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Global Opportunities and Challenges for Clinical Neuroscience

Gretchen L. Birbeck, MD1,2; Michael G. Hanna, MD3; Robert C. Griggs, MD1
[+] Author Affiliations
1Department of Neurology, University of Rochester, Rochester, New York
2Epilepsy Care Team, Chikankata Hospital, Mazabuka, Zambia
3University College London Institute of Neurology, Queen Square, London, United Kingdom
JAMA. 2014;311(16):1609-1610. doi:10.1001/jama.2014.2744.
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Clinical neuroscience faces 2 challenges: (1) an increasing number of persons worldwide with neurodegenerative and neurovascular disorders and the increased expenditures necessary for their care; and (2) patients with rare neurologic diseases who also deserve and demand attention. Demographic changes and the “epidemiologic transition” (from infections to chronic diseases) have converged, causing an unprecedented global burden of disabling neurologic disorders: in 2010, approximately 35 million people were living with dementia; by 2030, this population is expected to reach 70 million and by 2050 is projected to exceed 115 million people, with most living in lower- and middle-income countries.1 Stroke, the principal cause of long-term disability irrespective of age, sex, ethnicity, or country, causes more deaths annually than AIDS, tuberculosis, and malaria combined; incidence of stroke is expected to increase over the next decade, primarily in regions already affected by these infectious diseases.

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