Articles – Page 53

AFAN-PAUNS Congress: Two Societies Achieve a Milestone of Joint Regional Meetings

Delegates gathered for a photo at the conclusion of the first meeting of the African Academy of Neurology conference, in Yasmine-Hammamet, Tunisia.

By Riadh Gouider, MD, and Wolfgang Grisold, MD

The first African Academy of Neurology (AFAN) conference and the 15^th Pan Arab Union of Neurological Societies (PAUNS) meeting provided a unique opportunity for both societies to meet on the same premises and hold their first joint congress. More than 500 delegates attended; they represented 52 nationalities from five continents.

The Tunisian Society of Neurology, on behalf of the African Academy of Neurology and the Pan Arab Union of Neurological Societies, organized the meeting. To help young participants attend, the WFN, the American Academy of Neurology (AAN) and the European Academy of Neurology (EAN) initiated a joint sponsorship. The Tunisian Society of Neurology was helpful and generous in supporting this event.

The congress took place in Yasmine-Hammamet, Tunisia. The staff of the Neurology Department of Tunis served as host and conference organizer. Helping to make the conference a success was that it coincided with the Tunisian National Day of Traditional Dress.

Flags from several continents were carried across the stage during a colorful ceremony.

Important topics were presented each day of the meeting:

Day 1: Neurology training initiatives in Africa and infectious diseases of the central nervous system
Day 2: Epilepsy and movement disorders
Day 3: Inflammatory diseases and dementia
Day 4: Stroke and neuro-pediatrics

The sessions were well attended and featured lively discussions. The opening session tackled inflammatory neuropathies, coma, paraneoplastic syndromes, and recent advances in the understanding of Parkinson’s disease. Many topics deserved attention, including inflammatory aspects of the neuromuscular system, new investigation techniques, and new therapies.

The meeting’s scientific program contained courses on epilepsy, stroke, and botulinum toxin use in dystonias. The program featured interesting e-poster presentations, which were well organized and showed promise that e-posters will be an important aspect of future meetings. The Tournament of the Mind winners were Dr. Osheik Seïdi, from Sudan, and Dr. Sywar Triki, from Tunisia.

WFN President Raad Shakir, MD: ‘Now the world of neurology is correctly represented.’

The AFAN business meeting concluded with the selection of Prof. Fuad Abdallah, from Egypt, as president-elect, and Prof. Shamsideen Abayumi Ogun, from Nigeria, as president. The PAUNS business meeting also was held during the conference, with Prof. Chokri Mhiri, from Tunisia, elected president.

The WFN was represented by its president, vice president, general secretary, and two elected trustees. The EAN president and an AAN representative also attended.

Conference organizers overcame many challenges. Besides organizing a large meeting, they brought together different societies and interests, and coordinated the travel needs of participants from low-income countries to make it affordable.

World Congress of Neurology 2021 Bid: Copenhagen

Four European cities are bidding to host the World Congress of Neurology 2021, an international conference focused on advancing the diagnosis and treatment of neurological disorders. In this issue, World Neurology publishes four articles written by neurology organizations and professionals about why WCN 2021 should take place in Copenhagen, London, Marseille, or Rome.

Copenhagen, a candidate host city for WCN 2021, is known as a charming, clean, safe, green city, with numerous bicycles.

By Prof. Gunhild Waldemar and Jesper Erdal

We are happy to present Copenhagen as the possible host city for the World Congress of Neurology 2021.

Denmark and Scandinavia

The Danish Neurological Society (DNS) was founded in 1900, and is probably the world’s oldest neurological society. Although mature of age, DNS is an active and lively society that in recent years has attracted a lot of dedicated young doctors.

Leading Danish neurologists have been active in international neurological societies for many years, including Prof. Jes Olesen, Prof. Per Soelberg Sørensen, and Prof. Gunhild Waldemar, who we propose for Congress president for WCN 2021.

Greater Copenhagen is a world leader for research and development pending, clinical testing, and drug development. It comprises four life science universities with 50,000 students producing 2,000 PhDs every year, more than 150 biotech and 200 medtech companies as well as 11 university hospitals, leading researchers, clinicians, and academics.

The neurological communities in Scandinavia are closely linked and cooperate both clinically and academically. We are proud to have the full support of our friends and colleagues in the Swedish Neurological Association and the Norwegian Neurological Association.

Nordic Style

Copenhagen is a truly charming city with a distinct Nordic, cool style. It is famous for its many old buildings mixed with modern prize-winning architecture, new Nordic gastronomy, and green environment, with numerous bicycles. Copenhagen is a clean, safe city that has been voted the most livable city numerous times.

Copenhagen has the main hub airport in northern Europe and an outstandingly good infrastructure. It takes only 12 minutes to travel from the airport to city center by the inexpensive metro.

