1
|
Shlobin NA, Ghotme KA, Arynchyna-Smith A, Gomez MG, Woodrow S, Blount J, Rosseau G. Neurosurgical Advocacy in the Prevention of Neural Tube Defects: Impacting Global Fortification Policies Through Leadership, Collaboration, and Stakeholder Engagement. Neurosurg Clin N Am 2024; 35:411-420. [PMID: 39244313 DOI: 10.1016/j.nec.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2024]
Abstract
The G4 Alliance and its member organizations formed a delegation that participated in the 76th World Health Assembly (WHA) in 2023, which unanimously adopted the resolution to address micronutrient deficiencies through safe, effective food fortification to prevent congenital disorders such as spina bifida and anencephaly, the first neurosurgery-led resolution since the founding of the World Health Organization. The WHA included other resolutions and side events by the G4 Alliance and other organizations relevant to neurosurgery. An opportunity exists for neurosurgeons to harness the momentum from this resolution to promote initiatives to prevent neurosurgical disease or expand access to neurosurgical care.
Collapse
Affiliation(s)
- Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, 710 West 168th Street, 4th Floor, New York, NY 10032, USA.
| | - Kemel A Ghotme
- Translational Neuroscience Research Lab, Faculty of Medicine, Universidad de La Sabana, Carrera 7 No. 117 - 15, Bogota, Columbia; Pediatric Neurosurgery, Department of Neurosurgery, Fundacion Santa Fe de Bogota, Campus del Puente del Común, Km. 7, Autopista Norte de Bogotá. Chía, Cundinamarca, Colombia. https://twitter.com/KemelG
| | - Anastasia Arynchyna-Smith
- Department of Neurosurgery, Division of Pediatric Neurosurgery, Children's of Alabama, University of Alabama at Birmingham, 1600 7th Avenue South, Lowder 400, Birmingham, AL 35233, USA.
| | - Martina Gonzalez Gomez
- Department of Neurosurgery, Division of Pediatric Neurosurgery, Children's of Alabama, University of Alabama at Birmingham, 1600 7th Avenue South, Lowder 400, Birmingham, AL 35233, USA
| | - Sarah Woodrow
- Department of Neurological Surgery, Cleveland Clinic, Neuroscience Institute, 1 Akron General Avenue, Akron, OH 44307, USA
| | - Jeffrey Blount
- Department of Neurosurgery, Division of Pediatric Neurosurgery, Children's of Alabama, University of Alabama at Birmingham, 1600 7th Avenue South, Lowder 400, Birmingham, AL 35233, USA. https://twitter.com/Jpb1007Jeffrey
| | - Gail Rosseau
- Department of Neurological Surgery, George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Avenue, NW 7 South, Washington, DC 20037, USA; Barrow Global, Barrow Neurological Institute, 2910 North Third Avenue, Phoenix, AZ 85013, USA. https://twitter.com/grosseaumd
| |
Collapse
|
2
|
Waris A, Ullah A, Asim M, Ullah R, Rajdoula MR, Bello ST, Alhumaydhi FA. Phytotherapeutic options for the treatment of epilepsy: pharmacology, targets, and mechanism of action. Front Pharmacol 2024; 15:1403232. [PMID: 38855752 PMCID: PMC11160429 DOI: 10.3389/fphar.2024.1403232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 05/09/2024] [Indexed: 06/11/2024] Open
Abstract
Epilepsy is one of the most common, severe, chronic, potentially life-shortening neurological disorders, characterized by a persisting predisposition to generate seizures. It affects more than 60 million individuals globally, which is one of the major burdens in seizure-related mortality, comorbidities, disabilities, and cost. Different treatment options have been used for the management of epilepsy. More than 30 drugs have been approved by the US FDA against epilepsy. However, one-quarter of epileptic individuals still show resistance to the current medications. About 90% of individuals in low and middle-income countries do not have access to the current medication. In these countries, plant extracts have been used to treat various diseases, including epilepsy. These medicinal plants have high therapeutic value and contain valuable phytochemicals with diverse biomedical applications. Epilepsy is a multifactorial disease, and therefore, multitarget approaches such as plant extracts or extracted phytochemicals are needed, which can target multiple pathways. Numerous plant extracts and phytochemicals have been shown to treat epilepsy in various animal models by targeting various receptors, enzymes, and metabolic pathways. These extracts and phytochemicals could be used for the treatment of epilepsy in humans in the future; however, further research is needed to study the exact mechanism of action, toxicity, and dosage to reduce their side effects. In this narrative review, we comprehensively summarized the extracts of various plant species and purified phytochemicals isolated from plants, their targets and mechanism of action, and dosage used in various animal models against epilepsy.
