Additional Candidate for President: Gustavo Roman

Gustavo Román

romanMy nomination as candidate  for president of the World  Federation of Neurology  has been endorsed by the  American Academy of Neurology and the Neurological Association of Colombia.

I was raised in a tropical Third World country in Latin America,  educated as a neurologist at the Salpàªtriè
re Hospital in Paris, France, and at the University of Vermont. These early experiences gave me a good background in global neurology. Fluency in Spanish, French and English — languages spoken by  2 billion collectively — has allowed  me to communicate with many  people and provided me with an  appreciation for the cultural richness  of their nations. Moreover, the practice of clinical neurology in academic  centers in Colombia and in the  U.S., in addition to international  research collaboration in many  parts of the world as director of  neuroepidemiology at the National Institutes of Health (NIH), allowed  me to develop a deeper understanding  of the problems confronted by  neurologists in many parts of the  world.

WFN Involvement

I have been involved with the World  Federation of Neurology (WFN) for  more than 20 years, particularly with  the education and research groups in  neuroepidemiology, dementia and  tropical neurology. I recently created the Environmental Neurology Research Group (ENRG).

For more than 15 years, I have been a member of the editorial board of The Journal of the Neurological Sciences, the official publication of the WFN.

In 2008, I began my three-year  service as an elected trustee to the  WFN Board of Directors under the  current administration. I was re-elected  in 2011 for a second consecutive term; thus, I have participated in all major policy and administrative decisions of the WFN for the past five years.

Throughout my career, I have been  interested in numerous research topics ranging from tropical neurology, in  particular nutritional problems in  neurology, meningitis, herpes  encephalitis, neurocysticercosis and  tropical spastic paraparesis due to HTLV-1; to the neuroepidemiology of dementia and Parkinson’s disease, stroke and  vascular dementia; to recent studies of two modern epidemics: Alzheimer’s  disease and autism.

I am currently the scientific director and administrator of a large clinical and research Alzheimer’s and Dementia Center in Houston, Texas, and have been successful in fundraising.

I hold an academic position as  professor of neurology at Weill Cornell Medical College with involvement in  the neurological education of medical  students, residents and fellows, including an active observership international program.

Presidential Agenda

My presidential agenda can be summarized in the motto “Neurology for the  21st Century,” emphasizing the need  for widespread and novel use of  communication technologies such as cellular telephones and web-based social media as a forum for collaboration, education, training and service including long-distance consultations (telemedicine); encouraging the provision of imaging  and clinical neurophysiology equipment  in places where neurologists are still  deprived of these critical elements for  the modern practice of neurology;  supporting the translation and  dissemination of educational and  informational materials of the WFN  from English into other languages  as a way to improve communication among the member societies, trainees  and fellow neurologists throughout the world.

I would seek sponsorship and  multinational cooperation for  neuroepidemiological studies: By  facilitating the sharing of international databases, the WFN could allow  researchers to analyze the public health implications of the main neurological problems in different parts of the  world. I intend to reinforce the African Initiative launched by Johan A. Aarli, as well as Vladimir Hachinski’s Latin American Initiative and Asia-Oceania Initiative. I will continue to enhance the WFN collaboration with the World Health Organization (WHO) and with other international neuroscience  societies, particularly with neurosurgery specialists.


Early in life, I learned that education  is critical in order to overcome the  limitations imposed by environment and economic restrictions. I believe  that community education is also the answer to many of the neurological problems resulting from treatable risk factors such as hypertension, malnutrition, trauma and violence, among others. Therefore, public health practice and policy should become important tools for neurologists.

Increasing the number and educational level of neurologists worldwide by means of modern communication technologies must result in tangible benefits for the neurological health and care of all countries and their peoples. This presidential agenda would continue the legacy of my illustrious predecessors and enhance the name of the WFN in areas of the world where neurology is still a young specialty.

