39^th European Neurology Congress

Brain imaging has evolved significantly over the past few decades, allowing for more accurate diagnosis and monitoring of neurological conditions. Techniques such as MRI, CT scans, PET scans, and functional MRI (fMRI) provide valuable insights into brain structure and activity. Advanced imaging can detect early changes in neurodegenerative diseases, stroke, and brain injuries.MRI provides high-resolution images of soft tissues, while functional MRI allows for the study of brain activity during specific tasks. PET scans help in detecting biochemical changes, such as abnormal amyloid deposits in Alzheimer’s. Diffusion Tensor Imaging (DTI) is another advancement, which maps white matter tracts, aiding in understanding conditions like multiple sclerosis or traumatic brain injury.Genetic and molecular imaging techniques are emerging, offering the potential for more targeted diagnostic and therapeutic approaches. Machine learning and AI algorithms are also being integrated into imaging to enhance diagnostic accuracy, predict outcomes, and guide treatment decisions.

Neurovascular disorders including stroke, transient ischemic attacks (TIAs), and aneurysms, represent a significant cause of morbidity and mortality worldwide. Stroke is primarily classified into ischemic (due to a blockage in blood flow) and hemorrhagic (due to bleeding in the brain) types.Preventive strategies focus on managing risk factors like hypertension, diabetes, smoking, and hyperlipidemia. Antiplatelet drugs, anticoagulants, and blood pressure management are used to reduce stroke risk. For ischemic strokes, thrombolytics or mechanical thrombectomy are used to restore blood flow.Rehabilitation and post-stroke care focus on recovery and improving quality of life. Early intervention and clot-busting treatments can significantly improve outcomes. Research into genetic and molecular factors influencing stroke risk is underway, which could lead to personalized prevention and treatment strategies.Lifestyle modifications and early identification of at-risk individuals are key to reducing the global burden of neurovascular diseases.

Cognitive neuroscience examines the relationship between brain structures and cognitive functions such as memory, perception, and decision-making. Alzheimer's disease (AD), a common neurodegenerative condition, is characterized by cognitive decline, especially memory loss, and affects millions globally.The primary pathological hallmarks of AD include the accumulation of amyloid plaques and tau tangles, which disrupt normal brain function. These abnormalities lead to neuronal damage and shrinkage of brain areas involved in memory and cognition.Current therapeutic strategies for AD include cholinesterase inhibitors and NMDA receptor antagonists, but they primarily manage symptoms rather than halting disease progression.Cognitive neuroscience research explores the neurobiological basis of memory, language, and attention, with a focus on understanding how these processes are altered in Alzheimer’s. There is also growing interest in biomarkers for early detection and interventions that could slow disease progression. Technological advancements in imaging and genetics are playing a crucial role in uncovering new insights into AD, and potential drug therapies aim to target the root causes of the disease.

Artificial intelligence (AI) has the potential to revolutionize neurology by enhancing diagnostic accuracy, predicting outcomes, and personalizing treatment. Machine learning algorithms are trained on large datasets to recognize patterns in imaging, clinical records, and genetic data.In neurology, AI applications are particularly prominent in brain imaging, where algorithms can detect abnormalities such as tumors, plaques, or lesions. AI is also being used to analyze EEG patterns in epilepsy, predict stroke risk, and assist in the diagnosis of neurodegenerative diseases.AI-driven diagnostic tools provide faster, more consistent interpretations of complex data, helping neurologists make better-informed decisions. These systems can also predict patient outcomes based on historical data, guiding treatment plans. However, challenges remain, including data privacy concerns, the need for large and diverse datasets, and ensuring that AI systems are transparent and interpretable. Collaboration between neurologists and data scientists is essential for AI tools to be fully integrated into clinical practice.