Collapse
Affiliation(s)
- Abdul Waris
- Department of Biomedical Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Ata Ullah
- Department of Biomedical Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Muhammad Asim
- Department of Neurosciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
- Centre for Regenerative Medicine and Health (CRMH), Hong Kong, Hong Kong SAR, China
| | - Rafi Ullah
- Department of Botany, Bacha Khan University Charsadda, Charsadda, Pakistan
| | - Md. Rafe Rajdoula
- Department of Neurosciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Stephen Temitayo Bello
- Department of Neurosciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
- Centre for Regenerative Medicine and Health (CRMH), Hong Kong, Hong Kong SAR, China
| | - Fahad A. Alhumaydhi
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia
| |
Collapse
|
3
|
Gupta S, Aukrust CG, Bhebhe A, Winkler AS, Park KB. Neurosurgery and the World Health Organization Intersectoral Global Action Plan for Epilepsy and Other Neurological Disorders 2022-2031. Neurosurgery 2024:00006123-990000000-01020. [PMID: 38224233 DOI: 10.1227/neu.0000000000002828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/27/2023] [Indexed: 01/16/2024] Open
Abstract
The World Health Organization's Intersectoral Global Action Plan (IGAP) on Epilepsy and Other Neurological Diseases 2022-2031 is a holistic, interdisciplinary, and intersectoral plan with a strong focus on equity and human rights. The IGAP was unanimously approved by all World Health Organization Member States at the 75th World Health Assembly in May 2022 and provides a framework for researchers and clinicians to study and address national and global inadequacies in the evaluation and management of people suffering from neurological disorders and their prevention. While IGAP has applied epilepsy as an entry point for other neurological disorders, advocacy by neurologists and neurosurgeons has broadened it to include diseases with a large and growing global health footprint such as stroke, hydrocephalus, traumatic brain injury, and brain and spine cancers. The IGAP is important to neurosurgeons globally because it provides the first ever roadmap for comprehensively addressing unmet neurological and neurosurgical care in low- and middle-income countries. Furthermore, it creates an opportunity for neurologists and neurosurgeons to scale up services for neurological diseases in tandem. As such, it provides a structure for the neurosurgery community to become involved in global health initiatives at all levels.
