Global clinical neuroscience: Journey of a thousand miles begins with a single step

摘要

We read with great interest a recent high-profile article by Dr. Birbeck and colleagues about current global opportunities and challenges facing clinical neurosciences [1]. Indeed, we agree with them that the burden of stroke, which is the leading cause of poor neurologic outcomes, is disproportionately borne by low- and middle income countries (LMIC), a disparity that is likely to worsen with time. [2] However, the article did not emphasize the eminently preventable nature of stroke or mention ongoing study initiatives currently funded by the National Institute of Neurological Disorders and Stroke (NINDS) that cover both T4 and "T5" research, and incorporate systematic avenues for research capacity building in LMIC. World Health organization estimates indicate that death from stroke in LMIC accounts for 86% of stroke deaths worldwide, and the disability adjusted life years lost in these countries are seven times the number lost in high-income countries [3], Most of these LMICs are in Africa [3]. Hypertension, the most potent modifiable risk factor for stroke, and once rare in Africa, is emerging as a serious endemic threat [4]. Therefore, there is an urgent need to craft and validate translatable effective care delivery programs that can mitigate the devastating consequences of stroke through enhanced control of high blood pressure in LMICs.