything, including international meetings. ICNMD 2020, which was scheduled to take place in Valencia, Spain, in July 2020, was cancelled because of global travel restrictions.

The unprecedented situation necessitated the development of new strategies for holding the meeting. The ICNMD team decided to provide a virtual (digital), brief, topic-focused update on neuromuscular diseases for 2020. Since many new diagnostic and therapeutic options are increasingly available, an interim update was deemed to be important. Specific examples for which new therapies are available include spinal muscular atrophy (SMA), hereditary ATTR (hATTR), amyloidosis, and myasthenia gravis. Many additional therapies are in various stages of development.

The challenge was to organize and dedicate speakers who could present time-sensitive information on myopathies, neuropathies, neuromuscular transmission, and motor neuron disease, as well as satisfy the requirements of an EACCME-accredited meeting. Time also was dedicated for excellent industry-sponsored presentations, similar to satellite symposia in face-to-face meetings.

With the help of professionals from International Conference Services Ltd, the development and fulfillment of ICNMDigital 2020 went extremely well. ICNMDigital achieved an impressive attendance of over 796 delegates from more than 58 countries. The program featured 27 speakers in 12 scientific sessions across four thematic days. In addition, several Industry-Supported Symposia were presented. Feedback from attendees was very positive, and most participants suggested that some form of virtual presentations remain a part of future meetings.

As validation of the sucess of the conference, we offer the following comments from participants:

“We hope that 2021 will give us the possibility to organize the live congress again in Valencia, and definitely we have learned that virtual sessions and hybrid constructions will be useful and necessary in the future.”

“ICNMDigital met the challenge to organize in a very short time frame an exciting congress with outstanding content. The technical staff was incredibly helpful to make it a successful and smooth experience. Two thumbs up for organizers and all people with hands on!” –Laurent Servais

“I was fortunate to be able to give a talk alongside Mary Reilly, one of the best inherited neuropathy researchers in the world. Her talk brought a great crowd and set us on the right track. Davide Pareyson was a wonderful moderator, and we had incredible questions from the audience. The virtual format worked well, and I think encouraged even more thoughtful questions, which is what helps everyone learn. The ICNMD conference pulled off a great conference given very difficult circumstances.” – Brian Callaghan

As a reminder, the live ICNMD 2021 meeting is scheduled for May 28-June 1, 2021 in Valencia, Spain. Faculty from ICNMDigital 2020 will again join with the addition of new experts/sessions addressing updates and breakthroughs in research. A special session on COVID-19 is planned. All previously accepted abstracts remain on the schedule for ICNMD 2021. In addition, the ICNMD 2021 website will reopen for new or updated abstract submissions. See www.icnmd.org for details.  •

 

 

Parkinson’s Disease in Africa: A South African Perspective

A Report in Relation to World Brain Day 2020

By Dr. Marcelle Smith and Dr. Patty Francis

The African continent has been experiencing rapid changes in recent decades, with increases in life expectancy. The average healthy life expectancy increased from 46.1 years in 1990 to 55.2 in 2017.1 This is still far below the average life expectancy in high-income countries of over 70 years.2 However, this has been sufficient to increase the burden of age-related and neurodegenerative conditions such as Parkinson’s Disease (PD).

Marcelle Smith, Patty Francis

There is a belief that PD is less prevalent in African countries, but incidence or prevalence studies for Africa are lacking. Most of the available studies are specific to individual countries. Williams et al. reviewed all the literature on PD in Sub-Saharan Africa published up to May 2016. The authors observed a prevalence of PD ranging from 7/100,000 in Ethiopia to 67/100,000 in Nigeria.3

African countries experience unique challenges when it comes to diagnosis and treatment of PD. Firstly, there are far fewer neurologists in African countries compared to high-income countries, 0.03/100 000 in Africa versus 4.84/100,000 in Europe as per the WHO Neurology Atlas. The WHO recommends at least one neurologist per 100,000 people.4 Approximately 270 million Africans live in countries where there are less than five neurologists per country. Less than 50% of Sub-Saharan African countries have a neurological society.5 This limited access to neurologists leads to underdiagnosis and treatment of patients with neurological disorders such as PD.

The Neurology Association of South Africa comprises 87 neurologists in full-time private practice, 28 in full-time public sector practice and six members in limited practice. 27 registrars are currently in training. This gives a crude estimate of one neurology service provider per 400,000 population in South Africa.

Many African countries are also overburdened by malaria, TB, HIV, and other infectious outbreaks, e.g. Ebola. Hence very few facilities and resources are dedicated to non-communicable illnesses. Medication is only available to 12.5% of Africans with PD compared to 79% in Europe.5 60% of Africans live off less than $2 a day and are unable to afford the necessary treatment themselves.6

South Africa’s population was estimated at 59,308,690 people at mid-year 2020, according to UN data. Between 16-17% of these have private medical insurance, while the rest are dependent on state facilities for health care. Only three PD medications are available in state hospitals at present: levodopa, amantadine, and dopamine agonists. South Africa’s largest private medical funder’s formulary includes biperiden, pramipexole, amantadine, levodopa/decarboxylase inhibitor, and rasagiline.

It is estimated that over 160,000 patients with PD have had deep brain stimulation (DBS) surgery worldwide. This is increasing at a rate of approximately 12,000 per year.7 Three tertiary state neurological centers in South Africa are equipped to perform DBS but still struggle with funding for devices. Four private sector practices offer DBS, although these are general neurology practices with a special interest in movement disorders. No singular movement disorders center exists due to the absolute necessity to cover the entire spectrum of neurology given the ratio of neurologist to patients.

