ANA Investigates

Restless leg syndrome is a common movement and sleep disorder affecting 2-3% of the population. Certain neurologic disorders are associated with a higher incidence, and neuropsychiatric medications prescribed by neurologists and psychiatrists often exacerbate these symptoms. In January, the American Academy of Sleep Medicine published updated guidelines for the evaluation and treatment of RLS. The recommendations shifted from recommending the use of dopamine agonists, to prioritizing iron evaluation and supplementation, alpha-2-delta ligands (gabapentin, gabapentin enacarbil, pregabalin), and recommending against the long-term use of dopamine agonists. The guidelines also recommend opiates for moderate-severe medication refractory RLS. Dr. Winkleman is a Professor of Psychiatry at Harvard Medical School and chief of the Sleep Disorders Clinical Research Program in the Department of Psychiatry at Massachusetts General Hospital. He is the first-author on the new guidelines, and is here to discuss these changes and what is needed to effectively change practice. He is interviewed by Dr. Kara Wyant, Clinical Assistant Professor of Neurology, University of Michigan Medical School. RLS Curbside  

Look around you right now and think for a minute about all of the things you're exposed to: the coffee you're drinking, the mug holding the coffee you're drinking, the soap that mug was washed in, the sleep you got last night -- or didn't get. All of this is part of what we now call your exposome. And as we're learning, the neural exposome influences our risk of developing a range of neurologic diseases.   Our guest today is Dr. Eva Feldman, the  James W Albers Distinguished University Professor and the Russell N. De Young professor of neurology and neurosurgery at the University of Michigan. She'll talk to us about research on the neural exposome in neurodegenerative disease -- and what we should be telling patients and policymakers about this research. Dr. Feldman was interviewed by Dr. Vinita Acharya, Professor of Neurology and Distinguished Educator at Penn State College of Medicine. Guest: Dr. Eva Feldman, the  James W Albers Distinguished University Professor and the Russell N. De Young professor of neurology and neurosurgery at the University of Michigan - https://medicine.umich.edu/dept/mni/eva-feldman-md-phd  Interviewer: Dr. Vinita Acharya, Professor of Neurology and Distinguished Educator at Penn State College of Medicine Disclosures: None

Neurologists bring an important perspective to health policy. But few have formal training in how to advocate for patients at a state or national level. Our guest today, Dr. Kara Stavros, is an associate professor of neurology at The Warren Alpert Medical School of Brown University and the President of the Rhode Island Medical Society. She's also a self-described advocate, who's found a number of ways to speak up for her patients and influence health policy. Dr. Stavros spoke about her path to advocacy with Dr. Sarah Nelson, Assistant Professor of Neurology at Tufts Medical Center. Guest: Dr. Kara Stavros, associate professor of neurology at The Warren Alpert Medical School of Brown University and the President of the Rhode Island Medical Society Interviewer: Dr. Sarah Nelson, Assistant Professor of Neurology at Tufts Medical Center Disclosures: None

Parkinson's Disease has long been a clinical diagnosis. But recently, there have been proposals to redefine the disease based on biomarkers of alpha-synucleinopathy and dopaminergic dysfunction. A similar shift has already occurred in Alzheimer disease, with the “amyloid, tau, and neurodegeneration,” or ATN, classification system.    Our guest today, Michael Okun, is is Professor of Neurology and Director of the Norman Fixel Institute for Neurological Diseases at the University of Florida and medical advisor for the Parkinson's Foundation. He co-authored an op-ed in JAMA last summer in JAMA arguing that there would be benefits to a biological definition of Parkinson's - but there would also be risks. He'll unpack both sides of this debate today with Dr. Christine Doss Esper, Associate Professor of Neurology at Emory University. Series 6, Episode  5     Featuring: Guest: Dr. Michael Okun, is Professor of Neurology and Director of the Norman Fixel Institute for Neurological Diseases at the University of Florida and medical advisor for the Parkinson's Foundation Interviewer: Dr. Christine Doss Esper, Associate Professor of Neurology at Emory University Disclosures: None

We all know that atrial fibrillation is associated with increased risk of stroke. But new research suggests that how we define afib -- and the timing and duration of the arrhythmia -- may be important for how we manage it in stroke patients. Luciano Sposato is a Professor of Neurology and Head of the Stroke Program at Western University in Ontario. He'll talk to Christoph Stretz, vascular neurologist at Brown University, about the latest research into afib and aflutter after stroke -- and how this research might impact current clinical practice. Series 6, Episode 4 Featuring: Guest: Dr. Luciano Sposato, Professor of Neurology and Head of the Stroke Program at Western University in Ontario & Interviewer: Christoph Stretz, vascular neurologist at Brown University Disclosures: Dr. Sposato disclosed consulting fees and honoraria from Bayer, Boehringer Ingelheim, Pfizer, Gore, Astrazeneca, and Simcere.

