Message From the WFN President About World Brain Day 2020

World Brain Day is July 22, 2020. This year, we are excited to announce that the World Federation of Neurology is partnering with the International Parkinson and Movement Disorder Society to raise awareness for Parkinson’s disease.

There are more than 7 million people of all age groups with Parkinson’s disease worldwide, and the illness affects many more than this number through its impact on families and caregivers.

Parkinson’s is a chronic, neurodegenerative whole-body disease that affects movement and almost all aspects of brain function. Its prevalence continues to rise at an alarming rate, making the actions of today vital to improving the lives of those who have been and will be diagnosed.

In order to meet our goal to diagnose earlier, treat more efficiently, and improve the lives of those living with this disease and of their caregivers, additional resources are needed to help better understand and treat Parkinson’s.

COVID-19 is a dramatic reminder that health care is a global issue. Let us remember that Parkinson’s disease is also a daily challenge faced by all ages and people, mainly by the elderly.

We hope you’ll join us and help spread the word by following the World Federation of Neurology on Twitter and Facebook.

Prof. William Carroll
WFN President

Alberto Portera-Sánchez, Pioneer of Modern Spanish Neurology

Félix Bermejo-Parej, Luis Calandre, Teodoro del Ser

Alberto Portera-Sánchez when he was around seventy years old.

Prof. Alberto Portera-Sánchez died on November 30, 2019, in Madrid at the age of 91. He was born in Caspe, Saragossa, Spain. He graduated in medicine in 1950 in Spain and then he obtained the specialization in pediatrics and neurology in Paris and in the U.S. (at the Universities of Georgetown in Washington and in Maryland). In 1960, he returned to Spain and worked as a clinical neurologist in Madrid in several hospitals (private and public), mainly in the Clínico de San Carlos Hospital, where his neurological clinical sessions were successful and crowded with colleagues and medical students. In 1973, he gained the position of head of the Department of Neurology in the Hospital 1 de Octubre of Madrid, later called University Hospital 12 de Octubre (UH12O). From the beginning, his department was an exponent of the modern neurological organization of medical neurology in Spain.

Historical Perspective

It is necessary to comment briefly on the precarious situation of neurology practice during the 1950s and 1960s in Madrid (and in general in Spain, perhaps only with the exception of Catalonia). After the Spanish Civil War, many famous neurologists of the Madrid Neuroscientific School with foreign-based medical training and Republican ideology had to go into exile. This school was a renowned school with well-known neuropsychiatrists and neurohistologists, such as P. Rio Hortega, G. R. Lafora, and others that went from Madrid into exile and, in addition, the Cajal Institute disappeared1. During this time, the Spanish medical establishment had the neurologists as assistants to the neurosurgeons and medical internists that were the heads of Neurosurgery and Medicine departments respectively with rare exceptions. The few existing neurologists’ practice was undertaken without beds in their charge. There were no academic posts for neurologists and neuropsychiatrists, with scarce knowledge of clinical neurology, attended the neurological outpatients care in the Spanish public health Service

This situation was analogous in other countries2, but in Spain, and specifically in Madrid, it was extreme because the heads of neurology and neuropsychiatry had gone away.

Bearing this situation in mind, it is easy to understand the dramatic change that Portera-Sánchez made. He received a new department in a new and very large hospital (about 1,000 beds), which was modern and well equipped with current medical technology. He was able to select his collaborators and to organize the neurological service. He went for a large department, in accordance with the recommendations of the American neurology style. (He was a member of the American Academy of Neurology.) Long before, the NINDS had indicated the benefits of neurological sub-specialties and the importance of adequate training for future neurological staff2. The neurologists in his department practiced clinical neurology and all sub-specialties of neurology, that is to say, general neurology, child neurology, and clinical electrophysiology (EEG and EMG), including the study of muscle disorders. Additionally, every day a clinical neurologist was on duty in the emergency department of the UH12O to attend to acute neurological disorders (stroke, meningitis, head trauma, and so on). Furthermore, his neurologists had neuroradiology knowledge, although the official report came from the Neuroradiology Department. This organization was an exception in neurological care at this time in Spain and an example for the Spanish neurological service.

Career Highlights

The Consulting Section (Comisión Nacional de la Especialidad de Neurología) of the Spanish Ministry of Health named Portera-Sánchez as the president of this section that advised this ministry on the organization of the numbers and programs of the Residency in Neurology in Spain. In this position, he was able to introduce the rules to expand this modern (for Spain) model of neurology practice, and changed the previous model of neurologist as only assistants of internal medicine and neurosurgery. The Ministry of Health accepted these first recommendations and the following Consulting Sections prolonged this model. This increased the number of clinical neurologists and decreased the number of neurophysiologists in order to adopt an American model of neurological assistance with a great number of neurologists who were able to undertake all neurology sub-specialties. Gradually, Spanish neurology began to have services all over Spain, academic posts, and the number of neurologists increased greatly with young neurologists. Neurological care is now present in all medium-sized and large hospitals, and it works as an outpatient specialty because the Spanish National Health Service would like to include the main medical specialties near the population. This is the only point that Portera-Sánchez did not like. He thought that neurology should be practiced mainly in hospitals and probably for the progress of scientific practice it would be true3. Many young Spanish neurologists (now more than 3,500) do not know the precarious beginning of Spanish neurology in the third part of the last century.

Portera-Sánchez: Leader, Humanist, Friend

Early in the 20th century, Spanish neuroscience had a high international profile, personified by Santiago Ramon y Cajal. He was a winner of the Nobel Prize in Physiology and Medicine and last year his publications were cited 1,559 times, 85 years after his death. The Spanish Civil War (1936-1939) proved disastrous for neuroscience because of the exile of some of the most eminent and many promising scientists. Pio Rio Hortega, discoverer of microglia, ended up in Argentina, and the physiologist August Pi Suñer in Venezuela and then Mexico. They are but two of the many exiles. Neuroscience and neurology entered a long penumbra under the Francisco Franco regime.