In a recent survey, 74% of South African neurologists report they have referred patients for DBS for the management of a movement disorder.8 Roughly, only one in four (27.37%) neurologists felt they had enough knowledge of, and experience with, the indications for referral for DBS.8 Most South African neurologists refer to the few available DBS centers for Parkinson’s Disease (61.05%).8 However, one of these centers reported performing only five procedures over the last five years. Adequate treatment may allow PD sufferers to continue working and providing for their families for longer.

Most PD sufferers present with the tremor predominant phenotype, which is most common in high-income countries as well. There are, however, certain clinical characteristics unique to African cohorts. In 2016, Mahne et al. from South Africa demonstrated that the akinetic-rigid variant is encountered more frequently in Black patients compared to white patients and can be found in up to a third of all patients.9 This result was replicated by Smith and Modi in a larger cohort. The authors further demonstrated that Black patients appear to develop PD symptoms at an earlier age and develop cognitive impairment more frequently than their American and European counterparts.10 A recent study out of Ethiopia by Melke et al. has also demonstrated a higher prevalence of Parkinson’s disease-related sleep disorders compared to high-income countries.11

African populations have greater levels of genetic diversity and population substructure compared to non-African populations. Africans have also developed many genetic adaptations that have evolved in response to factors such as diverse climates and exposure to infective diseases.12 This makes Africa a prime place to study genetic diversity and its impact on different diseases. In the last two decades, research of PD genetics in Sub-Saharan Africa has gained momentum. In 2009, Bardien et al. concluded that mutations in the Parkin gene, a common cause of genetic PD worldwide, were not an important cause of PD in South Africa.13 The G2019S mutation in the LRRK2 gene is the most common mutation associated with PD. However, a 2019 study from Du Toit et al, revealed that none of the 91 Black South African participants in their study had this mutation.14 This shows that some of the most common PD-associated genetic mutations globally are not truly relevant in Sub-Saharan African populations. The mutations specific to PD in this populations have yet to be discovered and hold much potential for further research.

The dearth of genetic studies in African countries can, like many other problems on the continent, be attributed to a scarcity of resources. An in-depth look into PD genetics may provide answers to whether characteristics specific to PD in African countries does in fact have a genetic and ethnic foundation, or if it is related to poverty and other challenges experienced by low-income and under-resourced populations.

The amount of PD research in African countries has increased significantly in the last two decades; however, the studies have not been directly comparable because of inconsistence among study designs.15 As African neurologists we need to strive for collaboration between different countries across the continent to find solutions to our continent’s unique challenges.

GBA mutations have emerged as the most common risk factor in PD.16 Some of the clinical features including early age of onset and cognitive impairment are also more common in patients of African origin compared to Caucasians. A genetic study investigating the prevalence of the GBA mutation in PD patients in Africa may yield interesting results.

Academic centers across Africa are collaborating more and more with one another as well as overseas centers through shared congresses and research. An example of this is the combined annual meeting of the Neurological Association of South Africa and the African Academy of Neurology in 2019. Collaboration is the key to improving care for our continent’s Parkinson’s disease population and to better understand the unique aspects of Parkinson’s disease in Africa. •

Dr. Marcelle Smith, MBChB (Stell), MMEDNeurol (Wits), FCNeurol (SA), Wits Donald Gordon Medical Center and Sandton Mediclinic, Johannesburg, South Africa.

Dr. Patty Francis, BScHONS (UCT), MBChB (WITS), FCNeurol (SA), neurology consultant, Private Practice Netcare Umhlanga Hospital, Durban, South Africa.

References:

  1. Wiysonge, C S. People in Africa live longer. But their health is poor in those extra years.
  2. Duffin, E. (2019). Life expectancy in Europe in 2019, Statista.com.
  3. Williams, U. et al (2018). Parkinson’s Disease in Sub-Saharan Africa: A Review of Epidemiology, Genetics and Access to care, J Mov Disord, 11(2), pp.53-64
  4. WHO. (2004). Neurology atlas, Country resources for neurological disorders [online]. Available from who.int
  5. Bower, J H. et al (2014). Addressing neurologic needs in sub-saharan Africa: An opportunity for multisociety cooperation, Neurology, 83(13), pp. 1270-1209.
  6. Dotchin, C.L., et al (2007). The challenge of Parkinson’s Disease in Africa, Age and Ageing, 36(2), pp.122-127.
  7. Lee, DJ et al (2019). Current and future directions of deep brain stimulation forneurological and psychiatric disorders, J Neurosurg, 131, pp.333-342.
  8. Huth , M. B. et al (2019). South African Neurology Survey 2019 Johannesburg: Neurological Association of South Africa.
  9. Mahne, A.C. et al (2016). Clinical findings and genetic screening for copy number variation mutations in a cohort of South African patients with Parkinson’s Disease, SAMJ, 206(6)
  10. Smith, M and Modi, G. (2016).The clinical profile of idiopathic Parkinson’s Disease in a South African hospital complex- the influence of ethnicity and gender, African Journal of Neurosciences, 35(1)
  11. Melka, D et al (2019). Prevalence of sleep disorders in Parkinson’s Disease patients in two neurology referral hospitals in Ethiopia, BMC Neurology, 19(205)
  12. Campbell, M. C. and Tishkoff, S. A. (2010). African Genetic Diversity: Implications for Human Demographic History, Modern Human Origins, and Complex Disease Mapping, Annu Rev Genomics Hum Genet, 9, pp.403-433.
  13. Bardien,S et al (2009). Molecular analysis of the parkin gene in South Africa patients diagnosed with Parkinson’s disease, Parkinsonism Relat Disord, 15(2),pp.116-21
  14. Du Toit,N. (2019). Frequency of LRRK2 G2019S mutation in South African patients with Parkinson’s Disease, Neurogenetics, 20(4), pp.215-218.
  15. Oluwole, O G. et al (2018). Parkinson’s Disease in Nigeria: A review of published studies and recommendations for future research, J Mov Disord, 11(2), pp. 53-64.
  16. Barkhuizen, M. et al (2016). Advances in GBA-associated Parkinson’s Disease- Pathology, presentation and therapies, Neurochemistry international, 93, pp.6-25