Epilepsy is a chronic neurological disorder characterized by recurrent seizures caused by abnormal brain activity. It affects millions worldwide, with diverse types of seizures and etiologies. Advances in the understanding of the molecular mechanisms of epilepsy have paved the way for more targeted treatments. Antiepileptic drugs (AEDs) remain the mainstay of epilepsy treatment. However, drug-resistant epilepsy, which occurs in around one-third of patients, requires alternative approaches. Newer AEDs, neuromodulation techniques (such as deep brain stimulation), and ketogenic diets are being explored to improve seizure control.Recent research focuses on understanding the genetic and molecular basis of epilepsy. Advances in neuroimaging, particularly fMRI, enable better localization of seizure foci in the brain, improving surgical planning for patients who are candidates for resective surgery. Epilepsy research is also investigating personalized medicine approaches, including gene therapy, that may offer the potential for long-term seizure control. As knowledge about the brain’s electrical activity advances, novel therapies, including precision neuromodulation and targeted drug therapies, show promise in improving the lives of individuals with epilepsy.

Neurogenetics focuses on understanding how genetic factors influence neurological disorders. Genetic mutations and variations play a crucial role in the onset and progression of various neurological diseases, including neurodegenerative disorders, epilepsy, and neurodevelopmental conditions.Advancements in genomic technologies, such as whole-genome sequencing, have led to significant insights into the genetic underpinnings of diseases like Alzheimer’s, Parkinson’s, and Huntington’s. Identifying specific genetic markers can help predict disease risk, guide early diagnosis, and inform treatment decisions.Personalized medicine, which tailors medical treatment to an individual’s genetic profile, is at the forefront of neurogenetics. For example, genetic testing can help select the most effective drug therapies for patients with epilepsy or other genetic conditions. CRISPR-based gene editing technologies hold promise for potential future therapies that could correct genetic defects underlying neurological diseases. However, ethical concerns, safety issues, and the need for further research must be addressed before these technologies become widely available.

Neurorehabilitation focuses on helping individuals recover from neurological injuries or conditions that affect movement, cognition, or communication. It includes rehabilitation for stroke, traumatic brain injury (TBI), and neurological diseases like Parkinson’s and multiple sclerosis.Key techniques in neurorehabilitation include physical therapy, occupational therapy, speech therapy, and cognitive rehabilitation. These therapies aim to help patients regain lost abilities and adapt to changes in their neurological function.Advances in neurorehabilitation include the use of robotic devices, virtual reality, and brain-computer interfaces. These technologies offer new opportunities for enhancing rehabilitation outcomes and helping patients regain lost motor skills or improve cognitive function. Multidisciplinary approaches that combine physical, cognitive, and psychological rehabilitation have shown promise in improving recovery outcomes. Early intervention, neuroplasticity (the brain's ability to reorganize itself), and patient-specific treatment plans are critical to optimizing rehabilitation and recovery.

Pain is a common and often debilitating symptom of many neurological conditions, including multiple sclerosis, migraine, neuropathy, and neurodegenerative diseases. Neuropathic pain, caused by damage to the nervous system, is particularly challenging to treat. Management of neurological pain often involves a combination of pharmacological treatments, physical therapy, and psychological interventions. Medications such as anticonvulsants, antidepressants, opioids, and topical analgesics are commonly used. Emerging therapies include neuromodulation techniques like transcranial magnetic stimulation (TMS), deep brain stimulation (DBS), and spinal cord stimulation, which can reduce pain by altering pain pathways.Research is focusing on better understanding the mechanisms of chronic pain, particularly in conditions like fibromyalgia and neuropathic pain, to identify more effective, non-invasive treatments. Personalized pain management strategies that consider the specific needs of each patient are becoming increasingly important.