Portera-Sanchez did part of his training in the United States and gained a faculty position. However, he returned to Spain to become the founder of modern Spanish neurology. He linked it internationally as demonstrated by his role in the World Federation of Neurology and the symposia that he organized, including a pioneering and memorable one on neuroplasticity. He was also leader in trying to link the brain with the arts and humanities. He organized a series of colloquia on “El cerebero en si mismo” (roughly translated “The brain in itself”) that featured a neuroscientist and an eminent artist or humanist. One example was a neuroscientist specializing in vision and a leading Spanish artist. I was paired with Cristobal Halffter, a Spanish leading composer on the topic “Music and the brain.” The presentations and commentaries were published as booklets.

He was a respected art collector and critic. He recognized talented young artists early in their careers and bought their paintings when they were affordable. He often wrote and commented on art, including publishing a book on the subject.

He had many pupils, admirers, and friends. He hosted innumerable international guests at his country home with his gracious wife Catherine.

At meetings, one could spot Portera-Sanchez easily. He was the person with the most people gathered around him.

Portera-Sanchez will continue to live in our memories and through his deeds and teachings, multiplied by his many pupils. •

Vladimir Hachinski
Past President, World Federation of Neurology

Portera-Sánchez was not only an organizer of the neurological service of the UH12O, he was a brilliant clinical neurologist and an untiring “neurological business man” who made contacts all over the neurology world. He invited to his department many prestigious neurologists to give lectures, such as Carleton Gajdusek, when he was Nobel laureate, Vladimir Hachinski, Luigi Amaducci, David Marsden, and many others. It is worth remembering that Bruce Schoenberg, when he was chief of the Neuroepidemiology Branch in the NINDS of the National Institutes of Health, visited our neurology department at UH12O and gave a course on neuroepidemiology, and then designed a community study of the main neurological diseases in Madrid4. This interest for Neuroepidemiology continued in his department. At the end of the 1980s, Portera-Sánchez and his team formed part of the Age-Associated Dementia Project of the World Health Organization consortium (AAD SPRA-WHO) that would implement a dementia study in six countries (Canada, Chile, Malta, Spain, and in black populations of the U.S. and Nigeria). Luigi Amaducci, standing neuroepidemiologist, directed the Coordinating Center of this WHO study in Florence, Italy, and took as advisors leaders of the dementia field such as Z. Khachaturian, R. Katzman, and others. The study did a panel concordance in the diagnosis of dementia5 and a validation of the main screening tools6 for the future study. However, the Canadian team had advanced its own study (Canadian Study of Health and Aging) and declined to participate in the new study as well as the Nigeria-U.S. (African Americans and Yoruba-Nigerians) study, which had designed a complex investigation. The only study that continued with the validated methodology was the NEDICES in Spain funded by the official Spanish Research Agency (FIS).

Portera-Sánchez had an interest in many fields of neurology, but mainly in dementias and edited the first dementia book in Spain7. Additionally, he had great interest in cerebrovascular disorder8,9. Moreover, he and his neurological team of the UH12O worked in other neurological fields, such as peripheral neuritis, brain infections, neuroimaging, and others.

The International Stage

We must underline his international neurological affairs. He was elected as vice president of the World Federation of Neurology (WFN) from 1989 to 1993. In addition, he formed part of the WFN Education Committee10, the education committee of the Federation of Neurological Societies11, and was an honorary member of the American Academy of Neurology in 2003.

In Spain, after many years of being professor of neurology, he obtained the first chair in neurology in Madrid in the Complutense University (UCM) in 1996. Previously, in 1993, he was elected to membership of the select Spanish Royal Academy of Medicine.

Supporting the Arts

This remembering of his life would fall short if we omitted an important part of his life. Portera-Sánchez was a man of vast culture and love for the arts. He was a friend of many famous contemporary painters such as Chillida, Guerrero, Millares, Mompó, Saura, and others. Additionally, filmmakers and other well-known artists formed part of his frequent social gatherings, where it was possible to find neurologists, scientists, and people from the arts. In fact, Portera-Sánchez was an art (paintings) collector, and his love for painting was a passion throughout his life, which he passed on to one of his sons12. To recognize this dedication to art works, he was rewarded as corresponding academic of the Royal Fine Arts Academy of San Fernando and member of the Patronage of the National Museum of the Queen Reina Sofia in Madrid.

Finally, the community of Spanish neurologists is grateful to Portera-Sánchez for his contribution to the development of clinical neurology in our country. In addition, as his pupils, we rend our gratitude for having shared with us his neurological skills, his brilliant teaching, his spirit open to the culture and to the scientific innovations, and his permanent cordial, warm, and human manners. •

Félix Bermejo-Pareja, Research Institute,
University Hospital 12 de Octubre,” Madrid, Spain

Luis Calandre, department of neurology,
University Hospital “12 de Octubre,” Spain

Teodoro del Ser, Alzheimer disease research unit, CIEN Foundation, Madrid, Spain

Reprinted with permission from the Journal of the Neurological Sciences 411 (2020) 1167032

