Aug/Sept 2023

WCN 2023 and WFN Activities

Here’s a preview of the upcoming World Congress of Neurology (WCN) 2023 in Montreal as well as an update on some WFN activities.

By Wolfgang Grisold

Wolfgang Grisold

The preparation for a WCN starts four years before the congress, when a new site is elected by the Council of Delegates (COD). The WFN is aware of how much effort goes into these site applications and bidding procedures and is thankful to all societies who make this effort. Yet, only one site is selected based on the needs of the WFN.

The WCN is also the site for the COD meeting, which is the highest decisive WFN body. The delegates this year will decide on two positions within the trustees: treasurer and one trustee. The present term of the current office holders ends and cannot be prolonged. I want to thank Richard Stark, WFN treasurer, and Morris Freedman, elected trustee, for their efforts and contributions to the WFN.

During the Montreal meeting, the congress site for 2027 will be selected. This congress meeting will be held in the African region.

All voting will be electronic, and information on the dates and voting procedures will be on the website.

As we have experienced in recent years, the face-to-face meetings are important despite technology, and the WCN is a unique platform for taking all parts of neurology on board, as well as providing the platform for international participants and personal exchange, which are important elements in communication. Important ideas and developments are often generated in personal contact “over a cup of coffee.” Using this idea, we have generated a few “coffee meetings” at the WCN. These will be public coffee spaces, where important topics such as the IGAP and WFN education will be presented by experts, and participants can ask questions or make comments. We will also have the three past presidents and myself available for thoughts on the WFN in regard to the past, present, and future during one of these sessions. The coffee meetings will be arranged in the exhibition area and will be open. No registration will be necessary. We hope you will be able to participate in this new initiative.

We are introducing other elements to WCN 2023, including debates and meet the lecturers of plenary sessions. We will continue the AAN/WFN advocacy course as well as feature two sessions created by our group of young neurologists. We are grateful for initiatives of our Canadian hosts, which will include a painting session, Yoga session, and a WCN run.

Image during WHO Rehabilitation Meeting. “Disability is part of human diversity” from the WHO meeting (from Third Global Rehabilitation Meeting.)

The scientific program is of high quality and the result of a long preparation time of the Scientific Committee, which was chaired by Mathew Kiernan and Alex Henri-Bhargava, and the Teaching Course Committee, which was chaired by Riadh Gouider and Morris Freedman. We are honored that the WHO will participate in a plenary lecture and in a joint session, which will give information and transparency on the important cooperation with the WHO.

We are looking forward to the plenary lectures and scientific sessions and to the hopefully lively exchange at the guided poster tours. Needless to say, the educational program and teaching courses will be an excellent opportunity to update and receive important information from an excellent faculty.

The social program will consist of the welcome reception, a president’s reception for delegates and committee members, a ticketed networking event, and a final reception by the host society. On Oct. 17, we will host a reception 4:15 to 5:30 p.m. for young neurologists (Young Neurologist Networking Event) at the congress venue. Montreal is a vibrant city and will provide many additional opportunities for networking.

Because of all of our experiences from COVID-19, we have all become much more comfortable with electronic media, and we will offer the WCN virtually. This has at least two reasons: first, to enable persons from low-income countries to participate (also with electronic posters), and second, to offer the possibility of participation for countries that cannot obtain visas, or where the burden of travel and congress costs are too high. We are aware of visa issues and have added a list to the WCN website where we will try to help.

We have the traditional congress bursaries, which lift a significant part of the costs, and we will give a number of free virtual congress participations to a number of low-income countries, selected areas of crisis, and to students.

One of the core activities of the WFN is to provide education in all parts of the world, and we are glad that our concept of the educational days, one for Africa, one for Asia, and a joint event with IHS /GPAC for Africa are well-attended, and we can keep the principle of permanent education and information at a constant level, despite two years between the World Congresses.

As the permanent stream of information and development in neurology increases, the need for additional worldwide education will grow, and the WFN will have to make efforts to fill this gap.

It is important to continue WFN educational projects, and we want to thank all hosting participants in the WFN Department Visit programs, as well as all WFN Training Centers for their ongoing work. The concept of the Training Centers started in Rabat in 2013, and we thank this location and its chair, Prof. El Alaoui for the initiating spark. Rabat was followed by Cairo, Senegal, Mexico, and Cape Town. We will take this opportunity to thank the chairs of the WFN Training Centers in a special session at the WCN in Montreal. The activities to permanently sustain the Training Centers is almost entirely carried out by the WFN, and is a long-term commitment based on the financial capacity of the WFN.

We realize that all of this is not enough for global education, but we add piece by piece, such as hopefully a Training Center in Asia devoted to education for low-income Asian countries.

We are also glad on the support for the department visit program, and India will join offering department visits for Asian low-income countries. The overarching theme is “to empower regions” and help to create centers of excellence that can train and promote neurology at the WFN level.

