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WFN Targets Advocacy and Teaching in 2025

A preview of upcoming WFN projects and goals this year.

By Prof. Wolfgang Grisold

Welcome to the new edition of World Neurology, the newsletter of the World Federation of Neurology (WFN). Since the last issue, several projects have been announced and are forthcoming.

The deadline for applications for WFN trustee positions ended Feb. 14, 2025, and the Nominating Committee has listed the candidates for the positions of president, vice president, and one trustee. The list of nominees, short biographies, and statements from the candidates can be found in this issue as well as on the WFN website.

According to the bylaws, additional candidates supported by any of the five member societies can apply for any position until one month before the election. The election will be held virtually. The date and deadline will be announced on the WFN website. We look forward to interested and motivated candidates who will work for the WFN in the future. Traditionally, the trustees are not involved in the process of recommendation.

Individuals with experience in the tasks of the WFN will be welcomed to apply, and their expertise is needed. Information on the work of the WFN can be found on the WFN website, the WFN essentials page, and the newest Journal of the Neurological Sciences (JNS) Service Page.

The main WFN activities can be summarized by two letters: A and T. A is for advocacy and global activities, and T is for teaching and training.

Advocacy

Dr. Tedros Adhanom Ghebreyesus (left), director general of the WHO at the Geneva meeting 2025, pleading for more attention for emergency activities.

Advocacy for neurology is a growing part of the WFN’s activities. The importance of advocacy is implemented in the World Health Organization’s (WHO) Intersectoral Global Action Plan (IGAP). It is the core of WFN’s activities to communicate and work with the WHO and the U.N. Economic and Social Council (ECOSOC).

We need to increase the teaching of advocacy at all levels of health services. In addition to the WFN patient forums, we have a joint project with the American Academy of Neurology (AAN), the Global Advocacy Leadership Program (GALP), which will be presented for the first time this year at the AAN Annual Meeting, the World Congress of Neurology (WCN), and virtually.

The WHO’s brain health initiatives and the IGAP are supported by the WFN. The WFN community of neurologists considers the IGAP a unique opportunity to implement neurology in countries in need, to encourage all countries to invest in research and innovation, and to engage more in public health.

The U.N. ECOSOC is well defined by the 17 Sustainable Development Goals (SDGs). In particular, SDG 3 (good health and well-being) and SDG 5 (gender equality) are important for the WFN. Health is a central, but not the only, component of the work of the U.N. ECOSOC. We are appreciative that the U.N. ECOSOC will support this year’s World Brain Day (WBD) on brain health.

The GALP is a unique project of the WFN and AAN to increase awareness of the need for advocacy and to teach both advocacy and leadership skills. The course has many elements of the successful AAN Palatucci Advocacy Leadership courses and will add several topics of global relevance.

Twenty people from low-middle and low-income countries were selected from 100 applicants and will be fully supported to attend. After a face-to-face meeting, which took place at the AAN Annual Meeting in April in San Diego, the participants will attend a series of five virtual meetings and a final meeting and graduation at the World Congress of Neurology in October in Seoul, South Korea. Also, both the AAN and the WFN will waive the congress fees, so that participants may attend both meetings.

Prof. El Alaoui (left) studies the recognition certificate for the Training Center in Rabat during the WFN site visit. Prof. Nahzda Birouk (center), incoming Training Center chair, looks on with Prof. Wolfgang Grisold, WFN president.

Teaching

The educational activities of the WFN have included a visit to all Training Centers in Africa. A visit to Mexico City is planned for this year. In addition to the numerous reports, the African Training Centers received an analysis summary of the site visits, and we hope to continue this important activity.

The financial burden of the Training Centers is almost entirely on the WFN, although we have help from the Association of British Neurologists (ABN) for the Training Center in Cairo, and our successful Specialty Group at the International Congress on Neuromuscular Diseases regularly supports a large number of trainees in Rabat on electrophysiologic and neuromuscular training.

In related news, Prof. Nahzda Birouk will take over responsibilities from Prof. El Alaoui as chair of the Training Center in Rabat. We thank Prof. El Alaoui for his longstanding support and merits from the WFN.

Watching the results from the EMG machine during the WFN site visit in Rabat.

There are three four-year trainees in Africa and five one-year fellowships in Africa (general neurology, neuromuscular, epilepsy, and stroke). In Mexico City, we have a one-year fellowship on stroke. This is a large number for the WFN, but only a small crystal to offer for the 1.4 billion inhabitants on the African and Central and South American continents. However, crystals grow at various speeds, from minutes to many years.

Over the last 10 years, the North African centers, along with Senegal and Cape Town, have trained additional people. Several African universities are also poised to take up neurology training. This emphasizes the need for, and the increasing efforts of, training in Africa for Africans. “Empower the regions” is not just a concept; it is producing powerful teaching instruments, which will have long and enduring effects.

Cynthia Marleny Aliñado Ramos, the present WFN trainee, at the Training Center in Mexico City.

The increase in the number of neurologists is hoped to be exponential. This is only the peak of a needs pyramid, requiring other health care professionals, structures such as labs, imaging, testing, and inpatient and outpatient facilities, and access for all in need.

Although trained neurologists are forming the top level of that pyramid, there is also the model of the inverted pyramid, which on its large base has the most frequent and most important content. Seeing and appreciating the large needs for neurology, our effort must be directed toward implementing neurological care and knowledge into primary care. Increasing awareness of the most frequent neurological symptoms and signs, as well as the most frequent neurological diseases, will be important.

Education Days

Figure 1: Word bubble from the participants of the AOAN Education Day with requests for future topics.

Education and teaching have been successfully achieved with the most recent Education Day, held jointly with WFN, the Asian and Oceanian Association of Neurology (AOAN), and the Movement Disorders Society (MDS). The quality of the course was excellent, and the topics were of worldwide importance. We had a record number of registrants, and more than 1,000 participants. We will continue to partner with AOAN on more Education Days in the future.

The past series of Education Days, which were held over several years with the International Headache Society (IHS) and the Global Patient Advocacy Coalition (GPAC) were also successful. The most recent African Education Day on neuropathies was held in 2024. The preparation, organization, and financing of these events is an important task of the WFN, which needs strong cooperating partners.

World Brain Day (WBD)

World Brain Day 2025 will feature the topic of brain health, which seems to be attracting attention worldwide. The full wording of this year’s theme is “Brain Health for All Ages.” This wording concurs with the United Nations SDG3 (good health and well-being) and is a fundamental part of healthy living. It will increase attention toward disease groups in different age groups and regions.

There is also a great divide between communicable and noncommunicable diseases (NCDs). Despite the global increase of NCDs, infections worldwide still present a challenge, which is often underestimated. The lessons from the COVID-19 pandemic concern all of us, and we can see that the WHO prepares and invests in emergency structures for the future.

World Congress of Neurology (WCN)

A successful Coffee Talk at the WCN 2023 in Montreal. Left to right: Ashley Logan (moderator), WFN President Prof. Wolfgang Grisold, with WFN past presidents Prof. Vladimir Hachinski, Prof. Bill Carroll, and Prof. Raad Shakir.

WCN 2025 will take place Oct. 12-15 in Seoul, South Korea. We are grateful to the Korean Neurological Association (KNA) and to the region for supporting this important showcase for neurology in Asia.

Asia is large in geography and population, and access to neurology varies in many countries. The WCN is not only intended to discuss developments and updates, but will also have a series of brain health topics, including plenary lectures, dedicated global lectures, and regional lectures. These topics are dedicated to global health, indicating the important role for neurologists to increase and add to their activities.

The WCN will also have five plenary lectures, with topics ranging from the importance of the WHO to advances in the concept of senescence. Several joint sessions are planned with world neurological societies such as the WHO, MDS, International League Against Epilepsy (ILAE), and the Peripheral Nerve Society (PNS).

A look at the future stage for Coffee Talks at the WCN 2025 in Seoul.

Much attention is dedicated to the Teaching Course program. Similar to the WCN in Montreal, we will expand our interactive programs, which will be a series of “coffee talks.” We will also feature a program on Continuum, and include young neurologists from the region. We will continue the concept of a hybrid meeting as the participation in the hybrid form was great, and we had a reach of 135 countries. Costs for hybrid attendance will be kept low to allow participants from low-middle and low-income countries to participate.

There will be social programs and opportunities to network and sightsee in Seoul.

Publications

It is the determination of the WFN to be heard in as many forms of publication as possible. The WFN website provides information on the structure and substance of the WFN. It is also used for news and information distribution. This is supported by our social media feeds, where the WFN teams post information.

World Neurology is the active newsletter, collecting articles worldwide. It is free to download and also offers access to the World Neurology archive. The official journal of the WFN is the Journal of the Neurological Sciences (JNS), with John England as the editor-in-chief, and the eNS with Walter Struhal as the editor-in-chief.

For the JNS, we are adding quarterly Service Pages, and the eNS now has 10 articles from the WFN Digital Update (WNU) course available as open access.

We are working on a collective book on neurology called the White Book of Neurology. It will be edited by Prof. Alla Guekht, Steven Lewis, Prof. Riadh Gouider, and myself, and will be published by Springer. The idea is to delineate and describe the present structure of neurology, from the historical development toward the future.

