Lackluster prioritization of the health sector in government spending and dwindling donor contributions drive slow growth in health spending in Sub-Saharan Africa

PLOS

 

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Fig 2. Proportion of health spending that is development assistance, 2021.

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Credit: Apeagyei et al., 2024, PLOS Global Public Health, CC-BY 4.0 (https://creativecommons.org/licenses/by/4.0/)

 

Slow growth in health sector spending is projected in Sub-Saharan Africa as reported in a study published in the open access journal, PLOS Global Public Health. The decline is expected to continue to 2050, according to Angela E Apeagyei and researchers at the Institute for Health Metrics and Evaluation, University of Washington, Seattle, and is driven by tepid growth in the share of government spending that is allocated to health and reductions in development assistance for health.

The research analyses data from databases covering development assistance for health, global health spending and gross domestic spending (GDP) per capita as well as an expected health spending database which provides projected health spending data to 2050. It finds that except for central and eastern Europe and Central Asia, around the world total health spending is expected to rise as a share of GDP, but in Sub-Saharan Africa (except in southern sub-Sahara Africa) it is expected to decrease.

Beyond the challenge of a low prioritization of the health sector in the government budget, another major driver of this decline is a reduction in development assistance for health. The Millennium Development Goals led to a period of growth in health funding, and development assistance for health grew on average 11.1% annually from 2000 until 2015. It has since dropped to just 4.6% and was particularly hit by the global economic issues caused by the COVID pandemic and subsequent economic shocks such as the war in Ukraine. Although government spending on health in Sub-Saharan Africa has increased, and is expected to continue to rise, the gap left by decreases in development assistance will not be met.

Without improvements, this trend will pose a significant challenge to meeting health-related Sustainable Development Goals and the African Union’s Africa Agenda 2063. The authors hope that their analysis will help policymakers understand future health spending patterns and can translate the insights into tangible actions that can help navigate the region’s complex economic and health challenges.

The authors add: “For countries in sub-Saharan Africa, the projected growth in donor and government funding for health is expected to be significantly lower compared to countries in other regions. This worrying trend underscores the need to prioritize innovative financing strategies to strengthen health systems in line with the region's economic growth and the broader health needs of its population.”

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In your coverage please use this URL to provide access to the freely available article in PLOS Global Public Health: https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0003433        

Contact: Angela Apeagyei, amicah@uw.edu

Image Caption: Fig 2. Proportion of health spending that is development assistance, 2021.

Image Credit: Apeagyei et al., 2024, PLOS Global Public Health, CC-BY 4.0 (https://creativecommons.org/licenses/by/4.0/)  

Image Link: https://plos.io/3SV6Tnx

Citation: Apeagyei AE, Lidral-Porter B, Patel N, Solorio J, Tsakalos G, Wang Y, et al. (2024) Financing health in sub-Saharan Africa 1990–2050: Donor dependence and expected domestic health spending. PLOS Glob Public Health 4(7): e0003433. https://doi.org/10.1371/journal.pgph.0003433

Author Countries: Ghana, United Kingdom, United States

Funding: AEA, BLP, NP, JS, GT, YW, WW, AW, and JLD were funded by the Bill & Melinda Gates Foundation. YZ and JN received no specific funding for this work. The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report.

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Journal

PLOS Global Public Health

DOI

10.1371/journal.pgph.0003433 

Method of Research

Observational study

Subject of Research

People

 

Unhealthy commodities—like alcohol and social media—are connected with poor mental health

Commercial determinants such as social media, air pollution associated with depression and suicide

PLOS

 

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Mental health

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Credit: Image by Rosy / Bad Homburg / Germany; free to use under Pixabay Content License

“Unhealthy commodities” such as tobacco, alcohol, ultra-processed foods, social media, and fossil fuels, as well as impacts of fossil fuel consumption such as climate change and air pollution are associated with depression, suicide, and self-harm, according to a study published August 28 by Kate Dun-Campbell from the London School of Hygiene & Tropical Medicine, and colleagues.

