European Societies Merge for Stronger Voice in Neurology

Daniel M. Keller, PhD

June 13, 2013

BARCELONA, Spain — This week's 23rd Meeting of the European Neurological Society (ENS), held here, will be its last. Similarly, there will no longer be a European Federation of Neurological Societies (EFNS) going forward.

The 2 organizations are merging to form the European Academy of Neurology (EAN), with its formal inauguration at a joint meeting of the societies in Istanbul in 2014. The first EAN meeting is planned for Germany in 2015.

The societies have existed side-by-side as friends for more than 2 decades, and they have had a 4-year engagement, planning for this wedding.

Dr. Claudio Bassetti (left) and Dr.  Gustave Moonen (right)

"The idea of the marriage is not just to bring together 2 societies and have a sum of what is currently done and has been done in the past but really to invent something new and to create something new, and we do have some needs that must be met concerning the future of neurology," Claudio Bassetti, MD, president of ENS and head of the Department of Neurology at Bern University Hospital in Switzerland, commented to Medscape Medical News.

Origins and New Directions

The ENS was modeled on the American Academy of Neurology (AAN), with individuals in clinical and experimental neurology as members, a deliberate break from national societies as members. Activities have included training, education, and conferences. Founded in 1986, ENS, publisher of the Journal of Neurology, held its first conference in 1988 in Nice, France.

The EFNS began in 1991 with a conference in Vienna, Austria, and is a federation of national neurologic societies, not individuals. It, too, provides training, continuing education, and congresses, as well as publishing the European Journal of Neurology, formulating guidelines on neurologic conditions, and doing political advocacy in the interest of its member societies.

As Dr. Bassetti alluded to, a vibrant future for neurology depends on meeting certain needs. One of those needs is to maintain the specialty in light of the large size of the discipline, where there is "a fragmentation taking place," he said. He believes it is important to keep communication and collaboration going among the disciplines. "This is 1 thing that we will be able to probably deal with in the future if we join forces... Size does not always matter, but sometimes it's relevant to get attention and to get people to attend."

He cited as an example that at one time, amyotrophic lateral sclerosis was seen as strictly a motor neuron disorder, but for several years people have recognized it as also involving dementia processes, such as frontotemporal dementia. The message is that clinicians and researchers working in a very specific area should know what is happening in other areas. Another example is the effect of sleep disorders on the course and outcome of neurologic diseases.

Fostering translational medicine is another goal. "I believe that the new society should address this issue and really keep the information coming up from basic science and going into the clinical world," Dr. Bassetti said.

A further goal will be to attract and keep young people in the specialty. Recently, the proportion of younger workers in the field has been decreasing. Furthermore, commercial interests have not funded subspecialty meetings as in the past, and Dr. Bassetti said meetings should capitalize on fields that are attractive to companies in order to support areas of neurology not as interesting to companies but important to future neurologists.

"We do have the ambition of creating something that may have a role not only on the continent but in the overall evolution of the field worldwide," he said. Attracting basic scientists to the new society "must be on the agenda" while keeping a balance with clinical medicine so that the meetings are still attractive to neurologists in private practice.

Collaborators, Not Competitors

Dr. Bassetti foresees that the EAN may eventually work on issues with the AAN. He does not view the 2 societies as competitors but as collaborators to attract more attention and support from the political authorities. He said diseases of the brain and the nervous system in general are the costliest disorders in Europe but significantly lag in financial support behind other conditions.

Although he does not see the European societies and the new EAN as a direct competitor to the AAN, there may be some competition for congress attendees. "We must not forget that we are competing internationally as conference organizers, in our case with the United States. As a joint European platform, we are also more attractive for participants from Asia, Africa, and the Middle East," he was quoted as saying in an ENS news release.

Gustave Moonen, MD, PhD, secretary general and past president of ENS and a member of the Department of Neurology at the University of Liège in Belgium, pointed out that ENS and EFNS have existed somewhat in parallel for many years, doing very similar jobs: organizing meetings and teaching courses, publishing a journal, and giving grants. He said it became evident to most European neurologists that to avoid redundancies, a new organization should be formed.

Dr. Claudio Bassetti

A major goal of the EAN will be to serve general neurology with continuing education on a wide variety of conditions in 1 meeting because most neurologists are not subspecialized. Dr. Moonen reiterated the need for a forum where all specialists can meet and share knowledge across fields within neurology (eg, stroke, sleep, epilepsy, peripheral neuropathies, motor dysfunctions).

Another goal will be to advocate for more funding for research in neurology. "Progress in clinical medicine and progress in neurology will not come any more from serendipity. It will come from the results of science," Dr. Moonen said. "If you want to get results of science, you have to invest in science."

He said ENS currently has a collaboration and a joint membership with the AAN and anticipates that the board of the EAN will also pursue such a collaboration, with a goal of better teaching and patient care in neurology worldwide.

He told Medscape Medical News that the new society will be organized as a sort of parliament with 90 people running it: 45 appointed by the respective national societies and 45 elected by all the individual members so all of the European societies and all the EAN members will be represented. He anticipates that EAN annual meetings will attract between 6000 and 7000 attendees.

Positive Relationships

From this side of the Atlantic, the view of the merger is also positive. Timothy Pedley, MD, president of the AAN and professor of neurology at Columbia University Medical Center in New York City, told Medscape Medical News that the AAN has been following the ongoing merger discussions and considers the decision "thoughtful and well-reasoned," with AAN providing advice to ENS and EFNS when asked.

AAN foresees efficiencies in administration, planning, and delivery of services to the members of the new EAN, as well as a unified position on issues that arise. But there will be challenges in creating 1 new culture from 2 distinct organizations have existed separately for many years.

The AAN has always had "positive relationships with the current organizations," Dr. Pedley said, and once the new organization is fully established, AAN "would welcome discussions about possible collaborations." AAN has endorsed particular programs and has been included in the ENS annual meeting. Joint meetings are probably not in the cards, "but many of their members are members of the AAN, and a number of AAN members, including me, are members of the ENS," he said.

AAN has also developed guidelines with EFNS and plans to continue to do so with the EAN. Dr. Pedley anticipates the continued attendance of many European neurologists at AAN meetings and American neurologists at EAN meetings.

23rd Meeting of the European Neurological Society (ENS).

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