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      Paper of the Month

      Research Paper of the Month: Apixaban for Stroke Prevention in Subclinical Atrial Fibrillation

      December 4, 2023

      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – December 2023

      December 1, 2023

      Brain Health

      Swiss Brain Health Plan launches in Zurich

      November 24, 2023

      EAN News

      EAN 2024 – Abstract submission and registration OPEN!

      November 22, 2023

      Executive Page

      Executive Page: Join or renew your membership now and celebrate 10 years of the EAN

      November 6, 2023

      Executive Page

      Executive Page: Advocacy for brain health gaining momentum across the neurological landscape

      October 1, 2023

      Executive Page Dear EAN members, dear friends, It is my pleasure to give you an update on behalf of the EAN Scientific Committee following a busy year since my appointment as chair. It has been a privilege to be so deeply involved in the scientific activities of the EAN and to work closely with an amazing community of people who are so dedicated to the advancement of neurology. One of the strongest threads within that community is the EAN’s group of Scientific Panels, which are often referred to as the organisation’s ‘scientific backbone’. The panels have a hand in everything the EAN does from a scientific point of view, including coordinating clinical research, disseminating good practice, assisting in planning the EAN annual congress, supporting the EAN’s educational efforts, and producing guidelines that assist neurologists in daily practice. All of this work requires a considerable amount of oversight, and this is why each panel is run by its own Management Group, elected by the panel members. Being a part of one of these Management Groups (PDF) is an opportunity to play a direct part in determining the direction of scientific progress within Europe, and I am excited to say that the call for applications to stand for election will be announced in September. All panel members and EAN individual members are eligible to apply to be candidates, with the vote being held among the existing panel members in autumn. I would like to urge every neurologist with a passion for the scientific future of their special area of interest to consider standing for election to the relevant Management Group and to look out for the call for applications later this month. I can tell you from personal experience that fulfilling a role such as this within the structure of the EAN is a fascinating and extremely rewarding experience. The chance to take on such a unique leadership position should not be missed! The most satisfying aspect of being involved in the EAN’s organisational structure is surely seeing all the hard work and planning come to fruition when a small idea evolves into a newly launched project. One such example is the 1st EAN Science School, taking place in Salzburg next March. The idea of the Science School is to offer early career neurologists with an interest in translational research a new avenue for learning about basic pathomechanisms of neurological disorders. Application for this very first edition, on ‘Pathophysiology of disorders of the nervous system’, closed last week and we have been delighted with the level of interest. It was a pleasure to be part of the task force in charge of planning this new project and I look forward to seeing it officially transferred to the hands of the Scientific Committee after a successful event and evaluation in spring. Of our ongoing activities, one of the most significant is the EAN Neuro-covid Registry, which aims to collate epidemiological data on neurological manifestations in patients with COVID-19 infection reported by neurologists in outpatient services, emergency rooms, and hospital departments. We currently have 1,542 patients entered in the database, from 35 centres across 23 countries. So far, 29 patients have been followed for 12 months and 387 have completed the 6-months follow up. This is a decent start, but I would like to strongly encourage EAN members and their institutions to get involved and contribute cases to what will become an invaluable resource for neurologists and clinicians to improve care for Covid-19 patients. Finally, I would like share a word on a forthcoming collaboration between EAN and the Human Brain Project in December, that I think will interest a lot of EAN members. The EAN-EBRAINS joint workshop on ‘The future of medical data sharing in clinical neurosciences’ will be a three-day virtual event that aims to discuss issues and challenges associated with data sharing in Europe, from ethics to data safety and privacy, including those specific to data federation, such as the development and validation of federated algorithms. The whole workshop is completely free of charge and registration is open until 25 November, so please check out the details and sign up! I wish you all a healthy and pleasant autumn and I look forward to updating you again. Best wishes Thomas Berger Chair of the EAN Scientific Committee

      Executive Page: Management Group elections are coming – run for office and help shape our future!

      September 1, 2023

      Executive Page

      Executive Page: Thank you for making the EAN Congress 2023 a great success!