 

 

A Great Time at The Neuro

My Report of the Canadian Department Visit Program (2019)

by Guillermo Delgado-García, MD

A snowy Montréal received me on a Saturday in mid-November; the previous morning I sat my annual examination and then I was there—3,700 kilometers from Mexico City. After touring Montréal’s museums, Monday arrived and I visited Dr. Anne-Louise Lafontaine, chief of the Department of Neurology of the McGill University Health Centre at the Montreal General Hospital. Dr. Lafontaine was extremely kind, welcomed me warmly, and asked me about my plans for the observership and also for the future.

From left to right: The author, Dr. Eliane Kobayashi, program director of the Frederick Andermann Clinical & Research Fellowship in Epileptology & EEG, and Dr. Dina Namiranian, a senior neurology resident, at the EEG lab.

Back at The Neuro, I looked for Dr. Eliane Kobayashi (Fig. 1) and found her at the weekly epilepsy rounds, held at the EEG lab, where cases are presented and discussed by a world-renowned multidisciplinary epilepsy team, including epileptologists, neurosurgeons, and neuropsychologists, among other highly trained professionals. At the end of the rounds, I introduced myself to Dr. Kobayashi, and she received me with open arms from the beginning. I then joined her team at the Epilepsy Monitoring Unit (EMU). This team was awesome, very friendly, and included Dr. Ghada Abbas (epilepsy/EEG fellow), Dr. Austin Zaloum (neurology resident), and Dr. Rafael Batista João (visiting epileptologist from Unicamp). The EMU is a place specially designed and equipped to care for adult patients undergoing long-term video EEG and is currently considered the gold standard for the diagnosis of epilepsy and seizure-like spells (Epilepsia. 2018;59:27-36).

On Wednesday mornings, I attended McGill’s neurology grand rounds in the de Grandpré Communications Centre, and afterward I stayed there with the neurology residents for the academic half-day activities. One afternoon that first week, I joined Dr. Kobayashi at the outpatient clinic, and there I also met Dr. Giovanni Pellegrino (epilepsy/EEG fellow), with whom Dr. João and I discussed the differences in neurological and epilepsy training in different parts of the world.

On Thursday morning, I met my supervisor, Dr. Birgit Frauscher, at the EEG lab. She was extraordinarily kind, generous, and inclusive all along. From that moment on, I started interpreting routine and prolonged EEGs with her at the reading room. That very day, she introduced me to her wonderful and diverse team from the Analytical Neurophysiology (ANPHY) Lab: Dr. Véronique Latreille, Dr. Petr Klimeš, Dr. Laure Peter-Derex, and Tamir Avigdor. This lab seeks to employ a variety of quantifiable tools in order to shed light on neurophysiological and pathological processes (mainly sleep and epilepsy). In the ANPHY lab, I was also introduced to high density EEG and other advanced source localization techniques.

After one of Dr. Gotman’s lab meetings. In the background, the evocative mural The Advance of Neurology (1955) by Mary (Filer) Spence-Sales can be seen (room 124). From left to right: Abdullah Azeem, Natalja Zazubovits, Tamir Avigdor, Dr. Petr Klimeš, Dr. Birgit Frauscher, the author, Dr. Jean Gotman, Dr. Véronique Latreille, Dr. Willemiek Zweiphenning, Dr. Andreas Koupparis and Dr. Nicolás von Ellenrieder.

That weekend Dr. Frauscher invited me to the First National Training Course on Sleep Medicine, which she organized and chaired. This two-day program was designed to provide a basic working knowledge of sleep medicine for Canadian neurology residents, and included a range of internationally renowned speakers and hands-on practical training on case interpretations of polysomnography. This course allowed me to interact with neurology residents from different universities, as well as with Canadian sleep experts.

 

The next week, I joined Dr. Frauscher at the outpatient clinic, where she introduced me to the very practical basics of vagal nerve stimulation in epilepsy. Furthermore, she let me get involved in preparing the next stereo EEG planning meeting and this was, in fact, my first real-life exposure to stereo EEG. Meanwhile on the scientific side, on Friday afternoons we all attended Dr. Jean Gotman’s lab meetings, which were both challenging and appealing.

From that week on, I started attending The Neuro’s Killam Lectures, held on Tuesday afternoons, and also the weekly epilepsy conferences, held on Thursday afternoons. The Killam Lectures are supported by the Killam Trusts and are given by outstanding guest speakers whose research is of interest to the scientific community at The Neuro and McGill University. On the other hand, the epilepsy conferences included a case presentation, EEG review, and roundtable discussion.

