Clinical Neuroscience

Publication Analysis 2007-2013
by Kathleen Gransalke, Labtimes 02/2016

View the Tables: Europe...and the World, Most Cited Authors...and Papers

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Image: Charles Bell, The Anatomy of the Brain, Wellcome Library, London

London is the Mecca for neurologists, including Europe’s top neuroscientist. He and several of his highly-cited colleagues study Alzheimer’s disease, the discipline’s hottest topic.

Neuroscience again, you may wonder. Wasn’t it already in the last issue? Yes, but this time we will have a closer look at the clinical part of brain research. That part of the discipline that deals with the pathogenesis, diagnosis, management or treatment of disorders of the brain. And there are hundreds of neurological conditions. Autism, dementia, depression, traumatic brain injury, multiple sclerosis, epilepsy, sleep disorders, mental retardation or eating disorders – all can be traced back to anomalies in our nervous system, central and/or peripheral.

In 2010, the European Brain Council (EBC), a non-profit organisation that brings together neuroscience societies, patient associations and industries, estimated that about a third of the European continental population is affected by brain disorders and that “total direct and indirect costs to the European society of brain disorders has risen to 798 billion euros” ( The EBC report revealed that mood disorders, such as depression and bipolar disorder, are the most costly diagnostic group. About 30 million patients require €113 billion each year. Not far behind (€105 billion) are the costs for dementia; neuromuscular disorders cost the most per patient, €30,000 per year.

Rising costs of brain disorders

Since January 2016, the costs of brain disorders in Europe have already crossed the €200 billion mark. One doesn’t have to be a superbrain to predict that, at the end of the year, the total costs will pass the €800 billion from 2010. That leaves one question open: Does the funding for research on neurological disorders match the costs? Not yet but funding providers are getting there. From €85 million earmarked for brain research in FP5 to €400 million in FP7, money allocated and hence awareness of the importance of brain research is steadily increasing. Interestingly, the EBC report also found that “the return on investment in brain research far exceeded the return from any other branches of research when looking at the total societal perspective”.

Thus, there are many good reasons to intensify neuroscience research. Here, we look at the scientific output of European clinical neuroscientists between 2007 and 2013. As usual, we’ll start with a few words about our publication analysis methodology.

For our nations’ ranking, we, once again, relied on 'expert' journals as listed by the Web of Science database, which we used for this analysis in the Clinical Neuroscience category. Among these specialist journals are, for instance, Lancet Neurology, Alzheimers & Dementia or Movement Disorders, to name but a few. This constraint, however, was not applied to the most-cited authors’ ranking. Here, we included articles, reviews and proceedings papers published in both multi- and mono-disciplinary journals.

How do European basic and clinical neuroscience compare? There isn’t much of a difference, actually. For each sub-discipline, the first five places are occupied by the same nations: England and Germany lead the tables (almost head-to-head), followed by Italy, France and The Netherlands. Regarding citations per article both are pretty close, too. Focussing again on the clinical neuroscience ranking, a few smaller countries stand out for their good performance. Hence, Estonia (28.1), Scotland (26.8) and Finland (25.4) collected, on average, the most citations-per-article. Could this be due to their participation in a few bigger studies?

Within Europe, clinical neuroscientists wrote almost 80,000 articles, gathering more than one million citations. In comparison, European basic neuroscientists penned close to 100,000 articles, collecting twice as many citations. In the same period, US clinical neuroscientists published almost 60,000 articles, which attracted 1.2 million citations. This translates to a citation-per-article ratio of 20.2 (EU: 16.1). Canada (22.1) and Australia (21.1) did still better than Europe and the US.

Stroke, Alzheimer and MS

Having a brief look at the most-cited papers in clinical neuroscience gives us a small hint about the discipline’s hottest topics. Which brain disorder receives the most attention from the scientific community? In number one spot, with quite a few of our top heads on the list of co-authors, is a paper about the treatment of stroke. Spots two and three are articles dealing with the diagnosis of Alzheimer and Multiple Sclerosis, respectively. Paper number four is about a method used in research and clinical practice: transcranial magnetic stimulation. And last but not least, the genomics study in fifth position explored genetic variants associated with Alzheimer’s disease.

