The brain in focus: Flemish experts put neuro research in spotlight

Summary

A non-profit and a group of Flemish neurological experts have taken the opportunity during the European Year of the Brain to dispel stubborn rumours about mental disorders and to urge that more attention be paid to mental health care

Understanding psychosis

Although science has already uncovered many of the mechanisms that control how it works, the human brain continues to hold a lot of mysteries. At the occasion of the European Year of the Brain, Flemish experts have put their heads together to analyse the challenges faced by mental health policy and brain research in Flanders.

This year was designated as the Year of the Brain by the European Brain Council to raise more awareness around the research into this hyper-complex organ that is the foundation for our personalities, thoughts and feelings. The government of Flanders also gave extra support to the non-profit organisation Breinwijzer, in addition to tasking a steering group of experts with examining the current state of local mental health policies and brain research.

“It’s essential to spread accurate and accessible information about the workings of the brain because mental disorders, like depression and dementia, are having an increasingly large impact on our society,” says Eva De Vlieger from Breinwijzer. “It’s our mission to explain what the government’s investments in brain research are used for, with more nuanced information than what you see in popular media.”

A virtual psychosis

Since 2008, Breinwijzer has striven to improve the dialogue between the neuroscience sector, health-care professionals and the public. The non-profit publishes articles on its website, invites speakers for lectures and organises the annual I-Brain festival. This day-long event aims to attract people of all ages and backgrounds with a mix of accessible presentations and surprising workshops that involve such things as virtual reality applications.

One in three Belgians have problems such as anxiety and chronic stress

- Neurologist Paul De Cock

While Breinwijzer normally only organises one I-Brain festival in Ghent, this year the not-for-profit received funds to stage an additional, two-day festival in Leuven. At the events at both cities, which shared the umbrella theme of creativity, health-care professionals and other visitors were able to try out a unique device that simulates what it’s like to suffer from a psychosis. This Labyrinth Psychotica is a project of the Dutch-Canadian artist Jennifer Kanary Nikolova.

Breinwijzer also co-ordinates the Meeting of Minds for Youth (MOM4Y) project for students ages 14 to 18. This initiative allows teachers to request a kit with information on the functioning of the brain. To enter the MOM4Y competition, their students have to select one subject, compile a list of research questions and present them to an expert.

Their report and a short film they’re asked to make about the results are then evaluated by a jury. The three best teams get to compete at the MOM4Y festival in March during the Brain Awareness Week, which includes workshops around improvisational comedy.

Another crucial step taken by the Flemish governmentas part of the Year of the Brain was to task a steering group of experts with drawing up an advisory report. This document will be used as the foundation for an action plan around mental health policies and brain research in Flanders.

The team of experts included representatives from Flemish universities, governmental organisations and other stakeholders. Their memorandum will be presented during a symposium in the Flemish Parliament on 12 December.

A skewed lens

According to the president of the steering group, retired paediatric neurologist Paul De Cock, one of their major findings was that disproportionate attention is paid to brain disorders that mainly occur in the last stages of life, such as Parkinson’s disease and dementia.

“But many brain disorders develop in earlier life stages, even before birth,” he says, pointing out that many parents-to-be don’t realise the extent to which tobacco, alcohol and drug use during pregnancy is harmful for the development of babies’ brains – as are stress and depression.

In their report, the group also emphasises difficulties faced by adolescents with intellectual disabilities in today’s society. “There should, for example, be more investments to adapt the learning conditions in schools to their needs,” says De Cock.

To improve the social integration of adults with neurological disorders, the experts argue for a labour system with more flexible working conditions and for incentives for employers to hire such individuals. “Patients have periods during which they can work well and other periods when they find it impossible to be productive,” De Cock explains. “Most companies today are not able to deal with this situation, so these patients usually become dependent on disability benefits.”

The experts also urge for additional measures to improve the active participation of the elderly in society, since this has been shown to prevent or decelerate the development of brain disorders like dementia.

On stress

Asked which mental disorder is the most common in Flanders, De Cock’s answer is brief – stress. Citing the recent Health Survey organised by the Scientific Institute of Public Health, he says: “One in three Belgians reported problems with anxiety, chronic stress or sleeping.”