Neurotrauma refers to injury to the nervous system, including traumatic brain injury (TBI), spinal cord injuries, and peripheral nerve injuries. TBI can range from mild concussions to severe, life-threatening conditions.The mechanisms of neurotrauma involve both primary injury (direct mechanical damage) and secondary injury (ischemia, inflammation, oxidative stress, and apoptosis). Research is focused on mitigating secondary injury and promoting brain and spinal cord repair.Treatment options for neurotrauma vary depending on the severity and location of the injury. Acute management includes stabilization, monitoring, and surgery to remove hematomas or repair fractures.Rehabilitation following neurotrauma includes physical therapy, speech therapy, and cognitive therapy. Emerging treatments such as neuroprotective agents, stem cell therapy, and gene therapy show promise in promoting recovery and reducing long-term disability. Advanced neuroimaging is also helping to assess injury severity and predict outcomes in patients with neurotrauma, aiding in more precise treatment and management.

Parkinson’s disease (PD) is a progressive neurodegenerative disorder that affects movement, characterized by tremors, rigidity, bradykinesia (slowness of movement), and postural instability. It is caused by the loss of dopamine-producing neurons in the brain’s substantia nigra.Treatment typically involves dopaminergic medications, such as levodopa, and deep brain stimulation (DBS) for advanced stages. Additionally, physical therapy and lifestyle changes help manage symptoms.Other movement disorders include essential tremor, dystonia, and Huntington’s disease, each with unique causes and treatments. Research into gene therapies, neuroprotective drugs, and stem cell therapies holds promise for future treatments. Understanding the molecular mechanisms underlying PD and other movement disorders is critical for developing disease-modifying therapies. Innovations like optogenetics and neurostimulation are being explored to enhance motor function.

Psychiatric comorbidities such as depression, anxiety, and psychosis frequently occur in individuals with neurological disorders like Parkinson’s disease, multiple sclerosis, and epilepsy. These conditions can exacerbate symptoms and negatively impact quality of life.Managing psychiatric symptoms in neurological patients often requires a multidisciplinary approach, combining neurology, psychiatry, and psychotherapy. Antidepressants, anxiolytics, and antipsychotics may be prescribed, but careful monitoring is needed due to potential side effects. Neurological disorders themselves, such as structural brain changes or altered neurotransmitter levels, may contribute to psychiatric symptoms. Research into biomarkers and treatment strategies targeting both the neurological and psychiatric aspects of these conditions is essential for more effective care.

Neuropharmacology involves the study of how drugs affect the nervous system and is critical in the development of treatments for neurological diseases. Traditional neuropharmacological agents, such as antiepileptics, antidepressants, and antipsychotics, are essential in treating disorders like epilepsy, depression, and schizophrenia.Emerging therapies include biologics (monoclonal antibodies), gene therapy, and neuroprotective agents, which aim to modify disease progression rather than just alleviate symptoms. Advances in the understanding of neurochemical signaling, receptor interactions, and brain networks are paving the way for new classes of drugs.Precision medicine, which tailors treatments based on individual genetic profiles, is another area of focus in neuropharmacology. Novel treatments for neurodegenerative diseases, pain management, and psychiatric disorders are actively being researched.

Neuroinflammation refers to the inflammatory response within the central nervous system, often initiated by infection, injury, or neurodegeneration. It is a critical factor in many neurological diseases, including Alzheimer’s disease, multiple sclerosis, and stroke.Microglia, the resident immune cells in the brain, play a central role in neuroinflammation. While they protect the brain during acute injury or infection, chronic activation of these cells contributes to neurodegeneration and worsens disease progression.
Research into neuroinflammation focuses on identifying biomarkers and therapeutic targets to modulate the inflammatory response without compromising the brain's immune defense. Anti-inflammatory drugs, cannabinoids, and lifestyle factors such as diet are being studied as potential treatments to reduce neuroinflammation in chronic neurological conditions.

Sleep disorders, including insomnia, sleep apnea, narcolepsy, and REM sleep behavior disorder, have significant neurological implications. Poor sleep quality or insufficient sleep can exacerbate or even contribute to the development of neurological diseases such as Alzheimer’s, Parkinson’s, and epilepsy.Sleep disturbances often affect brain function, leading to cognitive impairment, mood disorders, and reduced quality of life. The mechanisms underlying these disorders involve disrupted circadian rhythms, neurotransmitter imbalances, and abnormal brain wave patterns.Treatment approaches for sleep disorders may include behavioral therapies, pharmacological interventions, and addressing underlying conditions. Research into the role of sleep in neurodegenerative diseases and the impact of sleep medications is ongoing, with a focus on how improving sleep could slow or prevent disease progression.

