The Italian Society of Neurology (SIN) was founded more than 100 years ago by a group of neuroscientists including Leonardo Bianchi, Carlo Besta, Amico Bignami, Ugo Cerletti, Cesare Lombroso, Giovanni Mingazzini, Onofrio Fragnito, Ottorino Rossi, Camillo Nigro, Enrico Morselli, Eugenio Tanzi, Ernesto Lugaro, and Camillo Golgi. These founders came from some of the oldest and most prestigious universities in Turin, Naples, Rome, and Pavia.
In the period between World War II and the end of the 1950s, services for the treatment of neurologic and mental disorders were generally located within psychiatric hospitals and the discipline was called Clinics of Nervous and Mental Diseases. Subsequently, special units for neurology and neuropathology were established in a few hospitals, separated by internal medicine.
Since the 1970s, SIN established a clearer identity. The separation of neurology from psychiatry was realized and independent clinical units of neurology were created in all major hospitals and various subspecialties began to emerge. These included clinical neurophysiology, neuropathology, neuropsychology—which already had a long tradition with its journal Cortex— neurorehabilitation, and neurogenetics.
In 1979, the Italian Journal of Neurological Sciences was founded by Renato Boeri, who was the Director of Istituto Neurologico Besta, and this became the official journal of the Society. Published by Springer-Verlag and now called Neurological Sciences, it has acquired a strong international reputation (figure).
The new 2012 cover (left) and a previous cover (right). Reproduced with permission.
Today, SIN has about 3,000 members and is well organized into areas of interest in order to facilitate interaction among experts. More than 4,000 neurologists attend the annual meeting, which includes 4 days of courses, workshops, seminars, and symposia. The SIN pays special attention to education with many regional meetings and special courses. Representatives of SIN also contribute to the development of strategic plans for social care in neurology.
The Presidents of the Italian Society of Neurology in the last 40 years are reported in table 1.
The Presidents of the Italian Society of Neurology in the past 40 years
Like other societies in Italy and around the world, important demographic changes are evident within SIN. There is an increasing number of women (around 40%) and young people (25%) (table 2).
Members of the Italian Society of Neurology, 2011, with particular regard to gender and age (under 35 years)
Neurologists—like other Italian specialists—are trained by universities, in a 5-year program, usually spent in an academic hospital or teaching hospital with training under a full professor and the Director of the education program. Fellowship includes periods spent in different areas of neurology and internal medicine, including training in the emergency room and key aspects of neuroradiology and clinical neurophysiology. The number of new trainees each year is around 100, divided among the different Italian medical schools. The SIN shows great interest in these trainees: every year the SIN offers special residential courses for 2 or 3 students from each school, completely supported by the society (the courses address emergency care, neurosciences, neurorehabilitation, neuroimaging, and rare neurologic disorders).
For young neurologists in training, SIN also promotes 150–200 grants to participate in the annual meeting and other facilities.
Most Fellows are also involved in some research activities. Italian neurologic research has a long tradition which continues despite the decreasing support from national research agencies, due to poor economic conditions. Italian researchers have greatly contributed to vital research in neuropsychology, multiple sclerosis, movement disorders, neurogenetics, and neuroimaging. In Europe, Italian neurologists are second only to German neurologists for number of published articles in peer-reviewed scientific journals.1
Italian neurologists, as in other countries, have ongoing competition to defend their role: with geriatrics for management of dementias, with internal medicine for stroke, with physiatrists for neurorehabilitation, and with emergentists for acute neurologic disorders. Italian neuroradiologists belong to general radiology departments, making efficient interaction difficult. Interventional neuroradiology is completely in the hands of radiologists.
ITALIAN NEUROLOGY: CURRENT STATUS
Following the economic crisis of Europe and Italy, some restrictions in neurology include a trend to limit hospital beds dedicated to neurologic patients; a trend to follow the majority of those with chronic neurodegenerative disorders as outpatients and higher responsibility for the use of high-cost treatments (immunoglobulins, monoclonal antibodies, recombinant enzymes); and shrinking autonomy of neurology. In several hospitals, neurology departments have disappeared as intensity departments emerged. Different specialties are associated in the same spaces, with the same nurses, in relationship to the same level—or intensity—of care; absence of neurologists in the majority of peripheral hospitals: as a result, stroke, dementia, and other common neurologic diseases are not primarily followed by a neurologist; and aging of current neurologists working in the national care system, with a large number of retirements in the next 5 years (20%) with very limited availability of substitutes.
Despite these growing problems, the interest in the specialty of neurology among medical students is very high. In the universities, the most brilliant students very often consider neurology for their future. The prolongation of life necessitates a growing role for prevention and treatment of neurologic disorders. This leaves our specialty with a large responsibility to defend the role of neurologists in the Italian health system as well as in academic systems.
DISCLOSURE
A. Federico is Past-President of the Italian Society of Neurology, serves as Editor-in-Chief of Neurological Sciences, received research support by Ever Neuro Pharma GmbH, and Regione Toscana grants # I61J11000000001 and B61J09000650009. G. Comi is President of the Italian Society of Neurology–SIN and serves as Associate Editor of Neurological Sciences. He receives honoraria from the following pharmaceutical companies: Actelion, Bayer-Schering, Teva Pharm, Sanofi-Aventis, and Novartis. Go to Neurology.org for full disclosures.
- Copyright © 2012 by AAN Enterprises, Inc.
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