No brain, no gain

The European Brain Council's Executive Director Dr Alastair Benbow tells Public Service Review why it is high time that the brain becomes an important focus for Europe…

Last year, a report commissioned by the European Brain Council (EBC) made headlines by setting the annual cost of brain disorders in Europe at almost €800bn – more than double the estimate made only six years previously. 'Cost of disorders of the brain in Europe 2010'¹ commanded extensive media coverage in more than 30 countries, referring to the issue as a social and political 'ticking bomb' and 'the number one economic challenge for European healthcare now and in the future'.

However, EBC Chief Executive Dr Alastair Benbow explains to Public Service Review that the underlying message remains a positive one rather than a cause for alarm – as long as it is acted upon. "Many people have the perception that nothing can be done about certain brain disorders," he declares. "This is absolutely not the case."

A coordinating body of Europe's major scientific societies in neurology, psychiatry, neurosurgery, neuroscience, patient organisations and pharmaceutical companies, the EBC allows its key stakeholders to speak with one voice in an attempt to encourage further brain research while improving quality of life for those affected by such disorders. Having established national brain councils and action groups across the continent, the EBC works on regional, national and international levels, promoting education as well as dialogue between scientists and society, right up to interaction with policymakers such as the European Commission, European Parliament and the European Council.

"When we point out that the direct and indirect costs of brain disorders are more than those of heart disease, diabetes and cancer combined, we are not saying that the brain is more important," says Benbow. "The message is that, actually, a fantastic job has been done in managing heart disease and diagnosing cancer, and that if we gave that same focus to brain disorders then we could make the same progress."

Indeed, the EBC has been combating such perceptions since its launch 10 years ago. The statistics suggest that this has been successful, with funding at the European Commission level rising from €85m in the 5th Framework Programme (FP5) in 1998-2002 to almost €1.5bn today. However, as Benbow points out: "Even when supplemented at local level, this sum remains miniscule in comparison to the annual cost of brain disorders."

To illustrate this, the 2010 report covered well over 100 disorders, ranging from headaches and migraines through to psychotic disorders and stroke, with the cost of mood disorders alone – which include major depression and bipolar disorder – estimated at just over €113bn per year, followed by dementia at €105bn.

"The EBC's priority is not just to keep on reiterating the clear and urgent need for greater funding, but also to actively engage the European public in the debate," says Benbow. Hence the decision to launch the 'Year of the Brain' in an effort to drive the agenda forward on all fronts. The campaign – which is unprecedented in scope and will attempt to educate and engage the public, as well as influencing future pan-European policy – will include a hi-tech, interactive roadshow that is due to visit European cities and towns during 2014.

The 'Year of the Brain' has been devised as much as a celebration as a call to arms, focusing on the wonder of the human brain – with its one hundred billion nerve cells, it is often referred to as the most complex structure in the universe – as well as the diseases that can affect it. "The average person knows very little about brain disorders, and some even attach a stigma to them," explains Benbow. "Yet such disorders touch the lives of a huge number of people – more than one-third of the continental population of 514 million are estimated to be in some way affected, either as sufferers themselves or as supporters, helpers or full-time carers."

The project has already won the backing of more than 200 organisations and sponsors, as well as Europe's institutions, with European Commissioner for Research and Innovation Máire Geoghegan-Quinn also planning to hold a 'Month of the Brain' in May 2013. "Improving the quality of life for those with brain disorders is essential," Benbow asserts. "This is a huge issue that really matters – and will matter even more as Europe's population continues to age."

Attitudes to such disorders as dementia and Alzheimer's are changing rapidly. "When I talk to people, I find that dementia, in all its various forms, is becoming as big a concern as cancer – and again, there is often a sense that nothing can be done about it," asserts Benbow. "The same goes for stroke and depression – for example, there are so many good treatments available, but tragically, 50% of people who commit suicide because of depression have never consulted a specialist.

"We're not saying, of course, that we are going to cure or prevent dementia today," Benbow continues. "However, increasingly more can be done to minimise its effect for as long as possible, from better and earlier diagnosis to new treatments and strategies. Then there are the public health preventative measures, such as regular exercise and keeping your blood pressure under control, which have been shown to be beneficial in stroke and dementia. Personal behaviour can make a big difference. It is not all about hoping that a pharmaceutical company suddenly discovers a miracle drug. It's just as much about sharing information and promoting greater collaboration right across society."

Ultimately, the 'Year of the Brain' should prove to be the perfect vehicle to make this happen which, in turn, is certain to fuel calls for greater institutional research. "We're sure the project, which will also include a schools and universities programme backed up by digital and social media, will act as an important catalyst," Benbow concludes. "Until recently, there was the belief that if a bit of the brain died then that was that. But we now know the brain is quite plastic and can grow new connections.

We can now carry out far more complex scans than we could previously, and we can functionally image the brain and study which receptors are involved in individual decisions – we could not do any of this to the same extent 10 years ago. We are still at the early days of really understanding the brain in all its wonderful complexity. It deserves our full focus."

¹ Gustavsson A, et al

This article originally appeared on Publicservice.co.uk: No brain, no gain