Monthly Google Analysis

The monthly Google analysis shows an increase in followers and interested colleagues and parties. We want to thank our constantly leading countries — the U.S., India, and Great Britain — for their interest. •

The Brain House at Davos 2025

Advancing brain health and economic resilience.

Prof. Freedman attended this meeting on behalf of the WFN.

By Morris Freedman

(Left to right): Prof. Morris Freedman, George Vradenburg, and Dr. Alfred Njamnshi.

The launch of the Brain House was held in conjunction with the World Economic Forum in January 2025 in Davos, Switzerland. It was hosted by the Davos Alzheimer’s Collaborative (DAC) under the leadership of George Vradenburg, chair of the DAC and founder of Brain House. Co-organized by Harris Eyre, who leads the Baker Institute Neuro-Policy Program at Rice University, Brain House served as a global platform to highlight the critical link between brain health and economic growth. I attended on behalf of the World Federation of Neurology (WFN) as a trustee and treasurer.

Brain health is a key priority for the WFN, as demonstrated by its strong global engagement and advocacy efforts. Over the past four years, the WFN has dedicated consecutive World Brain Day campaigns to the theme of brain health, highlighting its critical role in overall well-being. These initiatives have focused on brain health for all, prevention, and disability, with this year’s theme being Brain Health for All Ages.” Through international collaboration, communication, and knowledge exchange, the WFN continues to promote brain health as a global concern, aligning with initiatives such as the Brain House at Davos to further drive awareness and action.

The event featured six expert-led sessions, bringing together stakeholders from diverse sectors — including funders, policymakers, industry leaders, nongovernment organizations (NGOs), and foundations — to discuss strategies for enhancing brain health and driving systemic change on a global scale. The Brain House aimed to build a global coalition to lead transformative efforts, explore the intersections between brain health and economic resilience, and mobilize resources and innovation to address shared challenges. Throughout the discussions, the role of partnerships and research in achieving these goals was emphasized.

Much of the discussion centered on prevention and early detection of cognitive impairment. However, during one of the discussion periods, I had the opportunity to emphasize that brain health encompasses the full spectrum of cognitive function — from normal cognition to severe dementia — with the goal of maximizing function at all stages. Thus, we must include individuals who are beyond the stage of prevention and early detection (i.e., those who already suffer from dementia) in our efforts to promote brain health worldwide.

Brain Capital and the Brain Economy

A recurring theme throughout the conference was the concept of brain capital, a form of human capital that integrates brain health with essential cognitive, emotional, and social skills, including analytical thinking, creativity, adaptability, and empathy. Closely related is the concept of the brain economy, an economic paradigm that positions brain capital as a core asset. This model, driven by advances in neuroscience, responds to the increasing demand for cognitive, emotional, and social brain skills in the modern workforce.1,2

(Left to right): Dr. Zul Merali, Dr. Harris Eyre, Dr. Alfred Njamnshi, and Dr. Morris Freedman.

Key Sessions

Session 1 | A Life Course Approach to Brain Health for the Future

This session explored how employers, consumers, governments, and investors can foster innovation across sectors and societies, promoting best practices and actionable models for progress. Dr. Catharina Boehme, assistant director-general of the World Health Organization (WHO), opened the panel discussion by presenting a report prepared by WHO Director-General Dr. Tedros Adhanom Ghebreyesus.

The report underscored the global challenge posed by aging populations, with over three billion people affected by neurological diseases. Given that nearly 50% of dementia cases are attributable to known modifiable risk factors, the report advocated for a life course approach to dementia prevention. Key recommendations included promoting maternal health, good nutrition, quality health care access, early education, and nurturing environments. It also emphasized the importance of a healthy workplace, access to mental health services, physical activity, social interaction, and managing risk factors such as hypertension and diabetes.

The report also outlined the WHO’s priorities, urging policymakers, industry leaders, health care providers, and innovators to champion brain health, educate communities on its significance, and foster lifelong learning and social connections.

Session 2 | Fueling Brain Health: The Innovation and Investment Imperative

The discussion emphasized the urgent need for innovation and investment in brain health to drive sustainable progress. Experts highlighted the importance of collaboration and the opportunity to leverage the convergence of emerging technologies.

Session 3 | Unlocking Global South Potential: Building Economic Resilience Through Brain Health

This session explored how brain health can strengthen economic resilience in the Global South, with a focus on Africa. Zul Merali, founding director of the Mind and Brain Institute at Aga Khan University, highlighted that Africa’s older population is growing rapidly and is expected to become one of the largest aging populations in the world.

Session 4 | Brain Resilience Strategies for Emerging Global Challenges

Panelists discussed strategies to enhance brain resilience in response to global challenges, including an aging population. They highlighted that most dementia cases over the next 50 years will arise in regions such as Africa, the Middle East, and Asia. The discussion also underscored the importance of implementing brain resilience strategies early in life to maximize their effectiveness.

Session 5 | Brain Capital: Unlocking Workforce Resilience and Long-Term Economic Growth

This session emphasized the vital role of brain capital in fostering workforce resilience and long-term economic growth. The discussion underscored the growing importance of investing in brain capital amid evolving global trends, including an aging population, shifts in the nature of work, the rising burden of neurological disorders, and an increasing understanding of early brain development.

Session 6 | Setting a Yearlong Course of Action: Launching a Global Brain Health Movement

As chair of this final session, George Vradenburg, chair and co-founder of UsAgainstAlzheimer’s, emphasized the pressing challenges posed by aging demographics and the rapid rise of chronic diseases associated with aging. He highlighted the economic burden of these conditions, projecting that associated costs will triple within the next 25 years.

Vradenburg also underscored the shrinking workforce due to declining birth rates and stressed the need to enhance brain resilience to improve productivity. He advocated for a strong focus on the Global South, where population growth will drive much of the world’s future economic expansion. He further emphasized the importance of integrating technology into brain health solutions in ways that are accessible and applicable in resource-limited settings.

Drawing a parallel to the global response to COVID-19, Vradenburg called for similar energy and commitment in tackling the pandemic of brain disorders.

Claudio Bassetti, past president of the European Academy of Neurology and vice chair of the European Brain Council, was another panelist during this final session. He indicated that next steps for advancing the goals of the Brain House include partnerships, a holistic approach, and setting priorities.

Watch videos of the sessions.

Conclusion

The Brain House served as a pivotal platform to underscore the indispensable link between brain health and economic security. By bringing together leaders from government, health care, academia, business, and advocacy, the event facilitated interdisciplinary discussions to shape comprehensive strategies for improving brain health globally. •


Prof. Morris Friedman is treasurer of the WFN.

References:

  1. Eyre HA, Ayadi R, Ellsworth W, et al. Building brain capital. Neuron 2021;109:1430-1432.
  2. Smith E, Ali D, Wilkerson B, et al. A Brain Capital Grand Strategy: Toward Economic Reimagination. Molecular Psychiatry 2021;26:3-22.

Brain Health Is Brain Wealth

Greater productivity, resilience, and well-being at the 2025 World Economic Forum.

Disclaimer: We thank Prof. Njamnshi and his co-authors for this report and detailed plans for future directions. This article represents the opinions of the authors and does not represent an official report of the WFN.

By Alfred K. Njamnshi, Harris A. Eyre, Zul Merali, Frédéric Destrebecq, Kristina Adorjan, and Claudio L. A. Bassetti

The launch of the Yaoundé Declaration on World Brain Day 2024 by SCAN, BRAIN, and the Technical Scientific Committee.

It has taken some time, but we have finally recognized that the brain is not only the most vital organ in the body — since anencephaly is incompatible with life — but that it is the seat of who we are as humans. What we do, feel, believe, aspire, and hope for, including a better socio-economic paradigm, is governed by the brain. Indeed, our brains carry the footprint of our past, present, and future, defining both our heritage and our legacy.

The officiating personalities with some members of the Cameroon government present at the endorsement ceremony for the Yaoundé Declaration.

Since the inaugural World Brain Day (WBD) on July 22, 2014, the World Federation of Neurology (WFN) has been celebrating the brain each year to raise global awareness about its vital importance.1 The celebration of WBD has been expanded in some parts of the world to a full week of activities focused on the brain. Brain Week in Cameroon and Africa (BWCA)2,3 by the Society of Cameroonian Neurologists (SCAN) and Brain Research Africa Initiative (BRAIN) is one example.

As part of the BWCA, the first “African high-level science summit on the brain economy, brain health, and brain capital” was organized on July 22 and Aug. 22, 2024, and the resulting Yaoundé Declaration on the brain economy, brain health, and brain capital was launched on World Brain Day 2024. The deliberate choice of this date for this official launch was to align with the vision of the WFN to further celebrate the brain and mobilize more stakeholders and partners around the world to do the same. The Yaoundé Declaration, the Swiss Brain Plan, and other regional and national initiatives have since been discussed at multiple meetings. These include:

The World Economic Forum (WEF) is held annually in Davos, Switzerland, with a mission to “bring together government, businesses, and civil society to improve the state of the world.” One of the standout innovations of the WEF this year was the launch of the Brain House, a groundbreaking concept introduced by the Davos Alzheimer’s Collaborative (DAC), under the leadership of George Vrandenburg.

