On October 20, 2025 at a round table organized by the Brain Health Council Foundation in partnership with the Bulgarian Medical Association and the Sofia Medical Association, the draft National Plan for Brain Diseases in the Republic of Bulgaria (2026–2030) was presented and discussed. The document outlines a long-term program for building a comprehensive, sustainable, and high-tech system for prevention, early diagnosis, effective treatment, rehabilitation, and social support for people with brain diseases.

“The National Plan for Brain Diseases provides for the inclusion and interaction of all stakeholders. We see that a sustainable framework for brain health care is being created in our country. I am convinced that today’s expert decisions will turn into real actions tomorrow,” said Minister of Health Assoc. Prof. Silvi Kirilov, welcoming the guests at the round table. The governor of the National Health Insurance Fund, Assoc. Prof. Petko Stefanovski, expressed his concern about this significant medical and social problem and emphasized that the institution’s goal is to support affected people by helping them regain their confidence and fully realize their potential in society.

Brain health is one of the most underestimated topics in the healthcare system, even though these diseases are the leading cause of disability and the second leading cause of death worldwide. According to data from The Lancet Neurology from 2024, by 2021, more than 3 billion people, or 43% of the world’s population, suffered from brain-related diseases. In Europe, 179 million people are affected, and the associated costs exceed €800 billion per year – more than the combined costs of cancer, cardiovascular disease, and diabetes.

According to the Brain Health Atlas (2021), stroke, neurological and mental disorders have the greatest impact on health in Bulgaria. In 2022, over 1.2 million cases of brain disorders were registered in Bulgaria, resulting in more than 33,000 deaths. Stroke is the cause of nearly 16% of all deaths in the country. “Caring for brain health is no longer just a medical issue—it is a moral, social, and economic necessity. Investing in brain health is an investment in human capital and the future of Bulgaria,” said Prof. Nikolay Gabrovsky, Chairman of the Brain Health Council Foundation and moderator of the round table.

The National Plan for Brain Diseases (2026–2030) offers a strategic response to one of the greatest health challenges of the 21st century and is fully in line with the efforts of the World Health Organization and the European Brain Council for integrated policies. The document covers five strategic areas:

Science, Data, and Innovation;

Access and Quality of Care;

Integration and Coordination of Activities;

Public awareness and social support; and

Policies and sustainability.

The plan provides for the establishment of a national monitoring system and digital infrastructure, the introduction of telemedicine and the use of artificial intelligence, as well as the creation of national registries for brain diseases. The focus is on investing not only in technology but also in people—doctors and healthcare professionals through continuing education, as well as the creation of specialized structures for aftercare and long-term care. Telemedicine and digital solutions will shorten the path to a specialist, remove geographical barriers, and speed up timely treatment.

The first part of the forum was devoted to proposals from leading scientific and professional organizations. Acad. Ivan Milanov, Chairman of the Bulgarian Society of Neurology, and Prof. Dimitar Maslarov, Board Member of the Brain Health Council Foundation, presented measures for the development of a network of centers for diagnosis, acute treatment, and rehabilitation after stroke and other brain injuries. Prof. Georgi Onchev, Deputy Chair of the Bulgarian Psychiatric Association, emphasized the integration of mental health into general medical practice and the elimination of stigma. Prof. Nikolay Gabrovski presented the proposals of the Bulgarian Society of Neurosurgery aimed at improving emergency neurosurgical care, creating modern rehabilitation programs, and reorienting hospital structures toward follow-up care and intensive rehabilitation. Arkadi Sharkov, health economist and Board Member s of the Brain Health Council Foundation, said that in 2024, brain diseases led to over 800,000 years of life with disability (DALY), which represents about one-third of the total burden of disease in Bulgaria. The economic impact is estimated at approximately €1.2 billion in losses per year, highlighting the need for better prevention, early diagnosis, and access to quality treatment. The Chairman of the Bulgarian Medical Association, Dr. Nikolay Branzalov, emphasized that the topic is of utmost importance not only for public health, but also for patients and the medical community as a whole. He expressed confidence that the efforts of leading specialists in this field will lay the foundations for a modern and effective national approach that will combine scientific potential, clinical experience, and policies for the prevention and treatment of brain diseases.

