8^th Global Experts Meeting on Advances in Neurology and Neuropsychiatry August 27-28, 2018 Tokyo, Japan

Pediatric neurology is also called as child neurology, which is a specific branch in medicine. It mainly deals in the field of identifying and managing the neurological conditions in the newborns, toddlers, kids and teenagers. The area of the pediatric neurology incorporates illnesses and syndromes in brain, peripheral nervous system, spinal cord, autonomic nervous system, blood vessels and muscles that affects people.

Neuropsychiatry is combination of both Neurology and Psychiatry which focuses on disorders related to mental health, in which many cases were revealed to be originated from a recognizable malfunction in the brain. The aim of Neuropsychiatry is to comprehend the relation among the body, mind and its behavioral activities. The trained Neuropsychiatrist in the field of both neurological and psychiatric features of disease seats them in exceptional position to deliver this care. Neuropsychiatrist works along with additional Neuroscience clinicians, namely neurosurgeon and neurologist, to deliver complete care to the patients.

Behavioral Neurology field emphases on pathological and clinical characteristics in neural developments associated with mental activity, subsuming cognitive functions, emotional states, and social behavior. Historically, the foremost importance of Behavioral Neurology has been to characterize the phenomenology and pathophysiology of intellectual disturbances in relation to brain dysfunction, clinical diagnosis, and treatment. Representative cognitive domains of interest include attention, memory, language, high-order perceptual processing, skilled motor activities, and "frontal" or "executive" cognitive functions. Behavioral Neurology incorporates three general types of clinical syndromes: 1) diffuse and multifocal brain disorders affecting cognition and behavior (e.g. delirium and dementia), 2) neurobehavioral syndromes associated with focal brain lesions (e.g. aphasia, amnesia, agnosia, apraxia), and 3) neuropsychiatric manifestations of neurological disorders (e.g. depression, mania, psychoses, anxiety, personality changes, or obsessive-compulsive disorders, which may accompany diseases such as epilepsy, cerebrovascular disease, traumatic brain injury, or multiple sclerosis).

Neurogenetics is an important discipline which deals with the most exciting translational clinical and basic research in neurology and human genetics. Several of the essential processes underlying neurological disease remain indefinable and/or poorly understood. Genetics and proteomics (the study of proteins produced by genes) can enhance our understanding of predisposition to diseases so we can build the next wave of therapies to treat neurological disease. Advances in genomics and emerging technologies has helped to better outline neurological syndromes, understand neurological disease progression, and refine clinical treatments. 

NEUROLOGICAL SURGERY is an medical discipline and surgical specialty that offers care for adult and pediatric patients in the treatment of pain or pathological processes that may alter the function or activity of the central nervous system (e.g. brain, hypophysis, and spinal cord), the peripheral nervous system (e.g. cranial, spinal, and peripheral nerves), the autonomic nervous system, the supporting structures of these systems (e.g. meninges, skull & skull base, and vertebral column), and their vascular supply (e.g. intracranial, extracranial, and spinal vasculature).

Treatment incorporates both non-operative management (e.g. prevention, diagnosis – including image interpretation – and treatments such as, but not limited to neurocritical intensive care and rehabilitation) and operative management with its associated image use and interpretation (e.g. endovascular surgery, functional and restorative surgery, stereotactic radiosurgery, and spinal fusion – including its instrumentation).

The utmost common forms of neurological disorders are Infectious diseases of the nervous system, their percentage in the structure of general pathology of the nervous system is about 40%.In recent years abilities of the diagnostics of neuroinfections have significantly enhanced. There are acute (meningitis, encephalitis), subacute and chronic lingering (arachnoiditis, arahnoentsefality) infections of the central nervous system.

The Neuroimmunology is the interdisciplinary field merging neurology, immunology, and aspects of neuroscience. It is a scientific and clinical domain. Scientifically, neuroimmunology tries to understand the bidirectional links among the nervous and immune systems, and their inferences to illnesses. Clinically, various “classical” neuroimmune diseases (e.g., multiple sclerosis – MS) and recently more diseases are being documented for their influence by both the nervous and immune systems, including cancer and coronary heart disease. The biological underpinnings of neuroimmunology include the descending pathways from the brain to the immune system, manifested by innervation of lymph nodes, effects of stress hormones on immunity, and the presence of neurotransmitter receptors on immune cells.

A biomarker is a characteristic, that is, objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes or pharmacologic responses to a therapeutic intervention. There are several features that are desirable for biomarkers to be useful in the Neurocritical Care Unit (NICU). They must be brain specific; they must increase or decrease significantly during the relevant neurological insult; they must be available within a few hours. All these features will help a treating physician to make better diagnosis and direct care.

Clinical neurology is the diagnosis and treatment of patients who have neurological conditions. It is a non-surgical, patient-oriented specialty practice in medicine. There are certainly neurologists who might participate in research or teaching and don’t have much contact with patients. In these cases, these doctors would not be practicing clinical neurology, since clinical tends to be defined as having to do with patient care. It is important to note that Clinical neurology is not the same as neurosurgery. Though both are concerned with the nervous system, only the neurosurgeon performs surgery.

Neuro-oncology defines the study of brain and spinal cord neoplasms, many of which are very dangerous and life-threatening. For example: glioma, glioblastoma multiforme, ependymoma, pontine glioma, and brain stem tumors etc.  Most Commonly used treatments in neuro-oncology are Radiotherapy, Chemotherapy, Corticosteroids and Neurosurgical Interventions.