Collapse
Affiliation(s)
- Saksham Gupta
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Global Health and Social Medicine, Program for Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA
| | - Camilla G Aukrust
- Department of Neurosurgery, Oslo University Hospital-Rikshospitalet, Oslo, Norway
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Arnold Bhebhe
- Department of Neurosurgery, University Teaching Hospital, Lusaka, Zambia
| | - Andrea S Winkler
- Department of Global Health and Social Medicine, Program for Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Neurology, Center for Global Health, Technical University of Munich, Munich, Germany
| | - Kee B Park
- Department of Global Health and Social Medicine, Program for Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
4
|
Shu Y, Wu Z, Yang X, Song M, Ye Y, Zhang C, Yuan Q, Wang L. The burden of epilepsy in the People's Republic of China from 1990 to 2019: epidemiological trends and comparison with the global burden of epilepsy. Front Neurol 2023; 14:1303531. [PMID: 38146443 PMCID: PMC10749336 DOI: 10.3389/fneur.2023.1303531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 11/23/2023] [Indexed: 12/27/2023] Open
Abstract
Background Epilepsy is associated with a significant global burden of disease, affecting over 50 million people worldwide. The specific aim of this study is to compare the burden of epilepsy in the People's Republic of China (PRC) with the global burden, and to analyze the epidemiological trends of epilepsy, the relationship between the burden of epilepsy and social demographic index (SDI), and the relative contributions of epidemiological factors. Methods This is a retrospective population-based study, data were obtained from the Global Burden of Disease (GBD) study in 2019. We employed Joinpoint software and the age-period-cohort (APC) model to analyze epilepsy's epidemiological trends. Health inequality analysis was conducted to investigate the impact of SDI on epilepsy burden. Decomposition analysis was performed to examine the relative contributions of age, population, and epidemiological changes to epilepsy. Results Between 1990 and 2019, the incidence rate in the PRC increased by 45%, significantly surpassing the global incidence of epilepsy. However, Disability-Adjusted Life Years (DALY) decreased notably, and the proportion of Years of Life Lost (YLL) decreased from 62.73 to 39.03%. Concerning incidence, the period Rate Ratio (RR) in the PRC initially increased and then decreased, while the cohort RR in the PRC and globally exhibited a consistent upward trend. In terms of mortality, period RR and cohort RR in the PRC displayed a gradual decrease, with mortality starting higher but eventually falling below the global mortality. The net drifts of incidence were greater than 0, whereas the net drifts of mortality were less than 0, both were lower in the PRC than at the global level. Decomposition analysis indicated that the changes of incidence and mortality in the PRC were mainly attributed to epidemiological changes. Additionally, global disparities in epilepsy decreased, with the burden concentrating in low SDI countries. Conclusion The incidence of epilepsy in the PRC rose during the 30-year study period, while epilepsy mortality decreased. The improved survival rate in the PRC is predominantly attributable to epidemiological changes. The burden of epilepsy in the PRC predominantly affects males, children, and the elderly, Chinese government should focus on specific populations.
Collapse
Affiliation(s)
- Yun Shu
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhifeng Wu
- Department of Pediatrics, Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Xiaolin Yang
- National Comprehensive Epilepsy Center, Department of Neurosurgery, Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Min Song
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yangyang Ye
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chunqing Zhang
- National Comprehensive Epilepsy Center, Department of Neurosurgery, Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Qing Yuan
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Li Wang
- Department of Neurology, Second Affiliated Hospital, Army Medical University, Chongqing, China
| |
Collapse
|
5
|
Nandi A, Counts N, Chen S, Seligman B, Tortorice D, Vigo D, Bloom DE. Global and regional projections of the economic burden of Alzheimer's disease and related dementias from 2019 to 2050: A value of statistical life approach. EClinicalMedicine 2022; 51:101580. [PMID: 35898316 PMCID: PMC9310134 DOI: 10.1016/j.eclinm.2022.101580] [Citation(s) in RCA: 83] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 10/25/2022] Open
Abstract
Background The burden of Alzheimer's disease and related dementias (ADRDs) is expected to grow rapidly with population aging, especially in low- and middle-income countries, in the next few decades. We used a willingness-to-pay approach to project the global, regional, and national economic burden of ADRDs from 2019 to 2050 under status quo. Methods We projected age group and country-specific disability-adjusted life years (DALYs) lost to ADRDs in future years based on historical growth in disease burden and available population projections. We used country-specific extrapolations of the value of a statistical life (VSL) year and its future projections based on historical income growth to estimate the economic burden - measured in terms of the value of lost DALYs - of ADRDs. A probabilistic uncertainty analysis was used to calculate point estimates and 95% uncertainty bounds of the economic burden. Findings In 2019, the global VSL-based economic burden of ADRDs was an estimated $2.8 trillion. The burden was projected to increase to $4.7 trillion (95% uncertainty bound: $4 trillion-$5.5 trillion) in 2030, $8.5 trillion ($6.8 trillion-$10.8 trillion) in 2040, and $16.9 trillion ($11.3 trillion-$27.3 trillion) in 2050. Low- and middle-income countries (LMICs) would account for 65% of the global VSL-based economic burden in 2050, as compared with only 18% in 2019. Within LMICs, upper-middle income countries would carry the largest VSL-based economic burden by 2050 (92% of LMICs burden and 60% of global burden). Interpretation ADRDs have a large and inequitable projected future VSL-based economic burden. Funding The Davos Alzheimer's Collaborative.