We are also convinced that science, knowledge, and skills in neurology are not enough, and we will need to invest in advocacy skills and leadership. The future of neurology will depend on engaged leaders in neurology. In addition to our permanent AAN-WFN advocacy course at the WCN, the WFN is aware of the need of more comprehensive training.

The WFN had a successful World Brain Day (WBD), themed “Brain Health and Disability,” with 470 registrants at the webinar and several reports from successful local WBD days on the website. We think that the topic “Brain Health and Disability” has initiated worldwide interest in the important aspect of disability. (J Neurol Sci 2023 Aug 15;451:120720). As we know from the Global Burden of Disease, neurological diseases are the main cause for disability, and the WFN needs to make efforts to keep the interest growing, as many of our patients are affected and often permanently and chronically. The increased access to rehabilitation and care, and disability as a right and not depending on charity, are important. Further engagement following disability in neurology will be needed.

We also want to make readers aware of the WHO rehabilitation meeting and formation of the WHO rehabilitation alliance and the package of interventions for rehabilitation: Module 3: Neurological Conditions, which can be downloaded.

Please continue to follow our website and social media for ongoing events, and if you or your society want to report on activities or an important event, do not hesitate to submit an article to World Neurology. The editors Profs. Lewis and Struhal will carefully look at it for possible publication.

Looking forward to meeting you in Montreal, either in person or virtually, serving the same theme: “Promote Neurology Worldwide!” •

Join Us at the XXVI World Congress of Neurology

Montreal plays host to the WCN 2023 Oct. 15-19.

The XXVI World Congress of Neurology (WCN 2023) will allow us to collaborate with thousands of peers from across the world, witness the best scientific and teaching programs and ground-breaking research. Taking place in Montreal, Canada, and accessible online, between Oct. 15-19, 2023, this event will offer many opportunities to broaden your knowledge and exchange ideas.

A Diverse Array of Sessions

WCN 2023 will feature an impressive lineup of sessions that cater to the diverse interests and expertise of neurology professionals. Attendees can look forward to engaging in the following exciting and novel sessions:

Presidential Symposia: Delve into cutting-edge topics and insights presented by leading experts in the field.
Regional Symposia: Explore regional perspectives and unique challenges in neurology from across the world.
Plenary Lectures: Gain valuable insights from distinguished speakers who will share their expertise and research findings.
Teaching Courses: Enhance your knowledge and skills through specialized teaching courses.
GNA Meeting: Connect with the Global Neurology Alliance and participate in discussions shaping the future of neurology.
Free Communications: Present and discuss your own research and discoveries with fellow neurology professionals.
Joint Sessions With Other Societies: Collaborate and exchange ideas with professionals from related fields.
Coffee Talks Sessions: Engage in candid conversations with current and past WFN leaders as they discuss topics like collaboration between WFN and WHO.
Young Neurologist Sessions: A dedicated space for emerging talents in neurology to network and learn from experienced peers.
Meet With Plenary Speakers: Interact with keynote speakers and engage in thought-provoking discussions.
Patient Day & Patient Forum: Gain insights into patient perspectives and participate in discussions about patient care.
AI Session and More: Stay updated on the latest advancements in artificial intelligence applied to neurology.

Tournament of the Minds

The 10^th Tournament of the Minds, a highlight of WCN, will once again blend education and entertainment. This unique event will explore various aspects of neurology in an engaging and interactive manner, offering attendees an opportunity to test their knowledge and problem-solving skills.

Meet Us at the WFN Booth

Meet WFN staff and trustees at the WFN booth in the exhibition hall.

As seen in this chart, the WCN is truly a global conference that touches every corner of our world. With participants from more than 80 countries, WCN2023 will bring together thousands of neurologists from around the world, thereby fulfilling one of the WFN’s primary goals: to foster quality neurology worldwide by promoting global neurological education and training.

Five Days of Scientific Excellence

WCN 2023 promises five exhilarating days filled with inspiring scientific experiences. Attendees will have the privilege of interacting with a global community of neurology professionals, fostering meaningful connections, and sharing their expertise.

With more than 2,300 abstracts submitted, the XXVI World Congress of Neurology stands as a testament to the enthusiasm and dedication of neurology professionals worldwide. Whether you are a seasoned expert or an emerging talent, WCN 2023 offers a remarkable platform to collaborate and learn.

Mark your calendars for Oct. 15-19, 2023, and join us in Montreal and online for this exceptional gathering of minds in the world of neurology. •

New Workplaces, New Opportunities to Mitigate Neurological Disability

Workplace disease-specific education and management programs to increase awareness, diagnosis, management, and productivity.

By Dr. Olivia Begasse de Dhaem

Olivia Begasse de Dhaem

Mitigating the impact of the disability related to neurological diseases goes beyond medical management and rehabilitation. Workplace accommodations and workplace disease education and management programs must be included in the continued efforts of the 2023 World Brain Day campaign.

