Brain Health and Disability: Leave No One Behind

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


By Tissa Wijeratne, David W. Dodick, Steven L. Lewis, and Wolfgang Grisold

World Brain Day 2023 annually commemorates the foundation of the World Federation of Neurology (WFN) on July 22. The previous World Brain Day themes focused on specific neurological diseases such as Parkinson’s disease, migraine, epilepsy, multiple sclerosis, and many others. We are again partnering with all six regions of the WFN as well as the World Federation for NeuroRehabilitation (WFNR) to unite the world on the disability that results when brain health compromised.

Brain disorders, affecting more than one billion people, are the leading cause of disability-adjusted life years (DALYs). Optimizing brain health, care, and rehabilitation for those with disability from neurological disease is a global priority, requires involvement of policy makers, health care providers, foundations, public health authorities, professional societies, patient advocacy organizations, and the private sector.

The World Health Organization (WHO) identified the following determinants for brain health:

  • Physical health
  • Healthy environments
  • Safety and security
  • Learning and social connections
  • Access to quality services

By addressing these determinants, we can optimize brain health, prevent neurological disease, facilitate early and rapid diagnosis, ensure universal access to care, and thus lower the prevalence and disability associated with most neurological diseases.  For those with progressive, late-stage, and incurable disease, access to palliative care to ensure human dignity at the end of life is an imperative.

The Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders 2022–2031 (IGAP) was initiated by WHO and unanimously adopted at the World Health Assembly on May 27, 2022. [].

The IGAP provides a comprehensive response to the burden of neurological disorders; the global action plan suggests actions to Member States and national and international partners to close the treatment gap for people with neurological disorders and support quality management of these conditions.

Since the IGAP is also directed to organizations such as the WFN, this is an excellent opportunity to strengthen the collaboration between the WFN and WHO by linking our actions with the principles of the IGAP.

In this year’s World Brain Day | Brain Health and Disability: Leave No One Behind, we intend to highlight five key messages.

Prevention: Brain disabilities can be prevented, treated, and rehabilitated.

Awareness: Global brain health awareness can reduce the burden of brain disorders.

Access: Universal access to care, treatment, rehabilitation, and assistive technology is essential.

Education: Education increases equity for those living with brain disabilities.

Advocacy: Brain health is a human right that applies to everyone, everywhere.

As in the previous World Brain Days, a special logo and material have been produced and will be made widely available for local/regional use by health care professionals, regional and national societies, and all other stakeholders involved in neurological disease advocacy. Before World Brain Day, a template for press mailings will be distributed to help the local organizations. On World Brain Day, a webinar will be launched and, with invited participants from the press, key messaging on brain health and disability will be disseminated.

The ultimate success of World Brain Day depends on your local activities. Please make World Brain Day your own, use all the material we provide, and ask for more if needed. Experience has shown that this international day has created considerable press attention, but local activities and information make the difference.

Please involve patients, caregivers, the public, local, regional, and national policy makers, and patient groups that might be interested in this topic. Please be sure to post your activities on social media to help raise awareness. Join us on World Brain Day as we ensure no one is left behind.

Brain health care faces many global inequalities. Let’s change this together. Let’s leave no one behind.

We eagerly await your reports of your local plans on World Brain Day events so that we can publish them in World Neurology.

Learn more at •



II Latin American Course of Neuroepidemiology

Punta del Este, Maldonado, Uruguay | March 6-10, 2023


By Dr. Carlos N. Ketzoian

Participants in the II Latin American Course of Neuroepidemiology, Punta del Este, Maldonado, Uruguay, March 6th to 10th, 2023. In the center, Dr. Daniel Salinas, Minister of Public Health of Uruguay.

Last March, the II Latin American Course of Neuroepidemiology took place in Punta del Este, Maldonado, Uruguay. This course was organized by the neuroepidemiology section of the Institute of Neurology at the University of the Republic in Uruguay, and the Université de Limoges in France, with the endorsement of the World Federation of Neurology (WFN). The course was held at the Eastern Regional University Center (C.U.R.E.) of the University of the Republic, Uruguay.

The I Latin American Course of Neuroepidemiology took place in Panama City, Panama, in April 2018. This II course was initially planned to take place in March 2020. Unfortunately, the COVID pandemic forced the organizers to postpone it until 2023. The structure and the content of these Latin American courses are based on the experience of the Erice’s International Course of Neuroepidemiology. (See World Neurology, posted Feb. 24, 2023. Report on the Ninth International Course of Neuroepidemiology: Methods and Clinical Applications

Twenty-one students, five teachers, three coordinators, and two invited speakers participated in five intense and enriching days of learning. Apart from local participants from Uruguay, the remaining students came from different Latin American countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Dominican Republic, and Peru. Two participants came from outside of the region (Republic of Armenia).

Profs. Walter Rocca (U.S.), Giancarlo Logroscino (Italy), Pierre-Marie Preux (France), Ruth Ottman (U.S.), Brandon Coombes (U.S.), and Carlos Ketzoian (Uruguay) were part of the teaching team. The course was coordinated by Prof. Carlos Ketzoian (Uruguay), Prof. Regina Alvarenga (Brazil), and Drs. Fabián Gómez Elso and Lucía Castro (Uruguay).