Globally, around one out of every eight people currently live with a mental health disorder. These disorders—including depression, suicide, anxiety, and other diseases and disorders—can have many underlying causes. Some of those causes could be related to commercial determinants of health—the ways in which commercial activities and commodities impact health and equity. Commercial determinants of health can be specifically unhealthy, such as alcohol or tobacco consumption, unhealthy food, and the use of fossil fuels. To further understand how these unhealthy commodities might impact mental health, the authors of this study performed an umbrella synthesis of 65 review studies examining connections between six specific commodities—tobacco, alcohol, ultra-processed foods, gambling, social media, and fossil fuels. The author also included studies looking at mental health impacts of fossil fuel use such as climate change and air pollution.

The umbrella review found evidence for links between depression and alcohol, tobacco, gambling, social media, ultra-processed foods and air pollution. Alcohol, tobacco, gambling, social media, climate change and air pollution were associated with suicide, and social media was also associated with self-harm. Climate change and air pollution were also linked to anxiety. The review brought together many different methodologies and measurements, and could not establish the underlying cause of the negative mental health outcomes. But the results indicate that unhealthy commodities should be considered when researchers attempt to understand and improve mental ill health. 

The authors add: "Our review highlights that there is already compelling evidence of the negative impact of unhealthy products on mental health, despite key gaps in understanding the impact of broader commercial practices."

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In your coverage please use this URL to provide access to the freely available article in PLOS Global Public Health: https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0003605        

Citation: Dun-Campbell K, Hartwell G, Maani N, Tompson A, van Schalkwyk MC, Petticrew M (2024) Commercial determinants of mental ill health: An umbrella review. PLOS Glob Public Health 4(8): e0003605. https://doi.org/10.1371/journal.pgph.0003605

Author Countries: United Kingdom

Funding: This work was supported by the Three NIHR Research Schools Mental Health Programme (award number: MH004) The grant was received by GH, NM, and MP. . MVS is funded by a National Institute for Health Research Doctoral Fellowship (Ref NIHR300156). MP is a co-investigator in the Spectrum consortium, which is funded by the UK Prevention Research Partnership (UKPRP), a consortium of UK funders (UK Research and Innovation research councils: Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, and Natural Environment Research Council; charities: British Heart Foundation, Cancer Research UK, Welcome, and The Health Foundation; Government: Scottish Government Chief Scientist Office, Health and Care Research Wales, National Institute of Health Research and Public Health Agency. AT is also supported by the Spectrum consortium. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

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Journal

PLOS Global Public Health

DOI

10.1371/journal.pgph.0003605 

Method of Research

Systematic review

Subject of Research

People

 

Bacterial cells transmit memories to offspring

Temporary stress can cause heritable changes without altering the genetics, study finds

Peer-Reviewed Publication

Northwestern University

 

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An artistic illustration of how cells retain and even pass down memories to their offspring.

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Credit: Camila Felix/Northwestern University

Bacterial cells can “remember” brief, temporary changes to their bodies and immediate surroundings, a new Northwestern University and University of Texas-Southwestern study has found.

And, although these changes are not encoded in the cell’s genetics, the cell still passes memories of them to its offspring — for multiple generations.

Not only does this discovery challenge long-held assumptions of how the simplest organisms transmit and inherit physical traits, it also could be leveraged for new medical applications. For example, researchers could circumvent antibiotic resistance by subtly tweaking a pathogenic bacterium to render its offspring more sensitive to treatment for generations.

The study will be published Wednesday (Aug. 28) in the journal Science Advances.

“A central assumption in bacterial biology is that heritable physical characteristics are determined primarily by DNA,” said Northwestern’s Adilson Motter, the study’s senior author. “But, from the perspective of complex systems, we know that information also can be stored at the level of the network of regulatory relationships among genes. We wanted to explore whether there are characteristics transmitted from parents to offspring that are not encoded in DNA, but rather in the regulatory network itself. We found that temporary changes to gene regulation imprint lasting changes within the network that are passed on to the offspring. In other words, the echoes of changes affecting their parents persist in the regulatory network while the DNA remains unchanged.”

Motter is the Charles E. and Emma H. Morrison Professor of Physics at Northwestern’s Weinberg College of Arts and Sciences and director of the Center for Network Dynamics. The study’s co-first authors are postdoctoral fellow Thomas Wytock and graduate student Yi Zhao, who are both members of Motter’s laboratory. The study also involves a collaboration with Kimberly Reynolds, a systems biologist at the University of Texas Southwestern Medical Center. 