In my third week, I worked with Dr. Frauscher and Dr. Zaloum at the EMU. It was an intense but also very rewarding week. In addition, I had the opportunity to attend the tribute to Dr. Frederick Andermann (1930-2019), where an international panel of renowned epileptologists gathered to present the latest advances in the field in an homage to Dr. Andermann, director of the epilepsy unit at The Neuro for 35 years and one of the world’s most distinguished epileptologists. This special event was both intellectually stimulating and moving. During the second half of my observership, I also had the honor to work under the supervision of Dr. Martin Veilleux at the EMU.

In addition to the impact of this observership on me in terms of clinical and scientific experience, I really want to highlight another aspect of my visit: the kindness and openness of all the people I met in The Neuro, as so perfectly exemplified by daily lab lunch with Dr. Frauscher and her team. Among those whom I have not mentioned by name above, Natalja Zazubovits and Abdullah Azeem from Dr. Gotman’s lab were eager to help all the time and their assistance was invaluable to me.

One morning there was an exception to my normal work week at The Neuro. On this occasion, I visited the Osler Library of the History of Medicine, a branch of the McGill University Library. This visit was only possible thanks to the immense generosity of Dr. Mary Yearl, the Osler librarian, since the Osler Library was temporarily closed due to a fire at the McIntyre Medical Sciences Building. Rare materials were rehoused in the McLennan Library Building and that was where Dr. Yearl patiently showed me the treasures and rarities of the Osler Library. She later took me to the Osler Room in the McIntyre Building and, even though it was empty, it was evident what Michael Bliss wrote in his book: the Osler Room was “a shrine, architecturally a cross between a church and a mausoleum.” (William Osler: A Life in Medicine, 1999)

Sir William Osler (1849-1919) has been one of my medical and intellectual role models for more than a decade, so this visit had a great impression on me. Although less and less read, many of his insights are still true for general neurology and even for epileptology. The following passage is an example of this: “It is well always to be suspicious of epilepsy developing in the adult, for in a majority of such cases the convulsions are due to a local lesion.” (The Principles and Practice of Medicine, 1892) When we said goodbye, Dr. Yearl told me that I could not leave Montréal without visiting Mont-Royal. Therefore, on my last day before returning to Mexico City, I walked down the Promenade Sir William Osler to the foot of Mont-Royal. It was a misty morning and a few drizzle drops fell from time to time. While there, the main staircase seemed endless to me but, 30 minutes later, I reached the Chalet du Mont-Royal. This trip was physically demanding but also unique, especially for my weakness for misty (and thus cryptic) landscapes.

My experience at The Neuro made me wonder about the unmet needs in my home country regarding the care of persons with epilepsy. I’m sure they are multiple and at different levels. Since my center is a public tertiary referral hospital, I think many of our most complex patients could benefit from long-term video EEG in an elective admission to a specialized inpatient setting (i.e., an EMU). Therefore, a first step might be to start an EMU here and, if successful, to extend this program to other strategic tertiary neurological services nationwide.

I finally want to acknowledge the World Federation of Neurology, The Neuro, and the Canadian Neurological Society for this great initiative that allowed me to experience the Canadian neurological system in an international environment, meet new colleagues, and foster future cooperation. I also want to thank Dr. F. Gonzalez-Crussi (Northwestern University), my long distance mentor, for his insightful comments on an earlier version of this report. •

Guillermo Delgado-García, MD, is a senior neurology resident and MSc student at the National Institute of Neurology in Mexico City.

 

In the Midst of the COVID-19 Pandemic

Since my last column, the COVID-19 pandemic has spread through most developed countries courtesy of international travel, tourism, and high-density populations. It is now set to decimate less developed countries in South America, Asia, and Africa, consequent upon insufficient resources and less sophisticated public health services. Those least well-resourced countries face, like in epidemics of old, the twin blights of the epidemic and economic collapse and risk ensuing anarchy. Even some better-off countries have pursued different strategies in balancing the health requirements and when to re-open their economies with differing results now and no doubt differing results in the longer term.

William Carroll, MD

What is different with this pandemic and the plagues and epidemics of the past, and even the more recent SARS, Ebola, and Zika emergencies, is the concatenation of the modern world by the internet. While the world looks for a more unified inter-governmental response, peoples of the world, and in particular scientists, clinicians, and concerned citizens, have joined a multitude of international, regional, and global groups to contribute to the care, surveillance, and data collection of those affected. Through the internet and modern communications, infection rates, mortality rates, and survival rates issue daily from most countries irrespective of denominators. Most of us are involved in one or more such activities while we watch with concern — and at times with incredulity — as nations make individual decisions to minimize the human and economic costs of this pandemic. We all hope to see a successful formula develop.

The WFN also hopes that all of its individual member neurologists have remained safe and in good health. Happily, the London office staff have done so and the same applies to the trustees and officers.

In the meantime, let me outline the WFN activities during the current situation.

Communication

The WFN has implemented a program to improve the communication between the London office and its members. In a time when communication is so important, it has been heartening to see the response of member societies to this initiative. Once complete, and this first part is almost there, the office will commence a rolling dialogue, contacting approximately 10 members each month to ensure the details are current. This will see the details for each of the 122 societies being updated annually. In addition to direct communication by email and phone, the WFN website is now regularly updated with changes being advised by social media. More active use of social media also follows each monthly trustees teleconference on the second Thursday of the month. It is hoped that members will visit the WFN website more frequently and advise the London office of necessary changes to their contact details.