As stated by Prof. David Dodick on World Brain Day 2023, disability is associated with developing chronic conditions; earlier mortality; disparities in terms of access to care, education, job; stigma; and poverty. Supporting people with neurological disorders in the workplace is crucial to mitigate the downstream impact of disability. Neurological disability interferes with occupational potential and earning, which in turn can negatively impact mental health and access to medical care and worsen the level of disease state and its related disability. Being in the workforce contributes to general and mental health.

Let’s take the example of migraine, the second leading cause of disability in the world according to the Global Burden of Diseases. Migraine is the second cause of presenteeism (being present at work but not as productive as usual due to the symptoms of a disease) in the United States, estimated to account for 16% of total workplace presenteeism and to cost $240 billion (USD) annually. Although the migraine-related productivity loss increases with the frequency of migraine attacks, there is significant productivity loss interictally as 41.5% of workers have moderate to severe interictal symptoms.

Thankfully, there are evidence-based ways to help workers with migraine, such as social support (between colleagues and by supervisor), job satisfaction, a sense of autonomy, and workplace accommodations (such as natural lights, noise reduction, scent-free areas, regular breaks, air quality). Small interventions such as raising awareness in the workplace and helping a supervisor understand the disease can have a huge impact. One patient of the author was about to lose her job as a cashier at a supermarket due to the numerous work absences she had because of her chronic migraine. After discussions and a doctor’s note, her supervisor helped her change her job from cashier to bagger, so instead of constantly rotating her neck to look at a bright screen while scanning, she was placing the groceries in bags. She was also allowed to take regular breaks to lay down on a mat in a dark, quieter closet. These accommodations enabled her to continue working full time with rare absences.

Migraine workplace education and management programs offered to all employees and supervisors increase understanding of the disease, decrease stigma, improve diagnosis and treatment, and increase productivity. It is crucial to educate the entire employee population and not target a specific group.

The Fujitsu Headache Project enrolled 73,432 (91%) of its employees in Japan with a migraine prevalence of 17%. This workplace education and management program improved:

• the understanding of headache disorders (73% of participants)

• the attitude toward colleagues with headache disorders (83% of participants without headache) – productivity

It reduced absences and presentee days by 1.2 and 14 days per employee per year, respectively, with a 32-fold positive return-on-investment.

As workplaces are being redesigned after the COVID-19 pandemic, now is the time for neurologists to advocate for equitable work opportunities for people with neurological diseases and to promote workplace education programs like the International Headache Society Global Patient Advocacy Coalition (IHS-GPAC) Migraine Fitness modules. •

For additional information:

• Begasse de Dhaem O. Migraines are a Serious Problem. Employers Can Help. Harvard Business Review. February 2021.

• Begasse de Dhaem O, Sakai F. Migraine in the workplace. eNeurologicalSci. 2022;27:100408. June 2022.

• Sakai F, Igarashi H, Yokoyama M, Begasse de Dhaem O, et al. Diagnosis, knowledge, perception, and productivity impact of headache education and clinical evaluation program in the workplace at an information technology company of more than 70,000 employees. Cephalalgia. 2023;43(4):3331024231165682.

• IHS-GPAC website.

Dr. Olivia Begasse de Dhaem is on the executive committee of the International Headache Society Global Patient Advocacy Coalition (IHS-GPAC) and co-chair of the IHS-GPAC Summit III in Seoul in 2023.

From the Editors

We’d like to welcome all readers to the August 2023 issue of World Neurology.

The issue begins with the President’s Column, where WFN President Dr. Wolfgang Grisold updates us on the upcoming World Congress of Neurology (WCN) Oct. 15-19 in Montreal and the many exciting new initiatives of the WCN, as well as other global activities of the WFN. Many initiatives and opportunities at the upcoming WCN are also well described in an accompanying article.

Next, Dr. Olivia Begasse de Dhaem describes innovative workplace initiatives intended to mitigate neurologic disability from migraine. In this issue’s History column, Dr. Peter J. Koehler delves into the differences and similarities of the theories of brain and mind as proposed John Hughlings Jackson and Thomas Laylock.

Dr. Dafin Muresanu then reports on two recent successful conferences that occurred in Romania: the EFNR-WFNR Eastern Europe Regional Meeting and the National Neurology Forum.

WFN Past President Dr. Raad Shakir, who is current Chair of the WFN Nominating Committee. reports on the activities and important responsibilities of the WFN Nominations Committee. Dr. Riadh Gouider, Dr. Grisold, Dr. Steven Lewis, and Dr. Imen Kacem describe the recent history of the WFN Educational Days and current planning for exciting upcoming Educational Days. Finally, the statements of all of the current candidates for WFN Treasurer and WFN Elected Trustee are republished/published in this issue, in anticipation of the upcoming voting by the members of the WFN Council of Delegates.

