Brazilian Academy Of Neurology Research Articles

Arquivos de Neuro-Psiquiatria: 80 years.

In June 2023, the Arquivos de Neuro-Psiquiatria (ANP) will complete 80 years of uninterrupted publication. The ANP was envisioned by the students of Professor Enjolras Vampré, founder of the São Paulo neurological school, who died prematurely.[1] The first edition of the ANP was in June 1943 and was presented by Professors Aderbal Tolosa (professor of Neurology at the University of São Paulo Medical School –USP), and Paulino Longo, (professor of Neurology at the Paulista School of Medicine – currently UNIFESP).[2] Dr. Oswaldo Lange (professor of Neurological Clinics at the University of São Paulo Medical School) was appointed editor-in-chief of the journal. Lange continued this noble work with mastery and dedication until 1986.[1] [3] [4] From 1987 to 2010, the editor-in-chief of ANP was Professor Antonio Spina-França, who was dedicated to making the ANP the leading journal of neurology in Latin America.[1] [3] [4] He was succeeded by his colleagues Professors Luís dos Ramos Machado and José Antonio Livramento, both from the Hospital das Clínicas at the University of São Paulo. They served as the editors-in-chief of the ANP between 2010 and 2017 with great harmony and dedication.[1] [3] [4] The editors chosen in 2018 were Professor Paulo Caramelli (full professor of Neurology at the University of Minas Gerais) and Hélio A. Ghizoni Teive (currently full professor of Neurology at the Federal University of Paraná).[1] [3] [4] This year, Professor Ayrton Massaro (Neurologist at the Hospital Israelita Albert Einstein, in São Paulo) replaced Professor Paulo Caramelli as editor-in-chief of the ANP. Demonstrating the great scientific evolution of Brazilian neurology in recent years, the ANP, the official journal of the Brazilian Academy of Neurology (BAN), has achieved an exponential increase in its impact factor, reaching 2.035.[5] This unprecedented achievement encourages even more its editors-in-chief, as well as all of its associated editors and the Brazilian neurological community, with the support of the BAN, to improve the scientific level of the journal, with the primary objective of reaching levels of excellence in the Latin American and world context of neurosciences.[5] This year, 2023, as current and past editors-in-chief of ANP, we are organizing a major scientific event to celebrate the 80th anniversary of the Journal, as well as the publication of a special issue of the ANP, with a series of scientific articles, covering topics of great interest in different subspecialties of neurology.

Brazilian Academy of Neurology: 60 Years.

The Brazilian Academy of Neurology (ABN – Academia Brasileira de Neurologia) was founded on May 5, 1962 in the city of Rio de Janeiro, under the leadership of Professors Deolindo Augusto de Nunes Couto and Adherbal Tolosa, who were disciples of Professors Antonio Austregésilo (founder of the first school of Neurology in Brazil and first professor of Neurology at the Faculty of Medicine of Rio de Janeiro in 1912) and Enjolras Vampré (founder of the São Paulo School of Neurology in 1925 and first professor of Neurology at the University of São Paulo), respectively.[1] [2] The inaugural meeting was held at the Institute of Neurology in Rio de Janeiro, and was chaired by Professor Deolindo Couto, who was is credited as the patron of ABN.[1] [2] [3] The two masters had the support of 47 other Neurology professors, from different parts of Brazil, many of them direct disciples of these two leaders from the Rio de Janeiro and São Paulo schools of Neurology.[1] [2] [3]

Subjective cognitive decline, mild cognitive impairment, and dementia - syndromic approach: recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology.

This consensus, performed by the Brazilian Academy of Neurology (BAN) will approach practically how to evaluate patients with cognitive complaints and how to clinically and etiologically diagnose the three clinical syndromes associated with the different stages of cognitive decline: subjective cognitive decline (SCD), mild cognitive impairment (MCI), and dementia. This BAN consensus discusses SCD diagnosis for the first time, updates MCI and dementia diagnoses, recommends the adequate cognitive tests and the relevant etiological work-up and care of patients with cognitive decline at different levels of care within the Brazilian Unified Health System. We also review the main assessment instruments used in Brazil and Latin America.

Declínio cognitivo subjetivo, comprometimento cognitivo leve e demência - diagnóstico sindrômico: recomendações do Departamento Científico de Neurologia Cognitiva e do Envelhecimento da Academia Brasileira de Neurologia

ABSTRACT This consensus, performed by the Brazilian Academy of Neurology (BAN) will approach practically how to evaluate patients with cognitive complaints and how to clinically and etiologically diagnose the three clinical syndromes associated with the different stages of cognitive decline: subjective cognitive decline (SCD), mild cognitive impairment (MCI), and dementia. This BAN consensus discusses SCD diagnosis for the first time, updates MCI and dementia diagnoses, recommends the adequate cognitive tests and the relevant etiological work-up and care of patients with cognitive decline at different levels of care within the Brazilian Unified Health System. We also review the main assessment instruments used in Brazil and Latin America.

