Neuroscience is one of the most exhausting areas in research and one of the most complicated and difficult to understand. The complexity of the human brain, how it is structured and how this structure and function is reflected on our behavior, personality and choices is a very puzzling field. Do choices vary depending on genetic coding, culture, upbringing or race? Historically, the Milgram experiment for obedience started with the idea that Americans would act differently, when it comes to obedience of orders, compared to how the Germans had acted during the Second World War. However, the experiment proved otherwise. Humans, given certain conditions, can be equally obedient regardless of their race or culture. From this prospective, I wish to emphasize the significance of multi-center research, from different cultures, targeting the understanding of human behavior and linking it with the neuroscience, neurobiology as well as genetic studies.
In developing countries, researchers have many constraints that prevent them from producing sound research that is readily added to international research and science literature. The lack of training on how to design, make and publish research, makes clinicians reluctant to document and organize their work in a way that can be published. From struggling to access medical data bases, to the lack of research support and funding offered from most employment bodies, leads most practitioners – even university professors – to concentrate more on their clinical work rather than research. It is rare to find a body or a person who is adopting a fixed line of research and taking it to further expertise levels. Another major element hindering research, is the accessibility to new technology and statistical analysis tools that would encourage one to do the research that he/she believes will make a difference for mankind.
I appreciate that researchers in developed countries can face their own difficulties – the cost of research, patient recruitment, very high salaries of researchers and the long time needed due to the scarcity of patients. In a casual conversation with a psychiatrist from Denmark, he said that in the hospital he works in, the average number of appointments in the outpatient clinic is 5 to 7 per day. In Egypt, it is normal to say that one is exposed to more than 30 patients per day. This flow of cases can help with collecting data in a shorter period of time, which can lower the research budget. Developed countries, however, can take advantage of cost saving benefits including out-sourcing and international recruitment; using call centers from countries like Egypt or India in order to reduce the cost of customer service; and take advantage of time zone difference, eg between the UK and Australia, as we see in radiology where case reporting can continue overnight without having to pay overnight working costs.
Where to now? is to help resolve this imbalance and bring many more brains and minds into the world of research. We can start by building an easily accessible database for researchers and practitioners from all over the world. The depth of the expertise, accessibility to patients and the availability of new technologies can open new horizons for partnerships. Such a database would allow researchers from all over the planet to collaborate. Building multi-center research teams from different countries and cultural backgrounds, not to mention patients with variety of cases, will not only add to the strength of research methodology, but will also resolve some of the constraints discussed earlier. Collaboration can be as simple as guidance in how to write a case report, to complex, random controlled multi-center research.
In order for this idea to succeed, we need to overcome many uncertainties and difficulties. Interrupted or lack of communication because of the distance is a major constraint. Forming teams can be a hard job when people know each other, drawing together international teams who do not could be a challenge. I am aware that some of these collaborations have failed, but overcoming these obstacles by unifying research methodology and data collection should help to prevent these problems.
Personally, I find that most of these problems can be solved. The most important element is communication and setting online and personal meetings to discuss every detail. By creating a successful globalization of psychiatric research, we can open the perspectives of research far beyond what we have today. I am confident this will allow us to understand our brain, behavior and personalities better than ever before.