The WFN is participating with the Brain Health Unit of the WHO in its COVID-19 neuro endeavor and with other groups interested in collecting data about potential neurological involvement in the course of COVID-19 infection. The WFN’s Environmental Neurology Specialty Group has advised that it will be keeping a registry of member societies of members who are doing this at a national level. Links to members of the Global Neurology Alliance, who are posting information related to their specialty and COVID-19, are available on the WFN COVID-19 website and undergo regular updating. WFN member societies also have available a bulletin board on the WFN website to post news on the pandemic situation in their countries.

Education

Like most global or large regional organizations, the WFN had been moving to a more electronic base for education. The COVID-19 pandemic has provided an additional spur to this direction. With the cancellation of the African Sub-Saharan Regional Teaching Course for 2020, which had been scheduled for Kampala in September, AFAN and the WFN have proposed an e-learning day. Plans are advancing for this to occur as the WFN/AFAN e-Learning Day focused on “Stroke: A Treatable and Preventable Disease.” It is likely that the EAN and AAN will contribute to this very necessary alternative. More information will be found on the WFN website. Plans for the XXV WCN in October 2021, at the new state-of-the-art La Nuvola Conference Centre in Rome, are advancing with the valuable assistance of the Society of Italian Neurology. The scientific and teaching course programs are now being finalized with additional flexibility to permit virtual programming if required.

Promotion

There are a number of other activities engaging the WFN at present which, while being broadly educational, also promote the visibility and good name of the WFN. World Brain Day is the most imminent of these. As most will know, World Brain Day (WBD) has continued to evolve. It typically begins on July 22 each year, the anniversary of the founding of the WFN, which partners with a member of the Global Neurology Alliance closely representing the WBD topic. WBD runs for two to three months to provide greater dissemination and authority of its message. This year the WFN is excited to partner with the International Parkinson Disease and Movement Disorder Society and believes that the 2020 WBD will achieve similar goals as those that the International Headache Society brought to the 2019 campaign.

A second promotional activity being developed is the Brain Health Initiative. This will focus on the importance of brain health in general and at present will comprise five modules of related topics. The Brain Health Initiative is a matter that dates from the GNA meeting held during the Lisbon EAN meeting in 2018. Several members of the Global Neurology Alliance expressed a desire for the WFN to consider such a campaign. The initiative is planned to run in parallel with the more disease-specific WBD campaign.

Other WFN Activities

There are other activities engaging the WFN at present which I will enumerate. First, the Annual General Meeting (AGM) of the Council of Delegates will be a virtual meeting on a Zoom platform commencing at 12 p.m. on Sept. 9, British Summer Time. Details of this important meeting and its agenda will be disseminated directly to member societies by email and to the membership at large on the website. Second, the election of a new trustee to fill the vacancy created by Prof. Riadh Gouider after completing his term will be undertaken in the week before the AGM, in order not to disadvantage member societies in time zones where the AGM might be occurring at unsociable hours.

While on the topic of WFN trustees, it is with much pleasure that I welcome Prof. Marianne de Visser as a co-opted trustee. Her experience, wisdom, and integrity will complement the work of the WFN. (See box above.)

Third, notification has been sent to member societies in the Asian and Oceanian Association of Neurology requesting expressions of interest in hosting the 2025 (XXVII) WCN. To date four member societies have done so.

Let me also, on behalf of the trustees and all member societies, express my gratitude to the work of the London office during the pandemic. They have been locked down, out of the office, but their output and the quality of work has remained exemplary.

Finally, I wish all members of the WFN, their families, and patients a safe passage through this pandemic.

 

 

Candidate Statements for Elected Trustee

Six candidates present their experience and vision for what they would bring to the role of elected WFN trustee. They are listed in alphabetical order.

Candidate Statement for Elected WFN Trustee: Prof. Kailash Bhatia

Prof. Kailash Bhatia

I am honored to be nominated for the position of the WFN trustee. The Association of British Neurology (ABN) nominated me as an elected World Federation of Neurology (WFN) trustee, and I am privileged to be considered as one of the candidates for this post. I hope to be able to contribute to the accomplishment of the WFN mission — to foster quality neurology and brain health worldwide — based on the background of my clinical, academic, and administrative expertise and the experience gained while being involved in clinical practice, research, and teaching in movement disorders and general neurology.

The recent COVID-19 pandemic has made us again aware that disease knows no boundaries, and the world is a connected place, and that strategies for health care and education have to be worldwide. Given that my initial training in medicine and neurology was in India, and I subsequently trained further and specialised in my field of movement disorders in the U.K., I thus have the experience on both sides with regard to needs and requirements as well as expertise and assets in different parts of the world in neurology. I also have the desire to foster communications and collaborations for education and make equitable services possible everywhere. Neurology has been a passion all my life, and I had the privilege of having great mentors both in India and in the U.K.. In turn, I have been able to teach and train over 40 fellows from all over the world. They have in turn appraised me of the situation in their respective countries in neurology and will be contacts for development of new initiatives for education and the WFN projects worldwide.

