Global Warming and Neurological Practice: Systematic Review

ABSTRACT Background Climate change, including global warming, is expected to cause poorer global health and a rise in the number of environmental refugees. As neurological disorders account for a major share of worldwide morbidity and mortality, climate change and global warming are also destined to alter neurological practice; however, to what extent and by which mechanisms is unknown. We aimed to collect the available information on the effects of ambient temperatures and human migration on the epidemiological and clinical manifestations of major neurological disorders. Methods We searched PubMed and Scopus from January 1, 2000 to November 30, 2020 for human studies published in English addressing the influence of ambient temperatures and human migration on Alzheimer’s and non-Alzheimer’s dementia, epilepsy, headache and migraine, multiple sclerosis, Parkinson’s disease, stroke, and tick-borne encephalitis (as a model disease for neuroinfections). The protocol was pre-registered at PROSPERO (2020 CRD42020147543). Results 101 studies met inclusion criteria, but we were unable to identify a single study addressing how global warming and human migration will change neurological practice. Still, extracted data suggested multiple ways by which these aspects might alter neurological morbidity and mortality in the future. Conclusion Significant heterogeneity exists across studies with respect to methodology, outcome measures, control of confounders and study design, but there is enough evidence to suggest climate change will affect the neurological practice of all major neurological disorders. Adequately designed studies to address this issue are urgently needed, which will require concerted efforts from the neurological community.