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President's Column

Read archives from AAN Past President Orly Avitzur, MD, MBA, FAAN, who served from May 2021 to April 2023.

March 2023

Brain Health Initiative Plays to AAN’s Public Education Strengths

Over the past year, the AAN has begun to lay the foundation for an expansive plan to closely examine brain health and serve as the leading authority of unbiased neurologic information and public education in the field. Towards that end, the Committee on Public Engagement, under the leadership of David A. Evans, MBA, chair, and Natalia S. Rost, MD, MPH, FAAN, FAHA, vice chair, has been hard at work developing the framework for a multi-year initiative to address brain health through the lifespan.

The framework, divided into five epochs, focuses on brain function in specific years of life, each led by a member of the committee:

  • Fetal Epoch / Brenda Banwell, MD, FAAN
    Brain health begins with neural development and is influenced by maternal, placental, environmental, and genetic factors. From birth through the early years of development, environmental enrichment, food security, educational opportunities, and a healthy familial microenvironment not only promote cognitive and emotional development, but also strongly mitigate early life genetic or acquired central nervous system injury. The advent of prenatal and newborn screening for treatable neurologic diseases is creating a new field of “preventive child neurology,” best exemplified by the availability and dramatic impact of gene therapy for infantile spinal muscular atrophy. Strong partnerships between maternal-fetal medicine, neonatology, geneticists, and child neurologists will be essential to meet this changing landscape, including the need for new training programs in fetal-neonatal child neurology. Brain health begins at home, and families have great potential to enrich their children’s brain health.
  • Adolescence Epoch / Rana R. Said, MD, FAAN
    The cornerstones of brain health in childhood, adolescence, and young adulthood include factors that extend beyond early life and also arise during these specific periods of growth and development. Important areas of focus include schools and education programs for children of all developmental abilities, including those with complex health care needs. Partnerships with colleagues and organizations focused on the health and well-being of children are vital. As we look at the global needs of children and adolescents, areas of focus will include interventions for conditions such as sleep, migraine, depression, and anxiety, with scalable programs tailored to meet the needs of all in this age epoch and address issues of resource distribution as a social determinant of health. Research and public policy are two arms of these initiatives, including direct-to-public messaging to understand the importance of brain safety, effects of sleep disruption, the impact of nutrition on brain health, toxins’ effects on the developing brain, and the mental health crisis.
  • Adulthood Epoch / Linda M. Selwa, MD, FAAN
    In the adult age group, it is critical to develop and maximize healthy behaviors that prevent longer term illness and injury and to optimize the intellectual, social, and physical well-being supported by a healthy brain. We plan to focus our efforts on prioritizing discovery of preventive strategies to mitigate the effects of vascular disease, genetic predispositions, trauma, and toxins on the brain; advocating for reduced cost and equitable access to treatments or interventions that prevent disability and disease; enhancing the education of the public in existing healthy brain strategies; and establishing preventive brain health as a neurologic discipline.
  • Maturity Epoch / Sarah Song, MD, MPH, FAAN
    The maturity age epoch has the job of looking backwards while moving forwards. We recognize three things: First, brain health and brain wellness are truly multifactorial, and to address them, partnerships with other disciplines and organizations will be key. Second, layered over every effort toward brain health is the need to address health equity. And finally, we must strike a balance between screening and prevention of medical conditions affecting brain health with treatment and rehabilitation of the sequelae caused by not addressing brain health. As a result, our recommendations center around innovative research strategies and building upon larger cohort studies; considering contributing issues in public policy such as nutrition, the environment, and mental health; and signaling the necessity of preventive care through publicizing brain health issues while recognizing the need to support caretakers, extend rehabilitation policies, and train the next generation of diverse neurologists.
  • Senescence Epoch / Daniel José Correa, MD, MSc, FAAN
    True brain health must include consideration of quality of life (QOL) and the quality of end-of-life care (QEOL) in late life. These concepts are not only essential for the senescence age/“platinum” epoch, but must be integrated into all life stages. As we advance brain health efforts to improve care and longevity, we also seek to support the hopeful increase of super-agers in our society. As a result, our recommendations center around expanding current research strategies to include QOL and QEOL; supporting public policy related to research and resources for the community to improve QOL; and adapting public and professional health education for these efforts. Future work will require continued feedback and collaboration across specialties and community advocacy organizations.

