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. Author manuscript; available in PMC: 2017 Jan 12.
Published in final edited form as: Nature. 2015 Nov 19;527(7578):S207–S213. doi: 10.1038/nature16037

Table 1.

Approaches to building research capacity

Category Activity General and specifc needs Anticipated benefts Specifc approaches
Human capacity
  • Increase the number of clinician researchers

  • Increased number of physicians and allied health professionals in research benefts all neuroscience researchers, including neurologists, neurosurgeons, infectious disease specialists, psychiatrists and other mental health practitioners

  • As the incidence of neurological conditions increases, so will the need for more trained neurologists involved in research

  • Practical experience and opportunities for future training12

  • Create protected time and funding for research

  • Decrease brain drain by investing in research and jobs in neurological areas

  • Research methodology training during graduate and post-graduate medical training

  • Increase research capacity of clinicians and researchers through workshops and short courses; and advanced degrees in public health (for example, epidemiology, biostatistics, clinical trials, health services and implementation science), clinical and basic science research

  • Sub-specialized training on specifc skills related to nervous-system disorders

  • As the neurosciences have not received as much attention from research training grants, most areas would beneft from increased funding for research training

  • Health-systems research is needed, which necessitates training in bioethics, research methodology, epidemiology, clinical trials, population-based methodology and intervention studies

  • Specifc areas of neuroscience with unique needs, include mental health for which health-services research is crucial to increase the capacity of care services

  • Many countries do not have the ability to diagnose neurogenetic conditions, and cannot provide genetic counselling or treatment

  • Address the shared burdens of common conditions, including neurodegenerative disorders, stroke and epilepsy

  • Development of multidisciplinary teams of health-care professionals to improve prevention, pre-hospital care, and clinical care in neuroscience, such as trauma, mental health or neurogenetics

  • Multidisciplinary training and research

  • The Wellcome trust-DBT India alliance fellowship for clinicians and research scientists

  • Innovation in science pursuit for inspired research programme

  • Initiative in neuroclinical research education

  • The African Brain Mapping and Therapeutics Initiative, which advances neuroscience research in Africa by promoting global partnerships for brain-disease prevention and treatment

  • Institutionalization of mentorship training

  • Outstanding mentoring is a prerequisite of any successful research-training programme

  • Mentors must be expert in particular areas of research, such as cognitive assessment scales for the study of dementia-associated conditions, or seizure management for studies of epilepsy

  • Capacity for conducting neuroscience research will increase as trainees move into positions where they will start mentoring subsequent generations of trainees

  • Increasing numbers of scientists and the development of research teams, research culture and an increase in scientifc literature and novel research

  • Wide spread mentorship training (for example, through programmes such as those of the NIH Fogarty International Center http://www.fc.nih.gov/)

Infrastructure
and tools
  • Neuroimaging (for example, computerized tomography or magnetic resonance imaging)

  • Most neurological conditions require neuroimaging to confrm a diagnosis, disease stage or to monitor progress

  • Increased availability of neuroimaging will lead to better defnition of the burden of many neurological conditions, such as stroke, CNS infections, developmental, degenerative and genetic disorders, and trauma

  • Mentoring in the tools needed through fexible research and research-training programmes (for example through the Fogarty Global Brain programme)

  • Genomic sequencing to detect SNPs in GWAS

  • GWAS are used to identify genetic variations (SNPs) associated with neurological and psychological disorders, including addiction

  • Detection of specifc genes through GWAS can lead to a better understanding of the functional mechanisms that are biologically important in disease pathogenesis and, ultimately, to better treatments for neurological diseases

  • The US National Center for Biotechnology Information has developed the Database of Genotype and Phenotype, where genetic sequencing information can be deposited and accessed

  • Increased laboratory capacity

  • Most studies of neurological diseases require at least a basic laboratory to process blood, cerebrospinal fuid or other human samples

  • With increasing complexity of studies, additional equipment is needed, such as polymerase chain reaction for detecting infectious pathogens or biosensors to detect environmental toxins

  • Many technologies introduced to increase laboratory capacity are also useful for diagnosing non-neurological diseases

  • Enhancement of laboratory capacity ofen requires the upgrade of electrical systems, and with larger laboratories may also require installation of air-conditioning systems

  • Culturally appropriate assessment and screening tools

  • WHO and NIH databank of valid and reliable assessments for young people and adults. Each has an armamentarium of tools that are culturally appropriate

  • Stigma, social and health disparities are more common with disorders such as epilepsy and schizophrenia

  • Disorders such as epilepsy and schizophrenia would beneft from increased recognition of barriers identifed through culturally appropriate screening tools

  • NIH and WHO promote scientifc discovery, and shared resources, that allow for data harmonization across many programmes

  • Network meetings with special interest groups value the use of unifed concepts of addiction and mental health, from DSM to ICD classifcations.