Bella Center

If Copenhagen were to win the bid, WCN 2021 would be held in October at Bella Center Copenhagen, Scandinavia’s leading and largest congress center. It is conveniently situated between the airport and the city center, only 10 minutes away from both downtown Copenhagen and the airport.

In recent years, Bella Center has been the venue of several large international medical congresses.

Reaching Out to the Public

We will strive to make new knowledge from WCN 2021 known to the public and to the health care authorities by collaborating closely with local and international media, patient organizations, and through various outreach activities.

The goal is to increase the public awareness of the frequent and often disabling neurological diseases, and the many new possibilities for treatment, rehabilitation, and care.

Academic-Industrial Cooperation

We wish to help create a congress in Copenhagen that promotes academic-industrial dialogue. This is crucial because of the obvious co-dependence. Along with the WFN, we will draw upon our international industrial networks to build a solid collaboration, both before, during, and after the congress. With an uncompromising focus on high academic quality, we wish to attract industrial participants and to help include relevant industrial themes.

Trainees, Young Neurologists, and Young Researchers

The congress in Copenhagen should serve as a hub for networking among young researchers, trainees, and young neurologists. Our goal is to support and help develop the work of the WFN International Working Group of Young Neurologists and Trainees. In connection with the WCN in Copenhagen, we will give young neurologists the opportunity to visit Danish neurological departments and research groups. The Danish Association of Young Neurologists will help take good care of our young foreign colleagues.

Our aim is creating friendship and international clinical and scientific networks that can last for years and develop further over time.

Support for Colleagues

It is important for our colleagues from low-income and low-middle income countries to have the opportunity to participate in the WCN 2021. Lundbeck Foundation has therefore offered to donate 50 bursaries of 1,000 euros ($1,100 U.S.) each to neurologists from low-income and low-middle income countries.

The Danish Neurological Society offers to donate half of the society’s profit from the congress to the World Federation of Neurology educational programs.

Welcome to Copenhagen in 2021

We sincerely hope to have the opportunity to welcome you to Scandinavia and Copenhagen for the World Congress of Neurology 2021. We will do our utmost to ensure that the congress will be a success, and that each and every delegate will have an exceptional and unforgettable visit.

Written on behalf of the Danish Neurological Society by Prof. Gunhild Waldemar and Jesper Erdal, president of the Danish Neurological Society.

World Congress of Neurology 2021 Bid: London

ABN conference delegates supporting the London WCN 2021 bid. Vote #NeurologyIsOpen #LondonIsOpen #WFN2021.

Members of the Association of British Neurologists (ABN) invite their colleagues throughout the world to join them in London to celebrate the 2021 World Congress of Neurology.

We last hosted this event in London in 2001, achieving a still unbroken record in delegate numbers. Much has happened in the intervening decades, both in London and in British neurology.

Excellent venue: Our proposed venue, London ExCeL, played its role as a sporting venue during the 2012 Olympics and has attracted a substantial number of successful medical congresses, consistently achieving higher delegate numbers than in previous or subsequent years. The Elizabeth Crossrail line, opening in 2018, should further enhance the venue’s appeal, reducing travel time into central London to just 15 minutes.

Neurology in the United Kingdom has grown significantly since 2001, from about 400 consultant neurologists in 2001 to almost 800 in 2016. The ABN has more than 1,500 members, more than half of whom are consultant neurologists, with a growing and enthusiastic younger membership of trainees, junior doctors, and medical students.

Successful meetings: Our 2016 annual conference, held in cooperation with the British Pediatric Neurology Association, attracted over 700 delegates supported by 100 abstract bursaries available to early career researchers. We hope to exceed that figure at our 85th anniversary meeting in 2017. Our regular pre-meeting training and development day, which includes sessions for foundation doctors, trainees, and general practitioners, has grown in popularity each year. Its work was reinforced in 2016 by the introduction of a Medical Students Day, which attracted over 100 delegates.

The association also held a joint symposium with the British Neuroscience Association in September 2016. It contributes symposia to its biennial Festival of Neuroscience and has commenced work with the Society of British Neurological Surgeons on a joint meeting planned for autumn 2018. We are confident that a London-based World Congress of Neurology would be of great interest to our colleagues in other neuroscience disciplines. Indeed, our bid is supported by 12 of our fellow U.K. and Irish neuroscience associations, and we offer these reasons we should host WCN 2021.

Engaged and active membership: The ABN has more than 150 consultant and trainee members directly involved in council, research, training, services, standards, and subspecialty advisory committee roles. These comprise an excellent pool of experience and enthusiasm from which to appoint our scientific program, teaching, social, and other congress committees.