For a complete curriculum vitae, please visit

Recent Literature

Three Important Steps to European Neurology Harmonization: Core Curriculum, Visitation Program, European Board Examination 23829235
Struhal W, Mellgren SI, Grisold W. Eur J Neurol. 2013 Aug;20(8):e101-4. doi: 10.1111/ene.12177. No abstract available. PMID: 23829235 [PubMed – in process]

Creation of the AAN Global Health Section, Part I: Introduction and Background 2062.short
Amy C. Lee, Jerome Chin, Gretchen L. Birbeck, James Bower, and Ana-Claire Meyer. May 28, 2013 80:2062-2064

Creation of the AAN Global Health Section, Part II: Vision and Goals 2151.short
Amy C. Lee, Jerome Chin, Gretchen L. Birbeck, James Bower, and Ana-Claire Meyer. June 4, 2013 80:2151-2153

When Is a Global Health Program Global? 2088.short
Johan Arild Aarli and Oded Abramsky. June 4, 2013 80:2088-2089

New Issue of Revista Cubana de Neurologà­a y Neurocirugà­a
The editors invite you to visit their web site to review articles and items of interest.

WFN Research Groups on Aphasia and Cognitive Disorders, and on ALS and MND

expertiseIn June 2011, the World Federation of Neurology Research Group on Aphasia and Cognitive Disorders and the World Federation of Neurology Research Group on ALS and MND collaboratively organized Workshops on Amyotrophic Lateral Sclerosis and Frontotemporal Dementias in China and Mongolia.

Financed by the WFN, Facundo Manes, Thomas Bak, Suvarna Alladi, John Ravits and Albert Ludolph held lectures on the relationship of these two diseases, both on the neuropathological and clinical level. They were supported by colleagues from China and Mongolia, respectively.

In China, more than 200 professionals attended the meeting. The program raised alot of interest, and finally the two groups together with their Chinese colleagues  organized a Local Network of Expertise. This includes developing a registry for ALS/MND in Beijing (Professor Liying Cui), which is mirrored by a registry for ALS/MND in Germany and potentially in Scotland. Currently, financial support is requested by the Chinese and German government.

Four days later, an educational course was held in Ulaanbaatar, Mongolia. It also was supported by our Mongolian colleagues and friends. The program was attended by more than 200 Mongolian neurologists. In the meantime, we have decided to establish a Local Network of Expertise in Ulaanbaatar, which mirrors the networks in Scotland and Germany. The Local Network of Expertise in Ulaanbaatar was established on Jan. 1, 2013, and the WFN will make every effort to support this project financially.

These most successful meetings show that the concept of the WFN to establish international scientific relations among physicians and basic scientists to hold teaching courses, to provide research groups a common bases and work together and finally establish Local Networks of Expertise is a most interesting future direction of clinical and basic research, which is doable and relevant for many fields.

Come to Kyoto, Japan, in 2017

kyotoWe, the Japanese Society of Neurology (JSN), would like to host the 23rd World Congress of Neurology in 2017 in Kyoto.

Founded originally in 1902, the JSN has evolved into a large society with its members topping 8,852 in the past 50 years particularly after its separation, in 1959, from the original society where both neurologists and psychiatrists were members.

During those years, Japan has developed superior human resources in a broad range of neurological subspecialty fields and conducted world-class high-quality research, primarily through cooperation with the World Federation of Neurology (WFN) as well as the Asian and Oceanian Association of Neurology (AOAN). In 1961, two years after the establishment of the current JSN, the AOAN was established through the leadership of our founders and its first meeting, the Asian and Oceanian Congress of Neurology (AOCN), was held in Tokyo in 1962. Moreover, in 1975, Japan launched a system to certify qualified specialists in neurology and has since then produced more than 4,866 board certified neurologists and 2,403 senior fellows.

With this system in place, Japan has built a rich environment to nurture its neurologists. With all this in mind, we are proud to say that the Japanese Society of Neurology has been continuously putting its best efforts to advance research, education and medical practice to a level at par with the best international standards.

The Kyoto WCN meeting in 1981 greatly contributed to the development of JSN and AOAN. Along with international cooperation and the achievements of the past 30 years, Japan is determined to make the WCN 2017 another historic meeting that will serve as a springboard to advance the Asia Initiative of the WFN for the worldwide advancement of neurology in both scientific and clinical aspects. In particular, we would like to focus on three issues in WCN 2017. First, the environment and an aging society are urgent global issues that need to be addressed, especially by the rapidly developing economies of the Asian and Oceanian regions. The Japanese Society of Neurology is in a position to contribute greatly in solving the above based on its experience in overcoming similar issues, as has been seen in its measures in controlling Minamata disease, sub-acute myelo-optico-neuropathy (SMON) and in battling dementia.

