by Mélisande Rouger
Four distinguished neurologists delivered the prestigious named lectures during the Presidential Symposium, held on the second day of EAN 2023.
“The lectures are named after three outstanding European neurologists and are reserved for outstanding active basic and clinical scientists,” EAN President Prof. Paul Boon said. “We are giving the floor to the most eminent neuroscientists and neurologists in the world.”
EAN Past President Claudio Bassetti introduced the speakers one by one, starting with the Brain Prize Awardee, Prof. Silvia Arber from Basel, Switzerland.
Organisation of neuronal circuits controlling movement
“The Brain Prize is the largest neuroscience research prize and it recognises highly original and influential inventions in any area of brain research,” said Bassetti in his introduction. “Professor Arber’s research investigates the mechanism involved in the function and organisation of neuronal circuits controlling motor behaviour.”
The daughter of Swiss microbiologist and geneticist Nobel Laureate, Werner Arber, Prof. Silvia Arber, who works at the Biozentrum and Friedrich Miescher Institute for Biomedical Research, focused on Circuits for Body Movements.
She showed videos of famous Swiss athletes to illustrate “the enormous diversity of frequent actions that the human body can carry out and that decays in degenerative diseases under neurological conditions.”
“It’s important to understand the circuitry in order to be able to intervene in conditions that affect the nerves that affect movement in turn,” she said. “Movement is very complicated to understand and the circuits that are influencing movement are distributed throughout the nervous system.’
In between the upper motor centres and execution surface are the brain stems, which are very poorly understood because they remain difficult to access – even though it is known that it acts as a switch board. “Understanding how they are organised is key,” she said.
Less is known about the circuit organisation when diverse actions are being generated. ‘That is the main subject of my lab, and that’s what I have been working on for the past ten years,’ she said.
Arber gave an overview of her work and how her team has made use of viruses that have been modified genetically to make them visible.
The Circle of Translation
Prof. Mary M. Reilly from London, UK then gave the Moritz Romberg Lecture on the Continuous Circle of Translation.
Prof. Reilly, who works at the National Hospital for Neurology and Neurosurgery and UCL Queen Square Institute of Neurology, is Past President of the British Peripheral Nerve Society and was the first woman President of the Association of British Neurologists in 2017.
Her interest has been inherited neurological diseases and particularly neuropathies, such as Charcot-Marie-Tooth (CMT) disease.
“The circle of translation is we start with the patient, we try to find the positive gene, we work out how that gene causes the disease, we develop candidate therapies, take them to clinical trials and develop treatments.”
There are over 120 genes that cause CMT. “The more we describe genes, the greater the phenotype variations we see,” she said.
A game changer in the treatment of inherited neuropathies has been the development of genetic therapies. In CMT, this hasn’t come to clinical trials yet.
“We’re at the beginning of therapies,” she said. “We have learned how to personalise disease by understanding the underlying genetic cause. We’re only beginning to think about personalising the patient. Patients have their own immune environment, so we have to understand the patients better to know how to treat them.”
Researchers need to optimise human in vivo studies, she added. “We need to be as good at studying humans as we are at studying mice.”
She acknowledged her patients, funders, and PhD students over the years, saying “working with enthusiastic fellows has been one of the highlights of my career and I’m delighted that the EAN prioritises the next generation, I think it’s the future”.
Prof. Mark Hallett, National Institutes of Health (NIH) Distinguished Investigator Emeritus who also led the National Institute of Neurological Disorders and Stroke Human Motor Control Section, gave the Charles-Édouard Brown-Séquard Lecture on Experimental Medicine and Functional Neurological Disorders.
Hallett divided his talk in two parts and first focused on what is a voluntary movement and the question of free will, a particular interest of his. He touched on a little aspect of free will, namely the issue of agency, which is the feeling of being causally involved in an action.
In one of their studies, he and his group used functional MRI (fMRI) to look at patients’ perception level of self-agency for each objective level of control, and also looked at regions in the brain that are responding proportionally to the loss of self-agency.
Hallett then talked about functional neurological disorders, a common disorder with a multiplicity of neurological symptoms. Hallett became interested in those conditions because, while these are fairly common disorders, they had not been extensively documented in the past and patients often fall into the gap between neurology and psychiatry.
Last but not least, Prof. Josep Dalmau, Professor at the Catalan Institution for Research and Advanced Studies (ICREA)-IDIBAPS, University of Barcelona, and Adjunct Professor of Neurology at the University of Pennsylvania, gave the Camillo Golgi Lecture on Autoimmune Synaptic Diseases: The Basics And The Latest.
In his lecture, Dalmau focused on disorders where neuronal antibodies are associated in encephalitis, and in particular on a recently identified group of autoimmune synaptic diseases, in which antigenes are on the cell surface of neurons.
“You can see that neuronal antibodies bind to the antigenes and cause structural and functional alterations. The infiltrates are more B cells, plasma cells and deposits of antibodies,” he said.
Those that associate with T cells frequently associate with cancer and usually have a bad prognosis, while those that associate with antibodies are more treatment responsive and can associate with or without cancer.