In closing, we look forward to seeing so many of you at the WCN in Montreal (in person or virtually) this October! And don’t forget to sign your department up for the exciting Tournament of Minds! •

John Hughlings Jackson and Thomas Laycock: Brain and Mind

Two historical neurology figures played huge roles in understanding functions of the brain and mind.

By E.H. Reynolds, MD FRCP FRCPsych

The place of the Yorkshireman John Hughlings Jackson (1835-1911) in the history of neurology is well documented, so much so that he has been described as the father of British neurology by Critchley and Critchley (1998). As physician to the newly established National Hospital for the Paralysed and Epileptic at the older London Hospital, he wrote extensively on the anatomical and physiological approach to neurological diseases, cortical localization, epilepsy and the nature of the epileptic discharge, aphasia, paralysis and disorders of movement, neuro-ophthalmology, the brain as a sensorimotor machine, evolutionary neurophysiology and dissolution in neurological disease, and finally his doctrine of concomitance of the relationship of brain to mind (York and Steinberg 2006).

old painting of Thomas Laycock wearing a suit with a red scarf and holding a cane

Thomas Laycock (1812-1876). (Reprinted by kind permission of the Royal College of Physicians of Edinburgh.)

Thomas Laycock and His Influence on Jackson

The influence of Thomas Laycock (1812-1876), also a Yorkshireman, on neurology is much less well recorded or appreciated, although as Jackson’s teacher at the York Medical School from 1852-1855, he introduced him to neurology and greatly influenced his approach to brain function and diseases of the nervous system, especially through Laycock’s theory of the reflex functions of the brain, which he presented to the British Association for the Advancement of Science in York in 1844.

Laycock studied medicine at University College London (1833-1835), followed by a session at La Pitié in Paris, where he absorbed the French clinico-anatomical-physiological-pathological method, which he later imparted to Jackson. He also graduated MD at Göttingen in 1839 before returning to York as lecturer in medicine. Unlike the philosopher-physician Jackson, he was fluent in French and German and took a scientific approach to medicine, becoming statistical secretary to the British Association for the Advancement of Science from 1844.

In 1855-1856, Jackson and Laycock headed in opposite directions from York. Jackson proceeded to London to complete his medical studies and later to develop his neurological career. Laycock successfully applied for the chair of the practice of physics in Edinburgh, the first Englishman to be appointed to the most prestigious chair in medicine in the UK at that time. In addition to his teaching duties, Laycock wrote widely on general medicine, including infectious diseases and public health, but from the beginning his overriding interest was always in nervous and mental diseases. His 1840 book, An Essay on Hysteria, was noted and commended by Charcot. In 1851, he translated A Dissertation on the Functions of the Nervous System by G. Prochaska from Latin into English. In 1860, he published his magnum opus, Mind and Brain in two volumes. Based on his encyclopedic knowledge of the scientific, medical, and philosophical literature, Laycock took an evolutionary view of brain and mind and of dissolution in disease. He viewed mental diseases as diseases of brain, based on continuity between physical, vital, and mental energies. He advocated the study of medical psychology in health and insanity as fundamental to medicine, society, and culture.

Accordingly in 1859, Laycock established the first university course on medical psychology and mental diseases, for which he was additionally appointed lecturer in medical psychology and mental diseases. Earlier in 1856, he had been appointed a Fellow of the Royal Society of Edinburgh and Physician to the Queen in Scotland. In 1868, he was elected president of the Medico-Psychological Association, giving his residential address in York to which Jackson traveled from London.

John Hughlings Jackson (1835-1911).

Jackson’s Brain/Mind Theory: Sensorimotor Machine and Concomitance

Influenced by Laycock, especially his theory of the reflex functions of the brain, Jackson continued to search for fundamental principles of nervous action. Building on Laycock’s theory, he developed his own theory in the 1870s and 1880s that the brain is exclusively a sensorimotor machine associated with his doctrine of brain/mind concomitance. He viewed the central nervous system as made up of processes of increasing degree of complexity representing impressions and movements. The whole nervous system was “a sensorimotor machine, a coordinating system from top to bottom.” Furthermore, brain and mental states are intrinsically different, occur in parallel and have no causal interaction between them. There is no physiology of the mind any more than there is a psychology of the nervous system. Thus:

“States of consciousness (or synonymously states of mind) are utterly different from nervous states of the highest center; the two things occur together, for every mental state there being a correlative nervous state; although the two things occur in parallelism, there is no interference of one with the other.”

Curiously, Jackson does not acknowledge Laycock in his own evolutionary approach to brain and mind, including dissolution in neurological disease, but instead he relies on the evolutionary philosopher, Herbert Spencer (1820-1903).