Second, Japan is a suitable place to share information and discuss the international cooperation related to neurological medical services in the disaster. Japan experienced not only the Great East Japan Earthquake but also the tsunami and nuclear disaster in March 2011, and has been recovering from the triple disasters thanks to the generous support from all over the world. We would like to discuss the role of neurology in disaster medicine as well as express our gratitude to all the countries that kindly helped us.

Third, as a country with a high standard of neurological service and research, exemplified by the establishment of induced pluripotent stem (iPS) cells and brain machine interfaces (BMI), Japan would be an excellent place to share information on highly efficient neurological medical services as well as results of state-of-the-art studies with our international colleagues, especially those in the Asian and Oceanian region.

Kyoto, famous for its rich history and culture, is a major part of Kyoto-Osaka-Kobe metropolitan area located in the central part of the main island of Japan. A former imperial capital with more than 1,200 years of history, Kyoto is a living museum with a fifth of Japan’s registered national treasures along with 17 UNESCO World Heritage sites, unmatched anywhere else in the world. In addition, Kyoto is a renowned center for its world-class sciences bearing fruit to many Nobel laureates including Shinya Yamanaka, who was awarded with the Nobel Prize for Physiology or Medicine in 2012. His discovery of iPS cells started a revolution in stem cell research not only in neurodegenerative disorders but also in other fields of medicine. Kyoto residents are renowned for their hospitality. Outstanding service can be expected wherever you go, be it meeting venues, hotels, restaurants or enchanting cobbled lanes, you will be welcomed with all the warmth of the cultural heart of Japan. In addition, because of Japan’s reputation for being a friendly and safe place for travelers, tourists feel comfortable traveling alone in the city at any hour of the day.

For the WCN 2017, the Japanese Society of Neurology looks forward to welcoming you to Kyoto, where you can experience the very essence of Japanese traditional and modern culture as well as the major breakthroughs and developments in the field of neurology.

Come to Seoul for WCN 2017

Since its establishment in 1982, the Korean Neurological Association (KNA) has demonstrated stable growth over the last three decades, and a lot of effort has been made to take the KNA to a global level. (For more, see “Changing Face of KNA” in Neurology 2013;80:1145-1147). Keeping up with the 30th anniversary of the KNA in November 2012, the KNA is currently preparing to make a new leap forward by planning to host WCN 2017 in Seoul.

The members of the KNA strongly believe that hosting the event for the first time in Korea can be meaningful since it will be a great opportunity for them to thank those who helped end the Korean War 60 years ago. It will be amazing for all our professional colleagues to see the unprecedented progress that Korea has made over the last six decades. Furthermore, it will be truly uplifting for those colleagues whose ancestors actually helped us during the war as they see the amazing impact that their sacrifices have brought to all Koreans. This is the reason that the KNA is so eager to host WCN 2017.

Foundation, Development of KNA

The KNA had a late start as an independent branch of the Korean Medical Association due to a rigid medical board system led by the government that did not easily permit the existence of an independent neurologic association. Through many struggles with other related fields, however, the KNA became a separate entity as an official independent academic association in 1982. The following year, the KNA began issuing the Journal of KNA. In 2005, the KNA began to issue a separate English journal, the Journal of Clinical Neurology (JCN; to help international readers. The JCN is published quarterly and is indexed in the SCI-E (impact factor in 2012: 1.892). In 1996, the KNA successfully held its first international conference, the Ninth Asian and Oceania Congress of Neurology (AOCN). Inspired by this success, KNA members have become more actively involved in international academic societies. Over the last decades, the KNA has made numerous achievements in the development of the fields of neurology and neuroscience, and has contributed to public health as well.

Current Activities of KNA in Korea

The number of total residents and board-certified members in neurology in Korea increased sharply to about 1,800 members. Since the late 1990s, the KNA has facilitated the establishment of diverse subspecialty societies, and has actively expanded academic exchanges with other countries. Starting with the Korean Epilepsy Society in 1996, 14 subspecialty societies have been founded.

International Activities

One of the major activities of the KNA is international collaboration. The KNA has been putting much effort to build relationships and tighten the ties between Korean neurology and other parts of the world. The KNA has been participating in the East Asian Neurology Forum to share academic knowledge and regional concerns with the neurologic societies of Japan and Taiwan. Along with the Ninth AOCN in 1996, which was the first international academic meeting hosted by the KNA, the Ninth World Congress on Sleep Apnea (WCSA 2009), organized by the Korean Society of Sleep Medicine, and the Seventh World Stroke Congress (WSC 2010), organized by the Korean Stroke Society, were landmark events that strengthened the international network.