Diagnóstico da doença de Alzheimer: recomendações do Departamento Científico de Neurologia Cognitiva e do Envelhecimento da Academia Brasileira de Neurologia

ABSTRACT This paper presents the consensus of the Scientific Department of Cognitive Neurology and Aging from the Brazilian Academy of Neurology on the diagnostic criteria for Alzheimer’s disease (AD) in Brazil. The authors conducted a literature review regarding clinical and research criteria for AD diagnosis and proposed protocols for use at primary, secondary, and tertiary care levels. Within this clinical scenario, the diagnostic criteria for typical and atypical AD are presented as well as clinical, cognitive, and functional assessment tools and complementary propaedeutics with laboratory and neuroimaging tests. The use of biomarkers is also discussed for both clinical diagnosis (in specific conditions) and research.

The importance of the Brazilian Society of Neurological Investigation (SBIN)

The Brazilian Society of Neurological Research (SBIN) was founded on December 19, 2000, by a group of neurologists headed by Professor Lineu César Werneck, MD, Ph.D., to promote scientific development and cultural diversity in neurology and neurosciences. The criteria for members’ admission have always been strict, and the group reached 80% of physicians with a Ph.D. degree. However, the conditions to become a member were modified to attract more researchers, especially the younger ones, and neuroscientists from other areas of health and biology. The scientific events were the primary goal of SBIN. Eighteen editions were performed. The board and members of the SBIN recognized that the Brazilian Academy of Neurology, and the other societies that encouraged the neurosciences, were working to continue the exponential increase of scientific production in the neurosciences in Brazil,realizing that their purposes were fulfilled. The society was dissolved in December 2020.

EEG education in Brazil: a national survey of adult neurology residents.

In light of the established challenges of resident EEG education worldwide, we sought to better understand the current state of neurology resident EEG education in Brazil. To define Brazilian EEG practices including in-residency requirements for EEG training and competency. We assessed the perspectives of adult residents (PGY1-3) on EEG education and their level of confidence interpreting EEG with a 24-question online survey. We analyzed 102 responses from 52 Brazilian neurology residency programs distributed in 14 states. There were 18 PGY1s, 45 PGY2s, and 39 PGY3s. Ninety-six percent of participants reported that learning how to read EEG during residency was very or extremely important. The most commonly reported barriers to EEG education were insufficient EEG exposure (70%) and ineffective didactics (46%). Residents believed that standard EEG lectures were the most efficient EEG teaching method followed by interpreting EEG with attendings' supervision. Roughly half of residents (45%) reported not being able to read EEG even with supervision, and approximately 70% of all participants did not feel confident writing an EEG report independently. Despite the well-established residency EEG education requirements recommended by the Brazilian Academy of Neurology (ABN), there seems to be a significant lack of comfort interpreting EEG among Brazilian adult neurology residents. We encourage Brazilian neurology residency leadership to re-evaluate the current EEG education system in order to ensure that residency programs are following EEG education requirements and to assess whether EEG benchmarks require modifications.

Telemedicine use among neurologists before and during COVID-19 pandemic.

After the public health emergency due to COVID-19 was declared in Brazil, the federal government temporarily regulated and authorized the use of telemedicine services for patient consultation, monitoring, and diagnosis. For more than a decade, neurologists have recognized the benefits of telemedicine in the acute management of stroke patients. However, as the use of telemedicine was restricted until the COVID-19 pandemic, the view of Brazilian neurologists about telemedicine is unknown. All neurologists registered at the Brazilian Academy of Neurology were invited by e-mail to participate in a survey about personal perceptions on telemedicine use. One hundred sixty-two neurologists from all regions of Brazil answered the online questionnaire. The survey showed that 18.5% of participants worked with telemedicine before the pandemic, while 63.6% reported working with telemedicine during the pandemic. The main telemedicine modalities used during the pandemic were teleorientation and teleconsultation. According to our data, the COVID-19 pandemic deeply influenced the behavior of Brazilian neurologists, who developed a more favorable view about telemedicine and actively searched for information about telemedicine. As there is a need for more training in this area in Brazil, universities and medical societies must strive to improve telemedicine education. Expanding the use of high-quality teleneurology can contribute to a better care for patients with neurological diseases in Brazil.

Cannabinoids in Neurology - Position paper from Scientific Departments from Brazilian Academy of Neurology.

Cannabinoids comprehend endocannabinoids, phytocannabinoids, and synthetic cannabinoids, with actions both in the central and peripherical nervous systems. A considerable amount of publications have been made in recent years, although cannabis has been known for over a thousand years. Scientific Departments from the Brazilian Academy of Neurology described evidence for medical use in their areas. Literature is constantly changing, and possible new evidence can emerge in the next days or months. Prescription of these substances must be discussed with patients and their families, with knowledge about adverse events and their efficacy.