      July 24, 2023

      EAN News One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – December 2023

      December 1, 2023

      EAN News

      Swiss Brain Health Plan launches in Zurich

      November 24, 2023

      EAN News

      EAN 2024 – Abstract submission and registration OPEN!

      November 22, 2023

      EAN News

      Call for Applications: e-Learning Platform Associate Editors

      November 7, 2023

      EAN Congress news

      EAN 2024 – Abstract submission and registration OPEN!

      November 22, 2023

      EAN Congress news

      Burden of Sleep/Wake Disorders Project at EAN Congress 2023

      October 19, 2023

      EAN Congress news

      African Academy of Neurology features in Special Studio Session at EAN 2023

      July 25, 2023

      EAN Congress news

      Find photos, facts, figures and reports in our EAN Congress Review

      July 24, 2023

      Interviews

      Video Interview: Prof. Mary Reilly, Moritz Romberg lecturer at EAN 2023

      July 4, 2023

      Interviews

      Video Interview: Mark Hallett, C. Brown-Séquard lecturer at EAN 2023

      July 3, 2023

      Interviews

      Video Interview: Josep Dalmau, Camillo Golgi Lecturer at EAN 2023

      July 2, 2023

      Interviews

      Video Interview: Dementia & Cognitive Disorders Panel Co-Chairs

      September 8, 2022

  • Research
    • All Paper of the Month Research Highlights
      Paper of the Month

      Research Paper of the Month: Apixaban for Stroke Prevention in Subclinical Atrial Fibrillation

      December 4, 2023

      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – December 2023

      December 1, 2023

      Paper of the Month

      Research Paper of the Month: Effects of oral anticoagulation in people with atrial fibrillation after spontaneous intracranial haemorrhage (COCROACH)

      November 6, 2023

      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – November 2023

      November 6, 2023

      Paper of the Month

      Research Paper of the Month: Apixaban for Stroke Prevention in Subclinical Atrial Fibrillation

      December 4, 2023

      Paper of the Month

      Research Paper of the Month: Effects of oral anticoagulation in people with atrial fibrillation after spontaneous intracranial haemorrhage (COCROACH)

      November 6, 2023

      Paper of the Month

      Research Paper of the Month: Transdermal Nicotine Treatment and Progression of Early Parkinson’s Disease

      October 1, 2023

      Paper of the Month

      Research Paper of the Month: Soluble Nogo-Receptor-Fc decoy (AXER-204) in patients with chronic cervical spinal cord injury in the USA

      September 1, 2023

      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – December 2023

      December 1, 2023

      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – November 2023

      November 6, 2023

      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – October 2023

      October 1, 2023

      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – September 2023

      September 1, 2023

  • Education
    • All eLearning Student Corner Resident and Research Fellows Fellowship reports
      eLearning

      End 2023 with highlighted content on the eanCampus!

      December 2, 2023

      Resident and Research Fellows

      EAN Spring School 2024 – Apply NOW until 31 January 2024

      December 1, 2023

      Resident and Research Fellows

      EAN Autumn School 2023: Report

      November 30, 2023

      eLearning

      Call for Applications: e-Learning Platform Associate Editors

      November 7, 2023

      eLearning

      End 2023 with highlighted content on the eanCampus!

      December 2, 2023

      eLearning

      Call for Applications: e-Learning Platform Associate Editors

      November 7, 2023

      eLearning

      Kick off the new season with highlights on the eanCampus

      October 13, 2023

      eLearning

      World Brain Day with the European Academy of Neurology

      July 21, 2023

      Student Corner

      Student Teaser Fellowship reports 2022 – Pisa, London, & Lausanne

      September 13, 2023

      Student Corner Illustration of a vertical pencil point on a blue background, with a yellow light bulb above it

      Student Corner: My EAN Congress experience

      September 5, 2023

      Student Corner

      Student Teaser Fellowship reports 2022 – Rotterdam, London, & Paris

      August 22, 2023

      Student Corner

      Student Teaser Fellowship winners 2023

      June 28, 2023

      Resident and Research Fellows

      EAN Spring School 2024 – Apply NOW until 31 January 2024

      December 1, 2023

      Resident and Research Fellows

      EAN Autumn School 2023: Report

      November 30, 2023

      Resident and Research Fellows

      Research Fellowship Report 2022 – Oxford Autoimmune Neurology Group

      September 16, 2023

      Resident and Research Fellows

      Research Fellowship Report 2022 – Centre Hospitalier Universitaire Vaudois, Lausanne