Why Seoul as Host for WCN 2017?

Active support from the Korean Government

seoulThe Korea Tourism Organization (KTO) and Seoul Tourism Organization (STO) will provide both financial and promotional supports to WCN 2017 to be held in Seoul. The Korean Government, including the Seoul Metropolitan City, sincerely welcomes the World Congress of Neurology and looks forward to meeting the members in Seoul, South Korea, in 2017.

The KNA has extensive experiences in hosting international congresses

Recently, the KNA has successfully hosted many international congresses in diverse fields of neurology. These experiences will certainly help make WCN 2017 a great success.

Providing opportunities for contribution  to WFN to new members

By helping the KNA to host WCN for the first time, all members will be inspired by an equal opportunity policy that the WFN pursues in making contributions to the society.

Special considerations provided to  participants from developing countries

Diverse academic and financial support programs are available for participants from the developing countries in regards to registration fees, accommodations and travel grants.

Convenience during the whole stay  from arrival to departure

The award-winning airport, comfortable accommodations, go-anywhere transportation, attractive places to see, convenient shopping and more create a most memorable trip for all participants.

See, Hear, Feel Korea

Korea offers an abundance of activities and festivals including Temple stay, DMZ tours, traditional SPAs, which are only available in Korea. Korea, with the 5,000-year history embraces the cosmopolitan flair of modern cities. Korean history stretches back thousands of years, and its culture is rich, complex and totally unique. Various palaces, fortresses, gates, museums and monuments are located all over Seoul, allowing visitors to experience the rich historical assets first hand.

Above all, the enthusiasm of KNA for the WCN 2017

Despite aforementioned advantages, nothing can be more important than the enthusiasm of Korean neurologists in hosting this glorious congress for the neurologists from all over the world. We believe that our enthusiasm for hosting the WCN 2017 in Korea will be the main key for the success of the WCN 2017.

Hong Kong Welcomes 2017 World Congress of Neurology

hongkongNeurological diseases inflict high morbidity and mortality in China: Stroke is now the No. 1 cause of death with 1.7 million deaths each year; 9.2 million persons live with dementia and almost half of the 4 million people suffering from Parkinson’s disease worldwide live in China.

Teaching and research in neurological diseases have advanced greatly in the last decade but we are still far behind the standard in Europe and the U.S. A world congress of neurology in Hong Kong will lift the standard of care and research capability of neurology in China. The Organizing Committee of the 2017 Hong Kong WCN bid has confirmed $200,000 (U.S.) donations to provide scholarship for neurologists from the developing countries to come to Hong Kong and learn from the top experts.

The Bidding Committee also has secured funding of $150,000 (U.S.) from the Hong Kong Tourism Board to support social activities and hospitality arrangement in order to save the congress budget. We will continue to seek more financial support from other charitable foundations in Hong Kong.

The Hong Kong Neurological Society, with the full support of the Chinese Society of Neurology, will promote the mission of WFN in pursuit of the highest standards of neurology and brain health worldwide. The society has hosted a number of successful major international congresses in the field of neurology, neuroscience and related disciplines, including the Third International Symposium of the Asian and Pacific Parkinson’s Disease Association in 2001, the Fourth World Congress in Neurological Rehabilitation in 2006, the Ninth International Symposium on Thrombolysis and Acute Stroke Therapy in 2006 and the forthcoming 14th Asian and Oceanian Congress of Neurology in 2014. The feedback on all these meetings, many of which had thousands of delegates, was consistently excellent with regard to both the scientific content and the social and administrative aspects.

As Asia’s world city, Hong Kong is a culturally diverse and sophisticated metropolis that blends eastern and western influences into a dynamic destination. Located at the heart of Asia’s most popular business locations that also links to Mainland China, Hong Kong is a highly accessible and safe city that is renowned for its success in hosting significant international and regional conventions from the World Trade Organization’s Sixth Annual Ministerial Conference to a number of the world’s high-profile conventions. The liberal visa policy allows foreign visitors from more than 160 countries to visit Hong Kong visa free.

Hong Kong has the world-class facilities, state-of–the-art venues like the Asia World-Expo providing function space with exhibition halls and meeting space of various sizes, a vast array of accommodations and professional support services to make conference an ultimate success, not to mention the whole experience of great dining, diverse shopping opportunities, sightseeing and exploring the culture and heritage of this vibrant metropolis. A wide selection of tours, ranging from sightseeing harbor cruises to a heritage tour, are also available for delegates to join before and after meetings.

