The history of Brain is written by Professor Emeritus Alastair Compston, former Professor of Neurology, University of Cambridge, and former editor of Brain journal (2004 - 2014).

Brain, a journal of neurology has been published continuously since April 1878. For 147 years, the journal has been a leading repository of knowledge on the nervous system in health and disease. From the outset, each issue combined original articles with commentaries. After a successful first decade during which the four founding editors took responsibility for the quarterly issues published by Macmillan and Co., they and others formed the Neurological Society of London (later, the United Kingdom). This adopted Brain as its official journal. With their finances inextricably linked, both remained viable but never wealthy. The growth of specialist societies waned towards the end of the nineteenth century. In 1907, the Neurological Society of the United Kingdom became the neurological section of the Royal Society of Medicine. This left Brain without a patron. A group of individuals agreed to secure the finances and continue publication as an independent business dependent on subscriptions and underwritten by the ‘Guarantors of Brain’.

After 1907, a Committee of Management assumed executive authority on behalf of the Guarantors. Apart from book reviews, the contents were now largely confined to original articles. The editors served without limitation of tenure. At first, the style was for long papers written by the elite of British and international neurology. Monograph length articles described the clinical and pathological features of newly identified conditions; and the effects of injuries of the brain and spinal cord sustained during the First World War. Subsequently, the preference was for shorter papers written by a broader community, including talented trainees. Many dealt with normal structure and function. The implications for disease were not necessarily explicit. Copy was short during the Second World War, but over the next thirty years to 1975, the editors responded to emerging interests such as disorders of higher cerebral function and diseases affecting nerve and muscle. Articles increasingly used methods, especially neurochemistry, which elucidated the mechanisms of disease. The experience of neurosurgery and neurology in the general medical setting of regional centres became prominent. And Brain documented the introduction of treatments that were increasingly effective.

Starting in 1920, the Guarantors periodically subsidised the publication of books celebrating the achievements of British neurology. Skilfully edited, these reflective contributions narrated the steady evolution of ideas on the nervous system. But they were not financially successful. Over decades, relationships with Macmillan became increasingly strained. In 1975, patience finally expired so that, after ninety-seven years, publication of Brain moved to Oxford University Press.

The story of Brain thereafter is one of expansion and wealth. The journal gradually shook off its reputation for long descriptions of structure and function based on physiological methods, supplementing classical clinicopathological description with the newer disciplines of immunology, molecular genetics and brain imaging. With a steady increase in submissions, publication changed to six issues per year; then the use of larger paper and printing in double columns; and, finally, the switch to monthly issues. A more radical change was the decision, from 2003, to manage the journal online and no longer accept paper copies. Although the contents of each issue were available through the website, Brain was also printed within a fixed page budget. As a result, the acceptance rate for submissions fell below 20%. During the 1960s, Brain employed an editorial assistant to administer the journal. Over time, this expanded to four employees. After the millennium, each issue included editorials and a range of contents, variously categorised, other than original articles. The aim was to make Brain a repository of contemporary knowledge set in its cultural and historical background. Following discussion over several years, both for commercial reasons and to manage the low acceptance rate, a second journal was launched online in 2019: Brain Communications.

After the 1970s, the treasurers of Brain no longer had to worry about financial viability. As a charity with increasing assets, schemes were introduced which supported training for clinicians and scientists working on the nervous system. Initially modest in scale, these provided travel grants to attend international meetings; funds for visiting bursaries; and partial support of domestic conferences. Later, at a time when other agencies started to withdraw from training, the Guarantors provided transitional funding for clinicians at difficult stages of entry and exit from clinical to scientific training; three-year doctoral fellowships for scientists working in a clinical environment; and an expanding number of clinical training fellowships.

Almost 150 years after Brain was founded, the Guarantors remain responsible for a well-established and successful journal; and they support the aim of the four founding editors to promote a community that works to illuminate the scientific basis of clinical neurology.