[A challenge to conquest of neurological diseases]

For the last three decades, neurology has witnessed remarkable progress in both basic sciences and clinical researches. They include detection of abnormal genes in common degenerative and metabolic diseases, clarification of brain mechanisms of movement and cognition with neurophysiology including unit recording from basal ganglia neurons, neuroimaging and neuropsychology tests. Treatment of intractable chronic diseases has also progressed. Medical, surgical and immunosuppressive treatment for Parkinson's disease, immunological diseases, and for certain metabolic diseases are examples. Neurologists in Japan contributed in research progress in the various fields. However, services in clinical medicine have devoted mainly in neurodegenerative, immunological diseases and myopathy. Promotion of nationwide clinical service for cerebrovascular disease, epilepsy and dementia is required. Research in neurology in the next century should be promoted in various fields with different methodology and targets; genes, molecular mechanisms, cellular activity, neural networks, brain as a whole and a human subject. Particularly integrated function of he brain shall be studied thoroughly not only from biological but also from psychological and social point of view. Leaders in neurology in Japan, particularly professors of neurology have been asked to chair all the activities of education, research and clinics. Merits of this system were reflected in connection of clinical and research data, resulting in establishment of new disease showing unusual combination of symptoms and signs. In future, coordination among specialists in different fields are required for further promotion of clinical researches and training of neurologists. Qualified neurological services in ordinary clinics can be achieved with cooperation of personnels in a team where neurologists are required to play a key role aiming at assurance of best QOL for patients and families.