      September 15, 2023

      Fellowship reports

      Research Fellowship Report 2022 – Oxford Autoimmune Neurology Group

      September 16, 2023

      Fellowship reports

      Research Fellowship Report 2022 – Centre Hospitalier Universitaire Vaudois, Lausanne

      September 15, 2023

      Fellowship reports

      Research Fellowship Report 2022 – Department of Neuromuscular Diseases Institute, University College London

      September 14, 2023

      Fellowship reports

      Student Teaser Fellowship reports 2022 – Pisa, London, & Lausanne

      September 13, 2023

  • Other News
    • All EAN Staff EBC News in general Surveys
      EAN Staff

      EAN Head Office Profiles: Ulla & Piyapat

      December 1, 2023

      EAN Staff

      EAN Head Office Profiles: Maria & Immanuel

      November 7, 2023

      Advocacy

      Brain community launches Call to Action during Brain Health & Research Day at UNGA78

      October 19, 2023

      EAN News

      Brain Innovation Days 2023: Meet the speakers!

      October 2, 2023

      EAN Staff

      EAN Head Office Profiles: Ulla & Piyapat

      December 1, 2023

      EAN Staff

      EAN Head Office Profiles: Maria & Immanuel

      November 7, 2023

      EAN Staff

      EAN Head Office Profiles: Kathrin & Sasha

      August 28, 2023

      EAN Staff Anja Sander receiving flowers at the end of EAN Congress 2023

      Celebrating 20 Years of Excellence: Anja Sander, EAN’s Executive Director!

      August 3, 2023

      EBC

      Brain community launches Call to Action during Brain Health & Research Day at UNGA78

      October 19, 2023

      EBC

      Brain Innovation Days 2023: Meet the speakers!

      October 2, 2023

      EBC

      Brain Innovation Days: Discover the early programme and register today!

      July 21, 2023

      EBC

      Join the community’s calls for a European Brain Research and Innovation Plan

      July 21, 2023

      News in general

      WHO’s Intersectoral Global Action Plan on epilepsy and other neurological disorders (IGAP) published in all six UN languages

      August 3, 2023

      News in general

      WHO recognises the public health need for effective and affordable treatments for multiple sclerosis

      August 3, 2023

      News in general

      Brain Innovation Days: Discover the early programme and register today!

      July 21, 2023

      News in general

      Join the community’s calls for a European Brain Research and Innovation Plan

      July 21, 2023

      Surveys

      Neurorehabilitation Across Europe after Ischemic and Traumatic Brain Injuries: a survey to increase knowledge on brain-injury-specific neurorehabilitation

      July 14, 2023

      Surveys

      ILAE survey on genetic testing in the epilepsies

      July 14, 2023

      Surveys

      COVID-19 and neurology: a survey of previous and continued restrictions on clinical practice, professional education and neuroeconomics

      March 3, 2023

      Surveys

      Help EAN contribute towards the development of a European Pain Research strategy

      December 5, 2022

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eanpages

  • EAN News
    • All Executive Page EAN News EAN Congress news Interviews
      Paper of the Month

      Research Paper of the Month: Apixaban for Stroke Prevention in Subclinical Atrial Fibrillation

      December 4, 2023

      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – December 2023

      December 1, 2023

      Brain Health

      Swiss Brain Health Plan launches in Zurich

      November 24, 2023

      EAN News

      EAN 2024 – Abstract submission and registration OPEN!