My main area of research has been in movement disorders in a translational way, merging clinical, genetic, and electrophysiology to understand pathophysiology. I have been honored to be the associate editor of Movement Disorders Journal and the current founding editor of Movement Disorders Clinical Practise Journal and have authored more than 600 papers in peer-reviewed international journals and several book chapters and books, including the BMA-award-winning Marsden’s Book of Movement Disorders, a large reference tome. I have led or participated in various international task forces for setting up new diagnostic guidelines for tremor, dystonia, and others.

It’s the endeavor of the WFN to develop cooperative strategies, and I can help promote these through my associations at senior levels with the European Academy of Neurology, ABN, and the International Movement Disorders Society.

I have been involved in spreading neurological education throughout the world, teaching in local symposia not just in Europe but also in India and the rest of Asia and also Africa on several occasions recognizing and tailoring to the available resources, which can vary — and these experiences will help me address specific needs and implement the charter of WFN.

It would be a tremendous privilege to be elected as trustee by the delegates of the WFN to implement the WFN strategy. My goals would be communication, education, and partnership and fostering new developments and collaboration with member societies and neurologists all around the world.

Candidate Statement for Elected WFN Trustee: Prof. Mustapha El Alaoui-Faris

Prof. Mustapha El Alaoui-Faris

I am Mustapha El Alaoui-Faris, professor of neurology at the University of Mohamed-V and director of the Alzheimer’s Centre of Rabat. I graduated with an MD from Mohamed-V University and trained in neurology and psychiatry in Rabat and in neuropsychology in France. I have taught neurology and neuropsychology and taken care of patients since 1981. My main interests in neurology are dementia, neuropsychology, stroke, Parkinson’s disease, multiple sclerosis, and neuro-epidemiology. I pioneered the translation of “Neuropsychological Tests in Arabic” and established the first master’s degree on clinical neuropsychology in Morocco.

In 2008, I developed deep brain stimulation for Parkinson’s disease at Rabat’s University, and in 2009, I led a national study on “Stroke Epidemiology, Risk Factors, and Genetics in Morocco.” I am past president of the Moroccan Society of Neurology and of the Maghreb Federation of Neurology and current president of the Moroccan Foundation Against Neurological Diseases.

I am a founding member of the African Academy of Neurology (AFAN), for which I actively participate in the drafting the bylaws, and I also draft the bylaws of the Pan Arab Union of the Neurological Societies (PAUNS). I was a member of the WHO board for the “Revision of the International Classification of Diseases 10 (ICD 10) of the Nervous System” and the WHO Zika Committee.

My commitment for the World Federation of Neurology (WFN) started with the organization of the 20th World Congress of Neurology (WCN) held in Marrakech in November 2011, of which I was the president. This congress was a great success with more than 3,500 participants worldwide; several African neurologists were able to participate in the congress thanks to the scholarships of the Moroccan Society of Neurology.

Since 2011, I have been the WFN Moroccan delegate, and I was involved in different activities of the WFN. Among others, I was a member of the Educational and Grant Committees. In 2013, I established the first WFN Training Center in Rabat, where several African neurologists have been trained in clinical neurophysiology. In 2014, I initiated the WFN Applied Research Group (ARG) on “Neurology in Migrants,” whose scientific work will be published by Springer this year. In order to perfect the continuing education of Moroccan neurologists, I coordinate, since 2016, three annual sessions to work on the AAN Continuum books.

In the last years, I was actively involved in the organization of the 24th WCN held in October 2019 in Dubai, as a co-chair of the Teaching Course Committee and also by preparing the Tournament of Minds material. I am currently a member of the WFN Finance Committee.

In the Dubai Congress, I was honored to receive the prestigious WFN Medal for Service to International Neurology.

I will be honored, if I am elected as a WFN trustee, to participate in the development of neurology worldwide, particularly in low- and middle-income countries. I will also campaign for the needs in neurological care of migrants and ethnic minorities to be recognized as a priority by international health authorities.

Candidate Statement for Elected WFN Trustee: Prof. Morris Freedman

Prof. Morris Freedman

I am honored to have served as WFN chair of the Membership Committee, Canadian delegate, Education Committee member, co-chair of the eLearning Task Force of the Education Committee together with Prof. Riadh Gouider, and trustee. I have also served as president of the Canadian Neurological Society, Canadian Congress of Neurological Sciences, and Federation of National Specialty Societies of Canada. My clinical, research, and education foci are on dementia. During the COVID-19 pandemic, I have been actively involved in providing virtual care to patients in long-term care facilities and acute care hospitals who are suffering from severe agitation and aggression associated with dementia. In many cases, this has prevented transfers to acute care hospitals. Thus, COVID-19 has taught us the power of virtual care for patients in need, including those who cannot attend an in-person visit. As a result, I have become a strong advocate for physician education and training in virtual assessment and management, especially as applied to dementia.

I am pleased that the Canadian Neurological Society has nominated me for election as a WFN trustee. I am proud that Canada developed a WFN Department Visit program for young neurologists from Central and South America through the efforts of Prof. Guy Rouleau, director of the Montreal Neurological Institute and Canadian delegate to the WFN, and that the Canadian Open Neuroscience Platform, which has its base at the Montreal Neurological Institute, is well positioned to serve as an integrator and facilitator of education worldwide.

