|Congresses and Meetings|
|11th EFNS Congress, Brussels, Belgium, 25 - 28 August 2007|
Jean Schoenen, Brussels
Presidential Opening Lecture at the 11th EFNS Congress held in Brussels from the 25 to the 28 of August 2007.
It is a great pleasure to welcome you in Brussels for the 11th Congress of the European Federation of Neurological Societies. We expect the same attendance as during previous years, although this congress takes place during a period in which still some people are on vacation.
However, I hope that the interesting scientific program and the social events will compensate the shortening of your vacation period.
You are here in the heart of Europe and the capital of the European Union. Brussels is a multi-linguistic and multi-cultural city, in which you will feel comfortable and well accepted. Take advantage to taste the Belgian specialties such as the different beers, the chocolates and the refined kitchen …. and do not forget the Belgian frites.
This congress would not be possible if we did not have a perfect organisation. First of allI I wish thank Prof. Jean Schoenen and the local organising committee for their kind hospitality and the excellent collaboration making this congress a great event.
Mrs Lisa Müller and the whole EFNS staff of the offices in Vienna, Florence and Prague have again done a great job in order that everything, up to details, is running smoothly.
The congress organisation by Mrs Dreman and Kenes is, as always, spotless.
As usual the President of the EFNS, in his opening speech, has to develop a topic of general interest. You will already be aware from our previous congress that I like to present a controversial topic. So this time it will be more or less the same. The title of my talk is “The Smoking Brain”.
Cigarette smoking is, as we all know, very bad for our health. It is an important risk factor for cancer and for cardiovascular diseases. However, there is a particular relation between our brain and smoking. Except for the fact that smoking is a risk factor for stroke, its influence on neurodegeneration has been questioned.
There is strong evidence that smoking is protective against Parkinson’s disease. It is possible for multiple system atrophy but not proven for Progressive Supranuclear Palsy. During the last fifteen years a passionate debate was developed concerning the protective or the harmful effect of smoking on Alzheimer’s disease (AD).
In vitro studies have shown that nicotine might have neuroprotective effects through its effects as anti-ß-amyloid, anticytotoxic, anti-free radical and on amyloid precursor protein.
Autopsy studies in the ageing brains of smokers have demonstrated less senile plaques mainly in women, lower densities of ß-amyloid deposition, more neurofibrillary tangles in heavy smokers and a trend of fewer tangles in previous smokers.
The great paradox is that early case-control studies have shown that smokers are at lower risk of AD, while recent cohort studies suggest that smoking may increase the risk of AD.
How to explain the paradox? Smokers died on average younger (5 yrs in women and 3 yrs in men). Thirty retrospective studies have been performed. Twenty-two case control studies (5,323 patients) and 8 cohort studies (43,885 persons) are found in the literature.
However, many studies are influenced, on one hand, by the influence of the tobacco industry, who have sponsored studies and conferences on the “benefit of neuronal nicotine receptors” and, on the other hand, by passionate rather than by evidence-based epidemiological studies.
Changing concepts are illustrated by epidemiologic studies in France and in the Netherlands, which showed initially a protective effect of smoking on AD, and 10 years later changed respectively in no and harmful effect of smoking on the cognitive status of AD patients.
A large prospective study on “Smoking and dementia in male British doctors” by R. Doll et al. (BMJ 2000; 320: 1097-1102), involving a cohort of 34,439 persons, showed no significant association between smoking and AD. However, you have to admit that there could be a bias in this study, not because the population was male or British, but because it was composed of doctors, who will not easily admit that they are still smoking.
So, the question, whether nicotine is neuroprotective, remains unanswered. It is not because smoking cigarettes is harmful for people’s health that the effects of nicotine on the brain should not be further investigated. If beneficial, and there could be other ways to administrate nicotine than by smoking, nicotine patches could be an alternative.
I hope that after this critical review you will not consider me as the Salman Rushdie of Neurology.