Learning from a model organism

Since researchers first identified the molecular underpinnings of genetic code in the 1950s, they have assumed traits are primarily — if not exclusively — transmitted through DNA. However, after the completion of the Human Genome Project in 2001, researchers have revisited this assumption. 

Wytock cites the World War II Dutch famine as a famous example pointing to the possibility of heritable, non-genetic traits in humans. A recent study showed that the children of men, who were exposed to the famine in utero, exhibited an increased tendency to become overweight as adults. But isolating the ultimate causes for this type of non-genetic inheritance in humans has proved challenging.

“In the case of complex organisms, the challenge lies in disentangling confounding factors such as survivor bias,” Motter said. “But perhaps we can isolate the causes for the simplest single-cell organisms, since we can control their environment and interrogate their genetics. If we observe something in this case, we can attribute the origin of non-genetic inheritance to a limited number of possibilities — in particular, changes in gene regulation.”

The regulatory network is analogous to a communication network that genes use to influence each other. The research team hypothesized that this network alone could hold the key to transmitting traits to offspring. To explore this hypothesis, Motter and his team turned to Escherichia coli (E. coli), a common bacterium and well-studied model organism.

“In the case of E. coli, the entire organism is a single cell,” Wytock said. “It has many fewer genes than a human cell, some 4,000 genes as opposed to 20,000. It also lacks the intracellular structures known to underlie the persistence of DNA organization in yeast and the multiplicity of cell types in higher organisms.Because E. coli is a well-studied model organism, we know the organization of the gene regulatory network in some detail.” 

Reversible stress, irreversible change

The research team used a mathematical model of the regulatory network to simulate the temporary deactivation (and subsequent reactivation) of individual genes in E. coli. They discovered these transient perturbations can generate lasting changes, which are projected to be inherited for multiple generations. The team currently is working to validate their simulations in laboratory experiments using a variation of CRISPR that deactivates genes temporarily rather than permanently.

But if the changes are encoded in the regulatory network rather than the DNA, the research team questioned how a cell can transmit them across generations. They propose that the reversible perturbation sparks an irreversible chain reaction within the regulatory network. As one gene deactivates, it affects the gene next to it in the network. By the time the first gene is reactivated, the cascade is already in full swing because the genes can form self-sustaining circuits that become impervious to outside influences once activated.

“It’s a network phenomenon,” said Motter, who is an expert in the dynamic behaviors of complex systems. “Genes interact with each other. If you perturb one gene, it affects others.”

Although his team is deactivating genes to test the hypothesis, Motter is clear that different types of perturbations could cause a similar effect. “We also could have changed the cell’s environment,” he said. “It could be the temperature, the availability of nutrients or the pH.” 

The study also suggests that other organisms have the necessary elements to exhibit non-genetic heritability. “In biology, it’s dangerous to assume anything is universal,” Motter contends. “But, intuitively, I do expect the effect to be common because E. coli’s regulatory network is similar or simpler than those found in other organisms.”

The study, “Irreversibility in bacterial regulatory networks,” was supported by the National Science Foundation (award number MCB-2206974).

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Journal

Science Advances

DOI

10.1126/sciadv.ado3232 

Method of Research

Computational simulation/modeling

Article Title

Irreversibility in Bacterial Regulatory Networks

Article Publication Date

28-Aug-2024

 

Marine engineering group to award ORNL researchers for innovative welding software

DOE/Oak Ridge National Laboratory

 

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ORNL’s Zhili Feng is honored with the Elmer L. Hann Award for his contributions to a groundbreaking welding software tool.

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Credit: Genevieve Martin/ORNL, U.S. Dept. of Energy

Zhili Feng, a distinguished R&D staff member, and Jian Chen, a senior R&D staff member, in Materials Science and Technology Division at the Department of Energy’s Oak Ridge National Laboratory, will receive the Elmer L. Hann Award at the Society of Naval Architects and Maritime Engineers, or SNAME, Convention on Oct. 15 in Norfolk, Virginia. SNAME plays a crucial role in promoting excellence in marine engineering and naval architecture, supporting professionals through education, research and collaboration.

