The 25th World Congress of Neurology (WCN) occurred virtually from October 3rd to 7th 2021. The biennial conference was organised by the World Federation of Neurology (WFN) in association with the Italian Society of Neurology (SIN). It was the first-ever virtual congress with the attendance of 4500 participants from 120 countries. The conference was originally scheduled in Rome, Italy.

Dr Antonio Federico – President of WCN at the Welcome address.

Dr Antonio Federico, President of WCN 2021, welcomed everyone on behalf of WFN and SIN on the e platform. The title of this congress was “Inspired by the past to build the future of Neurology” as Italy and Rome were the origins of many Arts and histories.

As a consequence of the travel restrictions from the pandemic, this was the first time that the WCN was held in an entirely online environment yet retained the local flavour. The fully personalised interactive virtual platform was created with a unique Italian flavour, based on the ancient Roman amphitheatre colosseum allowing the virtual user to enter the theatre and choose a preferred venue to attend.

The exceptionally exciting and diverse scientific programme was presented live and on-demand allowing participants for the first time to take part in all scientific sessions. The congress consisted of 77 scientific sessions and 45 teaching courses delivered by 277 speakers and there were numerous presidential and regional symposia. All the sessions were very interactive collaborating with thousands of peers across the world.

The World Congress of Neurology brings together leading neuroscientists and public health experts to turn research into action and emphasise the importance of brain health across the globe. This year, numerous landmark research findings were unveiled at the sessions.

New developments in the field of blood biomarkers for brain diseases including traumatic brain injury (TBI), and neurodegenerative diseases such as Alzheimer’s were brought up. The work of world-renowned Neuroscientist, Henrik Zetterberg, Professor of Neurochemistry, University of Gothenburg, Sweden, was presented at the congress. “Within the last five years, measurement techniques for biomarkers have become much more sensitive. We have seen a 500- to 1000-fold improvement in analytical sensitivity when we measure molecules that change in the brain of someone with Alzheimer’s disease, stroke, traumatic brain injury (TBI) or other brain diseases,” said Zetterberg.

This improvement in data analysis has led to the development of several tests that can detect both general neuronal activity and brain changes related to Alzheimer’s disease and other neurodegenerative dementias. Such tests include blood tests to measure neurofilament light chain in either TBI or Alzheimer’s disease, phosphorylated-tau-181 (ptau 181) and beta-amyloid protein in Alzheimer’s disease and a test to detect activation of astrocytes in brain damage. “These tests can help diagnose a brain injury as well as help determine when the brain has healed. For example, a sports player who experiences a concussion may receive a neurofilament light blood test to help determine if they are ready to return to playing or if they should remain on the side-lines for longer,” said Zetterberg. Although this research would not result in cures for TBI or neurodegenerative disease, it will hasten the development of drug treatments and assist in clinical trials in the fields.

Gero Miesenböck, Waynflete Professor of Physiology at the Centre for Neural Circuits and Behaviour, Oxford, England presented very interesting research on brain mechanisms that regulate sleep on 5th October 2021. He stated that the function and the biology of sleep are largely unknown and solving the mystery of sleep will help to cure many diseases. His research found that one particular ion channel in the sleep-inducing cells of fruit flies is crucial for turning sleep need into sleep. Determining how this mechanism works may lead to new therapies for sleep problems. “If I had to summarise my presentation in a single catchphrase, I’d say that sleep is an antioxidant,” said Miesenböck.

The 9th WCN Tournaments of the minds, as always, was very competitive and mind-blowing.

Performing the tournaments of minds on a virtual platform with attendees from different parts of the world would have been a huge technical challenge that was well handled. The team Kerala Institute of Medical Sciences of India won the trophy for 2021 and the team GB Pant Hospital in India were the runners up.

Through the poster gallery, a delegate could go through the e posters presented and the presenters were allowed to arrange chat rooms to discuss their research. The networking lounge allowed delegates to communicate with each other, on an e platform, which helped to build up fellowship.

The timeless magic of the eternal city of Rome could be felt virtually by exploring virtual tours to historical places in Italy. This brought much liveliness to the conference.

The World Congress of Neurology acted as a platform to raise global attention on the looming burden of neurological disorders. In his presidential plenary address, WFN President Prof. William Carroll discussed the origins, goals, and progress of the Intersectoral global development action plan on Epilepsy and other neurological disorders (IGAP). For the first time in its history, the World Health Organization (WHO) is recognising the need to focus on neurological diseases and disorders around the world, especially in under-resourced countries. The action plan seeks to address the challenges and gaps in providing care and services for people with epilepsy and other neurological disorders that exist worldwide and ensure a comprehensive, coordinated response across sectors.

The 8th World Brain Day was commemorated along with the congress in association with the Multiple Sclerosis International Federation. The theme of this year’s World Brain Day is “Stop Multiple sclerosis”. Prof William Carroll in his speech highlighted that; MS affects 2.8 million people of all ages globally and someone somewhere in the world receives this life-altering diagnosis every five minutes. Disease-modifying therapies to treat MS are still unavailable in many parts of the world, where there is a vast discrepancy among low income to high-income countries. It was revealed that none of the low-income countries has access to any of the disease-modifying treatments. Professor Carroll further emphasised that we can stop MS by diagnosing earlier, providing better access to treatment, and advocating for improving quality of life.

All sessions including those that were streamed live, can now be viewed on-demand until 7th January 2022. The next exciting event of WCN 2023 will be in Montreal, Canada.

WCN 2021 was a great experience with so many educational resources and food for thought. Being virtual, it was convenient and continuously useful as all the sessions and teaching courses are available to be referred to on demand. But I would honestly say I missed being in Rome in person, recollecting the experience of WCN meetings before.