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Staging has provided a framework for decision-making underlying the diagnosis and treatment of cancer for many years. Staging informs prognosis and serves as a common system for clinical and pathological descriptions across the global cancer-control community. It was the idea that an analogous staging approach might be applied to the study of neuropsychiatric disorders and their diagnosis and treatment that led to the ninth biennial meeting on Strategies for Studying Brain Disorders of the Fundación Cerebro y Mente. Staging implies progression and progression is well known in disorders such as Parkinson’s and Alzheimer’s disease. Progression is also implied by findings of poorer prognosis and more extensive brain changes associated with the duration of active symptomatology in schizophrenia. Which other neuropsychiatric disorders can be understood within a staging framework? Is there progression and if so what are the mechanisms of progression? What are the signs (biomarkers?) of progression and how can these be used to identify the stage of the disease? What are the implications of staging for treatment? These are some of the questions that inspired this meeting.

After 6 years and two intervening meetings in the extreme west of Andalusia, the meeting of the Fundación Cerebro y Mente returned to its favorite Andalusian site.

The village of Mojacar is located on the Mediterranean in the extreme east of storied and historic Andalusia, silent witness to the comings and goings of multiple tribes of people for millennia, including, for example, Phoenicians, Carthaginians, Greeks, Romans and Moors. As guests of the mayor of Mojacar in the old village at a special reception for meeting participants we were added to the lengthy stream of humanity findings its way to this panoramic hilltop. Mojacar’s combination of the ancient hilltop town and the newer residences and hotels of the waterfront, Mojacar Playa, provided a fitting setting for discussions of the well-known and newly discovered knowledge of neuropsychiatric disorders that was brought to bear on the question of staging. The spirit of the Indalo that has inspired Andalusians for centuries also inspired the creative genius of the many leading basic and clinical scientists who gathered for four days, October 14-18, 2009 to apply their minds to the staging of neuropsychiatric disorders and its implications for etiopathogenesis and treatment.

In the Moorish style of earthy tile, whitewashed plaster and wooden structure, the famous Parador Hotel of Mojacar provided invited speakers with a peaceful haven after their long travels from several continents. Fine Spanish cuisine inspired by the Almeria region provided many specialties including fish and rice dishes to satisfy the tastes of everyone and the wines of Rioja slaked the travellers’ thirst. The commixing of the intellectual energy of basic and clinical brain scientists with the soothing Andalusian Indalo-inspired spirit provided a formula for energetic and creative discussion of staging of neuropsychiatric disorders. The inspiration and intensity of the meeting was inevitably followed by sad goodbyes as the participants dispersed again to their several continents but participants also felt elation at having experienced simultaneously the ancient Andalusian culture and the contemporary neuroscientific community.

The embracing arms of the Indalo await the next comingling of internationally recognized brain scientists in Mojacar as the Fundación Cerebro y Mente looks to an exploration of the “Mente” in its next investigation of Strategies for Studying Brain Disorders.

Madrid, Spain Tomas Palomo
Johnson City, TN Richard Kostrzewa
Kingston, ON Canada Richard Beninger