The award is presented to authors of the best paper on ship production delivered at a SNAME event. In September 2023, Feng and Chen presented “Develop a Fast Analysis Solver for Welding Sequence Optimization” at the SNAME Maritime Convention in San Diego. The paper — by Feng, Chen and researchers from Ingalls Shipbuilding, a division of Huntington Ingalls Industries — describes the scientists’ creation of a user-friendly software tool that can quickly analyze and determine the best order for performing welds on ship structures. 

The tool is designed to reduce distortion caused by welding, improve the accuracy of ship parts and decrease the need for corrective work after welding. Some of the potential benefits are a reduced labor requirement for straightening welded parts, improved dimensional accuracy of ship parts and reduced rework and labor hours in downstream processes.

Leveraging more than two and a half decades of research and development experience, Feng leads a team of multidisciplinary scientists and supporting staff in both fundamental and applied studies related to materials joining and allied materials manufacturing processes. Feng has over 200 publications and nine patents. Chen leads and supports various fundamental and applied research and technology innovations sponsored by government agencies and industries. Chen holds multiple patents and software copyrights. Both Feng and Chen have been recognized with numerous awards for their work. 

UT-Battelle manages ORNL for the Department of Energy’s Office of Science, the single largest supporter of basic research in the physical sciences in the United States. The Office of Science is working to address some of the most pressing challenges of our time. 

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DOI

10.5957/SMC-2023-029 

 

UBC engineers develop all-in-one solution to catch and destroy ‘forever chemicals’

University of British Columbia

 

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Pictured: UBC chemical engineering student researcher Pani Rostami.

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Credit: UBC Applied Science/Paul Joseph

Chemical engineers at the University of British Columbia have developed a new treatment that traps and treats PFAS substances—widely known as “forever chemicals”—in a single, integrated system.

Per- and polyfluoroalkyl substances (PFAS) are widely used in manufacturing consumer goods like waterproof clothing due to their resistance to heat, water and stains. However, they are also pollutants, often ending up in surface and groundwater worldwide, where they have been linked to cancer, liver damage and other health issues.

“PFAS are notoriously difficult to break down, whether they’re in the environment or in the human body,” explained lead researcher Dr. Johan Foster, an associate professor of chemical and biological engineering in the faculty of applied science. “Our system will make it possible to remove and destroy these substances in the water supply before they can harm our health.”

Catch and destroy

The UBC system combines an activated carbon filter with a special, patented catalyst that traps harmful chemicals and breaks them down into harmless components on the filter material. Scientists refer to this trapping of chemical components as adsorption.

“The whole process is fairly quick, depending on how much water you’re treating,” said Dr. Foster. “We can put huge volumes of water through this catalyst, and it will adsorb the PFAS and destroy it in a quick two-step process. Many existing solutions can only adsorb while others are designed to destroy the chemicals. Our catalyst system can do both, making it a long-term solution to the PFAS problem instead of just kicking the can down the road.”

No light? No problem

Like other water treatments, the UBC system requires ultraviolet light to work, but it does not need as much UV light as other methods.

During testing, the UBC catalyst consistently removed more than 85 per cent of PFOA (perfluorooctanoic acid, a type of forever chemical) even under low light conditions.

“Our catalyst is not limited by ideal conditions. Its effectiveness under varying UV light intensities ensures its applicability in diverse settings, including regions with limited sunlight exposure,” said Dr. Raphaell Moreira, a professor at Universität Bremen who conducted the research while working at UBC.

For example, a northern municipality that gets little sun could still benefit from this type of PFAS solution.

“While the initial experiments focused on PFAS compounds, the catalyst’s versatility suggests its potential for removing other types of persistent contaminants, offering a promising solution to the pressing issues of water pollution,” explained Dr. Moreira.

From municipal water to industry cleanups

The team believes the catalyst could be a low-cost, effective solution for municipal water systems as well as specialized industrial projects like waste stream cleanup.

They have set up a company, ReAct Materials, to explore commercial options for their technology.

“Our catalyst can eliminate up to 90 per cent of forever chemicals in water in as little as three hours—significantly faster than comparable solutions on the market. And because it can be produced from forest or farm waste, it’s more economical and sustainable compared to the more complex and costly methods currently in use,” said Dr. Foster.

The research was supported by an NSERC Discovery grant and was recently published in Nature Communications Engineering.

