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Autumn 2026 5 As a neurologist, what major developments have you seen since Headlines was first published? One of the obvious ones is stroke. For instance, back in 1990, a neurologist had very little to do with patients who'd had a stroke. They used to be transported into hospital – rather slowly – and they were looked after by general physicians and geriatricians. Neurologists were hardly ever involved. The only stroke patients we looked after were very young or there was something unusual. Most of them didn't even have a brain scan. From about 1990 onwards, stroke care became organised. Dedicated stroke units developed overseas, and we established the stroke unit at Auckland Hospital during the later part of the 1990s. And then treatment became available. First, it was intravenous thrombolysis treatment which improved outcomes, and more recently, clot retrieval (when strokes are due to a blocked artery). This has had a much more striking outcome. People come to hospital unable to speak and paralysed down one side of the body, and after the procedure they're completely normal. It doesn't always happen that well, but it's not infrequently that we see an outcome like that. So, it is miraculous. Stroke is one area of huge improvement. Can you think of others? Multiple sclerosis would be another. Most people with multiple sclerosis have relapses. Prior to 1990, the only treatment offered was a short course of steroids to speed up the rate of recovery from an attack, but there was nothing available to prevent attacks from occurring and to slow the process down. But now there's a whole raft of different medications that are very effective in preventing the relapses from occurring and slowing or delaying the progressive phase. So that's made a huge difference. Does anything else come to mind? We can treat autoimmune diseases, such as autoimmune encephalitis, which was fatal without treatment. It’s an uncommon disorder that often affects very young people and we used to have no idea what the cause was, but we’ve since found it is due to antibodies. Now doctors can make a diagnosis quickly, then treat people with medication that reduces the production of the antibodies. Before, the patients almost invariably either died or were left severely disabled. Now, they usually make a complete, or almost complete, recovery. Migraine featured in our first Headlines . What do we understand better in 2026, and how have treatments improved? We understand the chemical changes that are occurring in migraine, which has led to new treatments. New drugs – CGRP blockers or antagonists – are now available in New Zealand. Unfortunately, they’re not funded, and they are quite expensive. The other thing that's changed in the last 30 years or so is injecting Botox into the scalp. It's a little bit mysterious how that helps, but it does. Again, that's unfunded, so it's only available for people who can pay for those treatments. Many of our long-time supporters may remember our early editions of Headlines (and perhaps have views on how far we’ve come). To celebrate our 150th edition, we spoke with Dr Neil Anderson, the Foundation’s Chief Medical Advisor, about the progress made in understanding and treating brain conditions, as well as the challenges that remain. The Neurological Foundation’s Chief Medical Advisor is a prestigious position. Dr Neil Anderson is only the third person to fill the role, following Mr Philip Wrightson and Dr Jon Simcock. Neil has been a consultant neurologist at Auckland City Hospital since 1987. After completing his neurology training, he became the first-ever recipient of the Neurological Foundation’s VJ Chapman Fellowship and was a Fellow in the Neurology Department at the Memorial Sloan Kettering Cancer Center in New York. Neil has a deep interest in history, having previously been president of the Auckland Medical History Society. As you’ll read here, he’s also vitally interested in the future.