The endorsement of the Yaoundé Declaration by the Cameroon Government on Aug. 22, 2024 (left to right): Messi Atangana Luc, mayor of Yaoundé City, Prof. A.K. Njamnshi, Naseri Paul Bea, governor of the Center Region of Cameroon, Prime Minister Dr. Joseph Dion Ngute, Prof. J. Fame Ndongo, minister of higher education, Prof. R.M. Etoua, rector, Yaoundé I University, and Prof. S.B. Chumbow, president of the Cameroon Academy of Sciences.

As to the connection between our brains and economic growth, health, and well-being, the DAC report states:

“At this year’s Davos gathering, DAC introduced the first-ever Brain House to spotlight the vital link between brain health and global challenges. Kicking off with an inspiring reception Monday evening, the event continued Tuesday with two standing-room-only panels on Life course and Investment…The history of economic growth is defined by breakthroughs that led to previously unimaginable productivity. From the steam engine that kicked off the Industrial Revolution to the transformation AI is driving today, key breakthroughs are constantly reshaping our world. We believe the next key breakthrough isn’t a tool, process, or technology. We believe it already exists in all of us — our brains. We believe by better understanding our brains, and by extension our motivations, needs, and natures, we’ll unlock the next great breakthrough. The Brain House exists to expand this pursuit beyond the halls of academia and medicine and center it in the world of capital markets and innovation needed to create a healthier, more resilient, and a more productive future.”

With this background, it is easy to understand why a Forbes article captured the spirit of Davos 2025 in these words: “Brain Health Emerges as Top Priority at Davos.” In the next paragraphs, we will attempt to summarize the main themes and highlights of the three-day experience at the Brain House in Davos WEF 2025. We will hopefully convey the urgent need for neurologists to engage and connect with other stakeholders, as we all seek “to foster neurology and brain health worldwide,” according to the WFN mission statement.

Day One

Participants at DAC Brain House launch at 2025 World Economic Forum in Davos, Switzerland. (Left to right): Prof. Zul Merali of the Brain & Mind Institute, Dr. Harris Eyre of the Brain Capital Alliance, Prof. Alfred K. Njamnshi, Prof. Morris Freedman, WFN representative, and Dr. Frederic Destrebecq of the European Brain Council.

One of the major highlights of day one of the DAC Brain House on Jan. 21, was the keynote speech written by Dr. Tedros Adhanom Ghebreyesus, World Health Organization (WHO) director general, and delivered by Dr. Catharina Boehme, WHO assistant director general:

“…prioritizing brain health for ourselves, for our families, and our communities across the life course, we can build a healthier, more resilient society for generations to come…Investing in brain health is critical to individual well-being as well as to the sustainable development of all humans…our one brain is the source of creativity, resilience, and human relationships.”

This speech opened the panel presentation and discussion titled “A Life Course Approach to Brain Health for the Future.” This perspective from a major WFN partner organization, especially given the recent adoption of the WHO Intersectoral Global Action Plan (IGAP), aligns with the WFN mission.

The second panel discussion of the day focused on “Fueling Brain Health: The Innovation and Investment Imperative.” It became evident that the brain health sector has not only emerged as a critical area for innovation, it is being recognized as a major sector for investments aimed at better productivity and well-being. This recognition will continue if current challenges are addressed.

Day Two

(Left to right): George Vradenburg, Lucy Pérez, Cara Altimus, Christa Studzinski, Claudio Bassetti, and Harris Eyre.

On day two, Jan. 22, the panel discussions focused on two themes.

The first panel was titled “Unlocking Global South Potential: Building Economic Resilience Through Brain Health.” The panelists represented esteemed organizations such as the WHO Foundation, Institute for Health Metrics and Evaluation, Wellcome Trust, and the Aga Khan University Brain and Mind Institute. They shared their insights on the future of brain health in the Global South, with a particular focus on Africa.

Africa is innovating in cheap, effective, and scalable solutions to brain health problems. One such solution is the Friendship Bench — a community-driven approach to mental health care originally developed and scientifically tested in Zimbabwe. This approach has been adapted by several countries around the world, including the Jordan, Kenya, Malawi, United States, Vietnam, and Zanzibar.

The audience for “A Life-Course Approach to Brain Health for the Future.”

Zul Merali presented the concept of “brainectome” as a consortium to address brain health issues across Africa. Prof. Alfred K. Njamnshi emphasized that the upcoming G20 Summit in South Africa later this year would provide an excellent opportunity for the summit leaders to be convinced to buy into and invest in brain health for the socio-economic development and well-being of Africa and the Global South in general. This would bring the region into alignment with the Yaoundé Declaration.

The issue of brain drain from the Global South was also discussed in the context of a new brain economy, which should be more brain positive, ensuring more diversity and less disparity. One favorite quote of the day by Byron Bitanihirwe from the Science for Africa Foundation was, “True progress lies in the Global North learning from the Global South’s experiences and innovations.”

In the second panel discussion of the day, “Brain Resilience Strategies that Address Emerging Global Challenges,” there was a lot to learn from experts in venture capital, neuroscience, neurotechnology, and academia. There was encouraging news about venture capital mechanisms and state governments investing significantly in university institutions in Houston and Rice (U.S.) for the development of neuroscience, neurotechnologies, and neuropolicies. These are expected to address the emerging global challenges and promote brain resilience.

Day Three

Panelists at the session titled “A Life-Course Approach to Brain Health for the Future.”

The third and last day, Jan. 23, was devoted to two conversations. The first was titled, “Brain Capital: Unlocking Workforce Resilience and Long-Term Economic Growth.”

Brain capital, simply put, is brain health plus brain skills. Some have qualified these as “soft” skills, including creativity, adaptability, emotional intelligence, and analytical and systems thinking.

The Brain Capital Dashboard defines it as: “a complex and productive stock composed of multidimensional factors that accumulate over the lifecycle. We consider brain capital as a multidimensional set of factors varying from physical to socio-cultural ones, enabling the brain to remain healthy, to develop, and to avoid deterioration.” It identifies key drivers of brain health (i.e. neurological and mental health), including food and nutritional security, lack of parental health care and general health services, the natural and cultural environments, and education.

Panelists at the session titled “Brain Resilience Strategies That Address Emerging Global Challenges.” (Left to right): George Vradenburg, Lucy Pérez, Cara Altimus, Christa Studzinski, and Claudio Bassetti.

The conversations on this theme at the Brain House focused on how employers and organizations can prioritize brain health and provide a workplace environment and culture that promotes brain health and the development of brain skills. That environment will, in turn, lead to better productivity while mitigating work-related stress, burnout, and depression. In that respect, lessons from the COVID-19 pandemic should not be forgotten or ignored.

This approach of unlocking work-force resilience and providing a brain-healthy environment for employers to continue to sharpen their brain capital would result in long-term economic growth and greater well-being. We have proposed ways of understanding the economy through neuroscience and how to transit into a more brain-healthy economy and build brain capital.7,8,9,10

The final event of the historical week was a vibrant roundtable, “Setting a Yearlong Course of Action,” moderated by George Vradenburg with interventions from Lucy Pérez, senior partner at McKinsey, Christa Studzinski of the Ontario Brain Institute, Caral Altimus of the Milken Institute, and Claudio Bassetti of the Swiss Brain Health Plan and the European Brain Council.

Panelists for the session titled “Brain Capital: Unlocking Workforce Resilience and Long-Term Economic Growth.” (Left to Right): Lucy Pérez, Tim Lash, Sheri Bronstein, Patrick Kennedy, and Steve Clemons.

The participants discussed the key actions necessary in the next 12 months to accelerate the ascension of the brain health agenda into major global conversations. These include the G7 in Canada (June 2025) and G20 Summit in South Africa later this year.

The following statements illustrate the ambiance of the day and indeed of the whole experience of the Brain House at Davos 2025:

  • Lucy Pérez, McKinsey Health Institute: “Public private partnerships are the key to aligning on our collective aspiration and driving systems change.”
  • Claudio Bassetti, EBC-vice president and chair of the Swiss Brain Health Plan: “One brain, one life, one approach: We need to join forces to make brain matters a public health priorities.”
  • Amy Kennedy, The Kennedy Forum: “Businesses introduced STEM into schools by highlighting the skills they needed. Now, it’s time for businesses to tell the education system that we need to invest in developing brain skills from an early age.”
  • Andy Moose, World Economic Forum: “Collaborative innovation is the theme this year and coming together physically and virtually under this common umbrella is critical. This allows us to do the work together to catalyze funding and find solutions.”
  • Sheri Bronstein, Bank of America: “Our health care costs amount to $2 billion. Every quarter, our CFO asks, ‘What are we doing about this?’ That’s why we prioritize brain health — it directly impacts our bottom line.”

In Conclusion

The three-day experience of the DAC Brain House provided everyone with a valuable opportunity to connect with business professionals, learn from their insights, and ultimately discover their genuine concern for our well-being and brain health. As neurologists, neuroscientists, and psychiatrists, we are focused on diagnosing and treating people with brain (neuropsychiatric) diseases and helping populations to have healthy brains as much as we can. We often are limited by the scarcity of resources, especially in the lower- and lower-middle income countries, and are devastated by the waste of resources in some high-income countries.