Collapse
Affiliation(s)
- Arindam Nandi
- The Population Council, New York, NY, USA
- One Health Trust, Washington DC, USA
| | - Nathaniel Counts
- Mental Health America, New York, NY, USA
- Albert Einstein Medical College, New York, NY, USA
| | | | - Benjamin Seligman
- Division of Geriatric Medicine, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Geriatrics Research, Education, and Clinical Center, Greater Los Angeles VA Health Care System, Los Angeles, CA, USA
| | | | - Daniel Vigo
- University of British Columbia, Vancouver, BC, Canada
| | - David E. Bloom
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| |
Collapse
|
6
|
Hale AT, Chari A, Scott RC, Cross JH, Rozzelle CJ, Blount JP, Tisdall MM. Expedited epilepsy surgery prior to drug resistance in children: a frontier worth crossing? Brain 2022; 145:3755-3762. [PMID: 35883201 DOI: 10.1093/brain/awac275] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 06/18/2022] [Accepted: 07/08/2022] [Indexed: 11/14/2022] Open
Abstract
Epilepsy surgery is an established safe and effective treatment for selected candidates with drug-resistant epilepsy. In this opinion piece, we outline the clinical and experimental evidence for selectively considering epilepsy surgery prior to drug resistance. Our rationale for expedited surgery is based on the observations that, 1) a high proportion of patients with lesional epilepsies (e.g. focal cortical dysplasia, epilepsy associated tumours) will progress to drug-resistance, 2) surgical treatment of these lesions, especially in non-eloquent areas of brain, is safe, and 3) earlier surgery may be associated with better seizure outcomes. Potential benefits beyond seizure reduction or elimination include less exposure to anti-seizure medications (ASM), which may lead to improved developmental trajectories in children and optimize long-term neurocognitive outcomes and quality of life. Further, there exists emerging experimental evidence that brain network dysfunction exists at the onset of epilepsy, where continuing dysfunctional activity could exacerbate network perturbations. This in turn could lead to expanded seizure foci and contribution to the comorbidities associated with epilepsy. Taken together, we rationalize that epilepsy surgery, in carefully selected cases, may be considered prior to drug resistance. Lastly, we outline the path forward, including the challenges associated with developing the evidence base and implementing this paradigm into clinical care.
Collapse
Affiliation(s)
- Andrew T Hale
- Division of Pediatric Neurosurgery, Children's of Alabama, Birmingham, AL, USA
| | - Aswin Chari
- Department of Neurosurgery, Great Ormond Street Hospital, London, UK.,Developmental Neurosciences, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Rod C Scott
- Developmental Neurosciences, Great Ormond Street Institute of Child Health, University College London, London, UK.,Department of Paediatric Neurology, Nemours Children's Hospital, Wilmington, DE, USA.,Department of Paediatric Neurology, Great Ormond Street Hospital, London, UK
| | - J Helen Cross
- Developmental Neurosciences, Great Ormond Street Institute of Child Health, University College London, London, UK.,Department of Paediatric Neurology, Great Ormond Street Hospital, London, UK
| | - Curtis J Rozzelle
- Division of Pediatric Neurosurgery, Children's of Alabama, Birmingham, AL, USA
| | - Jeffrey P Blount
- Division of Pediatric Neurosurgery, Children's of Alabama, Birmingham, AL, USA
| | - Martin M Tisdall
- Department of Neurosurgery, Great Ormond Street Hospital, London, UK.,Developmental Neurosciences, Great Ormond Street Institute of Child Health, University College London, London, UK
| |
Collapse
|
7
|