Technology
  • Incorporation of emerging POC diagnostics from both the development of cross-cultural tools to the use of the tools

  • POC diagnostics could permit rapid diagnosis of many neurological infections in the feld, resulting in improved recognition and treatment

  • POC diagnostics can be used to non-invasively monitor seizures, cerebral blood fow or intracranial pressure, but are not widely available for use in LMIC settings

  • Miniaturization of diagnostic technologies for genomics, infectious agents and environmental markers will enable a better understanding of gene–environment interactions and lead to new therapeutic approaches

  • Better sharing of data and instrumentation is needed, as well as collaborative grants

  • Access to electronic scientifc literature

  • Common to all research is the need for understanding past and current scientifc literature

  • Improved access to electronic scientifc literature should lead to more scientifcally sound research and ofen leads to the creation of journal clubs, which in turn strengthens the culture of research

  • The HINARI Access to Research in Health programme provides free or low cost access to 200 neuroscience journals for not-for-profts in LMICs, but the top ranking 50 journals are not available

  • Open access journals are available to everyone

  • Introduction of mHealth technologies and e-learning strategies

  • Adoption of mobile technologies for surveillance, assessments and treatment are particularly needed in LMICs where cell phone ownership is rising rapidly, but access to conventional health care and health-care providers is limited

  • Modular Internet-based curricula can be adapted for training for advancing neuroscience research

  • Low-tech clinical simulation training emphasizing early life-saving interventions and procedures

  • Reaching patients with disabling neurological conditions using cell phones may prove easier than conventional methods for providing health information

  • Share resources

  • Ofer classes for students at reduced cost

  • Increase Internet capacity

  • Adapt information and communication technologies to support research and research-training programmes

  • Video conferencing for direct communication between mentors, colleagues and training in diverse settings

  • Communication technologies include Skype, GoToMeeting, AdobeConnect, WhatsApp, Polycom and WebEx

Funding
  • Pilot awards for LMIC researchers

  • Funding for research in LMICs is limited, but funding for neurological disease research is even more so

  • Providing funding to support pilot studies to LMIC colleagues and trainees should lead to increased research relevant to the LMIC setting and provide pilot data on which larger grant applications could be developed

  • Mentor LMIC partners through application processes.

  • Increase governmental funding for research through universities and research institutions

  • Funds from national and international NGOs can increase research opportunities

  • Collaboration with foreign partners provides new research opportunities and support

  • PEPFAR, UNAIDS, WHO, and the Bill and Melinda Gates Foundation have made drugs and services signifcantly more accessible

  • Research frameworks to support the implementation of the outcomes of well-designed studies relevant to neurological diseases

  • Evidence-based public health strategies to incorporate child neurodisability screening, clinical evaluation and rehabilitation packages into the health-care system

  • Maternal health programmes that work closely with early childhood programmes could ensure optimal pregnancy outcomes and develop efective interventions to enhance child development

  • Capacity building in translational science and knowledge management

  • Learn to package the evidence in a format more accessible to policymakers in LMICs

  • LMIC partners are asking for translational science training

  • Infuence policymakers to redirect budget priorities to address brain disorders and their research

  • Involve community partnerships

  • Involvement of the community, private sector and research sponsors during project planning establishes priorities, identifes research needs within the community, and identifes resources34

CNS, central nervous system; DSM, Diagnostic and Statistical Manual for Mental Disorder; GWAS, genome-wide association studies; ICD, International Classifcation of Diseases; LMIC, low- and middle-income countries; NGOs, non-governmental organizations; POC, point-of-care; SNP, single nucleotide polymorphisms; WHO, World Health Organization.