This three-day interaction with policy and lawmakers, business strategists, economic investors, communicators, innovators, academics, and civil society enabled us to understand the complexities as well as the commonalities that can be leveraged to get the brain health movement to the next gear. •


Alfred K. Njamnshi, MD, FRCP, is the World Federation of Neurology delegate for Cameroon, a member of the Society of Cameroonian Neurologists (SCAN), a convener of the 2024 Brain Research Africa Initiative (BRAIN), and serves in the Neuroscience Lab in the Faculty of Medicine & Biomedical Sciences at the University of Yaoundé I, in Cameroon. Harris A. Eyre, MBBS, PhD, is a Harry Z. Yan and Weiman Gao senior fellow in brain health and lead of the Rice University’s Baker Institute Neuropolicy Program at the Center for Health and Biosciences, a visiting senior fellow at the Wharton Neuroscience Initiative at the Wharton School, University of Pennsylvania in Philadelphia, and founder and director of Brain Capital Alliance. Zul Merali, PhD, is founding director of the Brain and Mind Institute at Aga Kan University in Nairobi, Kenya. Frédéric Destrebecq, PhD, is executive director of the European Brain Council in Brussels, Belgium. Kristina Adorjan, MD, is on the Board of Directors for the Swiss Brain Health Plan and serves on the faculty of medicine at the University of Bern, Switzerland. Claudio L. A. Bassetti, MD, is chair of the Swiss Brain Health Plan and dean of the Faculty of Medicine at the University of Bern, vice president of the European Brain Council, and past president of the European Academy of Neurology. •

References:

  1. https://wfneurology.org/world-brain-day-2014.
  2. Njamnshi AK; Migraine in Cameroon: From the Painful Truth to the Powerful Tribute. World Neurology, September 11, 2019; https://worldneurologyonline.com/article/migraine-in-cameroon-from-the-painful-truth-to-the-powerful-tribute/.
  3. Njamnshi AK, Ngarka L, Njamnshi WY, Ahidjo N, Chabwine JN, Hachinski V; BRAIN-SCAN Congress 1.5 Scientific Committee and Organising Secretariat. The Brain Research Africa Initiative (BRAIN). Lancet Neurol. 2023 Jun;22(6):467-468. doi: 10.1016/S1474-4422(23)00164-3. PMID: 37210092.
  4. Njamnshi AK, Fame Ndongo J, et al. African Leadership in Brain Diplomacy: The Yaoundé Declaration Advances the Global Brain Economy Playbook for Better Brain Health. Neuroscience 2024 https://papers.ssrn.com/sol3/papers.cfm?abstract_id=5018989.
  5. Bassetti CLA, Heldner MR, Adorjan K, et al. The Swiss Brain Health Plan 2023-2033. Clin Translat Neurosci 2023; 7: 38: https://doi.org/10.3390/ctn7040038.
  6. Bègue I, Flauhaut A, Bolon I, Vicedo A.M., Bassetti CLA. One brian, one mind, one helath, one planet: A call from Switzerland for a systemic approach in brain health research, policy and practice. Lancet Public Health 2025; 50: 101229.
  7. Harris A. Eyre, Jennie Z. Young, Julian Karaguesian, Alfred Njamnshi, et al. The Brain Advantage for a Thriving Economy: A Global Call to Action. https://sciencepolicy.ca/posts/the-brain-advantage-for-a-thriving-economy-a-global-call-to-action/ (Preparatory Workshop to the G7 Summit in June 2025).
  8. Eyre HA, Hynes W, Ayadi R, Swieboda P, Berk M, Ibanez A, Castelló ME, Jeste DV, Tempest M, Abdullah JM, O’Brien K, Carnevale S, Njamnshi AK, Martino M, Mannix D, Maestri K, Yu R, Chen S, Ng CH, Volmink HC, Ahuja R, Destrebecq F, Vradenburg G, Schmied A, Manes F, Platt ML. The Brain Economy: Advancing Brain Science to Better Understand the Modern Economy. Malays J Med Sci. 2024 Feb;31(1):1-13. doi: 10.21315/mjms2024.31.1.1. Epub 2024 Jan 15. PMID: 38456111; PMCID: PMC10917588.
  9. Olivia Nail-Beatty, Agustin Ibanez, Rym Ayadi, Pawel Swieboda, Alfred K. Njamnshi, Jo-An Occhipinti, et al. Eyre Brain health is essential for smooth economic transitions: toward socio-economic sustainability, productivity, and wellbeing. Brain Communications, 2024 Oct 30;6(6):fcae360. doi: 10.1093/braincomms/fcae360. PMID: 39670109; PMCID: PMC11635447, https://doi.org/10.1093/braincomms/fcae360.
  10. Eyre HA, Graham C, Njamnshi AK and Vradenburg G. 4 Ways to make our economy brain healthy. The Brookings Policy Paper Series; 2024 https://www.brookings.edu/articles/4-ways-to-make-our-economy-brain-healthy/.

Candidate Statement for WFN Elected Trustee: Chandrashekhar Meshram

Meshram

I am grateful to the Indian Academy of Neurology and the World Federation of Neurology (WFN) for considering me worthy for the position of elected trustee.

I am indebted to WFN for giving me the opportunity to serve as co-opted trustee, elected trustee, and president of the Tropical and Geographical Neurology Specialty Group (TGNSG). In these roles, I have contributed to the mission of WFN: fostering quality neurology and brain health worldwide. Through TGNSG, I organized 16 webinar sessions on neuro-infections and gave opportunity to trainees from different regions of the world to sharpen their clinical skills. The series “Inspiring People in Neurosciences” was a step in the same direction.

I contribute timely updates for the “Spotlight on COVID and Current Global Neuro-Infections” blog on the WFN website. I was instrumental in starting the WFN Department Visit program in India. In 2024, the president of India conferred on me Padma Shri, one of the highest civilian honors in India.

I have served as a member of the Constitution and Bylaws and Scientific Program Committees. I am a member of the Infectious disease panel of the European Academy of Neurology. I am section editor of the Encyclopedia of Neurological Sciences and assistant editor of eNeurologicalSci.

World Brain Day is the most eminent public awareness initiative of WFN. As part of that initiative, I organize public education campaigns throughout the year. I have published about 500 articles for public education, including several in World Neurology.

WFN is making every attempt to take care of inequality in neurology care and education worldwide, and I am committed to addressing it. Collaboration with WHO and other societies is important for brain health. My passion to work for the WFN is the main reason I am standing for the post of elected trustee. I would be grateful for your support. •

The Use of Telemedicine Devices and Telehealth in Neuromuscular Disease

The expansion of telemedicine use in NMDs and development of clinically relevant but easy-to-use remote monitoring systems has potential to improve patient access to expert care.

M. S. Damian, MD, FEAN, FNCS, and Prof. P. Laforet, MD, PhD

Patients with neuromuscular disorders (NMDs) have diverse and complex care requirements, typically served by highly specialized centers. However, these may be geographically remote, and the COVID-19 pandemic underlined the system’s fragility by leading to widespread suspension of diagnostic, support, and rehabilitative services.1 Cancelled routine visits and limited outreach resulted in morbidity and even deaths. The demand for telehealth and remote care to help resolve this situation increased. This article describes the concept and current options using telemedicine in the care of people with NMDs.

Telemedicine in NMD at the Onset of the COVID-19 Pandemic

Prior to COVID-19, telemedicine was mainly used to overcome geographical challenges in thinly populated or resource-poor regions, or for monitoring patients with impaired mobility at home. Small case series suggested efficacy and economic advantages by reducing hospitalization. Zamarron et al. demonstrated the long-term feasibility of telemonitoring with video consultations plus Sp02, BP, ECG, overnight oximetry in home-ventilated patients via a residential internet gateway with alarm system and monthly outreach nurse check-ups.2 Challenges included changes in the patient-carer relationship, and difficulty procuring individually adapted systems.

COVID-19 forced a hasty rethink of this position. Guidon and Amato discussed neuromuscular telemedicine consultation by phone or videolink.3 They perceived high potential for follow-up in myopathy, myasthenia gravis (MG), and polyneuropathy when stable, or for management of pain; moderate utility for new or unstable neuromuscular disorders, but low utility where there were discrepant symptom findings, for second opinions, and for primary management of unstable patients. Face-to-face clinics remained mandatory where electrodiagnostic studies and muscle and nerve biopsies were urgently needed, and where the results would change management, as in new onset amyotrophic lateral sclerosis (ALS), MG, and immune-mediated neuropathy or myopathy.