Unsurprisingly, Alzheimer’s disease is high on European clinical neuroscientists’ research agenda. But is the search for genetic variants predisposing to the disease in vain? Spanish researchers recently presented evidence that the disease might have a very different aetiology. In tissue sections from the central nervous system of AD patients, they spotted cells and hyphae from several fungal species (Scientific Reports, 5:15015). Of course, this is not yet the final proof, “It could also be possible that, for reasons yet unknown, these patients are more prone to this type of infection,” the scientists say.

This brings us to the last section of our publication analysis, the most-cited clinical neuroscientists. Certainly, it isn’t easy to always make a clean cut between basic and clinical neuroscience. Some researchers simply do both clinical and basic research but we have tried to focus on those, who mainly published in journals dedicated to clinical neuroscience. This excludes also those researchers, specialising in psychiatry and neurosurgery, as well as neuro-oncology.

One hotspot for clinical neuroscience research in Europe seems to be situated in London, at the University College London to be exact. Not less than five neuroscientists work there, in the Neurology department. The rest of the top 30 is homogeneously distributed over Europe, in eleven different countries: Germany, The Netherlands, France, Sweden, Italy, Finland as well as Belgium, Spain, Switzerland and Austria. Happily, among our top 30 are also three women.

As already mentioned, Alzheimer’s disease (AD) is one of the top priorities in clinical neuroscience. This is also confirmed by our most-cited authors ranking. Not only did AD researchers John Hardy, Philip Scheltens and Nick Fox sweep the top three positions; altogether, eleven neuroscientists working on the neuro­degenerative disease made our top 30 ranking, including Kaj Blennow (5th), Martin Rossor (8th), Henrik Zetterberg (21st), Christine Van Broeckhoven (23rd) and Hilkka Soininen (29th).

Europe’s top neuroscientist wins lucrative prize

John Hardy, Europe’s number one clinical neurologist, as a matter of fact Europe’s top neuroscientist (basic and clinical neuroscience rankings combined), comes to fame and honour not only in our humble magazine. Last year, he also bagged the ­multi-million dollar Breakthrough Prize in Life Sciences. “It is a great honour to be awarded the prize for our work dissecting the causes of Alzheimer and Parkinson’s diseases. It is, of course, our hope and aim that this understanding leads to effective treatments. At UCL, with the Alzheimer’s Research UK Drug Discovery Institute, the Leonard Wolfson Experimental Neurology Centre and the fantastic clinical team we have at the Institute of Neurology, I feel we can beat these diseases,” he later said.

Seven of our top 30 most-cited authors study encephalomyelitis disseminata, also known as Multiple Sclerosis. Frederik Barkhof (7th), who in October moved his lab to where else but the University College London, employs Magnetic Resonance Imaging to approach the disease. Ludwig Kappos (9th) and Xavier Montalban (27th) probe the condition on a molecular level, while Chris Polman (17th) and Giancarlo Comi (18th) search for better therapies.

In addition, five highly-cited scientists (Hans-Christoph ­Diener, 4th; Werner Hacke, 6th; Peter Rothwell, 12th; Markku Kaste, 19th and Hugh Markus, 20th) are specialists in stroke therapy; while four scientists are dedicated to finding cause and cure for Parkinson’s disease: Andrew Lees (10th), Werner Poewe (15th), Nicholas Wood (24th) and Alexis Brice (26th).

Future neuroscience research will hopefully not only help in beating Alzheimer’s disease but also the hundreds of other brain disorders. And by doing so, cut the costs to society.

View the Tables: Europe...and the World, Most Cited Authors...and Papers

View the Picture: Most Cited Authors

Last Changed: 11.04.2016