Spinal cord injury (SCI) can result in paralysis and sensory loss, significantly affecting the quality of life. Advances in SCI treatment aim to minimize damage and promote recovery through both medical interventions and regenerative therapies.Acute SCI management involves stabilizing the spine, reducing inflammation, and preventing secondary damage. Corticosteroids and surgical decompression are used in the acute phase to reduce swelling and protect neural tissue.Regenerative approaches, such as stem cell therapy, tissue engineering, and neuroprotection strategies, are being explored to promote spinal cord repair and functional recovery. Neuroprosthetics and robotic exoskeletons also offer hope for improving mobility and independence for SCI patients.

Neurosurgery encompasses surgical procedures used to treat neurological disorders, such as brain tumors, epilepsy, and spinal cord injuries. Advances in neurosurgical techniques have dramatically improved outcomes for patients undergoing brain and spinal surgeries. Minimally invasive procedures, such as endoscopic surgeries and laser ablation, allow for precise interventions with smaller incisions, reducing recovery time and complications.Robotics, navigation systems, and intraoperative imaging (such as MRI and CT) have enhanced surgical precision, enabling neurosurgeons to operate with greater accuracy. Stereotactic surgery and deep brain stimulation (DBS) are increasingly used to treat conditions like Parkinson’s disease and essential tremor.
Ongoing research is focused on improving surgical outcomes and exploring the potential of regenerative approaches in neurosurgery.

Neuro-ophthalmology studies the relationship between the eyes and the brain, focusing on disorders that affect vision due to neurological causes. Conditions like optic neuritis, stroke, and multiple sclerosis can damage the optic nerve and visual pathways, leading to vision impairment.Recent advancements in neuro-ophthalmology include better imaging techniques, such as optical coherence tomography (OCT), which allows for high-resolution images of the retina and optic nerve.Neuro-ophthalmologists often collaborate with neurologists to diagnose and manage conditions that affect both vision and brain function. Early detection of neurological diseases through eye examinations is becoming more common, as the eyes provide a window into brain health.The treatment of neuro-ophthalmic disorders may include medications, surgical interventions, and vision therapy, depending on the underlying neurological condition.

The neurobiology of addiction involves understanding how substances like drugs and alcohol alter brain structure and function, leading to dependence and compulsive behaviors. Addiction affects areas of the brain involved in reward, motivation, and decision-making, such as the mesolimbic pathway.Chronic substance use leads to changes in neurotransmitter systems, particularly dopamine, which reinforces the behavior and increases craving. Genetic factors, environmental influences, and brain circuitry contribute to addiction vulnerability.Current research focuses on developing treatments that target the underlying neurobiology of addiction, including pharmacotherapies (e.g., methadone for opioid use disorder) and behavioral therapies (e.g., cognitive-behavioral therapy).Neuroimaging and molecular research are increasingly used to understand addiction’s impact on brain function, and emerging treatments aim to rewire the brain's reward system and prevent relapse.

Pediatric neurology focuses on the diagnosis and treatment of neurological disorders in children. These disorders can range from genetic conditions, such as Rett syndrome and cerebral palsy, to acquired conditions, like meningitis or epilepsy. Research into developmental neurology is particularly important as brain development during childhood affects cognitive and motor outcomes. Genetic insights into pediatric neurological disorders are uncovering new pathways for treatment, particularly in rare or undiagnosed conditions.Gene therapy, stem cell research, and precision medicine hold significant potential for treating genetic neurological disorders in children. Early diagnosis and intervention are crucial to optimizing outcomes, and neurogenetic testing is becoming an essential tool for pediatric neurologists. Neurodevelopmental disorders, including autism spectrum disorders and attention-deficit hyperactivity disorder (ADHD), are also an area of active research, with a focus on both genetic and environmental factors influencing brain development.

