欧洲脑研究共识文件。
Consensus document on European brain research.
作者信息
Olesen Jes, Baker Mary G, Freund Tamas, di Luca Monica, Mendlewicz Julien, Ragan Ian, Westphal Manfred
机构信息
European Brain Council, University of Copenhagen, Department of Neurology, Glostrup Hospital, Nordre Ringvej, Glostrup, Copenhagen, 2600 Denmark.
出版信息
J Neurol Neurosurg Psychiatry. 2006 Aug;77 Suppl 1(Suppl 1):i1-49.
Brain disease psychiatric and neurologic disease combined represents a considerable social and economic burden in Europe. Data collected by the World Health Organization (WHO) suggest that brain diseases are responsible for 35% of Europe's total disease burden. An analysis of all health economic studies of brain diseases in Europe, published by the European Brain Council (EBC) in June 2005, estimated the total cost of brain disease in Europe in 2004 to be Euro 386 billion. That burden is set to grow, mainly due to the fact that the European population is ageing. Investment in brain sciences does not match that burden now, let alone in the future. Brain research received only 8% of the life science budget in the European Commission's Fifth Framework Programme, which represents less than 0.01% of the annual cost of brain disorders for that period. Over the last decade, Europe has been losing ground to the USA and Japan in terms of both basic and clinical research. Many of Europe's young researchers are taking up posts in the USA and staying there. Big pharmaceutical companies are fleeing Europe for the USA, taking their drug development programmes with them. Research in the brain sciences now holds the promise of therapies that halt and even reverse neurodegeneration, of better diagnostic tools, neural prostheses for the paralysed and drugs for depression and anxiety that are tailored to the individual, thereby eliminating or reducing side effects. Our growing understanding of the normal brain could lead to better prevention of brain disease and to more effective teaching methods. The need for innovative treatments has never been greater, and Europe boasts clusters of excellent researchers in biotechnology who could collaborate with brain scientists and the pharmaceutical industry to realise this promise. But if Europe is to seize these opportunities and meet the challenge of brain disease, it needs to go forward on the basis of greater collaboration between countries, greater collaboration between industry, academia and patient organisations, and increased investment in the brain sciences. The EBC was formed in 2002 to bring together scientists, clinicians, the pharmaceutical industry, charities and patient organisations from all over Europe to campaign for these goals. It takes a novel, bottom-up approach to research policy, and in developing this consensus document, it aims to promote a greater and more focused effort in this area, to improve public understanding of the brain sciences and above all, to support brain research as a priority under the European Commission's Seventh Framework Programme (FP7, 2007-2013). The research programme outlined here was first conceived by the EBC board. An outline was sent to all member organisations and a number of individual experts for comments. Following that, a table of contents was developed. The 45 research themes were written by groups of experts from across Europe who represent a wide range of disciplines. Each one contains a proposal for future research on a specific brain-related theme which the EBC believes could form the basis of one or more integrated projects or strategic targeted research projects (STREP) funded under FP7. The EBC has deliberately focused on the major diseases and then described the basic research needed to understand and treat or perhaps even cure those diseases. The programme is therefore constructed "from man to molecule" and not the other way round, with equal importance attached to basic and clinical research. The EBC suggests that each of the proposed integrated projects or STREP should be awarded a budget in the order of Euro 10 to 15 million. In addition, brain research should be treated as an important element of many other parts of FP7, such as the European Research Council and research programmes on information technology and the causes of violence. Any research programme that concerns human behaviour should, by definition, take account of brain research. The EBC envisages that the priority for brain research it proposes at the European level will translate into higher priority for brain research at the national level, and this document may also serve as a starting point for the development of national consensus programmes. It seems likely that consensus conferences on brain research in Europe may further develop the themes and ideas discussed here. An EBC task force may also be established to further the consensus process. In general, increasing funding in the brain sciences would bring enormous economic returns by lightening the burden on healthcare systems and increasing the productivity of affected individuals-and might easily pay for itself. The human and social returns of such an investment are inestimable. And the time to act is now.