References

1. J.S. Dosil, The footprint in Mexican neurosciencee of Spanish exile, a legacy of Cajal overseas, Neurosci. Hist. 1 (2013) 154–161 (http://nah.sen.es/es/100-revistas/ vol1/numero-4/158; ISSN: 2254–6146).
2. H.H. Merritt, Influences of the national institute of neurological and communicative disorders and stroke on clinical neurology, in: D.B. Tower (Ed.), The Nervous System, Vol. 2 Raven Press, NY, 1975, pp. 1–3 (ISBN: 0–89004-076-I).
3. F. Bermejo-Pareja, Neurology and neurologists in Spain: the consolidation of the family neurologist? Neurología 22 (2007) 221–235 17492516.
4. M.C. Gutierrez-del-Olmo, B.S. Schoenberg, A. Portera-Sánchez, Prevalence of neurological diseases in Madrid, Spain, Neuroepidemiology 8 (1989) 43–47, https://doi.org/10.1159/000110164.
5. M. Baldereschi, M.P. Amato, P. Nencini, et al., Cross-national interrater agreement on the clinical diagnostic criteria for dementia, Neurology 44 (1994) 239–242, https://doi.org/10.1212/wnl.44.2.239.
6. M. Baldereschi, F. Meneghini, P. Quiroga, et al., Cognitive versus functional screening for dementia across different countries: cross-cultural validation of the mini-mental state examination (MMSE) and the Pfeffer activities questionnaire (PFAQ) against the standardized clinical diagnosis of dementia, Neurology 44 (Suppl. 2) (1994) A365.
7. Dementias, A. Portera, F. Bermejo (Eds.), Asociación Española de Neuropsiquiatría, Mayoría, Madrid, 1980(ISBN: 84–85.300-11-4).
8. A. Portera-Sánchez, L. Calandre, Evaluation of the patient with suspected cerebrovascular disease, in: P.J. Vinken, G.W. Bruyn, H.L. Klawans, J.F. Tool (Eds.), Handbook of Clinical Neurology, Vol. 53 Elsevier Sci. Pub., Amsterdam, 1988, pp. 175–199 (ISBN: 0-444-90404-2).
9. T. del Ser, F. Bermejo, A. Portera, J.M. Arredondo, C. Bouras, J. Constantinidis, Vascular dementia. A clinicopathological study, J. Neurol. Sci. 96 (1990) 1–17, https://doi.org/10.1016/0022-510x(90)90052-o.
10. M.T. Medina, T. Munsat, A. Portera-Sánchez, et al., Developing a neurology training program in Honduras: a joint project of neurologists in Honduras and the world Federation of Neurology, J. Neurol. Sci. 253 (2007) 7–17, https://doi.org/10.1016/ j.jns.2006.07.005.
11. W. Grisold, Z. Ambler, A. Hopkins, et al., FENS task force for continuing medical education (CME). European Federation of Neurological Societies (EFNS) – approval (co-sponsorship) of continuing medical education (CME) meetings, Eur. J. Neurol. 6 (1999) 259–265 10210904.
12. A. Portera Sánchez, Abstract painting, a mental esthetic construction without exact correspondence with reality (José Guerrero: manual and corporal expressions in his paintings), An R Acad. Nac. Med. (Madr) 123 (2006) 543–550 17451097. Félix Bermejo-Parejaa,b, Luis Calandreb, Teodoro del Serb,c*
a. Research Institute, University Hospital “12 de Octubre”, Madrid, Spain
b. Department of Neurology, University Hospital “12 de Octubre”, Spain
c. Alzheimer Disease Research Unit, CIEN Foundation, Madrid, Spain
E-mail address: tdelser@fundacioncien.es (T. del Ser).

World Brain Day 2020 Moves to End Parkinson’s Disease

A World Federation of Neurology and International Parkinson and Movement Disorders Society Collaboration

By Tissa Wijeratne, MD, Wolfgang Grisold,MD, Claudia Trenkwalder, MD, William Carroll, MD

World Brain Day was launched in 2014. Since then, the WFN, jointly with other international societies such as International League Against Epilepsy, World Stroke Organization, and the International Headache Society, chooses a topic with a view to drive home the importance of brain health and promote better neurological care globally.

World Brain Day 2020 Key Messages

World Brain Day 2020 is a joint collaboration between the World Federation of Neurology and the International Parkinson and Movement Disorders Society (IPMDS).

Get on board today. Spread the news through mainstream media, social media platforms, national, and international meetings throughout the year.

Arrange virtual education and advocacy activities around the World Brain Day “Move Together to End Parkinson’s Disease” campaign in your community, hospital, village, city, or region throughout the year.

For ongoing support, contact Prof. Tissa Wijeratne, World Brain Day chair, at Tissa.Wijeratne@wfneurology.org.

Access the educational and promotional material created by the WFN and IPMDS to help you advocate for your patients with Parkinson’s disease.

Move Together to End Parkinson’s Disease

Based on this background, the WFN chose the topic of Parkinson’s disease jointly with the International Parkinson and Movement Disorders Society (IPMDS) as the topic for World Brain Day 2020. As in preceding World Brain Day events, the aim of World Brain Day 2020 is to alert not only its member societies, but also the public on critical neurological issues. The member societies of the WFN will receive a “toolkit” of templates for press releases and also educational PowerPoint presentation sets to assist in their local activity to promote World Brain Day and advocate for patients with Parkinson’s disease and their caregivers.

Local press conferences and press coverage, including print, electronic, radio, TV, and YouTube are strongly encouraged to reach the public.

Let us spread the key messages from World Brain Day 2020 “Move Together to End Parkinson’s Disease” through mainstream media, social media platforms, and local, regional, national, and international meetings throughout the year. Please see and share our new logo, the web banners, social media images, and other educational material in your country. We invite our readers to rally around World Brain Day 2020 “Move Together to End Parkinson’s Disease.”

Please make the World Brain Day 2020 campaign an important priority. The educational and promotional material from the WFN and IPMDS collaboration will help you to be the best advocates for your patients with Parkinson’s disease and their caregivers. •

Prof. Tissa Wijeratne is chair of World Brain Day and chair of neurology at Western Health in Melbourne, Australia.

Prof. Claudia Trenkwalder is president of the IPMDS and professor for Movement Disorders at University Medical Center in Goettingen, Germany and medical director of Paracelsus-Elena Klinik, the largest hospital for Parkinson and Movement Disorders in Kassel, Germany.