      November 22, 2023

      Executive Page

      Executive Page: Join or renew your membership now and celebrate 10 years of the EAN

      November 6, 2023

      Executive Page

      Executive Page: Advocacy for brain health gaining momentum across the neurological landscape

      October 1, 2023

      Executive Page Dear EAN members, dear friends, It is my pleasure to give you an update on behalf of the EAN Scientific Committee following a busy year since my appointment as chair. It has been a privilege to be so deeply involved in the scientific activities of the EAN and to work closely with an amazing community of people who are so dedicated to the advancement of neurology. One of the strongest threads within that community is the EAN’s group of Scientific Panels, which are often referred to as the organisation’s ‘scientific backbone’. The panels have a hand in everything the EAN does from a scientific point of view, including coordinating clinical research, disseminating good practice, assisting in planning the EAN annual congress, supporting the EAN’s educational efforts, and producing guidelines that assist neurologists in daily practice. All of this work requires a considerable amount of oversight, and this is why each panel is run by its own Management Group, elected by the panel members. Being a part of one of these Management Groups (PDF) is an opportunity to play a direct part in determining the direction of scientific progress within Europe, and I am excited to say that the call for applications to stand for election will be announced in September. All panel members and EAN individual members are eligible to apply to be candidates, with the vote being held among the existing panel members in autumn. I would like to urge every neurologist with a passion for the scientific future of their special area of interest to consider standing for election to the relevant Management Group and to look out for the call for applications later this month. I can tell you from personal experience that fulfilling a role such as this within the structure of the EAN is a fascinating and extremely rewarding experience. The chance to take on such a unique leadership position should not be missed! The most satisfying aspect of being involved in the EAN’s organisational structure is surely seeing all the hard work and planning come to fruition when a small idea evolves into a newly launched project. One such example is the 1st EAN Science School, taking place in Salzburg next March. The idea of the Science School is to offer early career neurologists with an interest in translational research a new avenue for learning about basic pathomechanisms of neurological disorders. Application for this very first edition, on ‘Pathophysiology of disorders of the nervous system’, closed last week and we have been delighted with the level of interest. It was a pleasure to be part of the task force in charge of planning this new project and I look forward to seeing it officially transferred to the hands of the Scientific Committee after a successful event and evaluation in spring. Of our ongoing activities, one of the most significant is the EAN Neuro-covid Registry, which aims to collate epidemiological data on neurological manifestations in patients with COVID-19 infection reported by neurologists in outpatient services, emergency rooms, and hospital departments. We currently have 1,542 patients entered in the database, from 35 centres across 23 countries. So far, 29 patients have been followed for 12 months and 387 have completed the 6-months follow up. This is a decent start, but I would like to strongly encourage EAN members and their institutions to get involved and contribute cases to what will become an invaluable resource for neurologists and clinicians to improve care for Covid-19 patients. Finally, I would like share a word on a forthcoming collaboration between EAN and the Human Brain Project in December, that I think will interest a lot of EAN members. The EAN-EBRAINS joint workshop on ‘The future of medical data sharing in clinical neurosciences’ will be a three-day virtual event that aims to discuss issues and challenges associated with data sharing in Europe, from ethics to data safety and privacy, including those specific to data federation, such as the development and validation of federated algorithms. The whole workshop is completely free of charge and registration is open until 25 November, so please check out the details and sign up! I wish you all a healthy and pleasant autumn and I look forward to updating you again. Best wishes Thomas Berger Chair of the EAN Scientific Committee

      Executive Page: Management Group elections are coming – run for office and help shape our future!

      September 1, 2023

      Executive Page

      Executive Page: Thank you for making the EAN Congress 2023 a great success!

      July 24, 2023

      EAN News One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – December 2023

      December 1, 2023

      EAN News

      Swiss Brain Health Plan launches in Zurich

      November 24, 2023

      EAN News

      EAN 2024 – Abstract submission and registration OPEN!

      November 22, 2023

      EAN News

      Call for Applications: e-Learning Platform Associate Editors

      November 7, 2023

      EAN Congress news

      EAN 2024 – Abstract submission and registration OPEN!

