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Pan European Networks: Science & Technology

19

www.paneuropeannetworks.com

206

A network bridging basic and human studies

would advance this field to a great extent.

Brain monitoring during

intensive care

Brain-oriented care is rapidly advancing as a

standard in the emergency and intensive care

settings of all age groups. European academic

centres have pioneered in this area for

decades. In the past, European manufacturers

of brain monitors have developed most of the

technology that is currently sold around the

world; hence Europe is in a clearly commanding

position with strong competitive advantages.

To continue European excellence in the field

there is a need to prospectively support the

building of pan-European networks with clinical

studies on brain monitoring, as well as to

encourage their linkages with European-based

medical device industry for the next generation

brain monitors.

Clearly, many clinical, technical and commercial

challenges related to brain monitoring are

shared by other modalities of neurophysiology,

especially EEG, intraoperative monitoring,

integrative multimodal assessments, invasive

EEG studies, and multimodal evoked/event-

related studies.

Human consciousness

Human consciousness remains a major

challenge in basic as well as in clinical

neuroscience. Human consciousness depends

on brain function. Impairment of consciousness

may occur after focal or systemic brain lesions,

after functional disturbances such as epilepsy

or, for example, in the context of anaesthesia.

Inevitably, clinical neurophysiology at the

interface to diseases can play a central role

bridging basic neuroscience, neuropsychology,

computational neuroscience and other areas by

the methods described above whilst also

incorporating aspects such as selective attention,

memory, decision making and task monitoring.

possibility to acquire data on human brain function with a high potential

to reduce the amount of non-human primate research in this area.

Europe-wide networks between clinicians and basic scientists would

have a high potential for advancing knowledge of human brain function

by minimising animal studies.

Providing database infrastructure for the collection of clinical data of rare

patients is also an area which should be further investigated. The

prognosis of rare neurophysiological patients is frequently unclear due

to the lack of a sufficient number of patients. Europe-wide studies could

provide a sufficient number of patients. Clinical neurophysiology seems

to be particularly well suited: many exact measures such as nerve

conduction velocities, etc. allow a quantitative follow-up, in conjunction

with clinical and imaging data. A central EU-funded database would

contribute to closing this knowledge gap.

Interventional clinical neurophysiology

Interventional clinical neurophysiology (transcranial and deep brain

stimulation, focused ultrasound) provides a promising tool for treatment

of many neurological and psychiatric diseases beyond the state reached

so far. In particular, improving the efficacy of transcranial stimulation

methods requires a better understanding of underlying neurophysiology.

Professor Walter Paulus

Chair

European Chapter, International

Federation of Clinical Neurophysiology

wpaulus@med.uni-goettingen.de http://ec.ifcn.info/

Diseases assessed by clinical

neurophysiology approach

n

Epilepsy;

n

Stroke;

n

Disorders of consciousness;

n

Intraoperative monitoring;

n

Movement disorders;

n

Migraine;

n

Multiple sclerosis;

n

Myasthenia;

n

Tics;

n

Dementia;

n

Schizophrenia;

n

Depression;

n

Neuropathies and myopathies;

n

Motor neuron disorders;

n

Spinal and nerve root disease;

n

Sleep disorders; and

n

Chronic pain.

THE HUMAN BRAIN