The Chinese Society of Neurology under the Chinese Medical Association is the national organization representing all neurologists and neuroscientists in China. The Chinese Society of Neurology had pledged full support of the Congress should Hong Kong win the bid. With the support of the Beijing Central Government and Hong Kong Special Administrative Region Government, we expect thousands of Chinese neurologists and neuroscientists will attend the Congress.

On behalf of the Bidding Committee, we are confident that the Hong Kong Neurological Society will deliver a successful 2017 World Congress of Neurology and look forward to welcoming delegates from all over the world to experience the unique and truly exhilarating experience that is Hong Kong.

Neurosonology Research Group of WFN Launches Latin American Chapter

In order to promote neurosonology in Latin America, considerable efforts of the Neurosonology Research Group (NSRG) of the WFN have been undertaken during the last two years to establish a Latin American Chapter. The nucleus of the new chapter is spearheaded by a group of Brazilian Neurosonologists chaired by Viviane F. Zetola, MD, PhD, who organized a sonography workshop in October 2012 in Sao Paolo.

For the first time, there also was an opportunity for advanced participants to take part in a practical and theoretical examination according to the regulations of the NSRG. Twenty-three individuals finally passed the challenging certification procedure and received the NSRG document.

Faculty of recent NSRG teaching course in Sao Paulo: (from left) Ayrton Massaro (Brazil), Corina Puppo (Uruguay), Natan Bornstein (Israel), Silvia Cocorullo (Argentina), Viviane Flumignan Zétola (Brazil), Glória Meza Rejas (Paraguay), Manfred Kaps (Germany) and Marcos Lange (Brazil).

Faculty of recent NSRG teaching course in Sao Paulo: (from left) Ayrton Massaro (Brazil), Corina Puppo (Uruguay), Natan Bornstein (Israel), Silvia Cocorullo (Argentina), Viviane Flumignan Zétola (Brazil), Glória Meza Rejas (Paraguay), Manfred Kaps (Germany) and Marcos Lange (Brazil).

The Latin American chapter of neurosonology recently initiated a task force against Sickle Cell Anemia (SCA) in which transcranial ultrasound (TCD) is used to identify SCA patients in need of transfusion therapy in order to prevent stroke. Twenty-two neurologists participated in this pilot project and identified 13 percent of 56 cases examined during one day, carrying increased risk of stroke.  The project proved efficient and will be implemented in areas with high prevalence of SCD in Brazil during the next years.

In 1992, transcranial Doppler was introduced in Brazil; neurologists now aim to expand their diagnostic scope to the extracranial brain supplying arteries, which are actually mainly in the hands of non-stroke physicians. Therefore, the priority of the Latin American chapter will focus on education and on implementation of neurosonology in stroke care programs.

“We are looking for partners throughout Latin America to cooperate and to grow. Our chapter welcomes all physicians and investigators practicing neurosonology or that are willing to enter this field,” said Zetola, professor of Federal University of Parana (Brazil). The next opportunity to meet members of the Latin American chapter will be during the 16th World Neurosonology Meeting October 2013 in Sofia, Bulgaria (, or the Brazilian Congress of Cerebrovascular Diseases Nov. 13-16 in Fortaleza.

Kaps is chairman of the Neurosonology Research Group.

New Developments for the Journal of the Neurological Sciences

As the new editor-in-chief of the Journal of the Neurological Sciences (JNS), I would like to introduce the readers of World Neurology Online to some new features for the journal. The first and most obvious change is a new “face” or cover for JNS. The new cover is more abstract to reflect the modern global era. The design team at Elsevier is also making the journal website more intuitive with easy links to the websites for the World Federation of Neurology (WFN) and World Neurology Online.

To fulfill its mission as the official journal of the WFN, JNS will continue to publish the best original articles in neurology and neuroscience from around the world. In addition, new areas of special interest, each with a new associate editor, have been added. These new areas and associate editors are “Best Practices” (Carmel Armon), “Global Neurology” (Donald Silberberg), “Basic and Translational Sciences” (Nicolas Bazan), “Outcomes Research” (Bruce Ovbiagele) and “Reviews, Commentaries and Editorials” (Daniel Truong). JNS also has a new editorial board, which is comprised of internationally recognized experts in neurology and neuroscience from around the world.