It is a misunderstanding that addictions are only the fault of the patients

- Professor Geert Dom

One of the experts’ more positive findings was that many excellent neurological scientists are at work in Flanders. Aside from the various research groups at local universities, pioneering work is being done at, for example, the cross-university research initiative Neuro-Electronics Research Flanders and the pharmaceutical company Janssen Pharmaceutica.

The government’s Flanders’ Care programme, moreover, supports the development of health-care innovations. One example is the development of technology that allows patients to live independently and the elderly to stay longer in their own homes.

Still, stumbling blocks remain. “One problem is that there is still too little investment in very concrete applications to improve the health-care provision in Flanders,” De Cock says. “Another is the lack of close co-operation between Flemish research teams.”

Several of the steering group experts stress the need for increased co-operation between research groups. The steering group’s memorandum will therefore recommend establishing a platform to stimulate the exchange of neurological expertise in the region. The experts also agreed that the need for increased investments in mental health-care research is backed up by the data.

Statistics compiled by the World Health Organisation in 2004, for instance, show that brain disorders were responsible for 35% of all diseases in Europe. The data also showed that 2.9 million, or roughly one in three Belgians, suffered from a brain disorder, which carried economic cost of €1,029 per resident.

According to the steering group, the high prevalence of neurological disorders in this country has not been matched by resources, since less than 10% of the health-care budget currently goes to mental health-care initiatives.

Educating tomorrow’s doctors

In addition to such general observations, the researchers on the committee also pointed to specific challenges and innovations. Koen Demyttenaere, a psychiatry professor at the University of Leuven (KU Leuven) stresses that more attention should be paid to mental health-care in medical schools. “It is remarkable how under-represented this domain is in the current curricula of medical students,” he says.

Demyttenaere also points to important research innovations, like the insights from epigenetics, the study of heritable changes in our genomes. Such research has demonstrated that both traumatic and very positive childhood experiences can influence our genes, offering new explanations for the occurrence of depression, for example.

At Antwerp University, psychiatry professor Geert Dom is an expert in addictions and what are known as “double diagnoses”. “It is little known that about five out of 10 people with an addiction also suffer from a psychiatric disorder,” he says. “It is a big misunderstanding that addictions are solely the fault of the patients. Many addicts are vulnerable partly because of a certain sensitivity in their brains.”

Dom pleads for awareness-raising initiatives to reduce the stigma of addiction so that people are encouraged to see a doctor or psychologist earlier.

Shielding the brain

Frank Van Overwalle is a specialist in the field of social neurosciences and works at the psychology department of the Free University of Brussels (VUB). He examines the ability of the brain to implement social processes and behaviour, such as its capacity to perceive other people’s feelings.

“This enriches our social interaction with people,” he explains. One of his current research projects focuses on the differences in the brain activities of people who have autism, suffer from depression or have had a stroke.

The brain should be protected against the excessive stimulations of today’s hectic world

- Neuropsychologist Christophe Lafosse

Paul Boon, director of the Institute for Neuroscience at Ghent University, is an expert in neuromodulation therapy, which applies electric impulses to the nervous system.  Such treatments have been used to relieve the suffering of patients with brain disorders like epilepsy, depression and Parkinson’s disease.

“To limit the impact on the patients, we are developing innovative techniques that do not require risky surgery,” Boon explains. In magnetic neuromodulation, for example, magnetic fields produce only small electrical currents.

Neuropsychologist Christophe Lafosse, director of strategy and scientific policy at KU Leuven and a specialist at the Rehabilitation Hospital RevArte in Edegem, Antwerp province, also emphasises the importance of neuromodulation. But he also urges for more scientific recognition for non-medical techniques like mindfulness.

“Our scans clearly show that mindfulness has an effect on brain activity,” says Lafosse, “and is useful in the treatment of depression and burn-out.”

In Lafosse’s opinion, more awareness should be raised around the brain’s vulnerabilities. “The brain is a fantastic organ, but it should be protected against the excessive stimulations of today’s hectic world, like the constant need to adapt to new technologies,” he says. “Instead of pleading to stimulate the mind, as is so often done, I would advise to also protect it.”

Photo: A visitor at the recent I-Brain festival in Ghent tries out the Labyrinth Psychotica device
©Breinwijzer