      November 22, 2023

      EAN Congress news

      Burden of Sleep/Wake Disorders Project at EAN Congress 2023

      October 19, 2023

      EAN Congress news

      African Academy of Neurology features in Special Studio Session at EAN 2023

      July 25, 2023

      EAN Congress news

      Find photos, facts, figures and reports in our EAN Congress Review

      July 24, 2023

      Interviews

      Video Interview: Prof. Mary Reilly, Moritz Romberg lecturer at EAN 2023

      July 4, 2023

      Interviews

      Video Interview: Mark Hallett, C. Brown-Séquard lecturer at EAN 2023

      July 3, 2023

      Interviews

      Video Interview: Josep Dalmau, Camillo Golgi Lecturer at EAN 2023

      July 2, 2023

      Interviews

      Video Interview: Dementia & Cognitive Disorders Panel Co-Chairs

      September 8, 2022

  • Research
    • All Paper of the Month Research Highlights
      Paper of the Month

      Research Paper of the Month: Apixaban for Stroke Prevention in Subclinical Atrial Fibrillation

      December 4, 2023

      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – December 2023

      December 1, 2023

      Paper of the Month

      Research Paper of the Month: Effects of oral anticoagulation in people with atrial fibrillation after spontaneous intracranial haemorrhage (COCROACH)

      November 6, 2023

      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – November 2023

      November 6, 2023

      Paper of the Month

      Research Paper of the Month: Apixaban for Stroke Prevention in Subclinical Atrial Fibrillation

      December 4, 2023

      Paper of the Month

      Research Paper of the Month: Effects of oral anticoagulation in people with atrial fibrillation after spontaneous intracranial haemorrhage (COCROACH)

      November 6, 2023

      Paper of the Month

      Research Paper of the Month: Transdermal Nicotine Treatment and Progression of Early Parkinson’s Disease

      October 1, 2023

      Paper of the Month

      Research Paper of the Month: Soluble Nogo-Receptor-Fc decoy (AXER-204) in patients with chronic cervical spinal cord injury in the USA

      September 1, 2023

      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – December 2023

      December 1, 2023

      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – November 2023

      November 6, 2023

      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – October 2023

      October 1, 2023

      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – September 2023

      September 1, 2023

  • Education
    • All eLearning Student Corner Resident and Research Fellows Fellowship reports
      eLearning

      End 2023 with highlighted content on the eanCampus!

      December 2, 2023

      Resident and Research Fellows

      EAN Spring School 2024 – Apply NOW until 31 January 2024

      December 1, 2023

      Resident and Research Fellows

      EAN Autumn School 2023: Report

      November 30, 2023

      eLearning

      Call for Applications: e-Learning Platform Associate Editors

      November 7, 2023

      eLearning

      End 2023 with highlighted content on the eanCampus!

      December 2, 2023

      eLearning

      Call for Applications: e-Learning Platform Associate Editors

      November 7, 2023

      eLearning

      Kick off the new season with highlights on the eanCampus

      October 13, 2023

      eLearning

      World Brain Day with the European Academy of Neurology

      July 21, 2023

      Student Corner

      Student Teaser Fellowship reports 2022 – Pisa, London, & Lausanne

      September 13, 2023

      Student Corner Illustration of a vertical pencil point on a blue background, with a yellow light bulb above it

      Student Corner: My EAN Congress experience

      September 5, 2023

      Student Corner

      Student Teaser Fellowship reports 2022 – Rotterdam, London, & Paris

      August 22, 2023

      Student Corner

      Student Teaser Fellowship winners 2023

      June 28, 2023

      Resident and Research Fellows

      EAN Spring School 2024 – Apply NOW until 31 January 2024

      December 1, 2023

      Resident and Research Fellows

      EAN Autumn School 2023: Report

      November 30, 2023

      Resident and Research Fellows

      Research Fellowship Report 2022 – Oxford Autoimmune Neurology Group

      September 16, 2023

      Resident and Research Fellows

      Research Fellowship Report 2022 – Centre Hospitalier Universitaire Vaudois, Lausanne

      September 15, 2023

      Fellowship reports

      Research Fellowship Report 2022 – Oxford Autoimmune Neurology Group

      September 16, 2023

      Fellowship reports

      Research Fellowship Report 2022 – Centre Hospitalier Universitaire Vaudois, Lausanne

      September 15, 2023

      Fellowship reports

      Research Fellowship Report 2022 – Department of Neuromuscular Diseases Institute, University College London

      September 14, 2023

      Fellowship reports

      Student Teaser Fellowship reports 2022 – Pisa, London, & Lausanne

      September 13, 2023

  • Other News
    • All EAN Staff EBC News in general Surveys
      EAN Staff

      EAN Head Office Profiles: Ulla & Piyapat

      December 1, 2023

      EAN Staff

      EAN Head Office Profiles: Maria & Immanuel

      November 7, 2023

      Advocacy

      Brain community launches Call to Action during Brain Health & Research Day at UNGA78

      October 19, 2023

      EAN News

      Brain Innovation Days 2023: Meet the speakers!