Ruggiero RN, Peixoto-Santos JE, Bueno-Junior LS, Valente KD, Leite JP. Editorial: Psychiatric Comorbidities in the Epilepsies: Extensive Mechanisms and Broad Questions. Front Integr Neurosci 2022; 16:951170. [PMID: 35784497 PMCID: PMC9249385 DOI: 10.3389/fnint.2022.951170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 05/31/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- Rafael Naime Ruggiero
- Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School, University of São Paulo (USP), Ribeirao Preto, Brazil
- *Correspondence: Rafael Naime Ruggiero
| | - Jose Eduardo Peixoto-Santos
- Neuroscience Sector, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | | | - Kette D. Valente
- Institute and Department of Psychiatry, Faculty of Medicine of the University of São Paulo (HCFMUSP), São Paulo, Brazil
| | - Joao Pereira Leite
- Department of Neurosciences and Behavioral Sciences, Ribeirao Preto Medical School, University of São Paulo (USP), Ribeirao Preto, Brazil
| |
Collapse
|
8
|
Lartigue JW, Dada OE, Haq M, Rapaport S, Sebopelo LA, Ooi SZY, Senyuy WP, Sarpong K, Vital A, Khan T, Karekezi C, Park KB. Emphasizing the Role of Neurosurgery Within Global Health and National Health Systems: A Call to Action. Front Surg 2021; 8:690735. [PMID: 34708069 PMCID: PMC8542676 DOI: 10.3389/fsurg.2021.690735] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 09/09/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Worldwide, neurological disorders are the leading cause of disability-adjusted life years lost and the second leading cause of death. Despite global health capacity-building efforts, each year, 22.6 million individuals worldwide require neurosurgeon's care due to diseases such as traumatic brain injury and hydrocephalus, and 13.8 million of these individuals require surgery. It is clear that neurosurgical care is indispensable in both national and international public health discussions. This study highlights the role neurosurgeons can play in supporting the global health agenda, national surgical plans, and health strengthening systems (HSS) interventions. Methods: Guided by a literature review, the authors discuss key topics such as the global burden of neurosurgical diseases, the current state of neurosurgical care around the world and the inherent benefits of strong neurosurgical capability for health systems. Results: Neurosurgical diseases make up an important part of the global burden of diseases. Many neurosurgeons possess the sustained passion, resilience, and leadership needed to advocate for improved neurosurgical care worldwide. Neurosurgical care has been linked to 14 of the 17 Sustainable Development Goals (SDGs), thus highlighting the tremendous impact neurosurgeons can have upon HSS initiatives. Conclusion: We recommend policymakers and global health actors to: (i) increase the involvement of neurosurgeons within the global health dialogue; (ii) involve neurosurgeons in the national surgical system strengthening process; (iii) integrate neurosurgical care within the global surgery movement; and (iv) promote the training and education of neurosurgeons, especially those residing in Low-and middle-income countries, in the field of global public health.
Collapse
Affiliation(s)
| | | | - Makinah Haq
- GKT School of Medical Education, King's College London, London, United Kingdom
| | - Sarah Rapaport
- Johns Hopkins School of Medicine, Baltimore, MD, United States
| | | | - Setthasorn Zhi Yang Ooi
- Cardiff University School of Medicine, University Hospital of Wales Main Building, Cardiff, United Kingdom
| | | | - Kwadwo Sarpong
- Georgetown University School of Medicine, Washington, DC, United States
| | - Anchelo Vital
- School of Medicine and Pharmacy, State University of Haiti, Port-au-Prince, Haiti
| | - Tariq Khan
- Department of Neurosurgery, North West General Hospital and Research Center, Peshawar, Pakistan
| | - Claire Karekezi
- Neurosurgery Unit, Department of Surgery, Rwanda Military Hospital, Kigali, Rwanda
| | - Kee B Park
- Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, United States
| |
Collapse
|