Laycock’s Brain/Mind Theory: Continuity and Unconscious Cerebration

In the meanwhile, however, Laycock had developed a different concept of the relations between brain and mind. Although both saw the brain and mind as the highest point of evolutionary development, Laycock concluded from his theory that although much of human behavior was reflex, automatic, and involuntary, some was conscious and voluntary. Thus, he opened the door to what he called “unconscious cerebration.” Furthermore, unlike Jackson, he separated “mind” from “consciousness.” For Laycock, consciousness was conscious awareness. Mind he described as an agency in man distinct from matter and organization but dependent on organization, i.e. the brain, for the due display of its effects. Mind originates motion or wills, perceives the qualities of matter, compares the perceptions and thinks. Finite minds could not perceive matter without force (energy). Finite minds transfer force. The brain is adapted; the mind is the force that adapts to ends. All mental states are reflections in our consciousness of the vital laws and forces. Mental science is linked to physics through biology and the laws of life.

Jackson, on the other hand, considered consciousness and mind to be synonymous terms. He never defined “mind,” although he considered the brain and perhaps the whole body to be “the organ of mind.” He struggled with the concept of unconscious states of mind, which he considered a contradiction and rejected. Whereas Laycock envisaged higher centers in the brain serving instincts, feelings, knowledge, and reason, Jackson claimed that it was impossible to locate mental function because the nervous system is exclusively sensorimotor. Although mental disease may be present, he viewed its nature as beyond the purview of medical science.

Conclusions

Laycock was the primary and most significant influence on Jackson’s interests and approach to diseases of the nervous system. Jackson’s view of the brain as an exclusively sensorimotor machine and his doctrine of concomitance of brain and mind were founded on Laycock’s theory of the reflex actions of the brain. Laycock, however, moved on, separated mind from consciousness and viewed his reflex theory as opening the door to unconscious and conscious brain activity, both of which Jackson rejected. Laycock considered mind to be causally linked to the brain through physics and biology and urged the study of mind in health and insanity through medical science.

In Edinburgh, he taught a distinguished generation of neurologists and psychiatrists, including Sir James Crichton-Browne and Sir David Ferrier, who together with Jackson, who Laycock had earlier taught in York, were three of the four founders of the journal Brain in 1878. Laycock’s brain/mind concepts are nearer to current concepts than those of Jackson, and he would have approved of the modern neuroscientific approach to mental illness, which he first promoted. For many reasons, Jackson is rightly respected as a seminal influence on neurology. Laycock, however, is a rather neglected figure, although his views of brain, mind, and disease are nearer to our modern concepts than those of Jackson. If Jackson is the father of British neurology, Laycock has some claim to be considered father of British neuropsychiatry.

Another version of this text will be published in the newsletter of the History of Psychiatry Section of the Royal College of Psychiatrist in London. •

References.

Critchley M, Critchley EA. John Hughlings Jackson, Father of English Neurology. Oxford: Oxford University Press, 1998.

Laycock T. Reflex, automatic, and unconscious cerebration: A history and a criticism. J Ment Sci 1876; 21: 477-498

Reynolds E.H. John Hughlings Jackson and Thomas Laycock: Brain and Mind. Brain 2020; 143: 711-714

York GK, Steinberg DA. An Introduction to the Life and Work of John Hughlings Jackson with a catalogue raisonné of his writings. Medical History, supplement No. 26. London: The Wellcome Trust Centre for the History of Medicine, 2006.

Report of the EFNR-WFNR Eastern Europe Regional Meeting in Conjunction with the Bistrița Clinical Neuroscience Conference and Report of the National Neurology Forum

By Dafin F. Muresanu

The EFNR-WFNR Eastern Europe Regional Meeting in conjunction with the Bistrița Clinical Neuroscience Conference, took place March 31-April 1, 2023, in Bistrița, Romania. This significant academic gathering was held in a hybrid format and featured esteemed experts from various fields discussing potential advancements in neurorehabilitation. The event was jointly organized by the European Federation of Neurorehabilitation Societies (EFNR), the World Federation for Neurorehabilitation (WFNR), the County Council of Bistrița-Năsăud, and the County Clinical Emergency Hospital Bistrița. It received support from multiple organizations, such as the World Federation of Neurology (WFN), Foundation of the Society for the Study of Neuroprotection and Neuroplasticity (SSNN), the Foundation for the Study of Nanoneurosciences and Neuroregeneration (FSNN), the Romanian Academy, and the Romanian Society of Neurology (SNR).