The team, along with many other experts in brain health, presented their work at the Brain Health Summit held on September 15, 2022, in Washington, DC. Multiple organizations attended, including patient organizations such as the Alzheimer’s Association, ALS Association, and LEAD Coalition, and specialty organizations including the National Institutes of Health, American Heart Association, and American Academy of Family Physicians. Earlier in the week, US Reps. Earl Blumenauer (D-OR) and Morgan Griffith (R-VA), successfully introduced a congressional resolution to designate September 15, 2022, as "National Brain Health Day." As editor-in-chief of Brain & Life® for the past several years, I have witnessed the evolution of a remarkable compendium of material focused on wellness for the neurologic community and the general public alike. We have amassed a large number of resources at BrainandLife.org and integrated existing AAN patient education onto the website. The Brain & Life® Books series has produced helpful educational materials for patients and caregivers, like the recent Navigating the Challenges of Concussion by Michael S. Jaffee, MD, FAAN.

Over the past year, the Brain & Life podcast has interviewed people living with neurologic conditions, celebrity advocates, as well as physicians and other experts on their experiences, sharing their stories and advice with an increasingly growing listenership. Episodes have included a two-part series on brain health for women and multiple segments on multiple sclerosis, Alzheimer’s disease, migraine, Parkinson’s disease, myasthenia gravis, and more. There are often suggestions to improve lifestyle, including how to use diet, exercise, and mindfulness to achieve wellness. To learn more, listen, and share with your patients, visit Brainandlife.org/Podcast and follow wherever you get your podcasts.

If you want to learn more about the AAN’s Brain Health Initiative, the 75th AAN Annual Meeting in Boston will feature a HeadTalk on Sunday, April 23, at 1:00 p.m. entitled, “A Global Brain Health Conversation.” Representatives from the World Federation of Neurology and the European Academy of Neurology, with whom we plan to collaborate in the future, have been invited to participate. The Innovation Hub at the Annual Meeting will bring you a presentation by Mr. Evans; Dr. Rost; Justin T. Jordan, MD, MPH, FAAN; and Joel A. Salinas, MD, FAAN. They will discuss what’s next for the AAN’s Brain Health Initiative on Wednesday, April 26, from 11:30 a.m. to 12:30 p.m. As we continue this work over the next few years, we will be sure to keep you posted. In the meantime, please join me at the 75th AAN Annual Meeting in Boston to hear more.

Finally, it is my pleasure to announce that a new fund has been established to help support the Academy’s upcoming work in brain health. The Ralph L. Sacco, MD, Memorial Fund for Brain Health was recently launched with a generous bequest from Dr. Sacco, who served as AAN president between 2017 and 2019. Members are invited to donate to the fund in memory of Dr. Sacco at AAN.com/Sacco. Dr. Sacco dedicated his career to stroke prevention and the amelioration of brain health. He is the only neurologist to have served as both president of the AAN and president of the American Heart Association. It was his vision for our two organizations to work together, as he believed we could achieve new heights by joining forces.

It was on March 13, 1948, that the AAN was incorporated in its home state of Minnesota. As we take pride in our rich history and accomplishments, from founder Dr. A.B. Baker to Dr. Ralph Sacco, we are invigorated by ambitious projects like the Brain Health Initiative that build upon our successes and lift us toward an exciting future.

 

Orly Avitzur, MD, MBA, FAAN
President, AAN
oavitzur@aan.com
@OrlyA on Twitter