Neuroimaging is a technique that produce pictures of the brain without requiring surgery, incision of the skin, or any direct contact with the inside of the body. The neuroimaging technique allow noninvasive visualization of the structure and functionality of the brain. Neuroimaging has become an influential tool for both research and medical diagnosis.  While still young, the neuroimaging field has speedily progressed over the years due to innovations in technology and computational approaches. The main two in-vivo technologies are structural imaging and functional imaging.

Neuropharmacology is the study of how drugs affect cellular function in the nervous system. There are two key divisions of neuropharmacology: behavioral and molecular. Behavioral neuropharmacology emphases on the study of how drugs affect human behavior, as well as the study of how drug dependence and addiction affect the human brain. Molecular neuropharmacology includes the study of neurons and their neurochemical interactions, with the overall objective of developing drugs that have beneficial effects on neurological function. Both fields are closely related, since both are concerned with the interactions of neurotransmitters, neuropeptides, neurohormones, neuromodulators, enzymes, second messengers, co-transporters, ion channels, and receptor proteins in the central and peripheral nervous systems. Studying these interactions, researchers are developing drugs to treat many different neurological disorders, including pain, neurodegenerative diseases such as Parkinson's disease and Alzheimer's disease, psychological disorders, addiction, and many others.

Neuromodulation is defined as the flexibility of neural circuit operation and behavior. Different types of neuromodulators can have divergent actions in a neuron by targeting multiple physiological mechanisms. Neurotransmission is the process of transmission of chemical messenger released from the nerve ending of a neuron to communicate with adjacent neurons. The neurotransmitters are released by presynaptic neurons, and either excite or inhibit the post synaptic neuron.

Neuro rehabilitation benefits people having neurological disorders to enhance their quality of life. Progressive neurological disorders such as dementias, Parkinson's and tumors and isolated neurological events such as traumatic brain injuries and strokes can profit extremely from neuro rehabilitation. Once the acute stage of treatment for a brain injury is accomplished, neuro rehabilitation steps in to help the patient recover. It enhances their functional and cognitive abilities and to help them realize their individual goals. The initial step to neuro rehabilitation is a full assessment involving some tests. Some of these will test complete brain function, some will examine specific brain functions. The neuropsychologist uses the outcomes from these tests, teamed with an understanding of your complications to develop a comprehensive picture of what might be going on for you and what treatment could help.

Neurochemistry is the study of the identities, structures and functions of compounds (neurochemicals) that are produced by and that regulate the nervous system. Neurochemicals includes oxytocin, serotonin, dopamine and other neurotransmitters and neurotransmitter-regulating substances. There are two comprehensive groupings of chemistry in nerve systems that are significant. The first is the chemistry that generates electrical signals which propagate along nerve cells. The crucial chemicals involved in these signals are sodium and potassium ions.

Neuro-ICU, it consists of multidisciplinary team of specially trained physicians, therapists, nurses and other professionals delivers collaborative, coordinated, and attentive care in a unique environment. At the bedside, nurse’s monitor’s the patients’ vital functions, speech, movement, and cranial nerve responses every hour, or more frequently if necessary. Physical and occupational therapists mobilize patients as early as possible, working with everyone to help his or her ultimate rehabilitation needs. Swallowing functions are evaluated by highly trained speech-language pathologists, and experienced dieticians provide guidance on nutrition. Specially trained critical care pharmacists provide invaluable support to physicians and nurses in the Neuro-ICU.

Treatment decisions are made by a multidisciplinary team comprised of neurosurgeons, interventional neuroradiologists, vascular surgeons and physicians in related subspecialties. In the Neuro-ICU, this advanced level of experienced, responsive, and personalized care helps our patients recuperate, regain their strength, and move forward to the next phase of recovery. 

Neuropsychiatric conditions are mental disorders that are typically attributed to diseases that originate from the nervous system. These diseases greatly impair the health of those affected by them and impact their ability to learn, work, and emotionally cope. Luckily, researchers in the neuropsychiatry field are making great headway in determining the biological basis on these diseases. In neuropsychiatry, neuropsychiatric conditions fall into eight categories:

Addiction
Addiction is a psychological and physiological dependence on a substance or activity

Childhood and Development
These conditions are concerned with both neurological and behavioral development in childhood and adolescence, resulting in disorder and impairment. Some examples include attention deficit hyperactivity disorder (ADHD), autism, fetal alcohol syndrome, and tic disorders.

Eating Disorders
Eating disorders are a condition that is a product of reaction to physical growth and psychological development in children, adolescents, and adults. The major forms of eating disorders are Anorexia Nervosa, and Bulimia Nervosa.

Degenerative Diseases
These conditions refer to diseases such as dementia, Parkinson’s disease and Alzheimer’s. Degenerative diseases mark a decline in cognitive ability and often affect the elderly.

Mood Disorders
Mood disorders are serious medical conditions that are often misdiagnosed. They are a result of complicated interactions between genetic, environmental, and biochemical factors. This includes bipolar disorder, depression.

Neurotic Disorders
These are a class of mental disorders that involve mental distress and obsessive thought patterns. This includes Obsessive Compulsive Disorder, trichotillomania, and anxiety disorder.

Psychosis
This describes a mental state where the patient has lost touch with reality. This includes but is not limited to hallucinations, delusions, bizarre behaviors, difficulty assimilating with society and social expectations, and disorganized thinking. This includes, but is not limited to, schizophrenia.

Sleep Disorders
Affecting more than 10% of the population, these conditions include sleep apnea, narcolepsy, insomnia, parasomnia, and REM.