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Journal

Communications Engineering

DOI

10.1038/s44172-024-00267-4 

 

New USC research reveals untapped potential for mobilizing voters of color in battleground states

Center for Inclusive Democracy finds persistent low turnout for Latino, Asian-American and Black voters in all nine swing states; boosting groups’ participation could be gamechanger for November

University of Southern California

 

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Mindy Romero is the founder and director of the Center for Inclusive Democracy (CID) at the USC Sol Price School of Public Policy and is based in Sacramento, California.

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Credit: (Photo/USC Sol Price School of Public Policy)

With swing states playing a pivotal role in the 2024 presidential election, new reports from the Center for Inclusive Democracy (CID) at the USC Sol Price School of Public Policy have found significant voter turnout disparities between white, non-Latino voters and voters of color in all nine battleground states.

The reports highlight the persistent “voter representation gap,” where voters of color remain underrepresented at the polls, despite substantial population growth. If narrowed by November, the research concludes, this gap could significantly influence election results, particularly in swing states that had particularly close election outcomes in 2020. 

CID analyzed voter files from the 2020 general election for Latino, Black and Asian-American voters in Arizona, Florida, Georgia, Michigan, North Carolina, Nevada, Pennsylvania, Wisconsin and Texas. The study found that while the eligible voter populations of color in these swing states grew substantially from 2010 to 2020—outpacing the growth of the white, non-Latino population and often the general population—these voters of color had consistently lower turnout rates compared to white, non-Latino voters during the 2020 election.

“The huge number of eligible non-voters among communities of color in swing states presents an extraordinary opportunity for voter mobilization and engagement,” said CID Director Mindy Romero, the study’s lead author. “Getting more voters of color to the polls could be transformational and have the potential to impact election outcomes in November. Participation by these groups and all voters is foundational to our democratic values and processes.” 

See individual briefs for each battleground state here. Several notable findings in select states include: 

• Arizona: More than 850,000 Asian-American, Black and Latino eligible voters did not cast a ballot in Arizona’s 2020 presidential election, where the margin of victory was only 10,457 votes.
   
• Florida: Asian-American, Black and Latino eligible voter populations represented more than one-third of Florida’s eligible voters in the 2020 general election, yet a sizeable number of these voters – 2.2 million – did not cast a ballot, a number nearly six times larger than the vote margin of victory in the state. 

• Georgia: Even with a rapid growth in the eligible voter populations for Latinos, Blacks and Asian-Americans, more than 1.2 million did not vote in 2020, more than 100 times the margin of victory in the state.

Earlier this year, CID issued a national report on voter turnout. The New Electorate: The Strength of the Latino, Black and Asian-American Vote report revealed that in the 2020 presidential election, Asian-American, Black and Latino eligible voters comprised nearly 30% of those eligible to vote in the U.S., but represented just over 22% of all votes cast, significantly lower than their share of eligible voters. The report found this entrenched voter representation gap evident across nearly all U.S. elections. 

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Article Publication Date

27-Aug-2024

 

How stigma affects Asian Americans living with hepatitis B

Feeling judged by others may affect physical and mental health outcomes in those with chronic hepatitis B

Thomas Jefferson University

Asian Americans comprise just 6% of the U.S. population, but they represent over 60% of Americans with hepatitis B. Hepatitis B (HBV) is a virus that infects the liver, and while some people may recover from the infection, others can go on to develop liver failure or cancer. HBV is transmitted through blood, semen or other bodily fluids, but it can also be passed from mother to child during birth, which is how the majority of Asian Americans acquire the disease.

Up until 2010, laws in China allowed for discrimination against people with HBV, barring adults from employment and keeping children out of school. Though these policies are now outlawed, there remains a stigma against the disease in both China and the U.S.

Researcher Hee-Soon Juon, MSN, PhD, at Thomas Jefferson University has been working with Asian-American communities to investigate and raise awareness of HBV since the early 2000’s. In a new study published in The Journal of Viral Hepatitis, she explores how stigma against HBV affects those with the condition.

The study surveyed 365 Korean-Americans with chronic hepatitis B (CHB) to see how stigma against HBV affected them. Participants responded to questions about their physical health, mental health and if they believed they had experienced racial discrimination.