Dementia is a global issue, with two-thirds of people with dementia living in low- and middle- income countries. Despite this, dementia research continues to focus on patients in high-income countries. Our guest on this episode, Dr. Riadh Gouider, is working to correct this imbalance. Dr. Gouider is the Head of the Department of Neurology and the Alzheimer Center at Razi Hospital in Tunisia and an advisor on the latest WHO Global Action Plan on the public health response to dementia. He spoke with Dr. Jayant Acharya, Professor and Chair of Neurology at Southern Illinois University School of Medicine -- about challenges, and opportunities, for dementia research across the globe. Series 6, Episode 3 Featuring: Guest: Dr. Riadh Gouider, Head of the Department of Neurology and the Alzheimer Center at Razi Hospital in Tunisia Interviewer: Dr. Jayant Acharya, Professor and Chair of Neurology at Southern Illinois University School of Medicine Disclosures: None Below are the links to the publications discussed during this episode. Lancet Commission on Dementia: https://www.thelancet.com/commissions/dementia-prevention-intervention-care WHO Global Action Plan on Dementia: https://www.who.int/publications/i/item/global-action-plan-on-the-public-health-response-to-dementia-2017---2025

It used to be that surgery for medically refractory epilepsy was big, open and invasive, a treatment of last resort. The landscape has changed in recent decades, with more and more minimally invasive surgical approaches being developed. So what does this mean for the average patient with medically refractory epilepsy? Our guest today is Dr. Jon Willie, Associate Professor, Department of Neurological Surgery, Washington University School of Medicine in St. Louis. He speaks with Dr. Ionnis Karakis, Epileptologist and Adjunct Professor of Neurology at Emory University, about the new landscape of epilepsy surgery. Series 6, Episode 2 Featuring: Guest: Jon T. Willie, MD, PhD, FAANS, Associate Professor, Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri Interviewer: Ioannis Karakis, MD, PhD, MSc., Epileptologist and Adjunct Professor of Neurology at Emory University Disclosures: Dr. Karakis disclosed that he is a consultant for USB, GSK, Ceribell, and Epitel. Dr. Willie disclosed Consulting for Clearpoint, Inc, AiM Medical Robotics, Inc., and Fortec Medical, Inc.; Contracted Research with Abbott, Inc., Neurona, Inc., and Neuropace, Inc.; and Honoraria from Medtronic, Inc. 

Until recently, the Glymphatic System was a neglected corner of neuroscience. Now it's increasingly clear that the brain's system for the flow of fluid, nutrients, and waste plays an important role in sleep and brain disease. With glymphatics in the spotlight, researchers are coming up with innovative ways to study this slow, constant flow of cerebrospinal fluid throughout the brain. Dr. Daniel Claassen is a Professor of Neurology and Chief of the Behavioral and Cognitive Neurology Division at Vanderbilt University, who researches the glymphatic system in humans. He'll talk about new directions in glymphatics research with Dr. Cheran Elangovan, a Vascular Neurologist at the University of Tennessee Health Science Center. Series 6, Episode 1 Featuring: Guest: Dr. Daniel Claassen is a Professor of Neurology and Chief of the Behavioral and Cognitive Neurology Division at Vanderbilt University Interviewer: Dr. Cheran Elangovan, a Vascular Neurologist at the University of Tennessee Health Science Center Disclosures: No relationships

Just last week, we wrapped up another exciting annual meeting of the American Neurological Association, ANA2024. Right before we packed up to head home, the President of the American Neurological Association, Dr. Betsy Ross, sat down with Dr. Allison Willis, the 2024 chair of the ANA's Annual Meeting Programming Committee, to reflect on some of the highlights of this year's meeting. Series 5, Episode 12 Featuring: Guest: Dr. Allison Willis, the 2024 chair of the ANA's Annual Meeting Programming Committee Interviewer: Dr. Betsy Ross, President of the American Neurological Association - Producer: Dr. Michelle Johansen, chair of the ANA's Education Innovation Committee Disclosures: None