 

About Parkinson’s Disease

Prevalence: Parkinson’s disease is a chronic neurodegenerative brain disease that affects more than 7 million people of all ages worldwide, and its prevalence continues to increase.

Disability: Parkinson’s disease is a whole-body disease that affects the mind, movement, and almost all aspects of brain function, with symptoms worsening over time.

Standard of Care: Access to quality neurological care, life-changing treatments, and essential medication is unavailable in many parts of the world.

Research: Additional resources are needed to help unlock the cause, onset, progression, and treatment of this disease across all ages.

Advocacy: It’s important to work together to diagnose earlier, treat more effectively, and improve the lives of those living with Parkinson’s disease and their caregivers.

The 2016 Global Burden of Disease of Parkinson’s disease studied its global burden between 1996 and 2016 to identify trends and to enable necessary public health, scientific, and medical responses in 20181. Over the past generation, the global burden of Parkinson’s disease has more than doubled with potential longer disease duration and environmental factors1. We can expect that the trend will continue in the next few decades with the possibility of 12 million patients with Parkinson’s disease worldwide by about 20502.

The comorbid diagnosis itself has not emerged as a specific risk factor for poor outcomes of COVID-193. The hidden sorrows (potential medication supply issues, disruption to research, and clinical trials), and emerging opportunities (telemedicine, how the pandemic influences the course of Parkinson’s disease, and taking advantages of technology, such as wearable technology) have been visible during the COVID-19 pandemic3,4.

Parkinson’s disease is a complex disease process of the human brain that results in a broad spectrum of clinical features encompassing all aspects of human function. These primarily motor dysfunctions as well as non-motor symptoms can significantly limit the patient’s ability to take part in typical day-to-day activities with poor quality of life

It is indeed essential to understand the caregiving aspects and burden in Parkinson’s disease. Findings from a published meta-analysis indicate that motor symptoms and dependence in activities of daily living have a moderate relationship with caregiver distress5. Non-motor symptoms such as impaired cognitive function, including hallucinations, confusion, and affective disorders such as depression and anxiety, have a significant effect on caregiver strain. It is the hours spent on caregiving activities and sleepless nights that are strongly associated with caregiver burden6.

References:

  1. Collaborators, G.B.D.P.s.D., Global, regional, and national burden of Parkinson’s disease, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol, 2018. 17(11): p. 939-953.
  2. Rocca, W.A., The burden of Parkinson’s disease: a worldwide perspective. Lancet Neurol, 2018. 17(11): p. 928-929.
  3. Papa, SM, et al., Impact of the COVID-19 Pandemic on Parkinson’s Disease and Movement Disorders. Mov Disord, 2020.
  4. Helmich, R.C. and B.R. Bloem, The Impact of the COVID-19 Pandemic on Parkinson’s Disease: Hidden Sorrows and Emerging Opportunities. J Parkinsons Dis, 2020. 10(2): p. 351-354.
  5. Lau, K.-M. and A. Au, Correlates of Informal Caregiver Distress in Parkinson’s Disease: A Meta-Analysis. Clinical Gerontologist, 2011. 34(2): p. 117-131.
  6. Bhimani, R., Understanding the Burden on Caregivers of People with Parkinson’s: A Scoping Review of the Literature. Rehabil Res Pract, 2014. 2014: p. 718527.

Committees of the WFN

Wolfgang Grisold,
Secretary General, WFN

Wolfgang Grisold

Wolfgang Grisold

The committees of the WFN contribute greatly to the work of the WFN. The chairs are appointed by the trustees, and the committee is composed of members of the regions.

The present composition and membership can be seen on the WFN website and are listed in Table 1.

WFN Committees

  • Congress
  • Constitution and bylaws
  • e-communications
  • Education
  • Finance
  • Grants
  • Membership
  • Nominating
  • Public awareness and Advocacy
  • Publications
  • Regional liaison
  • Specialty groups
  • Standards and Evaluation

The task of the committees is to work on specific issues, and within their defined task they are of great value not only for the leadership of the WFN, but to the whole organization. This new column will introduce the committees in the next issues of World Neurology, starting with the Standards and Evaluation Committee in this issue.

Standards and Evaluation Committee

Table 1.

The most recently appointed chair is Prof. László Vécsei, head of Neuroscience Research Group, the department of neurology, University of Szeged, Hungary. He has much experience in educational matters, nationally, within the former European Federation of Neurological societies (EFNS- now EAN) and the Danube group of neurology.

This committee receives applications for meetings and also enduring materials. In the future, there will be an increasing need to endorse also webinars and virtual meetings.

The task of the committee is to scrutinize the event/material for scientific content, quality of speakers, and also make sure that the event is independent from industry or other influences. Once the event or material is endorsed, it is allowed to bear the WFN logo, as a sign of quality, and will be announced on the WFN website.

As Continuing Medical Education (CME)/ Continuous professional development (CPD) is subject to local and national regulations, the recognition of CME /CPD needs to be made locally, by the respective responsible body.

If you are planning a meeting or any other kind of virtual or enduring material, which is in English and of interest for our WFN community, please consider to have your event/material endorsed by the WFN. The WFN is free of charge and meant as a service for neurology. Details on the endorsement process, and also downloadable material for the application are on the WFN website.

Public Awareness and Advocacy Committee

This committee is chaired by Prof. Tissa Wijnerate from Australia. Its aim is to promote and enhance brain health and the visibility of the WFN. It has successfully organized previous World Brain Days. For a summary of 2019, organized with the International Headache Society, see the webinar of World Brain Day 2019.

This year’s World Brain Day is jointly organized with the International Parkinson and Movement Disorder Society. The motto is “Move Together to End Parkinson’s Disease” and will highlight the importance of treating patients with movement disorders and also support careers. See the associated article in this issue.

COVID-19 and the WFN

The WFN has set up website space for the present COVID-19 crisis. We are all concerned about the neurological effects as well as recommendations to handle this crisis.