Committed to education: We are committed to developing neurological training at home and abroad. Current projects include abstract bursaries (for early career researchers attending ABN meetings), travel bursaries (facilitating educational and research visits to developing countries), clinical research training fellowships (supporting the next generation of researchers), undergraduate prizes and intercalated degree bursaries (encouraging undergraduate interest in neurology). We provide speakers to many overseas meetings, and our international committee is charged with reviewing and extending this work.

Superb travel connections: Our chosen venue, London ExCeL, is in the best-connected city in the world that can be reached by more people, from more destinations, in less time, than any other global destination. WCN2021 will take place three years after the high-speed London Crossrail link opens, speeding conference attendees to the venue to hear the most cutting-edge neuroscience at a truly globally connected conference center. It will provide direct access from Heathrow Airport to ExCeL in 43 minutes, with 12 trains per hour that can carry 1,500 passengers.

U.K. is open: The ABN’s 2017 annual meeting theme in Liverpool is “A Port to a World.” This theme reflects our approach to neurology — welcoming colleagues from around the globe, treating patients from every land and every part of society, and traveling overseas to learn and to share skills. Thus for us, WCN2021 in London will be an even bigger “port” to welcome the global neurological community.

A notable anniversary: 2021 is a particularly appropriate year to invite the neurological world to London as it marks the 400^th anniversary of the birth of Thomas Willis, considered by many as the father of neurology. He was the first to coin the term “neurology” and to identify the Circle of Willis anatomically. What better place for the WFN to celebrate this anniversary than in the country of his birth?

We believe that a London-based World Congress of Neurology would be both popular and scientifically successful, and we hope that we will be given the opportunity to welcome the congress to London in 2021.

Hashtag: #NeurologyIsOpen #LondonIsOpen Vote London #WFN2021

World Congress of Neurology 2021 Bid: Marseille

By Prof. Gilles Edan, Prof. Jean-Marc Leger
and Prof. Jean-Philippe Azulay

France and the French Society of Neurology would like to be a candidate to host the World Congress of Neurology in 2021. France has never had this opportunity before and would be proud to convince the Council of Delegates to choose our country.

The Société de Neurologie de Paris was established on June 8, 1899, and its first meeting was held on July 6, 1899. It was renamed Société Française de Neurologie in 1949, and celebrated its 100th birthday June 16, 1999, in Paris. Our society is one of the oldest in the world, and a number of famous neurologists are part of our heritage.

The French Society of Neurology has an old and rich history, but also is a vivid society with an annual congress assembling more than 3,000 neurologists each year. The French teams are major contributors in all the fields of clinical neurosciences and will work with the international committee to develop an amazing scientific program. It is also the decision of the society to open the congress to participants from all around the world, with an intensive program of support dedicated to young neurologists.

To emphasize and symbolize this opening to the world, the city that the French Society of Neurology has chosen is Marseille. The oldest city of France was founded in 600 BC and became the main Greek city of the Western Mediterranean. Marseille is the second-largest city in France and is located in the south of the country by the Mediterranean Sea. It is the capital of Provence, one of the most visited parts of the world.

The Phocean City is a cosmopolitan port where people have met from around the world for centuries. Marseille is Europe’s door to all the Mediterranean countries, Africa, and Maghreb.

Marseille Provence Airport (MRS) welcomed 8.5 million passengers in 2016 and is currently linked to 96 destinations in 25 countries, with 129 scheduled services. MRS is well connected to all major hubs, providing easy access from all over the world at competitive airfares. Up to 36 daily flights are being offered to Paris-Charles de Gaulle (just a 90-minute flight), London-Heathrow, Frankfurt, Munich, Amsterdam, Brussels, Madrid, Rome, Lisbon, Istanbul, Montreal, Algiers, Casablanca, and Tunis. It is only a 25-minute drive from the airport to Marseille city center.

Marseille can be reached in less than three hours by high-speed train, with departures every hour. The train station is in the heart of the city.

October is a perfect time to come and visit the Provence Cote-d’Azur region and make a stop in Paris. The average temperature is 24°C/75°F, perfect weather to enjoy the Mediterranean Sea!

The entire French neurological community enthusiastically supports this candidacy and hopes that it will be successfully considered.

Prof. Gilles Edan is the 2017 SFN president. Prof. Jean-Marc Leger is the WFN French delegate. Prof. Jean-Philippe Azulay is a member of the local organizing committee.

World Congress of Neurology 2021 Bid: Rome

The legendary origins of Rome are seen in this sculpture of the wolf with the founders of Rome — Romulus and Remus.

The Italian Society of Neurology (SIN) is bidding to host the 25th World Congress of Neurology in 2021 in Rome. The Society was founded in 1907 with the mission to promote the study of neurology in Italy; foster scientific research, education, and specialist updating; and improve the quality of care delivered to patients with neurological diseases. SIN is an association of public and private neurology specialists, working in community, hospital, and university settings. It represents 3,000 members, making it the largest association of neurologists in Italy, providing a constantly growing number of education and training activities.