Dr. Sebastián Ameriso from Argentina gave a lecture on the epidemiology of stroke in Argentina and Prof. Abayubá Perna from Uruguay gave a lecture on the genetic epidemiology of limb-girdle muscular dystrophy (LGMD) in Uruguay.

Study design aspects, genetic epidemiology, and statistical methods applied to neuroepidemiology were discussed in the morning. After lunch, the participants analyzed published clinical-epidemiological studies in which the different methodologies presented in the mornings were addressed. Each day, the activities ended with lectures on different topics.

The course activities also included the IV Journée d’Amitié Neurologique Franco-Panamericaine with lectures by Profs. Abayubá Perna (Uruguay), Regina Alvarenga (Brazil), and Pierre Marie Preux (France). The program was endorsed by the French Embassy in Uruguay. A cocktail reception took place after the lectures. The Minister of Public Health of Uruguay, Dr. Daniel Salinas, who is a neurologist, participated in this opening academic and social event. On Friday, March 10, the course closed with a social dinner of traditional “Asado Criollo” (Uruguayan barbecue).

Participants, professors, and coordinators had the opportunity to discuss in-depth different aspects of the clinical-epidemiological methodology for the study of neurological diseases. This full-immersion course format allowed total focus on the subjects, and the participants were not distracted by other activities during the day.  The participants worked together for eight hours a day for five days.

We would like to emphasize that this kind of course corresponds to the objectives defined by the WFN Specialty Group on Neuroepidemiology during the meeting which took place Oct. 30, 2019, at the World Congress of Neurology in Dubai. •

Carlos N. Ketzoian is chair of the WFN Specialty Group on Neuroepidemiology.

Report of the World Stroke Congress 2022 in Singapore

By Stefan Kiechl and Deidre De Silva

The World Stroke Congress (WSC) is the flagship meeting of the World Stroke Organization (WSO). After the exclusively virtual events in 2021 and in 2020 (joint conference with the European Stroke Organization), the WSC 2022 in Singapore was the first international large-scale in-person meeting. With more than 4,400 attendees (approximately half in person and half online) this was the largest WSC ever. It served as an excellent opportunity to discuss latest clinical and research results with colleagues from all over the world. The participants were from 106 countries with highest attendance from colleagues from Australia, China, India, Indonesia, Malaysia, Philippines, Singapore, United Kingdom and the United States. The faculty of 204 invited speakers were well balanced across continents (Asia 34%, South and North America 24%, Europe 25%, Australia and Africa 18 %).

The opening ceremony included a video message from Tedros Adhanom Ghebreyesus, WHO director-general. In the three-and-a-half day program Oct. 26-29, the scientific program committee organized 97 sessions, teaching courses, joint symposia, and plenaries. These covered a broad range of topics, emphasizing the latest research and breakthrough discoveries across the globe, with priorities in acute stroke therapy, primary and secondary prevention, rehabilitation and recovery, cardiac aspects, and intracerebral haemorrhage.

One priority of WSC was the cross-link with partner organizations. The WSO and World Federation of Neurology (WFN) organized a joint symposium on education in stroke. With the conference being held in Asia, this granted the opportunity to collaborate with stroke societies from Asia, such as the Chinese Stroke Association, Asia Pacific Stroke Organization, Association of Southeast Asian Nations Neurological Association, and WHO South-East Asia Regional Office. Stroke support organizations substantially contributed to the WSC 2022, integrated into the main program and also in parallel independent sessions. During the coffee breaks, there was dialogues on non-communicable diseases (NCD).

The WSC 2022 had more than 20 late-breaking trials that were published in top journals like The New England Journal of Medicine and JAMA. One highlight was the first presentation of results of MR CLEAN-LATE. Patients admitted between 6 and 24 hours after stroke (NIH Stroke Scale ≥ 2, occlusion of the internal carotid artery or M1/2 segments of the middle cerebral artery), had a substantial benefit of endovascular stroke therapy. The only patients not considered in these trials were patients with large demarcated infarction (more than third of the territory of the middle cerebral artery) and patients with a collateral score of zero. Patients with indications of endovascular stroke therapy according to DAWN or DEFUSE-3 criteria were also not considered. Other highlights were the meta-analysis of six trials comparing endovascular stroke therapy alone against bridging (combined with intravenous thrombolysis). In this meta-analysis including 2314 patients, endovascular stroke therapy could not prove to be non-inferior to bridging therapy and this is also valid for multiple subgroups. The first phase 3 trial on stem cells in stroke recovery (TREASURE) was negative, a lowering of systolic blood pressure under 120 in successful endovascular stroke therapy has negative impact on the patients’ outcome (ENCHANTED2), and treatment by tenecteplase was non-inferior to alteplase treatment (AcT Study).

The WSC 2022 in Singapore contributed to a better clinical stroke management in the future and facilitated discussion about stroke care in various geographical regions. Hundreds of delegates, local organizers, and stroke advocates joined the annual Walkathon and with “One Voice” raised stroke awareness. The WSC 2023 will be organized in Toronto (Canada) between Oct. 10-12, a few days before the congress of the WFN in Montreal from Oct. 15-18. •

Stefan Kiechl and Deidre De Silva Chaired the Scientific Committee of WSC 2022.