In 1888, the British Physiological Society and Professors of Physiology all over UK initiated the international congresses of physiology with the following proposals ; ‘It is suggested that the International Meeting of Physiologists should be held at regular intervals, with the object of promoting physiology through interchange of ideas, mutual criticism, and of affording opportunities to workers in our science of knowing each other personally’. A year later, the first international physiology Congress was held in Basel. Participants were mostly Europeans with the exception of few Americans. No one from Asia and other Continents attended this meeting.
I have been looking forward to the 36th IUPS Congress in Kyoto since the San Diego meeting in 2005. Needless to say, the Congress is one of the most important activities of the Union as it provides an extraordinary platform for the physiologists across the world to exchange research experiences and achievements. Of particular importance is that the theme of the Kyoto Congress 2009 is“Function of life : Elements and integration”which clearly indicates the current trends in the study of biomedical sciences. We are now becoming more and more aware that pure reductionism has limitations to help us to understand the functions of the whole living organism, and therefore measures have to be taken to promote translational research and studies of integrative physiology. Professor Bjorn Folkow declared as early as 1994 that“integrative physiology is truly the biology of the future”. However, in recent years the advances in molecular biology and the grant funding policies have pushed biomedical research in the direction of molecular and cellular biology, leaving only a small number of physiological scientists conducting research at the whole body level. Therefore, the importance of translational research and integrative physiology should never be overemphasized. As we always say, the discipline of physiology plays a role as a bridge linking the bench and the bedside, therefore, the physiological scientists all over the world being the bridge builders, have the duty as well as privilege to promote the development of translational and integrative research. As Professor Allen Cowley wrote in 2005,“now is the time to begin building the scientific infrastructures that will enable an integrated understanding of the function of complex organisms and chronic diseases”. In this regard, the Long Range Planning Committee of the IUPS recently defined the discipline of physiology as“the study of the functions and integrative processes of life at all levels of structural complexity between the molecular level and that of the whole organism”. I am quite sure that the 36th IUPS Congress will be successful in directing world physiological scientists to a way of integrative research.
The last thirty years have witnessed a phenomenal expansion of the discipline that we now call“neuroscience”. Neurophysiology, the subdiscipline of physiology concerned with the study nervous system function, has de facto been incorporated into neuroscience. If this phenomenon were only a matter of terminology or of“fashion”, its importance would be quite limited. I am however afraid that it has also implied in many instances a decreased emphasis on the physiological perspective both for research and teaching. One of probably multiple factors that has somehow accentuated the dilution of a physiological perspective in neuroscience is the emphasis put on the study of the molecular mechanisms of nervous system development and of intracellular signaling and gene expression regulation. Not that one should be critical about these developments : quite the contrary, as they have allowed to make major progress in understanding the molecular determinants of the building of the nervous system as well as on how signaling cascades transduce signals originating outside the cell into modulation of regulatory elements of genes. This contribution is particularly significant in the field of developmental neuroscience, where genes have been identified that control particular steps in neuron migration and in nervous system construction, but neuroscience as a whole has benefited from molecular biology. The contribution of molecular tools to the understanding of nervous system cannot be sufficiently emphasized. However, we are now at a stage where the tremendous amount of data gathered thanks to the molecular approaches needs to be re-integrated into a physiological perspective of the function of the nervous system.
Deep brain stimulation (DBS) is an important component of the therapy for movement disorders and intractable pain. In Japan, the first case of DBS for controlling central pain syndrome was experienced in 1979 and DBS of the thalamic nucleus ventralis caudalis and periaqueductal gray matter have been used for pain control for many years. Neurosurgeons also initiated a clinical trial of DBS for controlling movement disorders, such as tremor, Parkinson′s disease (PD) and dystonia. Our government approved DBS to be covered by the public insurance system for pain control in 1992 and for movement disorders in 2000. In particular, DBS for subthalamic nucleus (STN) is currently the most common therapeutic surgical procedure for patients with PD. The long-lasting beneficial effects of STN-DBS on motor function have now largely been acknowledged. However, behavioral and/or psychiatric changes have been demonstrated in certain case reports and case series. DBS is also a successful therapeutic option for patients with primary dystonia and tremor syndrome who do not respond sufficiently to conservative therapies. The most common target of DBS in patients with dystonia is the internal region of the globus pallidus (GPi). GPi-DBS leads to long-lasting and remarkable improvement of dystonic movements in majority of patients. In Parkinson′s tremor or post-stroke movement disorder, the intermediate ventral nucleus of the thalamus (Vim) and the subthalamic region have proven to be promising targets for DBS electrodes. Especially in patients with essential tremor, Vim-DBS leads to an acute reduction of the tremor. In addition, DBS is beginning to be used as a new therapeutic procedure for psychiatric diseases, such as depression and obsessive-compulsive neurosis in many countries. We will summarize our experiences and previous reports, and discuss the mechanism and future perspectives for DBS in the management of central nervous system disorders.