Neuroimmunology studies the interactions between the nervous system and the immune system, particularly in conditions where the immune system attacks the brain or spinal cord.Multiple sclerosis (MS) is a primary example of an autoimmune neurological disorder, in which the immune system attacks myelin, the protective covering of nerve fibers, leading to demyelination and neurological impairment.Research in neuroimmunology aims to understand how immune cells, such as T cells and microglia, contribute to neurodegeneration and inflammation. This knowledge is essential for developing therapies to modulate the immune response in autoimmune diseases and improve outcomes in MS, neuroinflammatory disorders, and neurodegenerative diseases.Immunomodulatory drugs, such as interferons and monoclonal antibodies, are being used to treat autoimmune neurological disorders, with ongoing research into new biologics and vaccines.

Neuroplasticity refers to the brain’s ability to reorganize itself by forming new neural connections in response to injury, learning, or environmental changes. This remarkable ability allows the brain to adapt to new situations and recover from injuries such as stroke or traumatic brain injury. Research into neuroplasticity focuses on understanding the molecular, cellular, and network-level mechanisms that underlie brain adaptation. Factors such as neurotrophins (e.g., BDNF), synaptic plasticity, and experience-driven changes are crucial to this process. Therapies aimed at enhancing neuroplasticity, such as cognitive rehabilitation, physical therapy, and non-invasive brain stimulation, are being used to help patients recover lost functions. Understanding the limits and potential of neuroplasticity is essential for developing interventions that promote brain recovery after injury or disease.

Neuro-oncology focuses on the diagnosis and treatment of brain and spinal cord tumors, including gliomas, meningiomas, and metastatic tumors. Brain tumors are often challenging to treat due to their location, the blood-brain barrier, and the complexity of the brain's structure.Advancements in imaging techniques like MRI, PET, and spectroscopy have improved the ability to diagnose and monitor brain tumors. Genetic profiling of tumors has also led to personalized treatment strategies.Treatment options for brain tumors include surgery, radiation therapy, chemotherapy, and targeted therapies. Immunotherapy and gene therapy are emerging as promising treatment options for certain types of tumors.Research into the molecular mechanisms of brain tumors, including the role of tumor stem cells, is key to developing more effective treatments and improving patient outcomes.

Mental health disorders, including depression, anxiety, bipolar disorder, and schizophrenia, have a complex neurobiological basis, involving alterations in neurotransmitter systems, brain structure, and connectivity. Research in neuropsychopharmacology aims to identify biomarkers for mental health conditions and develop targeted treatments. Antidepressants, antipsychotics, and mood stabilizers are commonly used, but there is increasing interest in personalized approaches based on genetic and environmental factors. Neuroimaging techniques, such as fMRI and PET, are being used to study brain activity and connectivity in individuals with mental health disorders. These technologies offer insight into how brain regions interact during emotional and cognitive processes.Advances in understanding the neuroscience of mental health disorders could lead to new treatments and interventions, particularly in resistant cases.

Critical care neurology involves the management of neurological emergencies, such as stroke, traumatic brain injury, and status epilepticus, in intensive care settings.Immediate and effective intervention is crucial for improving outcomes in patients with acute neurological conditions. Management often includes airway control, hemodynamic stabilization, neuroimaging, and pharmacological therapies like thrombolytics for stroke or antiepileptics for seizures.Neurocritical care teams, consisting of neurologists, intensivists, and neurosurgeons, collaborate to provide comprehensive care for critically ill patients. Monitoring of intracranial pressure, cerebral perfusion, and neurological status is vital in the intensive care unit (ICU).Advancements in neurocritical care include the use of neuroprotective agents, real-time imaging techniques, and personalized medicine to improve outcomes in neurological emergencies. Research into more effective early interventions for conditions like acute stroke and brain trauma is ongoing.