New scores and protocols may mitigate these shortcomings: Garibaldi et al. developed functional scores for myopathies and neuropathies (the Myo-FRS and N-FRS), taking reference to older disease-specific scores such as the MG-ADL for myasthenia gravis, and the ALSFR-R for amyotrophic lateral sclerosis.4 Ricciardi et al. suggested a protocol for remote clinical testing in MG, featuring:

  • Counting aloud test in one breath (CAT)
  • Hoarseness test (voice change with high-pitched vocalization)
  • Head-up test (10s head flexion from supine)
  • Swallowing test (3oz = 90ml water swallow)5

Other approaches included the Veteran Affairs Neuropathy Scale, which Wilson et al. piloted in telemedicine clinics6 and teleswallowing, a remote swallow assessment.7 This work provides a toolkit to perform a detailed clinical assessment, remotely via videolink. Purely audio remote interviews are more limited. Significant technical challenges for remote clinics remain regarding the availability of monitoring devices, broadband speed, audio-visual quality, internet lagtime for timed tests (10m walk, Timed-up and Go-test), users’ technical expertise, and computer literacy. To improve this, protocols to perform a video NMD clinic have been published.8,9 Videoconferencing platforms have been evaluated,10,11,12 and video platforms are available in a number of commercial patient management systems. Overall, the use of telemedicine in NMDs increased during the COVID-19 pandemic, but telemonitoring was used considerably less.13

Telemonitoring found its first application in clinical trials to optimize remote clinical assessment, but also to improve trial recruitment and monitoring. Reliability and strong correlations between wearable physical activity monitors (sensor-based systems using activity watches or body-worn sensors, PAMs) and neuromuscular measures confirmed PAMs’ utility as outcome measures and in long term monitoring.14 Mobility data can be gathered by PAMs, or by ambient measurement systems (AMS), which passively measures movement such as ambulation speed, rise-to-stand speed, and arm-raise speed when someone is in range of a sensor.

Remote monitoring of life-supporting technology, such as home mechanical ventilation (HMV), requires regular monitoring of physiological variables (spO2, spCO2, respiratory rate) by carers supported by specialist outreach, and requires a continuous data link to the monitoring center for analysis and troubleshooting.15 It can enable remote initiation of HMV and may reduce costs, and may help predict exacerbations, allow remote interventions and adjustments.16,17 Challenges about data security and privacy, caregiver involvement and acceptance, availability of high-speed internet, and misconceptions around time needed, remain.18,19

Mobile Phone-Based Clinical Assessment

Wearable monitors have the disadvantage that they are expensive pieces of advanced technology, and the proliferation of devices patients must wear to allow multimodal monitoring can be intrusive. This makes them both cumbersome as well as unsuitable for low-income health environments. Therefore, exploring the potential of a ubiquitous device, such as a smartphone to provide multimodal monitoring is attractive.

Digital technologies are currently expanding rapidly, especially in the field of NMDs. They can reduce data collection burden and increase knowledge of real-life data. MG is an autoimmune neuromuscular disease characterized by very heterogeneous symptoms potentially associating ocular, bulbar, respiratory and skeletal muscles weakness and fatigability.

In current practice, visits to the physician’s office are planned every three to six months. However, since patients might experience worsening symptoms outside of visits, clinicians must often rely on patient recollection during consultations, which present a recall and subjectivity bias that can compromise the estimation of disease status. In this context, it will be clinically relevant to allow patients to self-assess their symptoms and physicians to collect and analyze digital biomarkers for a closer monitoring.

Figure 1. Remote clinical assessment enabled on a smartphone.

As an example, an ongoing study (ME&MG™, NCT: 05564936) aims to validate a digital solution that runs on patients’ smartphones. It is intended to be used as an unsupervised digital self-assessment tool for the monitoring of muscle weakness, fatigability, and disability in patients living with MG. This application contains digital active tests for the assessment of ptosis, breathing, dysarthria, upper- and lower-limb weakness, treatment follow-up, and validated e-questionnaires related to daily activities, pain, fatigue, sleep, and depression. The objectives of this study are to validate the clinical performance of the unsupervised at-home self-assessment of symptoms on the patient’s smartphone with ME&MG compared to the standard in-clinic testing, including analytical performance as well as to evaluate the safety of the solution, its usability, and satisfaction. Eight sites in France and the United States will be involved in this study.20 A further study evaluating the device is ongoing in the U.S. and Canada (NCT05566964).21

Figure 1 demonstrates the remote clinical assessment enabled on smartphone using the ME&MG software.

Machine-Learning Models of Telemonitoring and AI-Based Analysis of Digital Biomarkers

Machine-learning (ML) and AI-based models can conceivably help establish objective, rapid, and more accurate interpretation of remote data acquired by telemedicine monitoring. Vieira et al. devised an objective measure for ALS disease severity based on voice samples and accelerometer measurements, correlated with ALS-FRS-R scores over a four-year period with an audio voice recording and Actigraph GT3X accelerometers on each limb. They also trained ML models to predict bulbar-related and limb-related ALSFRS-R scores.22

Similar approaches were used to assess changes in an edaravone-treated patient sample. Wearables can produce an objective severity score.23 There have been several approaches to wearables for therapy studies,24 though robust validation is still awaited.

Conclusion

The expansion of telemedicine use in NMDs and development of clinically relevant but easy-to-use remote monitoring systems has potential to improve patient access to expert care, even in situations where direct face-to-face access is interrupted, as in the recent pandemic, or where scarce resources or geography prevents patient access to specialist care. Going forward, telemedicine might expand the availability of high-quality specialist care to patients in low-income societies, who hitherto have had little access. Recent developments in effective treatment can also be seen as an obligation on global medicine to explore how inequality in provision can be mitigated — telemedicine technology may advance us one step in this direction. •


M. S. Damian, MD, FEAN, FNCS, works at the Essex Cardiothoracic Centre, in Basildon, UK, and Prof. P. Laforet, MD, PhD, works in the Neurology Department, Raymond Poincaré Hospital, APHP, Garches, APHP, FHU PHENIX, Centre de référence des maladies neuromusculaires Nord Est Ile-de-France in Filnemus. 

References

  1. Mauri E, Abati E, Musumeci O, et al. Estimating the impact of COVID-19 pandemic on services provided by Italian Neuromuscular Centers: an Italian Association of Myology survey of the acute phase. Acta Myol. 2020 Jun 1;39(2):57-66. doi: 10.36185/2532-1900-008.
  2. Zamarrón C, Morete E, González F. Telemedicine system for the care of patients with neuromuscular disease and chronic respiratory failure. Arch Med Sci. 2014 Oct 27;10(5):1047-51. doi: 10.5114/aoms.2014.46223.
  3. Guidon AC, Amato AA. COVID-19 and neuromuscular disorders. Neurology. 2020 Jun 2;94(22):959-969. doi: 10.1212/WNL.0000000000009566.
  4. Garibaldi M, Siciliano G, Antonini G. Telemedicine for neuromuscular disorders during the COVID-19 outbreak. J Neurol. 2021 Jan;268(1):1-4. doi: 10.1007/s00415-020-10063-7.
  5. Ricciardi D, Casagrande S, Iodice F, et al. Myasthenia gravis and telemedicine: a lesson from COVID-19 pandemic. Neurol Sci. 2021 Dec;42(12):4889-4892. doi: 10.1007/s10072-021-05566-8.
  6. Wilson AM, Ong MK, Saliba D, Jamal NI. The Veterans Affairs Neuropathy Scale: A Reliable, Remote Polyneuropathy Exam. Front Neurol. 2019 Nov 1;10:1050. doi: 10.3389/fneur.2019.01050.
  7. www.teleswallowing.com
  8. Damian MS. Neuromuscular monitoring devices – where to go next? Curr Opin Neurol. 2021 Oct 1;34(5):721-726. doi: 10.1097/WCO.0000000000000977.
  9. Al Hussona M, Maher M, Chan D, et al. The Virtual Neurologic Exam: Instructional Videos and Guidance for the COVID-19 Era. Can J Neurol Sci. 2020 Sep;47(5):598-603. doi: 10.1017/cjn.2020.96.
  10. Fortunato F, Bianchi F, Ricci G, et al. Digital health and Clinical Patient Management System (CPMS) platform utility for data sharing of neuromuscular patients: the Italian EURO-NMD experience. Orphanet J Rare Dis. 2023 Jul 21;18(1):196. doi: 10.1186/s13023-023-02776-5.
  11. Reyaz A, Agarwal A, Padma Srivastava MV, et al. Impact of Tele-Neuromuscular Clinic on the Accessibility of Care for Patients with Inherited Neuromuscular Disorders during COVID-19 Pandemic in India. Ann Indian Acad Neurol. 2022 May-Jun;25(3):505-507. doi: 10.4103/aian.aian_565_21.
  12. Amin R, Pizzuti R, Buchanan F, Rose L. A virtual care innovation for home mechanical ventilation. CMAJ. 2021 Apr 26;193(17):E607-E611. doi: 10.1503/cmaj.202584.
  13. El-Hassar L, Amara A, Sanson B, et al. Telemedicine in Neuromuscular Diseases During Covid-19 Pandemic: ERN-NMD European Survey. J Neuromuscul Dis. 2023;10(2):173-184. doi: 10.3233/JND-221525.
  14. Rockette-Wagner B, Aggarwal R. A Review of The Evidence for the Utility of Physical Activity Monitor Use in Patients with Idiopathic Inflammatory Myopathies. Rheumatology (Oxford). 2024 Jan 18:keae004. doi: 10.1093/rheumatology/keae004.
  15. Angelucci A, Aliverti A. Telemonitoring systems for respiratory patients: technological aspects. Pulmonology. 2020 Jul-Aug;26(4):221-232
  16. Hazenberg A, Kerstjens HA, Prins SC, et al. Initiation of home mechanical ventilation at home: a randomized controlled trial of efficacy, feasibility and costs. Respir Med. 2014 Sep;108(9):1387-95. doi: 10.1016/j.rmed.2014.07.008.
  17. van den Biggelaar RJM, Hazenberg A, Cobben NAM, Gaytant MA, Vermeulen KM, Wijkstra PJ. A Randomized Trial of Initiation of Chronic Noninvasive Mechanical Ventilation at Home vs In-Hospital in Patients With Neuromuscular Disease and Thoracic Cage Disorder: The Dutch Homerun Trial. Chest. 2020 Dec;158(6):2493-2501. doi: 10.1016/j.chest.2020.07.007.
  18. van den Biggelaar R, Hazenberg A, Duiverman ML. The role of telemonitoring in patients on home mechanical ventilation. Eur Respir Rev. 2023 Apr 5;32(168):220207. doi: 10.1183/16000617.0207-2022.
  19. Ambrosino N, Vitacca M, Dreher M, et al. Tele-monitoring of ventilator-dependent patients: a European Respiratory Society Statement. Eur Respir J. 2016 Sep;48(3):648-63. doi: 10.1183/13993003.01721-2015.
  20. The ME&MG Digital Solution for Autonomous Assessment of Myasthenia Gravis. Online: https://clinicaltrials.gov/study/NCT05564936
  21. Descriptive Analysis of Real-world Data Collected With the ME&MG open Mobile Application Developed for Myasthenia Gravis Patients. Online: https://clinicaltrials.gov/study/NCT05566964
  22. Vieira FG, Venugopalan S, Premasiri AS, et al. A machine-learning based objective measure for ALS disease severity. NPJ Digit Med. 2022 Apr 8;5(1):45. doi: 10.1038/s41746-022-00588-8.
  23. Gupta AS, Patel S, Premasiri A, Vieira F. At-home wearables and machine learning sensitively capture disease progression in amyotrophic lateral sclerosis. Nat Commun. 2023 Aug 21;14(1):5080. doi: 10.1038/s41467-023-40917-3.
  24. Poleur M, Markati T, Servais L. The use of digital outcome measures in clinical trials in rare neurological diseases: a systematic literature review. Orphanet J Rare Dis. 2023 Aug 2;18(1):224. doi: 10.1186/s13023-023-02813-3.