脑疾病(精神疾病与神经疾病并存)在欧洲构成了相当大的社会和经济负担。世界卫生组织(WHO)收集的数据表明,脑疾病占欧洲疾病总负担的35%。欧洲脑理事会(EBC)2005年6月发布的对欧洲所有脑疾病健康经济学研究的分析估计,2004年欧洲脑疾病的总成本为3860亿欧元。这一负担还将增加,主要原因是欧洲人口老龄化。目前对脑科学的投资与这一负担不相匹配,更不用说未来了。在欧盟委员会的第五个框架计划中,脑研究仅获得了生命科学预算的8%,这还不到该时期脑疾病年度成本的0.01%。在过去十年里,欧洲在基础研究和临床研究方面都落后于美国和日本。许多欧洲年轻研究人员在美国任职并留在了那里。大型制药公司正带着其药物研发项目逃离欧洲前往美国。目前脑科学研究有望带来能够阻止甚至逆转神经退行性变的疗法、更好的诊断工具、用于瘫痪患者的神经假体以及针对个体的治疗抑郁症和焦虑症的药物,从而消除或减少副作用。我们对正常大脑的日益了解可能会带来更好的脑疾病预防方法和更有效的教学方法。对创新治疗方法的需求从未如此迫切,欧洲拥有一批优秀的生物技术研究人员群体,他们可以与脑科学家和制药行业合作来实现这一前景。但是,如果欧洲要抓住这些机遇并应对脑疾病的挑战,就需要在国家间加强合作、行业、学术界和患者组织之间加强合作以及增加对脑科学的投资的基础上向前发展。欧洲脑理事会成立于2002年,旨在将来自欧洲各地的科学家、临床医生、制药行业、慈善机构和患者组织聚集在一起,为实现这些目标而开展活动。它采用了一种新颖的、自下而上的研究政策方法,在制定这份共识文件时,旨在促进在这一领域做出更大、更有针对性的努力,提高公众对脑科学的理解,最重要的是,在欧盟委员会的第七个框架计划(FP7,2007 - 2013年)中将脑研究作为优先事项予以支持。这里概述的研究计划最初由欧洲脑理事会董事会构思。一份大纲被发送给所有成员组织和一些个人专家征求意见。随后,制定了一份目录。45个研究主题由来自欧洲各地、代表广泛学科的专家小组撰写。每个主题都包含一项关于特定脑相关主题未来研究的提议,欧洲脑理事会认为这些提议可以构成在FP7资助下的一个或多个综合项目或战略目标研究项目(STREP)的基础。欧洲脑理事会有意专注于主要疾病,然后描述为理解、治疗甚至治愈这些疾病所需的基础研究。因此,该计划是“从人到分子”构建的,而不是相反,基础研究和临床研究同等重要。欧洲脑理事会建议,每个提议的综合项目或STREP应获得1000万至1500万欧元左右的预算。此外,脑研究应被视为FP7许多其他部分的重要组成部分,如欧洲研究理事会以及关于信息技术和暴力成因的研究计划。任何涉及人类行为的研究计划,从定义上讲,都应考虑脑研究。欧洲脑理事会设想,它在欧洲层面提议的脑研究优先事项将转化为国家层面更高的脑研究优先事项,并且这份文件也可以作为制定国家共识计划的起点。欧洲关于脑研究的共识会议似乎可能会进一步发展这里讨论的主题和想法。还可能会成立一个欧洲脑理事会特别工作组来推进共识达成过程。总体而言,增加对脑科学的资金投入将通过减轻医疗保健系统的负担和提高受影响个体的生产力带来巨大的经济回报——而且可能很容易实现自我回报。这种投资的人力和社会回报是无法估量的。现在是采取行动的时候了。
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