Working with the publishing team at Elsevier, JNS is committed to serving the members of the WFN and strengthening our ties with the World Congress of Neurology (WCN). As such, we will publish the WCN-2013 abstracts as part of the September 2013 issue. Because JNS has a tremendous global reach and readership, we believe that this issue will be an excellent vehicle to communicate the new and exciting developments that will be presented at WCN-2013 in Vienna.

Also, Vladimir Hachinski, the president of WFN, and I will be convening a teaching course, “How to Get Published in International Journals” Sept. 23 at the WCN-2013. We believe that this course, which will highlight the new priorities of JNS, will be of interest to many WFN members.

JNS is offering a new service called AudioSlides. This feature offers authors of an accepted article the opportunity to include a five-minute presentation (PowerPoint or PDF) with their publications. As the name indicates, the presentation includes audio and slides prepared by the authors and available online at ScienceDirect under an Open Access license. Authors can easily assemble the presentation by using an Elsevier-provided website. We believe that this added feature will be of great benefit to both authors and readers.

The editorial team and I also are exploring ways to provide additional educational programs through the journal. We intend to offer CME-accredited opportunities by linking the JNS website to selected educational activities. Many of these activities will contain multimedia content, including videos. We are also working toward providing CME-credits through selected articles in the journal.

All of us on the editorial team of JNS look forward to serving the WFN by increasing the prominence and circulation of the journal. We are committed to playing a vital role in addressing the challenges in global neurology and educating neuroscientists, neurologists and allied health care professionals around the world.

England is editor-in-chief for the Journal of the Neurological Sciences and can be reached at

Applied Research Group on Space and Underwater Neurology

The Research Group on Space  and Underwater Neurology  was primarily founded to  coordinate studies about the  influence of the weightlessness  during space flights. After first  experiences in the real micro  gravity, it could be inferred that mainly the movement system was  affected, without an essential  influence on the cognitive abilities. The crew members in space stations can perform highest technical  programs and difficult scientific  projects. As main disturbances in  the weightlessness, a dysfunction  of the proprioceptive system, the reafference of motor control, was  discovered. As a temporary  disturbance after the return to  the Earth’s atmosphere, the  “Weightlessness Ataxia” was  described by I.B. Kozlowskaya.

Oleg Georgevic Gazenko, the director of the Russian Space  Medical Institute, introduced  simulated micro gravity in the research program of weightlessness. The Bed Rest Method and the Dry Immersion System are used on volunteers, staying in a horizontal position, cared with all hygienic  and nutritional support. With  this method, specific scientific  programs to study the weightlessness can be performed. As a main  result of the different elaborated  projects, the dysfunction of the  proprioceptive system was  confirmed.

In the transfer of the experimental results to clinical conditions,  the symptoms of the  Bed Rest  Syndrome can be stated, showing a polyneuropathy with additional primary muscle atrophies and a  posterior tract dysfunction.  Clinically, the Bed Rest Syndrome causes great problems in chronic neurological conditions, especially in long-lasting coma states but also in progredient neurodegenerative diseases. Bed Rest Symptoms can be observed in heart disturbances and in elderly people. New methods have to be developed to prevent this secondary complication. The different methods are mainly elaborated from the countermeasures used in real weightlessness.

With the fMRI method, an activation of the sensorimotor regions after a stimulation of the proprioceptive system could be demonstrated. In the meantime, this method is established as a paradigm of fMRI to discover rest functions of conscious in post-coma states.

In the subdivision Underwater Neurology, a working group was established to introduce the scuba diving system in neurorehabilitation. Spasticity in mild spinal cord lesions and a disturbance of the vertebral spine can be successfully treated.

The hyperbaric oxygenation treatment (HBOT), until now called a stepchild, has the handicap to need high technical equipment with a specially trained crew. HBOT can be included in neurorehabilitation programs. Our group has initiated a cooperation with the Adeli Medical Center in Piestany, Slovakia. A treatment program to introduce HBOT for cerebral palsy and for patients with a vegetative state/apallic syndrome has been developed.

The program of the ARG Space  and Underwater Neurology is  focused on the research of the  proprioceptive system and its  disturbances. The main clinical project is the Bed Rest Syndrome in long-lasting bed lay conditions such as prolonged coma states as well as in chronic  neurological diseases with reduced motoric activities. New methods in neurorehabilitation using stimulation of the proprioceptive system are in development. In HBOT, a cooperation with centers specializing in this method in neurological conditions is the goal.

