To analyze the scope of financial relationships between academic neurologists and the pharmaceutical and medical device industries (Industry), and to quantify the rate of relationship self-disclosure in major neurology journals.

Disclosure policies improve transparency regarding potential conflicts of interest (COI) between physicians and Industry. Most journals require authors to disclose relevant COI, while Industry publically reports physician payments through the Open Payment Database (“OPD”- ). To-date, neither the scope of Industry relationships nor the adequacy of COI disclosure has been studied amongst academic neurologists.

Articles published in 2016 in Neurology, JAMA Neurology, The Lancet Neurology, Brain, and Annals of Neurology were randomly selected (400 authors/journal; 182 total articles). 428 of 2000 authors were OPD eligible (i.e. MD/DO, US-based). We recorded OPD payments from 2013-2016; the paying company; payment category (non-research/general, research, or associated-research); and payment type. Small meal payments (<$10) were omitted. For each article, OPD-listed payments were compared to author-disclosed COI. Payments were categorized based on “relevance” and self-disclosure status. Payments from a company manufacturing a product tested and/or discussed in the article were considered “relevant.”

Only a minority of authors received Industry payments (mean/year = 31.2% (non-research payments), 9.5% (research payments), and 21.7% (associated-research payments)). Amongst authors receiving payments, median payment per year was $4,455.77, $1,678.08, and $60,176.82, respectively. 22% of general payments; 6% of research payments; and 4% of associated-research payments were “relevant.” Many “relevant” payments were not self-disclosed: 57% of general payments, 48% of research payments, and 32% of associated-research payments.

Financial relationships with Industry were prevalent amongst academic neurologists, driven mostly by a small group of recipients. Many payments from Industry were undisclosed even when immediately relevant to the article, despite journal policies mandating voluntary disclosure. Neurologists must strive to manage Industry COI in order to optimize collaborative benefits, professional integrity, and public trust.