      October 2, 2023

      EAN Staff

      EAN Head Office Profiles: Ulla & Piyapat

      December 1, 2023

      EAN Staff

      EAN Head Office Profiles: Maria & Immanuel

      November 7, 2023

      EAN Staff

      EAN Head Office Profiles: Kathrin & Sasha

      August 28, 2023

      EAN Staff Anja Sander receiving flowers at the end of EAN Congress 2023

      Celebrating 20 Years of Excellence: Anja Sander, EAN’s Executive Director!

      August 3, 2023

      EBC

      Brain community launches Call to Action during Brain Health & Research Day at UNGA78

      October 19, 2023

      EBC

      Brain Innovation Days 2023: Meet the speakers!

      October 2, 2023

      EBC

      Brain Innovation Days: Discover the early programme and register today!

      July 21, 2023

      EBC

      Join the community’s calls for a European Brain Research and Innovation Plan

      July 21, 2023

      News in general

      WHO’s Intersectoral Global Action Plan on epilepsy and other neurological disorders (IGAP) published in all six UN languages

      August 3, 2023

      News in general

      WHO recognises the public health need for effective and affordable treatments for multiple sclerosis

      August 3, 2023

      News in general

      Brain Innovation Days: Discover the early programme and register today!

      July 21, 2023

      News in general

      Join the community’s calls for a European Brain Research and Innovation Plan

      July 21, 2023

      Surveys

      Neurorehabilitation Across Europe after Ischemic and Traumatic Brain Injuries: a survey to increase knowledge on brain-injury-specific neurorehabilitation

      July 14, 2023

      Surveys

      ILAE survey on genetic testing in the epilepsies

      July 14, 2023

      Surveys

      COVID-19 and neurology: a survey of previous and continued restrictions on clinical practice, professional education and neuroeconomics

      March 3, 2023

      Surveys

      Help EAN contribute towards the development of a European Pain Research strategy

      December 5, 2022

EAN NewsEAN Congress news

Navigated transcranial ultrasound: the next revolution for neurotherapy?

June 21, 2021

Clarification (July 1, 2021):

The “must see” symposium “The next revolution for neurotherapy? Navigated transcranial ultrasound for surgery, blood brain barrier opening and neuromodulation” presented leading scientist and clinicians from the novel field of Ultrasound Brain Therapies. Prof. Andres Lozano introduced focal Ultrasound Surgery and stressed that among 4 currently available focal neurosurgical approaches, about 90% of his patients meanwhile choose Ultrasound as their therapeutic option. Prof. Jean-Francois Aubry introduced Ultrasound Blood-Brain-Barrier Opening where large clinical studies for targeted focal transfer of medications, antibodies or viral vectors are running. Prof. Roland Beisteiner introduced Ultrasound Neuromodulation Therapy and the Transcranial Pulse Stimulation technique (TPS) as a novel add on therapy. He reported promising results from the first clinical study with navigated ultrasound, improving cognitive performance in AD patients already on successful state of the art medication.

Symposium 8 at the EAN 2021 Virtual Congress addressed the subject of navigated transcranial ultrasound on Monday, June 21. A high quality panel delivered a trio of interesting lectures, tackling neurosurgery, blood brain barrier opening, and neuromodulation.

First to speak was Andres M. Lozano, from Toronto, Canada, covering ‘Focal surgery with ultrasound’. He explained that the most significant hurdle in the early development of transcranial ultrasound was that the skull blocks 90% of the beam energy, and it was only in recent decades that technology has been developed to focus many beams onto a single point to create therapeutic lesions. 

Lesions are created by increasing the temperature at the focal point; the temperature goes up, peaks at a required level, and then goes down, leaving a lesion at the focal point. The method can be used to great effect in reducing essential tremor. Immediately after each sonication, the effect on the tremor is evaluated, and the procedure is repeated with increasing temperature until the tremor disappears.