First East African Parkinson’s Disease Nurse Specialist (PDNS) Course Presented

PDNS Course faculty wearing their gifts.

PDNS Course faculty wearing their gifts.

There is limited access to diagnosis and treatment of Parkinson’s disease (PD) in Sub-Saharan Africa (SSA) with few neurologists. PD nurse specialists (PDNS) have become an integral component of multidisciplinary PD care in the U.K. and may be particularly useful in SSA with the lack of specialist doctors. We therefore conducted a PDNS course for East Africa in Moshi, northern Tanzania with joint funding from the World Federation of Neurology (WFN) and the Movement Disorder Society (MDS).

Invitations were sent to different countries throughout East Africa. Nurses needed to be working within a neurology department with a likelihood of caring for PD patients after the course. We had participants from Rwanda (3), Uganda (1), Ethiopia (2), Kenya (4), with two also invited from Nigeria and the remaining 10 from Tanzania, including two occupational therapists and three physiotherapists. The faculty comprised of Richard Walker and Catherine Dotchin (geriatricians with an interest in PD from the U.K.), Louise Ebenezer and Lynda Hind (PDNS from the U.K.) and Juzar Hooker, consultant neurologist (Nairobi, Kenya). Local contributions were also provided by Victor Minde (physiotherapy) and Oliva Msuya (PDNS).

The course was run in English and included diagnosis, drug treatment, motor symptoms, non-motor symptoms, physiotherapy and information provision. At the beginning of the course, we had a round of introductions by the faculty and the course participants in which people talked about their previous experience with movement disorders and the background on the care of movement disorders in the place, and country, where they worked.

Parkinson's Disease Nurse Specialist (PDNS) Course participants and faculty.

Parkinson’s Disease Nurse Specialist (PDNS) Course participants and faculty.

The course was primarily classroom based with interactive sessions conducted around PowerPoint presentations from the faculty covering all aspects of PD. There was a particular emphasis on areas that were of specific relevance to Africa, such as health beliefs about the symptoms of PD, and how this affects health seeking behavior; as an example, seeking help from traditional healers as these symptoms are not felt to be a medical problem. Expensive interventions, such as deep brain stimulation, were mentioned, but not in great detail as these are not available in the majority of African countries. We plan to develop appropriate information for SSA in English, which will then be translated into local languages as required. On one afternoon, two local PD patients attended to tell the participants what it was like to live with PD, and this also allowed demonstration of physical signs.

Useful websites, including the MDS and Parkinson’s U.K., were demonstrated. Each participant has been given a U.K. PDNS as an email mentor and will produce a report after six months giving details of the numbers of patients with PD they have seen, and the clinical spectrum, as well as the challenges where they work. We also plan to keep participants updated via email of any new relevant developments. Hopefully, this will ensure ongoing interest and contact between the participants themselves, and between the participants and the faculty and mentors.

Despite many challenges, not least getting the participants to Moshi, the course was a great success in large part due to the excellent hosting by Marycelina Msuya, dean of Nursing, and her colleagues at the Nursing School. The group as a whole bonded well as the week went by, and the course was very interactive. They are keen to provide ongoing mutual support. Despite the many other challenges to the care for PD patients in SSA, such as access to affordable and sustainable drug treatment, we have raised awareness and established a cohort of interested and educated health professionals to help take on the challenge.

Evaluation was positive. In September 2013, we will be running a similar course for PDNS in Anglophone West Africa in Accra, Ghana, funded by MDS. This will run in conjunction with a course for non-specialist doctors in Ghana, and other West African countries, which has been jointly funded by WFN and MDS. We hope to run similar courses in other regions of Africa in the future. We are grateful for the support of WFN.

Walker is consultant physician for North Tyneside General Hospital and honorary professor of aging and international health, Institute of Health and Society, Newcastle University.


Editor’s Note

Other faculty members for the course are: Catherine Dotchin, consultant geriatrician at North Tyneside General Hospital, Louise Ebenezer, Parkinson’s disease nurse specialist and Welsh PDNS course convener at Princess of Wales Hospital, Bridgend, Lynda Hind, PDNS, information adviser for Parkinson’s UK, London, and Juzar Hooker, consultant neurologist, Aga Khan University Hospital, Nairobi, Kenya.