As guidelines vary in subdisciplines and regions and countries, we have inserted a list of the websites of the global neurology alliance (GNA) as well as the WFN specialty groups. Some of them have specific guidelines and advice on their website, or could be directly asked.

The journals are presently overwhelmed with reports and observations of neurological involvement in COVID-19, and it is difficult to select peer reviewed and high quality articles. The WFN has appointed our three WFN editors (Journal of the Neurological Sciences, John England; eNeurological Sciences, Walter Struhal; and World Neurology, Steven Lewis) to go through suggested articles and give recommendations. You will find these selected articles on our website.

The Specialty Group on the Environment has published a letter in Lancet Neurology, encouraging all societies to establish databases and registries and look at neurological effects of COVID-19 (THELANCETNEUROLOGY-D-20-00339 S1474-4422(20)30148-4.)

We are also interested in suggestions and opinions concerning our committees. Please contact us via the London office (Jade), or my email at wolfgang.Grisold@wfneurology.org. •

Neurological Meetings in Transylvania

By Dafin Muresanu, Selejan Ovidiu, Cristian Andriescu, and Stefan Strilciuc

Prof. Dafin F Muresanu, MD, congress chair, president of the European Federation of Neurorehabilitation Societies (EFNR)

Over the past 15 years, there have been three annual international events in the field of neurology organized by the Society for the Study of Neuroprotection and Neuroplasticity (SSNN). The society was established in 2005 by an international group of clinicians and basic researchers at the initiative of Prof. Dafin F. Muresanu, MD, Romania, with the scope of promoting a strong collaboration platform for translational medicine, in an attempt to strengthen stronger collaboration between the academics and clinicians. Hence, there is dual focus on basic and clinical research. The organization’s aim is to create a discussion forum for better understanding of endogenous basic biological processes, consequently leading to the development of pharmacological and non-pharmacological strategies for positive manipulation of neuroprotection, neuroplasticity, and neurogenesis.

Soon after its establishment, SSNN became a member of the Global College of Neuroprotection and Neuroregeneration (GCNN). The SSNN continues to grow its network, by establishing scientific and academic relations with European and international institutions such as the World Federation of Neurology (WFN), the European Academy of Neurology (EAN), the European Federation of Neurorehabilitation Societies (EFNR), the World Federation of Neurorehabilitation Societies (WFNR), the IuIiu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania, the Tel Aviv University, Israel, the Danube University Krems, Austria, the Foundation of the Journal Journal of Medicine and Life, and the RoNeuro Institute for Neurological Research and Diagnostic in Cluj-Napoca, Romania.

International Summer School of Neurology

The mission of the International Summer School of Neurology is to provide a platform in which a select class of young neurologists-in-training can interact with an international faculty recognized for its expertise in both basic and clinical neurosciences.

From left to right. Prof.Gunther Deuschl, MD, past president of the EAN, Prof. Raad Shakir, MD, past president of the WFN, and Prof. Ovidiu Bajenaru, MD, past president of the Romanian Society of Neurology

The idea for the event dates back to 2005, being initiated by Muresanu, Prof. Natan Bornstein, MD, Israel, and Prof. Ovidiu Bajenaru, MD, Romania. The founders understood the young specialists’ and practitioners’ need to be connected with the latest developments in the complex field of neurosciences, hence developing a dynamic environment for this symbiosis to take place. After almost a year of preparations, the first edition of the International Summer School of Neurology opened its doors to participants on July 9, 2006. International experts covered current topics like blood-brain barrier research, secondary stroke prevention, the latest advances in neuroimaging and stroke, epilepsy, neurodegenerative disorders, and movement disorders.

Its community reach defines the success of the International Summer School of Neurology. At Poiana Brasov, Romania, 200 participants from eight different countries and 26 illustrious speakers joined together to participate in the 14th Summer School.

In addition to the educational program presented, SSNN also organizes the European Teaching Course on Neurorehabilitation and the EAN Task Force on Rare Neurological Disorders Teaching Course.

European Teaching Course on Neurorehabilitation

One of SSNN’s most prestigious academic projects is the European Teaching Course on Neurorehabilitation. Since its first edition in 2011, the organization joined forces with the educational architect of this program – the European Federation of Neurorehabilitation Societies (EFNR). The teaching course also benefits from the support and endorsement of the international organization in the field of neurorehabilitation, namely the World Federation of Neurorehabilitation Societies (WFNR).

14th International Summer School of Neurology. Presidential Session

The teaching courses’ objectives are (1) to advance the development and improve the quality of neurorehabilitation in Europe; (2) to stimulate the collaboration between clinicians and other disciplines of the neurorehabilitation team; (3) to facilitate the exchange of knowledge and scientific research between clinicians with an interest in neurological rehabilitation, and (4) to contribute to the development of cooperation and communication networks between National Neurorehabilitation Societies. Having these principles in mind, the SSNN and its collaborators have developed a comprehensive and up-to-date teaching course which addresses the pressing needs that reside in the field of neurorehabilitation year by year.

Neurorehabilitation societies are not the only stakeholders that actively contribute to the development of the teaching course. Many other international academic institutions have pledged support and active contribution, including the Foundation of the Journal of Medicine and Life; IuIiu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Tel Aviv University, Israel; Danube University Krems, Austria; and the RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania. In 2017, the EAN endorsed the European Neurorehabilitation Teaching Course.

This year, the European Teaching Course on Neurorehabilitation reached its 9th edition. The event set the stage for two days of intensive talks and debates between 150 participants from seven countries, on a broad range of challenges in neurorehabilitation and neuroscience, promoting the integration of new scientific information via keynote lectures. A rich and diverse audience of health care professionals interested in this steadily expanding and multidisciplinary field attended the event, including physicians, nurses, therapists, public health experts, and clinical researchers.