The Society’s training and updating activities are designed to enhance care activities, promote research studies into nervous system diseases, and facilitate interaction with patient organizations. Much research work is recognized at the highest international levels, contributing to the prestige of the Italian neurological community. SIN develops and promotes a wealth of clinical and scientific initiatives.

The vastness of the spheres of clinical neurology has prompted the development of working groups within SIN. Where required, these seek the expertise and contribution of specialists from other disciplines with a view to providing exhaustive responses to population needs. SIN’s official journal, Neurological Sciences, has a 2016 impact factor close to 2 and is among the leading European scientific journals in the field.

Italy is a valid representative of the European neurological community. The number of practicing neurologists in Italy is among the highest on the continent and its research activities hold top-ranking positions in international indexes.

Its geographic position and cultural vocation place Italy in a pivotal position among nations with a longstanding neurological tradition and North African and Middle Eastern regions keenly committed to the field of neurology. The Italian neurological community has many representative members in international societies in various branches of neurology, besides supporting projects to develop care, research, and scientific updates in all neurological subspecialties.

An active and positive member of the WFN, Italy has participated both at the structural level and in the WFN’s various ongoing activities. It should first be stressed that Rome was the venue of the WFN World Congress in 1961, and many Italian clinical neuroscientists have played an active role in WFN activities over at least the last 50 years.

Italy offers beautiful cities with modern conference venues, hotels, restaurants, infrastructure, and places of interest. Conference delegates coming to Italy will greatly enjoy the wide variety of suitable venues that provide a high standard of hospitality, with competitive prices compared to other European cities. No less important is that Italy, its history, and its culture attract high numbers of congress delegates.

For a variety of reasons, the presence of many active neurologists from all
over the world in Italy, be it temporarily or permanently, prompts the need to
host WCN.

Rome, often referred to as “The Eternal City,” is among the world’s most alluring venues, combining its leading role in the international multicultural scene with its millenary history. Alongside the splendors of ancient Rome and important archaeological remains, such as the Colosseum and the extensive Imperial Fora, visitors are party to some of the best examples of the world’s Renaissance art. Delegates will be able to admire the works of some of the greatest artists whose achievements continue to adorn the city as they have done over the centuries. The Italian capital is the home of important museums (including the Vatican buildings) and interesting permanent exhibitions. A visit to this city will enhance the artistic passion of enthusiasts of every art form (painting, sculpture, music, etc.).

Last but not least, being the world capital of Christianity, Catholic delegates from all over the world would have a wonderful opportunity to visit the Vatican.

Importantly, Rome can be easily reached from all corners of the globe. In addition, a modern, functional, attractive convention center, designed by one of the greatest living architects (Massimiliano Fuksas), has recently been opened in the city, rendering delegates’ time at the congress venue even more pleasant and productive. •

Brown-Séquard Syndrome and Networks

By Peter J. Koehler

Most neurologists will know about the Brown-Séquard syndrome, comprising an ipsilateral paresis and proprioception disorder with contralateral pain and temperature disturbances, resulting from hemisection of the spinal cord.

Charles-Edouard Brown-Séquard wrote his first publication on this finding between 1846 and 1849, starting at age 29. Born 200 years ago and raised on the isle of Mauritius, he moved to Paris in 1838 to study medicine. He worked at the private laboratory of physiologist Martin-Magron. This experience influenced him for the rest of his life.

Possibly because of his republican ideas, he left France after the coup d’état of 1851 by Louis Bonaparte, the later emperor Napoleon III. He went to Philadelphia with a letter of recommendation written by Paul Broca.

Later, Brown-Séquard worked in London, becoming one of the first physicians at the National Hospital for the Paralyzed and Epileptic. He was considered an expert in epilepsy.¹ From 1864-1866 (with interruptions), he was professor at Harvard University. He founded several journals, including Journal de la Physiologie (1858, Paris) and Archives de Physiologie normale et pathologique (in 1868 with Charcot and Vulpian).

In 1878, he succeeded Claude Bernard as the chair of physiology at the Collège de France in Paris. This brought more rest to someone who is said to have traveled the ocean 60 times. He worked and lectured at many places, in particular France, England, and the United States, but also on Mauritius. This restless traveling had several reasons, among which his birth at Mauritius, that was French originally, but became English following the defeat of Napoleon.

His father (Brown), whom he never met, was a sea captain from Philadelphia and died before his birth. Charles-Edouard added his mother’s name early in his career. Although a physician, his heart was always in the physiology laboratory, and he was always looking for such an appointment.