EFNR-WFNR Eastern Europe Regional Meeting

The event attracted over 150 participants from Eastern Europe, making it a remarkable success. World-renowned experts gathered to discuss a diverse range of topics, including post-stroke neurorecovery, cognitive decline after stroke, pharmacology in functional recovery, clinical case studies, traumatic brain injury treatment developments, effective stroke recovery, motivation in neurorehabilitation, innovation and sustainability, early rehabilitation after aneurysmal subarachnoid hemorrhage, cerebral vein and dural sinuses thrombosis, autonomic dysfunction in Parkinson’s disease, immunomodulatory treatment for multiple sclerosis, complex management of adult SMA patients, neurorehabilitation peculiarities in multiple sclerosis, and computer-assisted and robotic neurorehabilitation for stroke patients. Prof. Dafin F. Muresanu, EFNR president, and Prof. Volker Hömberg, WFNR president, led the scientific event, with experts from around the world sharing their knowledge on various neurorehabilitation subjects. As a special guest of the event, Prof. Wolfgang Grisold joined online for the opening ceremony to express his support of EFNR-WFNR initatives and congratulate both societies for the efforts.The regional meeting emphasized international viewpoints on current topics while showcasing national experiences and perspectives from countries such as Bulgaria, Hungary, Poland, the Republic of Moldova, Romania, Serbia, and Slovenia. During the March 31st meeting, the current state of neurorehabilitation in Eastern Europe was discussed. This specialized gathering aimed to present the health care systems and neurorehabilitation specifics of these countries, focusing on strategies to overcome limitations and improve neurorehabilitation approaches.

The objective of the event was to develop a joint action plan and extend the educational outreach and network of WFNR and EFNR. Another goal was to establish institutional partnerships among National Rehabilitation Societies.

The EFNR-WFNR Eastern Europe Regional Meeting, combined with the Bistrița Clinical Neuroscience Conference, served as a unique forum for knowledge exchange.

The National Neurology Forum 2023: Patients, Doctors, Authorities, Industry—Together for the Future of Neurology

The Romanian National Neurology Forum emerged as a distinctive and unparalleled event in the realm of neurological science, transcending toward policy the knowledge shared at the Annual Congress of the Neurological Society in Romania. Convening at the Palace of Parliament in Bucharest on April 21 and 22, the forum captivated over 350 participants, both in person and virtually, engaging in thought-provoking debates on pressing issues in national health care. Unlike traditional scientific conferences, the event focused on pinpointing the most effective strategies to surmount the common obstacles encountered within the Romanian Health Care System, providing valuable insights into public policy to facilitate national health care reforms.

The forum was organized by Prof. Dr. Dafin Muresanu, president of the European Federation of Neurorehabilitation Societies, Prof. Dr. Cristina Tiu, president of the Romanian Neurology Society, and Prof. Dr. Bogdan O. Popescu, prorector at the University of Medicine and Pharmacy Carol Davila Bucharest). Coordinated by the Foundation of the Society for the Study of Neuroprotection and Neuroplasticity (SSNN), the Ministry of Health, the Romanian Society of Neurology (SNR), Carol Davila University of Medicine and Pharmacy from Bucharest, Iuliu Hatieganu University of Medicine and Pharmacy from Cluj-Napoca, and George Emil Palade University of Medicine, Pharmacy, Science and Technology from Targu-Mures, the event featured an array of topics, from neurology and associated specialties, such as neurosurgery, cardiology, diabetes and nutritional diseases, and physical and rehabilitation medicine. Officials from public authorities, universities of medicine and pharmacy, and national and international professional societies were present at the scientific proceedings, including Prof. Dr. Wolfgang Grisold, president of the World Federation of Neurology (WFN), Prof. Dr. Volker Hömberg, president of the World Federation for Neurorehabilitation (WFNR), and Prof. Dr. Alexandru Rafila, minister of health Romania.

The event highlighted the National Strategy for Combating Cardiovascular and Cerebrovascular Diseases (SNBCC) as its central focus. Announced by Health Minister Prof. Dr. Alexandru Rafila in the autumn of 2022 and developed under the aegis of the Romanian Academy, the SNBCC is a central element of the 2023-2030 National Health Strategy. The scope of the policy is to improve health care approaches for the Romanian population by implementing a comprehensive reformative plan in the field of cardiovascular and cerebrovascular diseases. Furthermore, the objectives include assessing the impact of cardiovascular and cerebrovascular diseases on the Romanian population, developing prevention programs, advancing the domain of human resources specializing in interventional neurology, increasing access to neurorehabilitation services, and expanding the national network for stroke intervention.

Panel discussions covered a wide range of topics, including the implications of SNBCC for the Romanian health care system, the importance of prevention in cardiovascular and cerebrovascular diseases, Parkinson’s disease, epilepsy, cognitive impairment and dementia, multiple sclerosis, peripheral neurological diseases, neuro-oncology, and headaches and migraine. Each panel provided comprehensive approaches to understanding and addressing the various aspects of neurological conditions and health care. Discussions also emphasized the need for enhanced collaboration among the private and public sectors and authorities, converging toward the common goal of improved education and communication of public health knowledge.

The National Forum aimed to gather scientific insights from international health care systems to provide a comparative framework for future systematic guidelines. Moreover, the event provided ample opportunities for networking among medical professionals, researchers, patient association representatives, central public authorities, medical societies, and medical equipment producers and traders. •

Dafin F. Muresanu is president of the European Federation of NeuroRehabilitation Societies (EFNR), secretary general AMN (Academy for Multidisciplinary Neurotraumatology), past president of the Romanian Society of Neurology, and professor of neurology, chair of the department of neurosciences at “Iuliu Hatieganu” University of Medicine and Pharmacy in Cluj-Napoca, Romania.