EAN Task Force on Rare Neurological Diseases Teaching Course

The most recent educational project proposed by the EAN Task Force on Rare Neurological Diseases (EAN TF RND) to the international scientific community is developed together with the SSNN. From a neuroepidemiological perspective, rare diseases have significant public health impact due to their collective large number and diversity. The task of providing care for over 5,000 documented diseases that are considered to be rare worldwide is a daunting experience. While significant progress has been made in recent years with understanding and mapping rare diseases, providing early diagnosis and valid treatment options for patients with such afflictions is still a great challenge.

Rare neurologic diseases (RNDs) are vastly underdiagnosed and effective treatment is often lacking. The EAN Scientific Committee has established the task force intending to help patients with RNDs and their families, through strategies to facilitate earlier diagnosis, timely management and coordinating research. The Task Force members are experienced scientists, experts in the complex field of rare neurological diseases, who work together to raise awareness and improve knowledge, aiming for earlier diagnosis and specific research programs to identify disease mechanisms and lead to possible therapies.

The Task Force and the SSNN have developed a teaching course aimed to address all the open issues presented. The first edition of this event was hosted by Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca in 2017. Around 170 physicians, nurses, therapists, public health experts, clinical researchers, and students attended the educational event, along with 12 speakers, experts in the field of RNDs. The meeting in 2019 was the third edition of the EAN Task Force for Rare Neurological Diseases Teaching Course. Through the two-day teaching course, a wide range of topics on rare neurological diseases were approached, such as a detailed overview of rare neurologic disorders in the context of the most studied rare causes of stroke, dominant and episodic ataxias, oligodendrocyte dysfunction, neurometabolic genetic diseases, mitochondrial encephaloneuromyopathies, rare diseases and their relationship with the neurodegenerative diseases, dystonias, transthyretin amyloidosis neuropathy, Huntington’s disease, and many others.

SSNN continues to develop a wide range of activities and educational projects in collaboration with its international multidisciplinary partners to achieve our vision to meet ever-demanding patient needs and to bridge the gap between science and education in the medical community.

For details about the events organized by SSNN, please follow this link. •

Department of Neurosciences, IuIiu Haţieganu University of Medicine and Pharmacy, Cluj Napoca, Romania.

 

 

Editor’s Update for the Journal of the Neurological Sciences Regarding COVID-19

By John D. England, MD

John D. England, MD

John D. England, MD

The COVID-19 pandemic has created an unprecedented medical, social, and economic crisis. Although the respiratory system is the major site of infection with SARS-CoV-2, many other complications are now recognized. Although not initially suspected, neurological features of COVID-19 do occur. In fact, for patients who recover from the respiratory disease, neurological complications may be one of the severe lasting features of COVID-19. New information on COVID-19 becomes available very quickly, often on a daily basis.

To facilitate rapid dissemination of new results and observations on COVID-19, the Journal of the Neurological Sciences and its companion journal, eNeurologicalSci have agreed to review rapidly all manuscripts relevant to COVID-19 and to publish expeditiously all accepted papers. Additionally, all such articles are freely available

upon publication. To facilitate ease of access to COVID-19 articles and guidelines, Elsevier and the World Federation of Neurology have both developed new platforms specific to COVID-19. These sites are refreshed regularly as new research, guidelines, and commentary become available.

If you are interested in learning what articles and resources are available, please access the following sites: COVID-19 Health care Hub (covid-19.elsevier.health) and World Federation of Neurology. •

John D. England, MD, is editor-in-chief of the Journal of the Neurological Sciences, the official journal of the WFN.

 

 

 

Junior Traveling Fellowship Reports From The 24th World Congress of Neurology

Andina Wirathmawati, MD, Neurology Resident Brawijaya University, Malang, Indonesia

Andina Wirathmawati, MD

The 24th World Congress of Neurology was held held Oct. 26-Nov. 1, 2019, in Dubai, United Arab Emirates.

Many topics were presented by well-known experts worldwide. Formal and informal meetings in the congress gave an excellent opportunity to greet and meet or to share an exchange of knowledge and ideas, even on ongoing research projects to enhance and collaborate. This event was the best opportunity for new networking and contact with others.

It was a great honor given to me by the WFN to attend the congress as a poster presenter. I received many questions during my poster session as well as remarks from colleagues. This includes Prof. Reilly from the University College London, who had abundant questions about my poster. Overall, this congress gave me a boost to gain a better experience for further development as young neurologist.

My attendance at the congress was kindly supported by the WFN with support from the WFN Junior Traveling fellowship. I wish to express my gratitude and happiness for this great opportunity. Great thanks to all members of the WFN. •

Emmanuel Iwuozo, MBBS, Msc, FMCP

Emmanuel Iwuozo, MBBS, Msc, FMCP

As one of the privileged recipients of the WFN Junior Traveling fellowship 2019 Award, I attended the World Congress Neurology 2019, Oct. 27-31 at the World Trade Centre in Dubai, United Arab Emirates.

The registration for the congress, visa, flight, and accommodations were all free. I also had two of my abstracts accepted for poster presentation, which I uploaded before the congress.

The setting of the conference – the World Trade Centre – was excellent. I participated in the plenary sessions, teaching courses, botulinum toxin workshop, and tournament of the mind. The exhibition stand and congress abstract viewing sessions were equally enlightening.

This conference will remain the memorable one as it gave me opportunity to meet new friends and colleagues.

I remain grateful to the World Federation Neurology for support. Accept my kind regards. •

Mostafa Abdelmomen

Mostafa Abdelmomen

I am very happy to write this report after finishing the World Congress of Neurology 2019 in Dubai. This wonderful scientific event in all fields of neurology over five days covered each branch of neurology, with very informative teaching courses and a large number of posters with new fields of research.

In addition to all of the scientific aspects of the congress, I participated in the social network event in Bab Al Shams, which is a wonderful place with historic style for old Arabian life, and the horse and camel show.