26th World Congress of Neurology Plenary Speakers

Plenary speakers shared their latest research on topics such as diabetic neuropathies, Parkinson’s disease, ALS, and global health care equity.


The 26th World Congress of Neurology was held Oct. 15-19 in Montreal. This combined in-person and virtual meeting was attended by over 3,500 neurologists from 129 countries. The highlight of the meeting was a series of plenary lectures given by world experts in a variety of subjects, ranging from a rare disease to neuroepidemiology. They brought their insights into a plethora of important neurological problems, from rare diseases to the World Health Organization’s plan to address neurological diseases across the globe. Summaries and salient messages are presented below.  All of the subjects covered important issues that concern neurologists and that can potentially affect billions of people around the world.

–Guy Rouleau, vice president of the WFN


Hosted in Montreal, the 2023 World Congress of Neurology united experts to address key neurology challenges. Plenary speakers shared their latest research on topics such as diabetic neuropathies, Parkinson’s disease, ALS, and global health care equity.

Dr. Tarun Dua from the World Health Organization emphasized the urgency in tackling neurological disorders, shaping a collaborative atmosphere.

The congress served as a hub for diverse perspectives and initiatives. Explore the discussions in each plenary lecture by reading the full press releases linked with each lecture.

The Global Importance of Diabetic Neuropathies

Eva Feldman, MD, PhD, James W. Albers Distinguished University Professor, and Russell N. DeJong, Professor of Neurology, University of Michigan

Type 2 diabetes has reached epidemic proportions, and complications like ulcers and amputations not only impact quality of life but also strain health care systems worldwide. During her plenary lecture, Dr. Eva Feldman cast a light on diabetic peripheral neuropathy (DPN), a major complication of diabetes and a leading cause of global disability. Discover the latest insights into the global burden of DPN and learn about the urgent need for new treatment approaches, education, and lifestyle changes to combat this worldwide challenge.

Read the full press release.


The WHO, IGAP, and Brain Health

Tarun Dua, MD, Head, Brain Health Unit, World Health Organization, Switzerland

Neurological conditions are the second-leading cause of death and the leading cause of disability worldwide. The World Health Organization’s new Intersectoral Global Action Plan provides a critical blueprint for combating neurological conditions and calls for urgent action from governments and health care organizations around the world. Dr. Tarun Dua discussed this landmark coordinated effort to tackle the challenges posed by neurological disorders, including the five key objectives for addressing these conditions worldwide and 10 global targets to be achieved by 2031.

Read the full press release.


The Epidemiology and Burden of Neurological Disorders

Valery Feigin, MD, PhD, Professor of Neurology and Epidemiology, National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, New Zealand

Low- and middle-income countries currently experience a disproportionate degree of the global burden of neurological disorders. Dr. Valery Feigin revealed groundbreaking findings from the latest Global Burden of Disease (GBD) study. Learn about the top 10 neurological conditions causing 90% of global disability and see how this data can aid neurologists and global health organizations in reducing health care disparities in low- and middle-income countries.

Read the full press release.


Status of Disease-Modifying Therapy in Parkinson’s Disease

Anthony Lang, MD, Professor of Neurology, Jack Clark Chair for Parkinson’s Disease Research and Lily Safra Chair in Movement Disorders, University of Toronto, Canada

Parkinson’s disease is one of the fastest-growing neurological diseases on the planet. But what if researchers could detect signs of the disease years before symptoms start to show? During his plenary lecture, Dr. Anthony Lang presented a groundbreaking new model for identifying and studying Parkinson’s disease. This approach will help researchers investigate biological aspects of the disease that may be detectable many years before symptoms begin to show.

Read the full press release.


Clinical Trial Progress in ALS

Merit Cudkowicz, MD, Chair, Massachusetts General Hospital Department of Neurology; Director, Sean M. Healey & AMG Center for ALS, Massachusetts General Hospital; Julieanne Dorn Professor of Neurology, Harvard Medical School

One of the central challenges of amyotrophic lateral sclerosis (ALS) research is finding ways to slow the progression of this relentlessly degenerative disease. Several late-stage clinical trials in ALS have had positive results. In addition, recently, two promising experimental drugs were advanced to phase 3 clinical trials as part of the innovative HEALEY ALS Platform Trial. Dr. Merit Cudkowicz’s lecture highlighted the drugs currently being tested in the HEALEY ALS Platform Trial as well as several other recently approved ALS medications, the promise of gene therapies, and a proposed new biomarker that is aiding in the development of treatments and research.

Read the full press release.


The Rett Syndrome: From Clinics to Genetics

Huda Zoghbi, MD, Professor of Molecular and Human Genetics, Baylor College of Medicine

Rett Syndrome is a delayed-onset childhood disorder that causes a broad range of severe neurological disabilities, including loss of the ability to speak and socialize, and the development of tremors, ataxia, seizures, autonomic dysfunction, and stereotypic hand-wringing movements. In her lecture, Dr. Huda Zoghbi, MD, discussed what her lab has learned about Rett pathogenesis and the significance of MeCP2 protein levels in maintaining healthy brain function. She outlined how an insufficient amount of this protein contributes to Rett syndrome, while an excess (resulting from gene duplication) leads to another severe neurological condition.

Read the full press release.


Transformations in the Treatment of Stroke

Liping Liu, MD, PhD, Director, Neurointensive Care Unit (NICU), Neurology and Stroke Center, Beijing Tiantan Hospital, Capital Medical University, China

Stroke is a leading cause of disability worldwide. However, giving certain treatments—called reperfusion therapies—soon after the start of a stroke can dramatically improve patient outcomes and minimize long-term brain damage. Dr. Liping Liu highlighted recent advancements in stroke treatment and strategies for addressing the global burden of stroke. She presented recent research on the effectiveness of reperfusion therapies for ischemic stroke and advocated for increasing awareness and training in these types of therapies for the global neurology community.

Read the full press release.


President of African Academy of Neurology Calls for Urgent, Unified Action to Address Lack of Trained Neurologists

Dr. Augustina Charway-Felli, President of the African Academy of Neurology

Africa is faced with critical shortages of neurologists and health care funding, leading to some of the world’s highest rates of disability from neurological disorders. Dr. Augustina Charway-Felli presented a strategic plan at the WCN. The proposal underscores regional training to bolster Africa’s neurologist count and prioritizes educating primary care providers. Dr. Charway-Felli advocated for a unified approach focusing on training, reducing brain drain, increasing specialized neurologists, and public education. Interregional collaboration and WFN accredited training centers in Dakar, Senegal; Rabat, Morocco; Cairo, Egypt; and Cape Town, South Africa, are vital components. The plan aims to alleviate the severe neurologist shortage and improve neurological care accessibility in Africa.