Dr. Asen Medjidiev, Chairman of the Sofia Medical Association (SMA), noted that the Association has nearly 100 neurosurgeons, 400 neurologists, and about 200 psychiatrists as members, which is proof of the organization’s high expert potential in the field of brain health. “This is not the only reason why the SMA supports this forum—the shared experience and expertise of the participants will outline effective solutions and strategies that will undoubtedly improve the treatment and care of patients with brain diseases,” said Dr. Medjidiev.

The experts outlined the systemic challenges: chronic underfunding and uneven distribution of resources, low public awareness and stigma, lack of integration between health and social services, shortage of doctors and especially healthcare specialists, and an aging population, which increases the incidence of dementia. Better use of European resources and networks, targeted educational programs, strong inter-institutional coordination, political support, and sustainable funding based on responsibility and accountability were identified as key levers for change.

“The National Brain Health Plan is not just a document with recommendations, but a real tool for action – with a clear path, measurable goals and a vision for change. It is an invitation to all institutions, non-governmental organizations, professionals, and citizens to become part of the common cause for better brain health,” emphasized Prof. Nikolay Gabrovsky.

The second panel of the round table was dedicated to scientific achievements and innovations in the field of brain health.

Prof. Dimitar Maslarov presented the topic “Modern thrombolytic treatment in acute ischemic stroke,” emphasizing that timely thrombolytic therapy in the first hours greatly increases the chances of recovery. Prof. Nikolay Gabrovsky spoke about robotization and artificial intelligence in neurosurgery, focusing on technologies that increase the precision and safety of procedures. Prof. Tsvetalina Tankova addressed the topic of “Brain Health and Obesity,” emphasizing the link between metabolic disorders, insulin resistance, and cognitive decline, and emphasized the importance of weight and blood sugar levels not only for cardiovascular disease but also for brain health and dementia prevention.

Only 13% of Bulgarians recognize the symptoms of stroke

Findings from surveys conducted among members of the Bulgarian Society of Neurology, the Bulgarian Society of Neurosurgery, and the Bulgarian Psychiatric Association were presented today (June 9, 2025) during the media event “Brain Health – A Global Priority,” organized by the Brain Health Council Foundation. These expert opinions will form the basis for defining the key priorities in the upcoming National Brain Plan.

Prof. Dimitar Maslarov, Head of the Department of Neurology at University First General Hospital “St. John the Baptist” – Sofia and Board Member of the Brain Health Council Foundation, presented the major achievements in neurology over the past five years, along with short- and long-term scientific and organizational challenges. Significant progress has been made in the diagnosis and treatment of neurological disorders – from the application of artificial intelligence and modern neuroimaging diagnostics to new innovative therapies for multiple sclerosis, migraine, and rare genetic conditions. At the same time, the network of specialized stroke centers in Bulgaria is expanding, and the participation of Bulgarian research institutions in European research programs is growing. However, major challenges remain: a shortage of neurologists, regional disparities in access to care, delayed access to innovative therapies, the need for digitalization, development of scientific infrastructure, and strategies to retain young professionals in the country.

Prof. Georgi Onchev, Deputy Chair of the Bulgarian Psychiatric Association, discussed the achievements and challenges in psychiatric care in Bulgaria. In the past five years, psychiatry has advanced in key scientific areas – from genetic studies and biomarker development to innovative therapies, cutting-edge treatment methods, telepsychiatry, and digital solutions. Among the most urgent short-term challenges are the acute shortage of specialists, the need to reform specialization training, the development of day centers and protected housing, and improved interinstitutional cooperation. In the long term, the focus must be on overcoming stigma at the systemic level, introducing integrated care between psychiatry and social services, digitizing the sector, and investing in outpatient care as a sustainable alternative to institutional care.

Prof. Nikolay Gabrovsky, Corresponding Member of the Bulgarian Academy of Sciences, Chair of the Brain Health Council Foundation and of the Bulgarian Society of Neurosurgery, shared recent scientific developments and challenges in neurosurgery. Among the most significant achievements are advanced endovascular therapies, the rise of robotic surgery and artificial intelligence, and innovative developments in brain-machine interfaces and implantable neurochips. On the organizational level, notable milestones include hosting the 24th European Congress of Neurosurgery in Sofia (EANS 2024), publishing a Bulgarian-language textbook, recognition of the EANS exam for trainees as equivalent to the theoretical part of the Bulgarian specialization exam, and improved reimbursement for spinal implants. Short-term challenges include the urgent need for accelerated training and qualification, addressing staff shortages – particularly in healthcare support professions – and the lack of rehabilitation and post-acute care facilities. Long-term priorities include developing gene and immunotherapy for brain tumors, integrating high-tech solutions into clinical practice, and building modern centers that provide comprehensive care for patients with brain disorders.