Lozano said the most common side effect is paresthesia, but that some patients also see a gait disturbance or contralateral weakness. 3D volume reconstruction of lesions that caused such side effects showed encroachment of the lesion on neighbouring brain regions. Subsequent procedure have therefore been refined to avoid those encroachments avoid these encroachments.

The patients treated at Lozano’s centre are offered a range of options to treat tremors and the recent trend is that 90% choose the focuses ultrasound option, meaning it has overtaken deep brain stimulation in popularity and revolutionised treatment of tremor.

Lozano described progress in performing bilateral thalamotomies, with a six-month gap between performing the procedure on each side, showing extremely promising results.

He then discussed a range of uses that are being examined, such as pallidotomy, pallidothalamic tractotomy and subthalamotomy all for Parkinsons disease, and numerous other possibilities including brain tumour ablation, capsulotomy, thalamotomy to treat pain with immediate effects, and even sonothrombolysis.

The next speaker, Jean-Francois Aubry, from France, spoke about ‘Focal blood brain barrier opening with ultrasound’. He began with a short history of history of proposed techniques to open the blood brain barrier (BBB), including those that actually damaged the barrier and made the process irreversible, and addressed the work done to find the threshold to open the barrier without damage.

The gamechanger, he said, was the use of contrast agent microbubbles. Instead of generating cavitation with US, the contrast agent bubbles oscilate, expanding when pressure is low and contracting when pressure is high, causing the vessel walls to stretch just enough for drugs to pass through the tight junctions.

He discussed a study where doxorubicin was delivered through an opened BBB, showing significant improvement in the survival of animals, and  pointed out that this method can be used to treat tumours that are not reachable by chemotherapy. He also showed an application in clearing amyloid-β placques in a mouse model for alzheimers.

Aubry then said the method has been used in rats and addressed ‘the big question’ of how to translate this to humans.

He showed the results of several successful safety studies involving the opening of the BBB to administer chemotherapy in patients with glioma, to deliver therapy to patients with early to moderate alzheimers, and to open the BBB in the motor cortex of ALS patients.

He also showed that lightweight handheld and neuronavigated systems have been developed specifically for BBB opening and are now available. Finally, he showed how BBB opening can be

used to deliver neuroactive drugs to modulate brain activity, bridging the gap with another promising application of transcranial ultrasound: transcranial ultrasound stimulation (TUS).

The final speaker was session co-chair, Roland Beisteiner from Vienna, Austria, talking about ‘Focal neuromodulation with ultrasound’

He explained the background of navigated transcranial pulse stimulation (TPS), which began in earnest with a feasibility and safety study in Alzheimer’s patients. The method uses very short singular ultrasound pulses at a clinical pulse repetition rate in the range of 1-8 Hz to stimulate neurons.

Beisteiner explained that the advantages over FUS techniques are that pulse generation is based on clinically established technology, there are no secondary stimulation maxima, and no brain heating occurs. He also emphasised that the mechanical effects of pulse technology are only related to pressure pulses up to 25 Mpa, with no tissue damage ever having been observed at pressure below 40 Mpa. The effects only concern mechanosensitive channels and pore formations, leading to changes of transmitters and factors. Consequently, microalgia activation and plaque reduction have been observed in a mouse model and neuronal stem cell proliferation stem cell differentiation have also been observed. He said the final consequence is support of longterm neuroplasticity, which leads to behavioural and memory improvements in animals.

The advantages of TPS over electromagnetic neurostimulation are precise targeting in brain tissue with pathological conductivities and that it is a first non-invasive deep brain stimulation technology that can reach deeper regions of the brain.

Beisteiner explained that clinical benefits are likely for all diseases which benefit from neuroplastic reorganisation as well as for diseases which may benefit from non-invasive deep brain stimulation. Benefits are also likely for diseases with focal pathologies that require precise targeting, like Parkinsons, stroke and pain therapy.

Navigated transcranial ultrasound: the next revolution for neurotherapy? was last modified: July 1st, 2021 by Simon Lee
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