Brazilian Academy of Neurology (2006 – 2016)

Brazil is a heterogeneous country with continental dimensions. The different characteristics of cultural, socioeconomic, and demographic status of the population drive different strategies for neurological care. This knowledge helps the understanding of the current scenario with the consequent possibility of preparing for future challenges. We used data from annual internal forms of the Brazilian Academy of Neurology (BAN) since 2006 and the survey for all BAN members (3,240) in 2016. The geographic distribution of BAN members in Brazil follows the demographic concentration of the population. Participation of members from big cities was the most prevalent, 18.7% of participants were young neurologists, and 36.7% of neurologists had more than of 20 years of neurological practice. The improvement of knowledge of neurological practice in Brazil will be useful for BAN leadership in planning future actions. The BAN must make an effort to aggregate a greater number of neurologists, offering updating support contributing to health policies to disseminate neurological care in Brazil.

Cannabinoids in neurology--Brazilian Academy of Neurology

The use of cannabidiol in some neurological conditions was allowed by Conselho Regional de Medicina de São Paulo and by Agência Nacional de Vigilância Sanitária (ANVISA). Specialists on behalf of Academia Brasileira de Neurologia prepared a critical statement about use of cannabidiol and other cannabis derivatives in neurological diseases.

Women neurologist: a worldwide and Brazilian struggle

The main aim of this paper was to present some pioneer women neurologist, their struggle to pursue their career and the barriers mainly encountered at the beginning of their professional lives. It was also presented the progressive increasing of the feminine participation in medicine and in the neurology with study based on data of the School of Medicine of the Federal University of Rio de Janeiro and Brazilian Academy of Neurology. Their composition were analyzed according to gender, class and academic rank. In spite of this feminization, there is lack of a women's parallel advancement into leadership positions despite no visible barriers ("glass ceiling").

Treatment of Alzheimer's disease in Brazil: I. Cognitive disorders.

This article reports the recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology for the treatment of Alzheimer’s disease (AD) in Brazil, with special focus on cognitive disorders. It constitutes a revision and broadening of the 2005 guidelines based on a consensus involving researchers (physicians and non-physicians) in the field. The authors carried out a search of articles published since 2005 on the MEDLINE, LILACS and Cochrane Library databases. The search criteria were pharmacological and non-pharmacological treatment of cognitive disorders in AD. Studies retrieved were categorized into four classes, and evidence into four levels, based on the 2008 recommendations of the American Academy of Neurology. The recommendations on therapy are pertinent to the dementia phase of AD. Recommendations are proposed for the treatment of cognitive disorders encompassing both pharmacological (including acetyl-cholinesterase inhibitors, memantine and other drugs and substances) and non-pharmacological (including cognitive rehabilitation, physical activity, occupational therapy, and music therapy) approaches. Recommendations for the treatment of behavioral and psychological symptoms of dementia due to Alzheimer’s disease are included in a separate article of this edition.

O papel da academia brasileira de neurologia no ensino da neurologia uma visão pessoal

A Academia Brasileira de Neurologia (ABN) tem demonstrado crescente interesse pelo ensino da neurologia, tanto na graduação quanto na residência médica. Ela deve definir o padrão da prática da neurologia no país, traçar o perfil de competência mínima do neurologista, determinar a competência mínima em neurologia do médico não-neurologista, desenvolver suas próprias atividades de ensino, e definir e propiciar o desenvolvimento das qualidades humanísticas desejáveis no neurologista. A ABN deve formular um currículo mínimo de neurologia na graduação e na residência médica e esforçar por sua adoção pelas escolas médicas e pelos Programas de Residência. Além disso, a ABN deve, por si própria, tornar-se agente efetora do ensino através: de um Programa de Educação Continuada, promovendo cursos e simpósios; da elaboração de um sistema de ensino programado em neurologia, via postal; da implantação de videoteca e de banco de dados da literatura. A Comissão de Ensino deve desempenhar papel fundamental em todas as atividades de ensino promovida pela ABN, definindo sua política, estabelecendo prioridades e coordenando as ações de ensino dos Grupos de Trabalho e Pesquisa.

Medical residency and certification in neurology

Medical residency is the most appropriate form of post-graduate training in the various areas of Medicine. During residency young doctors have close contact with teachers at the bedside approach and management of a wide variety of situations in the actual practice of the profession. It is in this period that basic technical skills and methods of learning through medical observation and scientific discussions develop and the comprehension and sympathy toward suffering disease imposes upon man deepen. The medical societies have the ultimate responsibility to qualify Residency Programs in the various specialties, as well as to establish the standards of qualification doctors must fulfill to be eligible for certification. Continued government intervention on these issues in the last years in Brazil have brought catastrophic consequences for the medical education in this country. The Brazilian Academy of Neurology must expand its educational programs and define the standards of competence for a Neurologist. At the time Brazil returns to democratic life it is challenging for the medical profession to resume their right in relation to qualification of their own members.