Spinal Cord Experiments
His 1846 thesis Recherches et expériences sur la physiologie de la moelle épinière described the fact that section of the posterior columns did not lead to loss of sensation, concluding that other parts of the spinal cord should contribute to the conduction of sensory impressions. In 1849, he found that hemisection of the spinal cord did not result in ipsilateral sensory loss. This is in contrast to earlier findings,² but in contralateral hypalgesia.^3,4 Although he worked on the spinal cord mainly between 1846-1855, he would return to the subject later.

Understanding the Sympathetic Nerves
He worked on numerous other subjects, including rigor mortis and the action of the vasomotor nerves, in which he competed for priority with his predecessor at the Collège de France (Paris), Claude Bernard. Experimental observations that eventually elucidated the mechanism and function of the vasomotor nerves were carried out in the 1850s.

In November 1852, Bernard found that section of the cervical sympathetic led to increased blood flow, rise in facial temperature and miosis, the latter phenomenon, which he attributed to the discovery, more than a century earlier, by his compatriot Pourfour du Petit (1727). However, in contrast to Brown-Séquard, Bernard did not understand the observed phenomena as, in his understanding, the sympathetic was considered the producer of the animal warmth. Therefore, he expected the contrary, notably cooling of the face and was quite surprised. In August 1852, Brown-Séquard published the results of his animal experiments during his stay in Philadelphia. He had galvanized (probably he meant faradized, using an induction coil invented by Emil Du Bois-Reymond) the cervical sympathetic of several animals and noticed constriction of the blood vessels in the ear and diminished temperature of the facial skin.

When Du Bois-Reymond, himself a migraine sufferer, published a paper stating that migraine was not a disease of the brain or cranial blood vessels, but of the cilio-spinal center in the spinal cord, leading to an increased sympathicotonic (vasoconstrictive) influence on the blood vessels of one side of the head, Brown-Séquard presented arguments to the contrary. From his animal experiments and clinical observations, he had concluded that stimulation of the cervical sympathetic causes epileptic seizures, rather than migraine attacks. He opined that Du Bois-Reymond’s observations better fit a sympathicoparalytic (vasoparalytic) model of migraine, in which he was seconded by other physicians, including Friedrich Wilhelm Möllendorff, until Peter Wallwork Latham proposed to unify both theories.⁵

Expert in Epilepsy
Brown-Séquard’s physiological and clinical work on epilepsy led him to be considered an expert in the field. His spinal cord experiments in the early 1850s resulted in observations that he interpreted as epileptiform convulsions originating in the spinal cord. His observation of convulsions in guinea pigs following spinal cord sections, and that their offspring showed the same phenomena, led to his idea of artificially induced hereditary epilepsy.

The ideas were used by Charles Darwin, who referenced him in several of his publications. Brown-Séquard realized it was not the same type of epilepsy as in human beings.⁶ It was later suggested that the animals were suffering from lice on the paralyzed parts. As for the clinical observation, it is important to realize that the brain was considered not irritable at the time (up to the famous 1870 experiments by Fritsch and Hitzig in Berlin). In Brown-Séquard’s concept, a reflex mechanism from the periphery conducted by nerves to the central nervous system was considered essential.

Antilocalizer Networks
Following Broca’s proof of cerebral localization of aphasia/aphemia in 1861, Brown-Séquard, although being a founding member of Broca’s Société d’Anthropologie, where the aphasia case was presented, made many observations that were not in agreement with the localization concept. He objected to the theory of circumscribed localization of functions in the brain, which prevailed at the time. He even warned against the use of the theory in brain surgery, which was emerging.⁷ He believed that many of his observations in humans and experimental animals could not be explained by the current of localization.

His own notion of localization was dynamic and based on the principles of distant action (action à distance), involving inhibition and excitation. (He called it dynamogénie. He probably coined the term dynamogénie, development of energy or power, in 1879, although he had come across the phenomenon itself when he performed his experiments on the spinal cord in 1840.) Irritation in one location of the nervous system may be transmitted to another part where it may change its function dynamically.

He presented this theory of “réseau de cellules anastomosées”(network of anastomized cells) in 1875 to the Société de Biologie. Cells serving the same function were supposed to be interconnected. Nerve cells endowed with any of the cerebral functions, instead of forming a cluster as is supposed, are disseminated through the whole encephalon, so that considerable alterations or destructive lesions can exist in one of the cerebral hemispheres, or in both, without the loss of voluntary movements of sensibility, or of any other brain function. Brown-Séquard defended his theories several times in papers and during meetings, including those at the Société de Biologie in the 1870s, where he debated with Charcot.

With this model, he was able to explain the fact that damage in several locations of the central nervous system may produce the same effect, and to account for observations that some functions remain unimpaired despite extensive brain injury.⁸ Based on these localization theories and new experimental findings, Brown-Séquard even withdrew the theory of crossed sensory action of the spinal cord in 1894,⁹ although he admitted that it remained valuable with respect to the clinical syndrome.