Jacques L. De Reuck
President of the EFNS
You were 3,986 from 98 countries in Western and Eastern Europe, but also in Northern and Central Africa to attend the 11th EFNS Congress in Brussels. On behalf of the Belgian Neurological Society, I thank you for making this congress a success. Hosting you was a unique human and scientific experience which will be remembered as a major milestone, as much as the 1st World Neurology Congress organised in Brussels 50 years ago by the pioneer of Belgian Neurology, Ludo Van Bogaert. The latter event was duly commemorated during the historical session and the special session chaired by Johan Aarli, President of the WFN.
It was a pleasure and an honour to collaborate during the years of preparation with the scientific programme committee and his chairman Gian Luigi Lenzi, the ladies from the EFNS Head Office in Vienna and our congress secretariat Kenes.
We hope that you returned home having increased several of your “indexes”. Your neurological knowledge index must have gone up dramatically, as the congress comprised 47 scientific sessions, 1,121 poster presentations, 16 teaching courses attended by 1,946 amongst you and 17 satellite symposia.
At the opening ceremony, you may have been convinced by EFNS President Jacques De Reuck, a convicted pipe smoker, that tobacco, or more precisely nicotine, has potential neuroprotective benefits.
Hopefully, my opening speech added to your geographical and historical knowledge about Belgium, a complex country considered by some “a historical accident”, but which has been since its foundation in 1830 a political model for elaborating a peaceful and fruitful consensus between three communities with different cultural backgrounds and languages. The Royal Family, an important pillar for the country’s unity, was indirectly present through the patronage given to the congress by HRH Princess Astrid and the very thoughtful welcome message she addressed to you during the Opening Ceremony via her Counsellor R Ponjaert.
You must by now be better informed about the Belgian Neurological Society and all except two among you accepted the provocative statement that it must be the oldest neurological society on the globe, because it was founded in 1896. I must acknowledge and congratulate the two colleagues, W.D. Heiss and R. Rosenberg, who knew that this privilege belongs to the American Neurological Association founded as early as 1875.
From the ambiance created in the auditorium by Toots Thielemans and his musicians in the 2nd part of the Opening Ceremony, it seemed obvious to me that your mood index jumped to the ceiling. As Toots said, playing music is the best antidepressant for him, but clearly also for his audience. Besides alerting us emotionally, the band also demonstrated live that persons with a neurological handicap can be wonderful performers, a demonstration underlined during the congress by the special session organised by Mary G Baker, president of the EFNA.
In parallel to your mood, your life expectancy index probably increased, although this may have been dampened by some weight gain if you gave in to an excess of the excellent food and drinks served in the congress centre and downtown Brussels.
For those of you who attended the social event on Monday evening, the famous Ommegang certainly was a memorable cultural experience. This historical reconstitution of the glorious entry of Charles the 5th in Brussels is only exceptionally performed for private parties. It was made possible thanks to the mayor of Brussels, F Thielemans, probably a remote relative of Toots, who owed you this favour as his staff estimated that each of you would spend on average 350€ per day in Brussels during the congress. So, your financial index may have dropped somewhat, but you probably found it worthwhile.
Bitte hier das Bild “Ommegang” einfügen.
Finally, the closing ceremony, instead of being as usual an academic session in a sparsely occupied auditorium, became, partly thanks to the rescheduled session of the Belgian Brain Council, a “user-friendly” happening allowing for proximity and social exchange between the organisers, the remaining “hard core” of participants, the winners of the tournament and the poster prizes, as well as Antonio Gil-Nagel Rein, the vice-chairperson of the 12th EFNS Congress in Madrid August 23-26, 2008.
I hope to see you again in Madrid for surely another increase in several of your “indexes”. As a matter of fact, the Madrid Congress might also increase your mystical index, as Charles V who was fluent in most West European languages, pretended that Spanish was the language he used to speak to God.
On behalf of the Local Arrangements Committee