WFN Educational Days

Update on e-Learning opportunities.

By Riadh Gouider, Wolfgang Grisold, Steven Lewis, and Imen Kacem

The World Federation of Neurology (WFN) has been working with regional organizations and with a collaboration of other international organizations to create free e-learning days for neurologists, residents in neurology, and other health care professionals around the world.

The concept of these one-day educational events was boosted by the situation caused by COVID-19 pandemic, which suspended face-to-face conferences and regional teaching courses. The idea was to focus on one region, but also open the event to worldwide participation. The participation is free but registration is necessary.

The creation of these e-Learning days began with the African Region and was organized jointly with the African Academy of Neurology (AFAN).

The inaugural e-Learning Day, First WFN-AFAN e-Learning Day, took place Oct. 10, 2020. The theme was “Stroke: A Treatable and Preventable Disease,” with the collaboration of the World Stroke Organization (WSO), the European Academy of Neurology (EAN), and the American Academy of Neurology (AAN). Among those who registered, 576 participants from 60 countries participated in the event, with 513 participants from 31 African countries.

It was followed by the Second WFN-AFAN e-Learning Day, which took place on Nov. 6, 2021, and the overarching theme was epilepsy. The EAN, AAN, and the International League Against Epilepsy (ILAE) provided support for this educational event. The participation rate reached 48.5% of the registrations. Participants from 88 countries, including 33 African countries, attended the e-learning day.

The Third WFN-AFAN e-Learning Day was held Nov. 3, 2022. The event covered a number of topics on the theme of “Movement Disorders.” The Movement Disorders Society (MDS), AAN, and the EAN collaborated on this event. There were 514 attendees from 84 countries who participated in the event worldwide, with 334 participants from 30 African countries.

This year, the Fourth WFN-AFAN e-Learning Day will take place Saturday, Dec. 2, 2023, and will focus on neuropathies with the support of the AAN, EAN, the International Congress on Neuromuscular Diseases (ICNMD), and the Peripheral Nerve Society (PNS).

These interactive e-learning days consist of a one-day program, primarily in English conferences, and with French parallel sessions, with the participation of local and international speakers.

In addition to the successful WFN-AFAN days, for three consecutive years, the WFN and AFAN have been jointly organizing, with the International Headache Society (IHS) and the Global Patient Advocacy Coalition (IHS-GPAC), educational days on the diagnosis, management, and support of patients with headache. The aim is to improve the knowledge of practitioners in Africa and to raise their awareness of headache disorders, hoping to contribute to improving the management of headache disorders on this continent.

The first Education in Headache to Health Care Providers in Africa (EHHPA) was conducted over two days (Saturday, Aug. 21, 2021, and Saturday Sept. 4, 2021), with one parallel French conference on the first day and two parallel French conferences on the second day. The total number of attendees reached 498 participants from 71 countries with 65% of the participants from 32 African countries.

The Second Annual EHHPA, a one-day event, was held Saturday, May 14, 2022. It complemented the first one by focusing on the management and support of primary headache, with a focus on non-pharmacological management options, as well as the importance and strategy of advocacy for headache disorders.

The number of parallel French sessions increased to six parallel French conferences. 310 participants attended the Second Annual EHHPA hosted 310 participants of which 170 were neurologists and residents in neurology.

French parallel session

In 2023, the Third Annual EHHPA will be held Saturday, Sept. 23, 2023. Two parallel French sessions are scheduled, with three conferences each.

Registration is open now.

Following this successful pattern, the First WFN-AOAN e-Learning Day will be co-organized with the Asian and Oceanian Association of Neurology (AOAN), and have as the theme Advancing Stroke Care in Asia. This first Asian e-Learning Day is being planned for Saturday, Nov. 18, 2023 with the collaboration of the World Stroke Organization (WSO), the Asia Pacific Stroke Organization (APSO), and the World Federation for NeuroRehabilitation (WFNR).

These successful e-Learning activities are highly practical for neurologists and other health care professionals all over the globe to improve their neurological skills and practice. They play an important role within the mission of WFN, which is to foster quality neurology and brain health worldwide.

For more information and updates, visit the WFN website. •

The Nominating Committee

Raad Shakir

By Prof. Raad Shakir

This committee is the backbone of the federation. Although the WFN trustees form the nominating committee, it functions outside their direct control. This is crucial as its decisions form the basis of the future leadership and function of the organization. The idea of an independent committee to search, approve, suggest, and nominate appropriate future leaders is not unique to the World Federation. The composition of the Nominating Committee has to be representative of the whole WFN across the globe.