Achievements

I have taken an active international leadership role in neurological education. I have advanced international e-learning with a focus on dementia through weekly videoconferencing of behavioral neurology rounds that bring together health care professionals from across the globe within a virtual classroom. The goal is to develop greater international communication and knowledge transfer in dementia. I was awarded the prestigious Colin Wolf Award from the Faculty of Medicine, University of Toronto, for this initiative. The international rounds are now recorded and can be accessed through a link on the WFN website. More recently, I have facilitated expansion of international rounds to include general neurology.

An important development modeled on the international behavioral neurology videoconference rounds was the Neurology International Residents Videoconference and Exchange (NIRVE) that promotes international collaboration among neurology trainees.

Goals

My major goal in education through e-learning is directly related to the mission of the WFN to foster quality neurology and brain health worldwide. I will work hard to achieve this goal through innovative virtual programs. This will involve both developing and developed countries with a view to transferring knowledge in both directions with all participants as equal partners.

I have a vision, a clear sense of direction, and the focus to facilitate knowledge transfer for enhancing brain health globally. This will require extensive collaboration involving many people with diverse needs, and across many countries. Those who know me say that I am an excellent team player and organizer, qualities that are essential for success in promoting education in neurology worldwide.

Candidate Statement for Elected WFN Trustee: Prof. Beomseok Jeon

Prof. Beomseok Jeon

It is an honor and privilege to be considered for the position of elected trustee by the World Federation of Neurology (WFN). I am a professor of neurology at Seoul National University Hospital in Korea. My participation in WFN dates back to 2008, when I became the Korean delegate to WFN, and I now serve as the president of the Asian Oceanian Association of Neurology (AOAN).

A WFN trustee bears responsibilities requiring serious time, effort, and thorough understanding of the Federation’s workings. More fundamentally, a trustee must be committed to the WFN mission “to foster quality neurology and brain health worldwide.” Having served WFN in various capacities, I am fully prepared to carry out the duties of the position and overcome challenges in a pragmatic manner based on my experiences in various scientific, financial, organizing, and steering committees. I currently serve as the international executive committee member of the Movement Disorder Society and am an active contributor to other numerous international societies and journals. Moreover, my years with WFN have strengthened my belief in its core values. If elected as the trustee, I would like to help WFN realize its mission by pursuing the following objectives.

First, prioritize the development of educational programs. Through MDS, I have extensive firsthand experience lecturing in underserved regions as well as in establishing educational programs that cater to the specific needs of such regions. I also have years of experience through WFN, having been on the scientific and organizing committees of  the World Congress of Neurology. With awareness and appreciation for the scope of WFN’s educational activities, I believe we can further develop training programs to improve the quality of brain health care worldwide.

Second, expand collaborations with compatible academic organizations. We can be even more productive and increase WFN’s impact by taking advantage of the Global Neurology Alliance to identify and partner with other brain-related research institutions around the world.

Last, reinforce our support for under-resourced parts of the world in accordance with WFN’s avowed ideals. This means focusing on training and education so that people in underserved regions can receive better treatment for neurological disorders. I would like to offer my experiences with medical infrastructures in such regions to act as a bridge between WFN and regions in need.

What unites my experience as a neurological researcher, educator, editor, and administrative executive is my belief in the importance of brain health for all. I have had the pleasure of working with like-minded colleagues from around the world through WFN and hope we can achieve more in the years ahead. I am confident that I can fulfill the responsibilities of trustee and ask for your support.

Candidate Statement for Elected WFN Trustee: Prof. Chandrashekhar Meshram

Prof. Chandrashekhar Meshram

I am grateful to the Indian Academy of Neurology and the WFN for considering me worthy for the position of elected trustee.

Services to the WFN

My involvement with the WFN began in 2009 as the national delegate. The WFN balances its thinking and action very well, and I found that I have the experience, enthusiasm, and passion to work in such a milieu. I have served for three terms as a member of the Constitution and Bylaws Committee and for two terms as a member of the Scientific Program Committee. The tropical neurology subsection had been dormant for many years, and I took the challenge to resurrect it by successfully organizing the first International Tropical Neurology Conference in India in 2017. I was then given the responsibility to take it further as president of the Tropical and Geographical Neurology Specialty Group (TGNSG). I was co-chair for INTROPICON II held in Brazil. TGNSG now is one of the most vibrant specialty groups of WFN. I am co-editor for a special issue of JNS on tropical neurology. I am also involved in activities of the Global Neurology Alliance and the Environmental Neurology Specialty Group.

The World Brain Day initiative of WFN is highly praiseworthy. The public education campaign is close to my heart due to its importance in prevention and timely treatment of neurological disorders. I have been actively organizing World Brain Day activities. I have published a book of paintings by children about their perception of the brain. Taking inspiration from WFN, we started National Brain Week for public education in India. I have been the national convener of it for the last five years. In addition, for the last 20 years, I have been organizing public education activities on the occasion of World Parkinson’s, Alzheimer’s, Epilepsy, Rabies, Stroke, Autism, and Environment Days. I have published about 300 articles in various publications. The recent COVID-19 pandemic has emphasized the importance of public awareness in disease control and prevention.

The global burden of neurological diseases is massive, and there is a shortage of neurologists to deal with it. Therefore, for the last 12 years, through WFN Continuum activity and other CMEs, I have been organizing educational programs for neuroscientists and general physicians, so that they become more confident in handling neurological problems.