Read the full press release.


Kathy Oliver Champions Global Action for Patient Organizations at the 26th World Congress of Neurology

Kathy Oliver, chair of the International Brain Tumor Alliance

Patient engagement is gaining prominence in healthcare with Kathy Oliver championing this movement. Oliver emphasized the pivotal role of patient organizations in shaping clinical trials, drug development, health care policy, and regulatory issues. Patient engagement enhances research quality and resource allocation by aligning with patients’ priorities. Oliver highlighted five priorities for effective patient collaboration, stressing clear expectations, focusing on patients’ perspectives, promoting mutual learning, fostering effective collaboration, and ensuring timely involvement. Central to this approach is the principle “nothing about us, without us,” advocating for patient centrality in health care decisions.

Read the full press release.


Neurologist Reveals the Hidden Neurological Consequences of Historic Pandemics

Hadi Manji, MD, Consultant Neurologist and Honorary Associate Professor at the National Hospital for Neurology, United Kingdom

Although the height of the COVID-19 pandemic may be behind us, millions of people continue to experience disabling complications like long COVID—and researchers still don’t understand the full scope of COVID-19’s impact on the brain. During the congress, Dr. Hadi Manji shed light on the neurological complications of COVID-19 by exploring similar long-term complications of global pandemics, including the Spanish flu pandemic of 1918, HIV/AIDS, and Zika virus. This enlightening lecture explored what past pandemics can teach us about diagnosing and treating current post-infection complications like HIV-associated neurocognitive disorder (HAND) and long COVID, which impact millions of people worldwide.

Read the full press release.

Leveraging Technology in Resource Poor Settings: Not an Improbable Dream

Identifying problem statements, technology can help provide simple solutions that go a long way in bridging lapses in treatment.

Dr. Bindu Menon and Dr. Medha Menon

By Dr. Bindu Menon and Dr. Medha Menon

Epilepsy, when put simply, is a brain disorder that causes recurrent seizures. This disease can manifest as the typical jerky movements of limbs as well as only sensory complaints recorded as electrical disturbances on electroencephalography (EEG). This wide variation of disease manifestation makes it a condition one must be wary of and have a high index of suspicion. The number of cases of epilepsy touches 50 million globally, 80% of whom reside in middle- to low-income countries like India1.

It is important to realize why one must be wary of a disease that’s prevalent in such high numbers. Surely, its ubiquity implies the presence of a well-structured management plan? However, the enormity of the problem can become the hamartia of the disease.

One must first realize that more than three-quarters of the disease burden resides in regions that are struggling to bridge the treatment gap. In a world where everything is run by money, the catastrophic expenditure on health burdens every family in the lesser privileged sections of economy. This expenditure encompasses costs of medication, hospitalization, and continuation of care. The onus to balance livelihood and health falls on the patient, and when this burden becomes too much, they tend to stop being compliant to treatment — an ignition to the vicious cycle of expense and hospitalization.

Another stark problem one sees in the lower income countries is the stigma attached to the disease. The typical flailing of limbs often described as demonic possession in archaic times still brings out a level of unnecessary discomfort in onlookers of a seizure episode. These thoughts are easily curbed through a proper understanding of the disease. In a way, the stigma that hurdles a patient’s progress when vanquished empowers the community to provide moral support to the patient and their family.

The root of these problems is often lack of knowledge of the disease and so it is only natural that the solution is proper education and awareness. In this digitally advanced world, we must keep up and take advantage of the speed and extent of the reach of technology. Where once it was physically difficult to reach remote areas, in this day and age the internet and satellite connections help us reach the same areas remotely.

One such advancement is the Epilepsy Help App launched by our Foundation in India2 April 2016 — a free mobile app that can be downloaded on Android phones. It is available in English as well as vernacular languages and keeps record of a patient’s personal details, appointments, and reports.

When a patient presents to the emergency department with a seizure, it is of utmost importance that the doctor knows which medication and dosage the patient is on. The app shows the record of patient’s medications as well as has alarms for taking them, since a single missed medication can prove to be devastating to their life. Besides this, the patient can maintain a seizure diary within the app. The app has facilities for a bystander to take a video of a patient having a seizure attack, which proves to be of great value to a doctor to discern a diagnosis. On the whole, this app helps keeps track of a patient’s disease for their as well as the doctor’s benefit.

Among the patient stories we have permission to share was of one college student on three anti-seizure medicines. He often received different injections in the emergency department and was prescribed different cocktails of medicines due to his lack of record keeping. But with this app, he is documenting his prescriptions and scans and has currently been seizure free for eight months. The most useful feature for him, “For me, the drug reminder alarm is a huge help, and it makes sure I have not missed medications like I used to before.”

Another story was about the usefulness of keeping a video diary. An office worker who stayed in the dorms away from his family suffered from jerky motions, which were misdiagnosed as a seizure attack. Hence, he was put on wrong medication. But record-keeping of videos at several instances — once in the dorms, another at his home, and one while he was outside with friends who all knew of the app in his phone, helped in reaching the right diagnosis of a nonepileptic attack disorder upon physician review.

Another application is a Tele Awareness3 initiative, which is a toll-free number that can be called to receive information about epilepsy. It is accessible to all, and this number when disseminated in large numbers when in medical camps, helps ensure that the general population is made aware of the disease, its risk factors, management, and the need for treatment compliance. Furthermore, it is in these medical camps that they are made aware that the societal stigma about the disease needs to be abolished.

Stroke is another disabling disease that affects everybody differently. The life of a patient and their family changes drastically after a stroke which makes rehabilitation a crucial part of the spectrum of stroke care. Rehabilitation is all about getting back to a normal life and living a life as independently as possible. A venture in this direction is the Stroke Help app. This app has various physiotherapy exercises which are specific to the stroke deficits. The exercises are for passive and active limb exercises, handgrip and dexterity, positioning of the body, turning and mobilization, visual training, and balance exercises. This app has been extremely helpful for stroke patients especially during COVID, when medical services were not as accessible, but we did not want to falter in patient care. It is still being used4.

A novel project in the country is the Neurology on Wheels program where treatment-inaccessible areas are approached in a bus equipped with medical facilities. It follows the motto, “We Reach, We Teach, We Treat” Upon reaching the remote areas, there is an awareness camp followed by a medical camp with distribution of free medicines. An extension of this is We Care, wherein patients with epilepsy are followed up remotely. This is done with the help of the village head who gathers the patients in one place and sets up a telecommunication link to the doctor who can then follow up with each patient. This ensures compliance and treatment satisfaction especially in a resource-poor setting by curbing expenditure from both ends.

Technology doesn’t need to be used in grandiose gestures to be of use to the people. Identifying problem statements and finding simple solutions goes a long way in bridging lapses in treatment. A resource-poor country does not imply that the whole nation is lacking. Technologically linking the better-off areas to help the lesser privileged sections doesn’t have to be a lofty feat. Once the key to unraveling the tangled ball of problems is in sight, it is only a matter of like-minded individuals putting smart and economic solutions to improve health care. •

Dr. Bindu Menon is professor and head of the department at Apollo Speciality Hospitals in Nellore, India, secretary general of the Indian Epilepsy Association, and president of Dr. Bindu Menon Foundation. Dr. Medha Menon is resident in internal medicine at the Kasturba Hospital Manipal, India, and treasurer of the Dr. Bindu Menon Foundation.

References:

  1. https://www.who.int/news-room/fact-sheets/detail/epilepsy#:~:text=Key%20facts,%2D%20and%20middle%2Dincome%20countries
  2. http://drbindumenon.com/epilepsyapp/
  3. http://drbindumenon.com/teleawareness/
  4. https://play.google.com/store/apps/details?id=appinventor.ai_bindumenon2013.StrokeHelp

The Global Neuro Research Coalition: A Call for Collaboration

Join the collective network of neurologists, neuroscientists, and allied specialty professionals to create a research environment that tackled problems of global neurology.

Orla Hilton

By Dr. Orla Hilton

Founded in 2020, the Global Neuro Research Coalition works to advance research in global brain health and improve patient care through an ever-expanding international network of clinicians, allied health care workers, scientists, and policymakers who are passionate about brain health.

COVID-19 was the initial catalyst for the founding of the then-called Global COVID-19 Neuro Research Coalition, as the global neurological community began to be confronted with the largely unknown effects of SARS-CoV-2 on the nervous system and the inequalities in the management of patients who developed neurological complications of the virus. We have now expanded our focus and established as the Global Neuro Research Coalition, comprising over 120 members from 38 countries, with skills and translational expertise spanning from basic neuroscience research to clinical neurology and guidelines/policy decision-making.

Our coalition invites and welcomes new members of the global neurological community to join our collective network of neurologists, neuroscientists, and allied specialty professionals to create an inclusive research environment that can better understand and tackle the ever-evolving problems the field of global neurology faces.

Our mission statement: Advancing brain health research through interdisciplinary global collaboration.

The five pillars of the World Health Organization’s (WHO) Intersectoral Global Action Plan (IGAP) on Epilepsy and Other Neurological Disorders lie at the heart of our mission, as we work to harmonize networks and strategies for future neurological research and to develop clinical guidance by establishing open lines of communication between international colleagues and institutions, especially in low- and middle-income countries (LMICs).