Arkadi Sharkov, health economist and Board Member of the Brain Health Council Foundation, presented alarming data on the increasing number of traumatic brain injuries caused by e-scooter accidents. These incidents result in significant losses for both the healthcare system and the economy. According to the data, 80–90% of e-scooter accidents are solo falls, with 30–50% resulting in traumatic brain injuries. High risk is primarily associated with night riding, alcohol consumption, and lack of helmet use – fewer than 20% of the injured use protective gear. Other challenges include high speeds in urban settings, scooter instability, and lack of infrastructure. The most affected group consists of young men aged 20 to 35. In Bulgaria, in the first 7 months of 2024 alone, 192 injuries and 5 fatalities from e-scooter accidents were reported. These numbers mark an increase compared to the previous year and place Bulgaria among the high-risk countries in terms of growth rate of such incidents, though total numbers still remain lower than in countries like Germany, Italy, and France.

The economic impact is also significant. In addition to healthcare costs, there is a major loss of productivity associated with long-term work absences, particularly in cases of severe brain injury. Internationally, stricter regulations are being implemented – including speed limits, bans on urban riding, mandatory helmets and insurance. Countries like France, Italy, and Norway are introducing further measures such as minimum age requirements, registration numbers, and bans on scooter rentals.

The Brain Health Council Foundation proposed the following specific measures:

• Limiting night-time riding or restricting speed;

• Speed limits in pedestrian areas;

• Strict ban on riding under the influence of alcohol or drugs;

• Differentiated restrictions depending on the power of the e-scooter. Above a certain power threshold, certification and a motorbike helmet should be required;

• Raising public awareness through targeted campaigns and institutional partnerships.

During the event, current data on the economic burden of stroke – one of the leading brain disorders – was also presented. According to Global Burden of Disease (GBD) estimates, in 2021 there were around 11.9 million incident stroke cases, 160 million disability-adjusted life years (DALY), and 7.3 million deaths worldwide. In Bulgaria in 2022, nearly 41,000 patients received hospital treatment under clinical pathways, which cost the National Health Insurance Fund nearly 360 million BGN.

According to a May 2025 survey by “Trend” among 1001 respondents over 18, 86% of Bulgarians consider stroke to be a “very serious” condition. Nevertheless, awareness of its early symptoms is insufficient – only 13% are “fully informed,” while over 50% are poorly informed or not informed at all. This highlights the need for broader educational campaigns for early recognition and prevention.

In closing, Prof. Nikolay Gabrovsky summarized the key challenges facing Bulgaria’s brain health system. These include the lack of comprehensive, integrated, and interdisciplinary medical services, and the inefficient distribution of human resources due to the high number of medical facilities.

A major issue is the absence of specialized post-acute and rehabilitation units for severe cases – such as stroke, traumatic brain injuries, dementia, and degenerative diseases – which present serious social challenges. There is also a critical shortage of personnel, especially healthcare professionals, necessitating accelerated training and tiered preparation levels for new staff.

Another challenge is the rapid introduction of new technologies like artificial intelligence and robotics, which makes continuing medical education an urgent necessity.

On May 2, 2025, the Chair of the Brain Health Council Foundation, Prof. Nikolay Gabrovsky, and Board Member Arkadi Sharkov, held a working meeting with the European Commissioner for Startups, Research, and Innovation – Ms. Ekaterina Zaharieva. The key topic of discussion was the transformative role of innovation and artificial intelligence in medicine, as well as the need to adapt EU healthcare systems to emerging technological and demographic realities. The participants discussed how cutting-edge solutions can be integrated to enhance patient care and effectively address public health challenges. “We express our sincere gratitude to Commissioner Zaharieva for the open dialogue and her support for innovation as a key driver of the future of healthcare,” said Prof. Gabrovsky. According to him, 2025 will mark a turning point for brain health – a topic that requires a coordinated approach at both European and national levels. Over the past decade, the EU has invested more than 7 billion euros in brain health research and related policy development. This reflects a strong commitment to public well-being and sustainable progress. The Brain Health Council Foundation will continue to promote innovation, integrate scientific advancements into health policy, and foster sustainable connections between institutions, experts, and citizens.