Lastly, I would like to thank the WFN committee that helped me to attend this important event. Special thanks Prof. Steven Lewis and Jade Levy for their efforts on my behalf. •

Hamada Zehry

Hamada Zehry

I want to thank the WFN for helping me to attend the WCN 2019 in Dubai, United Arab Emirates. I was very satisfied with all the lectures, especially those concerning epilepsy and movement disorders. The congress provided the most up-to-date scientific content. Thank you. •

An Open Letter to All Member Societies of the WFN 

Dear Member Society, 

William Carroll, MD

At this time of what we all hope is the peaking of the COVID-19 crisis, I write to assure you that the WFN remains functioning normally with none of the trustees, staff, or executives physically affected. We trust that this continues and ask that if any member society is affected adversely in any way that they think we should be aware of, or that we might be able to assist, then please contact the London Office. 

For those of you who have been following our Facebook or Twitter feeds or the information on the WFN website or in the WFN newsletter, World Neurology, you will have noticed that the WFN had planned this year to ramp up its visibility, the promotion of brain health in parallel with this year’s World Brain Day, to commence the promotion of the 2021 World Congress of Neurology, and pursue and address the inequities of access to quality neurological care. Most of these activities were to combine both physical attendance at major international meetings and new press campaigns.  

With the impact of COVID-19 and the uncertainty of how long this will last, we will be transferring more emphasis of these efforts to the media. The cancellation of the 2020 American Academy of Neurology, the world’s largest neurological meeting, illustrates the likely direction for other major neurological meetings.  

It is paramount that neurological disorders and especially non-communicable neurological disorders do not become subsumed by the COVID-19 crisis and the response to it. In addition to providing our full support for the battle with COVID-19 by governments, their health services, institutions and hospitals, we also owe our patients with neurological disorders our reassurance and our vigilance.  

Most importantly, drug supply chains, access to medicines and pre-emptive information to those receiving neuro-immunological and other treatments, as to where to find the most appropriate and up-to-date information, will be invaluable to patients in jurisdictions where such services are already fragile. Most of the major neurological disease organizations and national and regional neurological organizations have done these preparations or are making them so it may just be a matter of ensuring the information pertinent to certain member societies is available. Fortunately, COVID-19 appears not to be neurotropic, and although there has been some earlier discussion on this in the literature, there has been no firm evidence to change this view.  

In closing, I wish all member societies, their individual members and their families, and above all, our patients, safe passage through this pandemic. 

William Carroll
WFN President

2020 WFN Status Report: Where Are We? 

2020 WFN Status Report: Where Are We?

WFN trustees, regional directors, and WFN President William Carroll (fifth from the left), AAN President James Stevens (second from the right) and EAN Claudio Bassetti (not pictured)

Following the end of 2019, highlighted by the successful World Congress of Neurology (WCN) in Dubai and a productive two-day strategy meeting just completed in mid-January in London, it seems appropriate to review where the WFN now stands as we move into 2020. I make no apology to those who read these columns regularly and who will have noted a similar theme for the first issue of 2019.

This report will cover a number of initiatives in which the WFN is now engaged as well as some future plans. It is important that the WFN membership is kept informed as to what the WFN is doing and why. It will be apparent to those who read this report that each initiative is closely interlinked with the others.

I will list the current endeavors and then expand on each. Before doing so, it is worth emphasizing that these are all directed to the core mission of the WFN, which is to “foster quality neurology and brain health worldwide.”

Visibility

This is a useful, overarching term used in respect of the WFN to enhance its recognition at a number of different levels. It is a means to facilitate the influence of the WFN. Within the world in which we now live, visibility and recognition are essential to reaching key targets, such as the WHO and global regional and national policymakers as well as civil society.

WHO Executive Board in session.

Such visibility and recognition that the WFN seeks benefits all associated organizations from the Global Neurological Alliance (GNA), through the regional WFN oorganizations serving the six WFN regions and of course the member societies and individual neurologists within those member societies.

To do this, the WFN has been in attendance at all important neurological meetings, such as the American Academy of Neurology (AAN), the European Academy of Neurology (EAN), and the PanArab Union of Neurological Societies (PAUNS) major member society meetings during 2019 and plans more WFN exposure at these in 2020.

The WFN is delighted to again join with a key global organization from the GNA, as it did in 2019 with the International Headache Society (IHS), for World Brain Day (WBD). This year’s WBD will be undertaken in partnership with the International Parkinson’s Disease and Movement Disorders Society (IPD and MDS) and promoted again with Yakkety Yak, the media partner from 2019. The collaborative effort spearheaded by Yakety Yak proved to be outstandingly effective (overall reach estimated in excess of 50 million). In 2020, as in 2019, WBD will be a campaign lasting several months and culminate in the IPD and MDS Congress Sept. 13-17 in Philadelphia, Pennsylvania. By allying this campaign with that for the importance of Brain Health, the WFN also hopes to increase its effective reach beyond the previous effort, again to the benefit of all.

As most would know, WBD is the annual partner of the WFN’s highest profile educational event, the biennial World Congress of Neurology (WCN). Plans are nearing completion for the promotion of the XXV WCN, which promises to be a highly successful event Oct. 3-7, 2021, in Rome.

Finally, the WFN trustees agreed during the London strategy meeting in January that the WFN Specialty Groups would be encouraged to both promote their specialty and the WFN and so further assist in the improved visibility of the WFN. (See Specialty Groups section on page 4.)

Inequities of Access, Neurological Non-Communicable Disorders (nNCD) and the Global Burden of Neurological Disorders

No matter how one looks at this, the topic is fundamental to our raison d’etre.

ILAE President, Prof. Samuel Wiebe.