Although his arguments were not always valid, because they were sometimes based on imprecise observations, his dynamic model influenced “antilocalizers,” such as Friedrich Goltz, John Hughlings-Jackson and probably Constantin von Monakow and Charles Scott Sherrington. The theory is reminiscent of Sherrington’s later ideas. In fact, Sherrington referred to some of the ideas in 1893.¹⁰ One cannot claim that Brown-Séquard played a role in the development of modern network theories, yet one would wonder how interested he would have been reading about the relatively recent laws, to which all kinds of networks obey.^11,12

Endocrinology
In the last phase of his career, Brown-Séquard studied the effects of (animal) testicular extracts. It was not the first time he subjected himself to experimentation. He injected the extracts, hoping it would have a rejuvenating effect. Noticing positive effects, he started the production of the drug in cooperation with his assistant Jacques-Arsène d’Arsonval.

They offered extracts to colleagues, without charge, in order to let them try it on elderly patients. Brown-Séquard’s first presentation on the subject was before the Société de Biologie de Paris in 1889. Two years later, George Murray presented his ideas on the treatment of myxoedema with thyroid extracts from a sheep at a meeting in England.¹³ Probably as a consequence of Brown-Séquard’s claims, he was ridiculed, by a senior colleague who suggested this would be like treating locomotor ataxia with an emulsion of spinal cord. Although Brown-Séquard had serious intentions with his studies on this subject, introducing organotherapy in 1893, public reception was unfavorable, which harmed his reputation. Nevertheless, his contribution to endocrinology was acknowledged by several scientists, including the Swiss surgeon Theodor Kocher, who referred to him in his Nobel Award lecture of 1909. Brown-Séquard is still considered the father of endocrinology.

As events in science and medicine are often reflected in literature, Brown-Séquard may be recognized in the 20th volume of the Rougon-Macquart novel series by Emile Zola, Le Docteur Pascal. It is about the country physician Pascal Rougon, who made a genealogical tree of his own family with the purpose of studying heredity. He noted interesting details about his family members, proving that degenerative traits are inherited.

The concept of degeneration was a popular scientific issue at the end of the 19th century, following the degeneration ideas in psychiatry of Bénédict Augustin Morel and Valentin Magnan. Zola staged Rougon not just as a physician, but also as a scientist. He extracts sheep brains and injects the material into patients. Although considering himself to be successful at the beginning, he finally realized the placebo effect and turns to the injection of water. One day, experimenting with organ extracts, he is criticized by his relatives:
‘… il est encore a` sa cuisine du diable!’
[… he is still in his devilish kitchen…], referring to his home laboratory.^14, ¹⁵

Additional reading:

Michael J. Aminoff: Brown-Séquard: An improbable genius who transformed medicine. New York, Oxford University Press, 2011

References:

1 Koehler PJ. Brown-Séquard’s spinal epilepsy. Med Hist. 1994;38:189-203.
2 Koehler PJ, Endtz LJ. Between Magendie and Brown-Séquard: Isaäc van Deen’s spinal hemisections. Neurology. 1989;39:446-8.
3 Brown-Séquard CE. Recherches et expériences sur la physiologie de la moelle épinière. Paris, Rignoux, 1846
4 Koehler PJ, Endtz LJ. The Brown-Séquard syndrome. True or false? Arch Neurol. 1986;43:921-4.
5 Koehler PJ. Brown-Séquard’s comment on Du Bois-Reymond’s “hemikrania sympathicotonica”. Cephalalgia. 1995;15:370-2.
6 Koehler PJ. Brown-Séquard’s spinal epilepsy.Med Hist 1994; 38:189–203.
7 Brown-Séquard CE. The localization of the functions of the brain applied to the use of the trephine. Lancet 1877;107–8
8 Koehler PJ. Brown-Séquard and cerebral localization as illustrated by his ideas on aphasia J Hist Neurosci 1996;5:26–33.
9 Brown-Séquard CE. Remarques à propos des recherches du Dr. F.W.Mott sur les effets de la section d’une moitié latérale de la moelle épinière. Arch Physiol 1894; 26:195–8
10 oehler PJ.Brown-Séquard’s localization concept: the relationship with Sherrington’s “integrative action” of the nervous system. In: Rose, FC (ed): Neuroscience across the centuries. London, Smith-Gordon, 1989, pp.135–8
11 Stam CJ, Reijneveld JC. Graph theoretical analysis of complex networks in the brain. Nonlinear Biomed Phys 2007;1:3.
12 Koehler PJ. Book review essay: An improbable genius? On Michael J Aminoff’s Brown-Séquard: An improbably genius who transformed medicine. Brain 2011;134:1864-7.
13 Welbourn RB. The emergence of endocrinology. Gesnerus. 1992;49 Pt 2:137-50.
14 Koehler PJ. Charcot, la Salpêtrière, and hysteria as represented in European literature. Prog Brain Res. 2013;206:93-122.
15 Koehler PJ. About medicine and the arts. Charcot and French literature at the fin-de siècle. J. Hist. Neurosci. 2001;10: 27–40.