Dr. Juon found that people who felt more stigmatized were more likely to report worse depression and physical health, and that greater knowledge of the disease didn’t necessarily translate to feeling less judged for their condition. Perceived racial discrimination was also tied to feelings of stigma and depression.

“We confirmed that stigma is very impactful for a CHB patient,” says Dr. Juon. “This can have consequences on their treatment journey.”

In fact, past research has shown that stigma against a disease may dissuade individuals from seeking care, cause mental distress or lead to explicit discrimination. Dr. Juon says the next steps in this research will be developing interventions that can help combat stigma for those with HBV.

By Marilyn Perkins

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Journal

Water Resources Research

 

New study: drug may stop migraines before headache starts

 LIKE MAGICK

American Academy of Neurology

MINNEAPOLIS – When taken at the first signs of a migraine, before headache pain begins, a drug called ubrogepant may be effective in helping people with migraine go about their daily lives with little or no symptoms, according to a new study published in the August 28, 2024, online issue of Neurology®, the medical journal of the American Academy of Neurology. The study focused on people with migraine who could tell when an attack was about to happen, due to early symptoms such as sensitivity to light and sound, fatigue, neck pain or stiffness, or dizziness.   

Ubrogepant is a calcitonin gene-related peptide receptor antagonist, or CGRP inhibitor. CGRP is a protein that plays a key role in the migraine process.

“Migraine is one of the most prevalent diseases worldwide, yet so many people who suffer from this condition do not receive treatment or report that they are not satisfied with their treatment,” said study author Richard B. Lipton, MD, of Albert Einstein College of Medicine in Bronx, New York, and Fellow of the American Academy of Neurology. “Improving care at the first signs of migraine, even before headache pain begins, can be a key to improved outcomes. Our findings are encouraging, suggesting that ubrogepant may help people with migraine function normally and go about their day.”

The study involved 518 participants who had migraine for at least one year and two to eight migraine attacks per month in the three months before the study. All of the participants regularly experienced signs that a migraine would be starting within the next few hours. Participants were asked to treat two attacks during a two-month period.

Researchers divided participants into two groups. The first group received a placebo for their first set of pre-headache symptoms of migraine, followed by taking 100 milligrams (mg) of ubrogepant for their second instance of symptoms. The second group took ubrogepant for the first instance and placebo for the second instance.

Participants evaluated limitations on their activity in their diary using a scale ranging from zero to five, with 0 meaning “not at all limited – I could do everything”; 1, “a little limited”; 2, “somewhat limited”; 3, “very limited”; or 4, “extremely limited.”

Twenty-four hours after taking the drug or a placebo, 65% of people who took ubrogepant reported themselves as “not at all limited – I could do everything,” or “a little limited,” compared to 48% of those who took the placebo.

Researchers found that as early as two hours post-medication, people who took the drug were 73% more likely to report that they had “no disability, able to function normally,” than those who took the placebo.

“Based on our findings, treatment with ubrogepant may allow people with migraine who experience early warning signs before a migraine occurs to quickly treat migraine attacks in their earliest stages and go about their daily lives with little discomfort and disruption,” said Lipton. “This could lead to an improved quality of life for those living with migraine.”

Lipton noted that participants showed that based on their headache warning symptoms, they could reliably predict impending migraine headaches.  These findings apply only to those with reliable warning symptoms. 

A limitation of the study was that participants recorded their symptoms and medication use in electronic diaries, so it is possible some people may not have recorded all information accurately.

The study was funded by AbbVie, the maker of ubrogepant.

Learn more about migraine at BrainandLife.org, home of the American Academy of Neurology’s free patient and caregiver magazine focused on the intersection of neurologic disease and brain health. Follow Brain & Life® on Facebook, X and Instagram.

When posting to social media channels about this research, we encourage you to use the hashtags #Neurology and #AANscience.

The American Academy of Neurology is the world's largest association of neurologists and neuroscience professionals, with over 40,000 members. The AAN’s mission is to enhance member career fulfillment and promote brain health for all. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer's disease, stroke, concussion, epilepsy, Parkinson's disease, multiple sclerosis, headache and migraine.

For more information about the American Academy of Neurology, visit AAN.com or find us on Facebook, X, Instagram, LinkedIn and YouTube.

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Journal

Neurology