Goals

The core mission of the WFN, fostering quality neurology and brain health worldwide, fascinates me. There is a glaring inequality in neurology care and education worldwide. The developing and underdeveloped countries lag behind in both these aspects, and WFN is making every attempt to help them catch up. I have experienced this firsthand, and I am committed to addressing it. We need to focus on the management and long-term care of diseases in settings with poor resources where the lack of manpower and funding remain as major obstacles. This has been brought into sharp focus by the COVID-19 pandemic. We need to emphasize to all countries that health, and especially brain health, is a priority and needs higher attention and budgetary allocation. Public participation and health education is important in improving the outcome of patients with neurological diseases and, as mentioned earlier, I have participated in this enthusiastically.

The WFN Executive Committee needs representation from developing countries. This need and a passion to work for the WFN are my reason for standing for the post of an elected trustee. I would be grateful for your support.

Candidate Statement for Elected WFN Trustee: Prof. Mohammad Wasay

Prof. Mohammad Wasay

I am currently a professor of neurology at Aga Khan University in Karachi, Pakistan; past president of the Pakistan Society of Neurology and Pakistan Stroke Society; president of the Neurology Awareness and Research Foundation; editor of the Pakistan Journal of Neurological Sciences; chief editor of Jahan e Aasab (a neurology public awareness magazine), and a member of the Technical Advisory Committee for Pakistan Health and Research Council (PMRC) and the Prime Minister’s Task Force on Science and Technology. I have also served as director of the World Stroke Organization (WSO) and currently serve as a fellow of the Pakistan Academy of Medical Sciences and the Pakistan Academy of Sciences and secretary of the Environmental Neurology Speciality Group (ENSG) of the WFN.

I have worked with WFN for more than a decade as an active neurology advocate and researcher from South Asia. I was trained at the Palatucci Forum and then received an Advocacy Leader of the Year Award by the American Academy of Neurology for my global advocacy contributions. I served as chair of the World Federation of Neurology Advocacy Committee for four years. This committee was instrumental in starting and organizing World Brain Day activities and promoting brain health across the globe. We organized many advocacy workshops during the Asian Oceanian Association of Neurology conferences, the Asian Pacific Stroke Conference, and the World Congress of Neurology.

I started the Afghan neurology initiative, secured funding from the American Academy of Neurology and the French Medical Institute in Kabul, Afghanistan, and trained three neurologists from Afghanistan at Aga Khan University in Karachi, Pakistan. These trained neurologists have started neurology training programs, education, and research in Afghanistan and established the Afghan Neurology Association (AFNA). We are working at Aga Khan University to establish a network of neurology training and research in Kenya, Tanzania, Afghanistan, and Central Asia. We established an Asian stroke network with more than 20 centers in 10 Asian countries. This network has published many multicenter and multinational studies related to stroke in young and Asian women, stroke in pregnancy, and cerebral venous thrombosis in Asia.

I have trained more than 40 neurologists under my supervision. Some of my trainees are now heads of departments and program directors not only in Pakistan but in the Middle East, United States, Canada, and the U.K.. I have published more than 170 papers in peer-reviewed medical journals with impressive publications metrics (IF: 466; citations=4276, H- index 33 and I10 index 85) for a clinical neurologist in a developing third world country. I have received many awards, including the Teacher Recognition Award by the American Academy of Neurology, a gold medal from the Pakistan Academy of Medical Sciences, a gold medal from the Pakistan Academy of Sciences and Research, and productivity awards by the Pakistan Council of Science and Technology. I have received 27 research and training grants (intramural and extramural) as principal investigator and co-principal investigator. I have been an invited speaker at more than 120 conferences in 70 countries.

The growing burden of neurological diseases in the world has established WFN as an important stakeholder in global health. We plan to establish brain health as a top agenda for WHO and the United Nations. There is an inequity in neurology training and care across the globe. South Asia, Central Asia, and Africa should be a center point for our future interventions. As a trustee, I could play a valuable role in promoting both of these agendas. Our advocacy committee and ENSG could play an important role in establishing WFN as a key player in global health.

Marianne de Visser Named Co-Opted Trustee

Prof. Marianne de Visser

The WFN welcomes Prof. Marianne de Visser to the position of co-opted trustee.

De Visser is an adult neurologist at the Amsterdam University Medical Center in Amsterdam, Netherlands, and emeritus professor of neuromuscular diseases at the University of Amsterdam.

She was trained as a neurologist at the University Hospital of Amsterdam. In 1988 and 1989, she was a visiting scientist at Andrew Engel’s lab at Mayo Clinic in Rochester, Minnesota, where she performed ultrastructural studies on skeletal muscle in dermatomyositis.

Her research interests are neuromuscular disorders and, in particular, myositis, ALS, post-polio syndrome, and hereditary neuropathies. Because of her work in ALS, she became interested in palliative care. Previously she was the president of the Netherlands Society of Neurology, and she served with distinction as a WFN elected trustee under Presidents Jun Kimura and Johan Aarli. Recently she stepped down as the secretary-general of the European Academy of Neurology.

De Visser will bring her extensive experience and her value of teamwork to the benefit of the WFN.

World Brain Day

A reminder to all readers that World Brain Day 2020, a collaborative effort between the WFN and the International Parkinson and Movement Disorder Society, and devoted to raising awareness for—and ending—Parkinson’s disease, is underway just as this issue is going to press. It began on July 22, 2020 and will extend for weeks thereafter. Please look to the next issue(s) of World Neurology for reports of the many efforts from member societies around the globe devoted to this important event.

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