Peter J. Koehler is the editor of this history column. He is a neurologist at Zuyderland Medical Centre in Heerlen, The Netherlands. He is also co-editor of the Journal of the History of the Neurosciences. Visit his website at www.neurohistory.nl.

Hachinski Receives the Prince Mahidol Award in Public Health

Vladimir Hachinski, MD, receives the Prince Mahidol Award at the Grand Palace from Princess Maha Chakri Sirindhorn of Thailand. Also in attendance were Prime Minister Prayut Chan-ocha and Canada’s Ambassador to Thailand Donica Pottie.

Vladimir Hachinski, MD, past president of the World Federation of Neurology, received the Prince Mahidol Award in Public Health for “contributions to the treatment of stroke, vascular cognitive impairment, and brain/heart interactions.”

He received the award from Princess Maha Chakri Sirindhorn of Thailand. Also in attendance were Prime Minister Prayut Chan-ocha and Donica Pottie, Canada’s ambassador to Thailand.

The Prince Mahidol Awards are considered the Nobel Prize of Asia, primarily because a number of awardees have gone on to receive the Nobel Prize in Medicine and Physiology from Sweden.

Dr. Hachinski continues to be active in research and is working to advance the updated World Stroke Proclamation, calling for the joint prevention of stroke and dementia, endorsed by the World Federation of Neurology, the International Brain Research Organization, the World Psychiatric Association, the European Academy of Neurology, and 18 other international, regional, and national organizations. •

JNS Editor’s Update and Selected Articles

By John D. England, Editor-in-Chief

John D. England

One of the prime missions of the Journal of the Neurological Sciences is to highlight activities of the World Federation of Neurology (WFN). Along those lines, I wish to remind everyone that the XXIII World Congress of Neurology (WCN) will be held Sept. 16-21, 2017, in Kyoto, Japan. The Congress will be co-hosted by the Japanese Society of Neurology and the Asian and Oceanic Association of Neurology. The theme of WCN 2017 is “Defining the Future of Neurology.” The WCN will feature a series of programs and lectures led by leading scientists, clinicians, public health experts, and policymakers from around the world. Some of the cutting-edge topics will include gene therapy, stem/iPS cell medicine, brain-machine interface, and robotics in medicine. Traditional topics of neurology and neuroscience also will be presented. I encourage all of our readers to consider attending the meeting. Detailed information about XXIII WCN can be accessed at www.2017.wcn-neurology.com/.

In our effort to inform readers of important and interesting developments in the journal, the editorial staff has selected two new “free-access” articles for our readership. This issue’s selected articles deal with cardiac transplantation in Friedreich’s ataxia (FRDA). Although ataxia is the clinical hallmark of FRDA, cardiac disease is the leading cause of death. There is no known cure for the cardiomyopathy of FRDA, and its course is independent of the neurological manifestations. For these reasons, a few patients with FRDA and severe cardiomyopathy have undergone cardiac transplantation. The results have been generally positive.

Ashley McCormick and colleagues describe their experience and long-term follow-up of three patients with FRDA who underwent successful cardiac transplantation. Although each patient experienced progression of the neurological manifestations of FRDA, all maintained stable cardiac status several years post-transplant. The patients remain alive and socially engaged at five years, eight years, and 19 years post-transplant, respectively. The authors conclude that cardiac transplantation can be a reasonable treatment for patients with FRDA who develop end-stage cardiomyopathy.

Ashley McCormick, et al., Cardiac transplantation in Friedreich Ataxia: Extended follow-up, J. Neurol. Sci. 375 (2017) 471-473. http://www.jns-journal.com/article/S0022-510X(17)30028-X/fulltext?rss=yes

In an accompanying editorial, David Pleasure reaffirms that cardiac transplantation might be a viable option for selected patients with FRDA who have life-threatening cardiomyopathy. He points out that the transplanted hearts in these and other patients have shown no signs of cardiomyopathy, suggesting that the heart disease in FRDA is independent of its other manifestations. He also outlines potential future treatment interventions for the cardiomyopathy of patients with FRDA.

David Pleasure, New hearts for Friedreich patients, J. Neurol. Sci. 375 (2017) 474-475.