Historically, the Nominating Committee started in earnest in 1965 following the retirement of the WFN first president Ludo van Bogaert. The first meeting was in Vienna under the chairmanship of Helmuth Tschabitscher (Austria), the recommendation was to propose Macdonald Critchley as WFN’s second president.

Currently, a chair and six members form the Nominating Committee. The members are from the six WFN regions. The committee functions are laid out in the WFN memorandum and articles of association. Article 6 states the functions of the committee are to “choose a list of candidates” for all positions and publish the list to all member societies.

The Nominating Committee is also instructed to “solicit” nominations for officers and trustees by approaching them directly. This is done to balance the composition of the trustees in the WFN. It is vital that, as much as possible, all the six regions of the world are represented and any duplication or “dominance” of any region is not allowed to occur, if at all possible. There has been a time when one region or even one country has been overrepresented, but this should be the exception and not the rule.

The list of candidates agreed by the Nominating Committee is published on the WFN website and World Neurology six months prior to the Council of Delegates meeting and further names may be added (subject to review by the Nominating Committee) if submitted by five or more approved delegates at least 30 days prior to the date of the council vote.

In selecting candidates, their professional status, contribution to the WFN, and future commitment to growth and development of the WFN are paramount.

The Nominating Committee has to consider geography and gender in all its considerations. The committee can supplement applicants, as it deems appropriate. This will eventually be subject to the WFN Council of Delegates vote.

It is quite possible that some candidates meet the guidelines, but for a variety of reasons cannot be shortlisted by the Nominating Committee. This exclusion does not in any way reflect their unsuitability.

The committee’s proceedings and decision-making process is held in private to avoid any outside pressures and influences. It is understood that regions and delegates canvas for their preferred candidates, and this is acceptable as long as it falls outside the Nominating Committee’s structure and function.

These rigorous criteria and procedures have evolved since the inception of the WFN and continue to serve the organization, ensuring its integrity and inclusivity. •

Prof. Raad Shakir CBE FRCP is a past president and current chair of the Nominating Committee of the WFN.

Candidate Statements

Candidates

(Click on each name for their candidate statement.)

Treasurer to take office Jan. 1, 2024

Elected Trustee to take office immediately after the COD Meeting

* This is an additional candidate nominated under Article 6.3 of the constitution (nominated by five member societies). All other candidates are by recommendation of the WFN Nominations Committee.

Candidate Statement for Treasurer: Marianne de Visser

Marianne de Visser

My name is Marianne de Visser. I am an adult neurologist and (emeritus) Professor of Neuromuscular Diseases at the University of Amsterdam, the Netherlands.

I would like to apply for the position of treasurer.

I have been committed to the good cause of the WFN for several decades. I have served under inspiring presidents. First, as a delegate on behalf of the Netherlands Society of Neurology, subsequently as an elected trustee under the late Presidents Jun Kimura and Johan Aarli. Under Bill Carroll’s presidency, I was chair of the Nominating Committee, and most recently, co-opted trustee. President Wolfgang Grisold appointed me as chair of the Membership Committee and chair of the Committee for Diversity, Equity, and Inclusion.

I have witnessed the growth of WFN. The increasing membership, but also the expanding role of the WFN in several impactful initiatives worldwide, are clear signs of leadership.

The close collaboration with the WHO has borne fruit for neurology.

One example is the Neurology Atlas, showing the country resources for neurological disorders. The data highlight that while the burden of neurological disorders is disproportionately high in low- and middle-income countries, health care services and resources are often scarce. The main project presently is the implementation of the intersectoral action plan for epilepsy and other neurological disorders, IGAP, which was approved at the World Health Assembly in May 2022, and has a time of 10 years for the duration of the program. It focuses on advocacy, treatment, prevention, research, innovation, and public health awareness, and is meant to implement neurology in all countries of the world.

The WFN puts many efforts in fulfilling its mission: “Fostering quality neurology and brain health worldwide.” One example is by organizing the World Brain Day, together with the six regional societies. World Brain Day is an extremely successful recurring event on July 22. This year, World Brain Day focuses on Brain Health and Disability: Leave No One Behind, conveying five important messages: Awareness, Prevention, Advocacy, Education, and Access.

Several WFN Programs focus on education, in particular aimed at residents and early career neurologists. This year, we celebrate the 10-year anniversary of WFN training centers, which provide one-year fellowships but also four-year residency programs. Another great success is the department visit program which enables an exchange of experiences and practices and also creates an opportunity to create an academic network for future cooperation.

At the beginning of his term, President Grisold stated that the WFN will need to take diversity, equity, and inclusion into consideration in its strategy, that the needs of early career neurologists require specific attention and action, and a platform for patient organizations should be installed in the WFN infrastructure. I embrace those initiatives, and I am fully committed to serve the WFN as treasurer to make those initiatives to a success in close collaboration with the trustees and the indispensable colleagues from the Head Office. •