EBC is pleased to join the European Academy of Neurosurgical Societies Congress 2025 set to take place from 5-9 October 2025 in Vienna (Austria). Suzanne Dickson, EBC President, will take part in a joint session on Sunday, 5th of October from 09:00 – 12:00. The topic of discussion will revolve around ‘Research in European Neuroscience’.

The EANS Congress is the highlight and the largest event of the busy educational portfolio of the association. Attended by 2.000 neurosurgeons from Europe and all over the world, the EANS Annual Congress is the main meeting point of the European Neurosurgical Community, and the connecting link between European Neurosurgery and all continental neurosurgical societies.

EBC is please to take a part in “Building Brain Health in Europe” session at EANS Congress 2024. The session will take place on 13th of October 2024 from 9:00 till 12:00 in Hall 6 of the Venue in Sofia.

About the session

This session, organized by EANS, will cover topics such as advocacy, brain health imaging, the brain tumours, neurosurgery in psychiatry and traumatic brain injuries. 

EBC will present the advocacy work in the brain space undertaken at the European level and explore not only the importance of the work being done but the potentials for strengthened collaboration and the needs going forward, for the benefit of all within the brain space, particularly with a spotlight on neurosurgery, neurology and neurological conditions (including the clinicians that treat them and the patients that live with them).

Session will feature a series of presentations by prominent experts in the field of brain health. Prof Torstein R. Meling will chair the session. Speakers include Prof Thomas Berger, Prof Suzanne Dickson, Tarek Yousry, Prof Johnny Duerinck, Dr Niklas Marklund, Majda Thurnher, Dr Ricardo Chavarriaga, and Dr Eric Suero Molina. Topics will cover various aspects of brain health, including neuroradiology, the impact of brain tumors, traumatic brain injury, and stroke, as well as the role of neurosurgery in modern psychiatry. Prof Suzanne Dickson will put forward the role of EBC in the advocacy of Brain Health and Dr Ricardo Chavarriaga will explore the ethics of neuroprosthetics.

Professor Suzanne L Dickson is a neurobiologist and Professor of Neuroendocrinology at the University of Gothenburg. She graduated with a Ph.D. in Neuroendocrinology from the University of Cambridge in 1993, where she later became Senior Lecturer in Physiology. She is a leading figure in neuroendocrinology and works within many European Union and international organisations and societies to promote research, facilitate grant funding and training of Early Career Scientists. Her research into the neurobiology of appetite aims to unravel neurobiological pathways that respond to orexigenic signals, such as the hormone, ghrelin, and that drive feeding behaviours, not only food intake but also food choice, food anticipation, food reward and food motivation. This work involves mostly preclinical studies and includes behavioural tasks, viral vector mapping, chemogenetics and RNAscope. She is Secretary and Executive Board member of the European College for Neuropsychopharmacology, and also chairs ECNP’s Workshop for Early Career Scientists in Europe. She also is founder and co-chair of ECNP’s nutrition network and EBRA’s BRAINFOOD cluster.

Neuroscientist and public speaker in neurotechnologies, artificial intelligence, and responsible innovation. Dr Chavarriaga leads the Responsible AI Innovation group at at the Center for Artificial Intelligence of the Zürich University of Applied Sciences (ZHAW) and is the head of the Swiss office of the Confederation of Laboratories for AI Research in Europe (CLAIRE). His work is focused on leveraging neuroscience, AI, and ethics for advancing responsible innovation and governance of human-centered technology.

The Annual Congress of the European Association of Neurosurgical Societies (EANS) will take place on 13-17 October 2024, at the National Palace of Culture in Sofia (Bulgaria).  

The congress theme will be “Innovation, Education, Leadership”, reflecting the current need to thoroughly discuss the future of neurosurgery in connection with technological advances that can improve neurosurgical education, training and treatment, aiming to create the next leaders of neurosurgery in Europe and all over the globe.  

The programme will include several sessions dedicated to technological advances and innovative prospects and projects, always maintaining its high quality in presenting new original neurosurgical research. 

EBC will be present at the Congress with a booth in the exhibition area. Make sure to pass by booth #38 where you can learn more about our ongoing projects, latest activities, and upcoming events! On Sunday 13th of October from 09:00-12:00, EBC will also participate in a session titled ‘Building Brain Health in Europe‘.