From the Editors

By Steven L. Lewis, MD, Editor
and Walter Struhal, MD, Co-Editor

Walter Struhal

Steven L. Lewis

We are very pleased to introduce the March/April 2017 issue of World Neurology. Much of this issue revolves around the educational activities of the WFN, starting with the article by Wolfgang Grisold, MD, and Steven Lewis, MD, who provide an update on the many and varied educational activities of the WFN and its partners. This issue also includes enthusiastic and vivid reports from several African neurologists who were recent participantsin the Neurology Department Visit programs in Germany, Norway, and Turkey. We would like to add our sincere thanks here to our partner societies who make these WFN/partner society department visits so successful and fruitful for everyone involved.

In his President’s Column, WFN President Raad Shakir, MD, provides a powerful proposition about the need for neurologists to work together, including educating the public, other providers, and our governments about the importance of brain health and systems of care delivery to combat brain diseases. We also report on the great honor recently bestowed on Vladimir Hachinski, MD, past president of the World Federation of Neurology, when he received the the Prince Mahidol Award in Public Health in Thailand. In his Editor-in-Chief’s Update from the Journal of the Neurological Sciences, the official journal of the WFN, John D. England, MD, describes his selected two new “free access” articles selected for the readership, which deal with the interesting issue of cardiac transplantation in Friedreich’s Ataxia.

In this issue’s history column, Dr. Peter Koehler provides a wonderful synopsis of the many contributions of Charles-Edouard Brown-Séquard (on the bicentennial of his birth), including but certainly not limited to, his eponymous syndrome. Finally, Prof. G. Logroscino and his colleagues from Italy and France report on the recent International Course of Neuroepidemiology, Clinical Neurology, and Research Methods in Low-Income Countries that took place in Phnom Penh, Cambodia.

We sincerely hope that you will enjoy the contributions in this issue, and, as always, we look forward to ongoing submissions on news of interest to neurologists around the globe. Please send any contributions to slewis@rush.edu. •

Cambodian Neurologists Participate in Research Methods Course

Prof. G. Logroscino
University of Bari, Italy
Prof. P.M. Preux
University of Limoges, France
Prof. B. Marin
University of Limoges, France
Dr. F. Boumediene
University of Limoges, France

Pierre Marie Preux

Giancarlo Logroscino

An intensive five-day course on research methods, with a focus on practice in low- and medium-income countries, was presented Feb. 7-11 in Phnom Penh, Cambodia. The course was developed to help Cambodian neurologists establish clinical and population-based research programs on topics of utmost interest, including epilepsy, stroke, dementia, and infectious disease.

“The International Course of Neuroepidemiology, Clinical Neurology, and Research Methods in Low-Income Countries” was organized by Prof. Giancarlo Logroscino, from the University of Bari; Prof. Pierre Marie Preux, Dr. Farid Boumédiene, and Prof. Benoît Marin, all from the University of Limoges; and Prof. Chan Samleng, president of the Cambodian Society of Neurology and chair of Neurology at the University of Health Sciences of Phnom Penh.

Farid
Boumédiene

Benoît Marin

The course was made possible through the support of a World Federation of Neurology (WFN) Grant in Aid 2015, and supplemented by grants from the University of Bari and the University of Limoges.

Cambodia is experiencing a transition characterized by a rapid increase in life expectancy and of chronic diseases. In this context, neurology plays a major role within medicine but has to change perspective on education, clinics, and research.

The course was held at the University of Health Sciences of Phnom Penh. The faculty were Prof. Logroscino, Prof. Marin, and Dr. Boumediene. It was attended by 14 of 16 members of the Cambodian Neurological Society (eight neurologists out of nine). Also attending were 14 students of the School of Medicine, selected by the faculty.

The course faculty met with the dean of the University of the Health Sciences and the chair of medical affairs of the Calmette Hospital. Both praised WFN for its support and asked for the development of new courses on research and on new developments of specific sectors of clinical neurology.

The chair of medical affairs expressed interest in a course developed specifically for the heads of the clinical departments to provide basic epidemiologic skills through a short seminar series. The general director of the Calmette Hospital also announced his goal to create a clinical research unit.

The course was characterized by great enthusiasm and a high level of interaction between attendees and the faculty. Pre-course and post-course evaluations of the attendees’ skills in epidemiology were performed. Scores improved 4-10 points between the pre- and post-course evaluations.

A satisfaction survey was performed. Attendees reported:

a high level of satisfaction
an adequate course level
a wish to progress to other courses at higher levels
a longer period of teaching

The course concluded with a discussion between the faculty and the neurologists of the Cambodian Neurological Society. Because two programs on the epidemiology of epilepsy are being presented by the Cambodian Neurological Society and the University of Limoges, discussion was focused on other diseases, particularly research prospects in the fields of stroke and dementia.

An additional theme has been proposed for future courses: amyotrophic lateral sclerosis. This last area has been proposed because of the paucity of epidemiological and clinical data from Asian countries, with the exception of Japan.

Prof. Samleng called for the Cambodian Neurological Society to collaborate with the WFN in the future.