The Future of Neuroscience Education

I spent the majority of my career in medical education and saw significant changes over time.

One encouraging sign was the emergence of neuroscience as a respected and beneficial academic discipline.

Now, a new perspective on Neuroscience Training for the 21st Center has been written by Huda Akil and colleagues. This perspective is recently published in the journal Neuron with free access to the full-text manuscript.

Here are my notes from reading this perspective. Readers can access the free full-text manuscript by clicking on the link in the citation below.

Two important challenges for the field

• Incorporating data and statistical skills traininng in neuroscience
• Integration of other scientific disciplines in neuroscience research (engineering, CS)

Need to improve trainee skills in high-level programming languages (i.e. MATLAB)

Enhanced communication skills in training are needed to address publication and grant-writing challenges

Improvement is needed in "enabling the process by which basic science discoveries add fundamental knowledge to the field and inform solutions for disabiling neurological and psychiatric conditions". 

The above goal can be met by integrating collaborative training of basic and clinical neuroscience trainees.

Neuroscience trainees will need to be trained to meet demands of job availability
Number of neuroscience Ph.Ds graduate greatly exceed number of academic faculty slots
Federal research funding is unable to meet needs of many neuroscience graduates
However, non-academic private positions in neuroscience are expanding providing optimism for many neuroscience Ph.Ds

Key roles exist in multiple sectors to attract and train the best and brightest

• Academia
• Private sector
• Societies and Patient-Advocacy Organizations
• NIH, NSF and other funding agencies

These agencies must plan and work together to "ensure the success of this next generation of neuroscientists"

My Commentary

This is an outstanding summary of the challenges and opportunities for neuroscience education. As a physician I am particularly excited about clinical opportunities for integrating basic neuroscience training the the medical setting. I have recently been thinking about how a name change for neurology and psychiatry might aid in this evolution. Stay tuned for a provocative post on a new integrated neuroscience medicine discipline.

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Akil, H., Balice-Gordon, R., Cardozo, D., Koroshetz, W., Posey Norris, S., Sherer, T., Sherman, S., & Thiels, E. (2016). Neuroscience Training for the 21st Century Neuron, 90 (5), 917-926 DOI: 10.1016/j.neuron.2016.05.030

Pain Prevalence in Dementia

The development of speech and language impairment in dementia presents barriers in many clinical domains.

One important clinical domain is assessment and management of pain. Dementia may preclude spontaneous or interview-elicited pain reporting.

A report today in MedicalXpress noted reduced reporting of pain in patients with diabetes and cognitive impairment.

I was able to locate one free full-text manuscript reviewing the prevalence of pain in various types of dementias. This literature review found the following:

• Pain prevalence was estimated at 46% of Alzheimer's disease patients
• Pain prevalence was estimated at 56% of vascular dementia patients
• Pain prevalence was estimated at 53% in mixed dementia patients
• Insufficient research study was found for determining rates of pain in frontotemporal and Lewy body dementia populations

These studies support rigorous pain assessment and monitoring for pain in dementia patient populations. Alert clinicians and nurses can aid in proxy assessment of pain when speech and language impairments reduce pain self reporting.

You can access this full text review manuscript by clicking on the PMID in the citation below.

I found a helpful education sheet produced by the Australian government on pain in dementia. This sheet included a list of potential non-verbal signs of pain in later stages of dementia including:

• Facial grimacing
• Moaning or crying out with movement
• Increased heart rate, blood pressure or sweating
• Changes in sleep patterns including increased or restless sleep
• Changes in behavior including increased irritability or aggression.

You can access the Pain and Dementia Education in the Dementia Q&A section at this link. 

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van Kooten J, Binnekade TT, van der Wouden JC, Stek ML, Scherder EJ, Husebø BS, Smalbrugge M, & Hertogh CM (2016). A Review of Pain Prevalence in Alzheimer's, Vascular, Frontotemporal and Lewy Body Dementias. Dementia and geriatric cognitive disorders, 41 (3-4), 220-32 PMID: 27160163