The building and strengthening of such a coalition remain vital as we investigate and understand the long-term neurological and cognitive sequelae of COVID-19, and look forward to pursuing the translation of current and future neurological research into policies that promote a ‘one health’ approach.

To date, the coalition has published over 10 papers together. A key example of the power of our consortium to perform global neurological research is the International Inter-observer Variability Study by Tamborska et al. (Journal of the Neurological Sciences, 2023), undertaken in collaboration with the World Federation of Neurology. This brought together 146 researchers and clinicians from 45 countries, who looked at the diagnostic accuracy for the acute neurological complications of COVID-19 and demonstrated the need for training in the global reporting of neurological syndromes. Other key works of our coalition have addressed the neurological manifestations of acute COVID-19 infections. Examples include the Consensus Clinical Guidance for Diagnosis and Management of Adult COVID-19 Encephalopathy Patients’ by Michael et al. (The Journal of Neuropsychiatry and Clinical Neurosciences, 2023), in addition Neurological Events Reported after COVID-19 Vaccines by Frontera et al. (Annals of Neurology, 2022), and Evaluation and Treatment Approaches for Neurological Post-Acute Sequelae of COVID-19 by Frontera et al. (Journal of the Neurological Sciences, 2023).

In addition, our coalition has also led to the creation of the Global Brain Health Clinical Exchange Platform in collaboration with the WHO. This platform hosts monthly free, online sessions, engaging hundreds of participants from over 50 countries to hear the latest from world leaders in neurology and exchange experience on the current challenges and future directions of a wide spectrum of neurological research. Topics have included the neuroepidemiology of emerging pathogens, management of acute neurological presentations, patient-and-public engagement and long-term care, and the delivery of improvements in health care systems.

The coalition is grateful for the ongoing support of the World Federation of Neurology and our other partner institutions. We endeavor to continue to collaborate and partner in an interdisciplinary way with other medical and allied specialties, especially in LMICs which often carry the heaviest burden of neurological disease. We welcome all new members. If you are interested in becoming part of the coalition, please visit https://www.liverpool.ac.uk/neurosciences-research-unit/knowledge-exchange/global-neuro-research-coalition/ and/or send an email to covidcns@liverpool.ac.uk. •


Dr. Orla Hilton (UK) is an academic foundation doctor in infectious diseases and clinical researcher for the national COVID-19 Clinical Neuroscience Study based at Infection Neuroscience Lab in Liverpool, UK.

WFN Reinforces Its Commitment to Advancing Global Neurology Education

Report of a press conference held at the World Congress of Neurology, Montreal, October 2023

On behalf of the WFN trustees, assisted by the WFN press support organization, Yakkety Yak.*

Key teaching initiatives bridge gaps in neurological care to promote brain health worldwide.

Neurological disorders are currently the second highest cause of death and the leading cause of disability worldwide. The new Global Burden of Disease (GBD) study shows that the number of people living with brain disease is expected to double by 2050.

One of the central challenges of addressing the growing burden of neurological diseases is the lack of available neurology care in under-resourced parts of the world. The World Federation of Neurology (WFN) is committed to finding new and innovative ways to educate and train an increasingly critical global neurology workforce to close this gap.

The World Health Organization (WHO) recommends one to five neurologists per every 100,000 people, but many low- and middle-income countries fall well below this number. In fact, the contrast in available neurologists between low-income and high-income countries is so stark that some of the lowest-income nations have 70 times fewer neurologists than countries like the U.S. and Canada.

“It’s impossible to develop appropriate care without education. It’s impossible to promote research without education,” said Dr. Alla Guekht, elected trustee of the World Federation of Neurology.

WFN will continue working with its regional neurological associations and member states to increase the availability of neurological care worldwide.

WFN Training Centers

WFN furthers its mission of fostering quality neurology and brain health worldwide by promoting global neurological education and training, with an emphasis on under-resourced parts of the world. WFN celebrates 10 years of WFN Training Centers, which facilitate training and knowledge exchange as well as visiting fellowships in global regions that have severe shortages of neurologists. WFN currently has training centers in Africa (Dakar, Senegal; Cairo, Egypt; Rabat, Morocco; and Cape Town, South Africa) and Mexico.

“The idea is not to go there and teach, but to empower regions to train their own neurologists,” said Dr. Wolfgang Grisold, president of the World Federation of Neurology. “This has been extremely productive, and while it does not fill the gap that is needed for neurologists in these and other regions, it does create important incentives.”

Future education efforts need to extend beyond neurology specialists to include training in neurological disorders and brain health at all levels of the health care system.

“Increasing the number of neurologists alone is not enough,” said Dr. Augustina Charway-Felli, president of the African Academy of Neurology. “We need to increase neurological awareness across health care providers of all levels — primary health care providers, general practitioners, specialists that are not neurologists and allied health care professionals.”

Global Partnerships and Visiting Neurologist Programs

WFN facilitates programs where residents or young neurologists visit hospitals in other countries for four to six weeks to gain exposure to different health systems and bring back their knowledge and experience to their home countries.

These initiatives are enabled by partnerships between the WFN and national neurological societies. They aim to enhance the exposure of young neurologists to their respective national neurological frameworks within a global context. This offers them the opportunity to connect with new peers and promote future collaborations among countries, universities, hospitals, and departments.

“We are very grateful for the many countries that receive either residents or young neurologists for short department visits,” said Dr. Grisold. “This has been very effective because people get exposed to a different health system for four to six weeks and come back with new ideas they can implement in their own departments and health care systems.”

Increasing Virtual Training

The COVID-19 pandemic required many health organizations to adapt to virtual modes of communication to expand access to training and education previously limited to in-person gatherings. WFN plans to continue utilizing virtual platforms to make critical neurology training and education available on a global scale.

“Increased virtual meetings empower us to be more relevant and efficient in all the different parts of the world,” said Dr. Guy Rouleau, president of the XXVI World Congress of Neurology. “Virtual education reduces costs for everyone —  both participants and the ones who generate the teaching — and we are also better able to tailor education and training to local needs.”

Ongoing education efforts must not only be more widely accessible to the global neurology community but also tailored to the specific needs of each country’s health systems and population.

WHO’s Intersectoral Global Action Plan (IGAP)

WHO’s Intersectoral Global Action Plan (IGAP) on epilepsy and other neurological disorders is a comprehensive framework aimed at reducing the global burden of neurological diseases and bolstering health care systems worldwide with the necessary resources and expertise. One of its goals is to increase training in neurological issues for the primary health care workforce and caregivers.

Dr. Tarun Dua, head of the World Health Organization’s Brain Health Unit, emphasized the need for a multifaceted approach to this complex issue beyond simply increasing the number of neurologists.

“The way we are building up our neurological workforce with the current education programs — even if we double the capacity, we are not going to bridge that gap in the nine years needed to meet the goals of the action plan,” said Dr. Dua. “We need to have a paradigm shift in our thinking.”

This paradigm shift must include not just new and expanded ways of training neurologists, but also reframing how we think of brain health as a human rights and global public health issue.

Spreading Education Through the World Congress of Neurology

The 26th World Congress of Neurology (WCN 2023) was held Oct. 15-19 in Montreal, Canada. WCN 2023 was the first in-person conference since the COVID-19 pandemic and brought together over 2,300 face-to-face and 1,300 virtual participants from 132 countries, including neurologists and advocates from the six global regions represented by our 124 WFN Member Societies. WFN also welcomed a new member society from the Republic of Chad.

“The resounding success of this year’s World Congress of Neurology is a testament to the unwavering dedication of the global neurology community,” said Dr. Grisold. “We’ve not only rejuvenated our connections but also extended our reach, embracing a new member society from the Republic of Chad. Together, we’ve paved the way for a brighter future in neurology.”

At WCN 2023, Dr. Steven L. Lewis, WFN secretary general and Congress committee chair, announced the locations for the next two biennial conferences:

  • 27th World Congress of Neurology, 2025, Seoul, South Korea
  • 28th World Congress of Neurology, 2027, Cape Town, South Africa

From 2024 onward, WFN will establish educational interim meetings called “WFN Digital Neurological Updates (WNU),” devoted to updates in neurology. These virtual meetings will be held in years between congresses and are intended to fill the gap between the bi-annual conferences.

“We will continue to find fresh ways to present the newest discoveries and the latest clinical information to attendees from around the globe,” said Dr. Lewis. “Our goal is to create the most accessible platform so that neurologists and other health care providers can bring this information back to their regions, to their hospitals and to their individual patients, to benefit from the latest developments in the field of neurology and to provide the best neurologic care to their patients wherever they may be.”

Looking toward 2024 and beyond, WFN is excited to find new and even more effective ways to support training for the global neurology community, foster regional exchange of knowledge and education, and prioritize brain health as a human right and a global public health issue. •


* This article was composed by our press consulting agency Yakkety Yak, Inc., on behalf of the WFN. It is based on interviews and communications and contains no industry influence or bias.

WCN 2023 and WFN Activities

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

By Wolfgang Grisold

Wolfgang Grisold

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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