Historical overview of the WFN-organised Congresses on Parkinson's Disease and Related Disorders

Abstract

Nearly fifty years after the first International Parkinson’s Disease Congress, the tradition of the WFN Research Group on Parkinsonism and Related Disorders to organise World Congresses on this theme is still alive and kicking. The first congress, organised by the Veteran’s Administrations of Canada and the USA in 1959, took place in Montreal, attended by a small group of no more than 40 or 50 invited participants, mostly neurosurgeons, with the aim of assessing the state of the art in Parkinson’s disease. In 2007, over 3,000 participants, mainly clinical neurologists, neurosurgeons, psychiatrists, neuroscientists and allied health professionals, are expected to attend the seventeenth edition of this, one of the world’s earliest disease-oriented, meetings in Amsterdam. In 1959, the surgical approaches of thalamotomy and pallidotomy represented the most important and successful strategies in the treatment of Parkinson’s disease, and therefore the main topics addressed technical aspects of stereotactic surgery. Other issues were presented as well though, for instance the accuracy of contemporary diagnostic criteria, pathophysiological mechanisms underlying specific parkinsonian signs, and methods to measure the response to therapy. These themes would be explored in increasing detail in the following Parkinson’s disease Congresses. The second Congress was held in Washington, DC (USA) in November 1963, whereas the third Congress was organized by the neurosurgeon F.J. Gillingham in Edinburgh, Scotland, in 1968. Every congress was expanded in respect to the previous one, in terms of both number of topics and participants. In fact, spurred by the biochemical and pharmacological discoveries pioneered by Arvid Carlsson from 1957 onwards, the potential of levodopa therapy [initially with the racemic dl-dopa] started to attract a wider audience. The epoch-making possibility to reverse the parkinsonian motor symptoms by the use of levodopa in advanced cases of Parkinson’s disease, as well as the data presented from the animal models, had an enormous impact in the neurological community. Especially the 1968 congress increased the feeling that a new era was emerging in the treatment of neurodegenerative disorders, in particular Parkinson’s disease. Among the attendants were Andre Barbeau (one of the hosts of the first Congress), George Cotzias and Rolf Hassler, founding members of the Research Committee on Extrapyramidal Diseases of the World Federation of Neurology (WFN), which from 1972 was chaired by Melvin Yahr. The fourth Congress was held in Zurich, Switzerland, in September 1972, again organized by a neurosurgeon, J. Siegfried, while the Ludwig-Boltzmann-Institute for Neurochemistry organized the V International Congress on Parkinson’s disease, in Vienna, Austria, in September 1975. At that time the meeting had increasingly become a forum for interaction between basic scientists and clinicians. l-Dopa treatment had been discussed regarding its potential benefits and also side effects. In this respect, the ability to use MAO inhibitors combined with l-dopa was fully addressed by W. Birkmayer, organizer of this last meeting. In his concluding remarks, Melvin Yahr stated that “So really that is what these meetings have become. They have become a forum for interaction between laboratory investigators in this field and clinicians. An opportunity to exchange information and ideas, hopefully to identify areas in which progress has been made and also areas in which there is no progress, to look for some of the signposts in research”. The VI WFN Congress, held in Quebec, Canada, in September 1978, was organized by L.J. Poirier, and the VII Congress in June 1982, in Frankfurt, Germany, was organized by R.G. Hassler. Melvin D. Yahr (Figure 1), who chaired the Research Group of Extrapyramidal Disorders of the WFN from 1972 until 2001, was the President of the VIII International Congress, held in New York City in June 1985. From the small group of about 50 participants of the first symposium in 1959, almost 25 year later the number of participants had increased to 500, coming from 28 countries. The topics encompassed a broad range of subjects from epidemiology to biochemistry and ultrastructural pathology, motor and non-motor aspects of Parkinson’s disease, and future approach to therapy. The IX Congress was held in Jerusalem, Israel, in June 1988, and was organized by Max B. Streiffler. This meeting was the first outside Europe and North America and succeeded in attracting over 850 participants. It saw the first mention of new agents (among them dopamine agonists, COMT inhibitors and amantadine), as well as the