We have made a good start. We have concentrated on Africa and the Sub-Saharan region in particular, following the lead of Johan Aarli in 2006. We now have four active teaching centers in operation in Africa: two each in francophone and anglophone Africa. These address the critical shortage of neurologists in parts of Africa. There are other countries and regions with similar personnel issues and yet others who are inadequately resourced with infrastructure, diagnostic facilities, and access to pharmaceuticals to combat the growing burden of neurological disorders and consequent financial impost.

In an attempt to approach these problems rationally, the WFN requires the information on which to base the relative needs. Consequently, it has begun to collate a registry of “needs.” The registry is to be formed by a modest survey completed by member societies from which it is planned to develop strategies to assist groups of countries with common inequities. It is likely that such plans will involve targeted advocacy campaigns in conjunction with the relevant regional WFN organizations to effect the change in the allocation of national resources. The data provided by the survey will aid this approach particularly for the argument for jurisdictions to re-evaluate the prioritization of their resources to meet the growing burden of nNCDs.

WFN Core Mission

  • Visibility
  • Inequities of access and the approach to neurological non-communicative disorders (nNCDs) and the global burden of neurological disorders.
  • Closer links to the WHO
  • Promoting importance of Brain Health
  • Global Neurology Alliance
  • Educational activities
  • WFN Specialty Groups

Closer Collaboration With the WHO

William Carroll, WFN president, at the Executive Board session on Epilepsy, with Action Amos, vice president of IBE, and Prof. Samuel Wiebe, ILAE president.

Although the WFN enjoys the status of being a non-state actor in official relations with the WHO and contributes regularly to the discussion of issues aligned with those of the WFN, its voice when heard is interpreted from the WHO perspective. The WFN therefore is seeking approaches that the WHO can accommodate to aid more rapid and targeted realization of the common goal of reducing inequities of access to quality neurological care within the broader WHO policy framework. The WFN has regularly supported the longstanding WHO initiative on epilepsy together with the International League Against Epilepsy. Indeed, a landmark decision was made by the WHO Executive Board meeting Feb. 6 on this matter. (See separate report on this page). This decision also for the first time acknowledged other neurological disorders that might be addressed synergistically by the same or similar approaches to be developed for epilepsy.

The WFN continues to prosecute the importance of brain health and is pleased with the modest acknowledgement of this in the recent restructuring of the WHO Mental Health and Substance Use department.

On the matter of brain health in general, the WFN is broadening the World Brain Day campaign to incorporate brain health, as mentioned above.

Global Neurology Alliance

The WFN continues to regard this group as an essential player in the promotion of brain health and for more targeted initiatives as they arise. The WFN is pleased to be able to provide a focal point for the Global Neurology Alliance (GNA) and plans to hold information updates at each of the AAN (Toronto) and EAN (Paris) meetings this year.

Educational Activities

This year, the more overt activities will be the World Brain Day (WBD) and planning for the 2021 World Congress of Neurology (WCN). Both of these are key educational events but are also essential elements to the visibility of the WFN. As I mentioned, in the 2019 WBD campaign, the total cumulative potential reach was more than 50 million. For the WCN in Dubai, the estimates for press coverage and social media were even greater. Some of these were detailed in my last President’s Column.

In addition, our educational training program continues. All African training positions have been allocated trainees for 2020, and the annual teaching course organized by the EAN and supported by the WFN, AAN, African Academy of Neurology (AFAN), and others will take place Sept. 23-25 in Kampala, Uganda.

WFN grants for 12-month incubator type research will again be offered for sums up to (USD) $25,000. Junior Traveling fellowships are also offered again (see WFN website), and the number of department visits available have been increased by the addition of more member society departments joining the scheme for short-term observerships.

An important addition to these activities, outside (the WCN and WBD) is the creation of an alumnus for all who have attended one or more of these activities. In January 2020, the WFN decided to offer this option to past and future attendees, to keep a list of them on the WFN website, and to issue a certificate of recognition to both attendees and providers.

Specialty Groups

Finally, WFN Specialty Group (SG) chairs and committees have been rotated as is the usual practice after two years. The WFN thanks all those who have contributed in this arena over 2018 and 2019. Without their efforts, these topics risk being lost to neurology and to the WFN. I am pleased to announce that a new SG has been approved by the trustees. Proposed by Prof. Antonio Federico, who will be the inaugural chair, it will provide an important focal point, educational resource, and active advocacy role for rare neurological diseases. I am also happy to advise that former WFN president, Raad Shakir, will chair the SG Committee, which oversees the process under which the WFN SGs operate. The SG committee will be a valuable resource for those SGs who may require advice in this regard.

In the interests of transparency, the WFN trustees decided in January to require each SG to operate under a Memorandum of Understanding (MOU) which spells out how the SG will operate, use the WFN logo, and where possible promote both the SG topic and the WFN.

I trust that this report provides members with an up-to-date summary of the WFN, what the current goals are, and how it is directing its efforts. In doing so, I acknowledge the hard work undertaken by the trustees and office staff and thank them for their active contributions. •

William Carroll
WFN President

WHO Geneva Adopts Key Decision 

The World Federation of Neurology successfully supported the International League Against Epilepsy (ILAE) in the adoption of a decision by the WHO Executive Board in relation to epilepsy and other neurological disorders. Support for the draft decision proposed by the Russian Federation and co-sponsored by China, Guyana, and many other member states, including the European Union, was overwhelming. 

This is the first time that neurological disorders have been referred to collectively in a WHO decision and provides an opportunity to promote neurological disorders, including inequities of access to quality neurological care within the global organization. It also provides significant impetus to the longstanding campaign the ILAE has conducted to have epilepsy considered a public health imperative and the adoption of coordinated care campaigns. 

The WFN acknowledges the hard work done by the ILAE; Prof. Samuel Wiebe, its president; the Russian Federation; and Dr. Alla Guehkt, WFN trustee. 

William M. Carroll
WFN president

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