Listen as Dr. Adeline Goss, Associate Chief of Neurology at Highland Hospital, discusses the groundbreaking potential of psychedelics in neurology with Dr. Steve Zeiler, a Vascular Neurologist and Associate Professor at Johns Hopkins, and Dr. Ghul Dölen, a Professor of Psychology and Neuroscience at UC Berkeley. The conversation explores the newfound excitement surrounding psychedelics like MDMA, LSD, and psilocybin for treating mood disorders like depression and neurologic conditions such as stroke recovery. The experts also delve into research showing psychedelics' ability to reopen critical periods in the brain, potentially revolutionizing therapeutic approaches for a range of neurologic and psychiatric conditions. Series 5, Episode 11 Featuring: Guests: Dr. Steve Zeiler, a Vascular Neurologist and Associate Professor at Johns Hopkins, and Dr. Ghul Dölen, a Professor of Psychology and Neuroscience at UC Berkeley Interviewer: Dr. Adeline Goss, host & executive producer of ANA Investigates and Associate Chief of Neurology at Highland Hospital Disclosures: Dr. Dolen & Zeiler share a patent on their work in psychdelics and rehab. Dr. Zeiler also reports research funding from Harmon and EVER Pharma.

AI is everywhere, whether you are a fan of it or not. This month, join us for a deep dive into the AI revolution with our guest Dr. Ethan Mollick, professor at The Wharton School at the University of Pennsylvania and author of the New York Times bestseller, "Co-Intelligence." Discover how this AI revolution stands apart from past technological advancements and how it is transforming academic research. Ethan was interviewed for this episode by Dr. Zach London, an Associate Professor at the University of Michigan Medical School.

There has been tremendous progress in recent decades in the management of ischemic strokes. Meanwhile, hemorrhagic strokes have stubbornly resisted this progress. Interventions for these types of strokes have failed again and again to show a benefit over standard medical management, until this year. The recently published ENRICH trial is the first to show that minimally invasive neurosurgery may improve functional outcomes for patients with hemorrhagic stroke. Study lead author, Dr. Gustavo Pradilla joins us today to talk about the differences between ENRICH and previous negative trials, and future neurosurgical approaches for spontaneous intracerebral hemorrhage. Dr. Pradilla is a Professor of Neurosurgery, Otolaryngology, and Head and Neck Surgery at Emory University School of Medicine and Chief of Neurosurgery at Grady Memorial Hospital. He spoke to Dr. Masoom J. Desai, neurointensivist and Assistant Professor of Neurology at the University of New Mexico. Series 5, Episode 9 Featuring: Guest: Dr. Gustavo Pradilla, Emory University School of Medicine & Grady Memorial Hospital Interviewer: Dr. Masoom Desai, University of New Mexico

2024 has been a year of exciting trials on minimally invasive techniques in intracranial hemorrhage. This month we're focusing on Chronic Subdural Hematoma, where a minimally invasive strategy called Middle Meningeal Artery (MMA) Embolization is offering expanded treatment options for select patients. Dr. Chris Kellner is a cerebrovascular neurosurgeon and associate professor of neurosurgery at Mount Sinai. He'll talk about the promise of MMA embolization with Dr. Sarah Nelson, neurointensivist and neurohospitalist at Tufts Medical Center. We'll have more on these trials on the podcast in our June episode as well, with a focus next month on Minimally Invasive Techniques in Spontaneous Intracerebral Hemorrhage. Series 5, Episode 8 Featuring: Guest: Dr. Chris Kellner, a cerebrovascular neurosurgeon from Mount Sinai Interviewer: Dr. Sarah Nelson, a neurointensivist and neurohospitalist at Tufts Medical Center Disclosures: Dr. Kellner is the PI for two studies discussed during the podcast funding was received from Medtronic and Cerenovus.

Football fans may remember in January 2023 when Damar Hamlin, a player for the Buffalo Bills, suffered a cardiac arrest and collapsed on the field during a game on live television. He had a remarkable neurologic recovery, prompting us to focus our podcast that month on the need to avoid nihilism when we prognosticate after cardiac arrest. But what is the right balance between pessimism and optimism? Today, we'll hear from Dr. Karen Hirsch, neuro intensivist and associate professor of neurology at Stanford, about finding the Goldilocks zone in neuro prognostication after cardiac arrest. Dr. Hirsch was interviewed by Dr. Sarah Stern-Nezer, vascular neurologist and neuro intensivist at UC Irvine. Series 5, Episode 7 Featuring: Guest: Dr. Karen Hirsch, Stanford Health Care Interviewer: Dr. Sara Stern-Nezer, University of California, Irvine Disclosures: None

Glioblastoma is the most common malignant brain tumor and one of the most aggressive solid tumors. Much progress has been made in the understanding and classification of gliomas, but progress in terms of prolonging survival has been limited. Several recent investigational therapies are bringing new hope. Our guest today is Dr. Eric Wong from Brown University. He is an international expert on advanced treatments for glioblastoma and a Professor of Medicine, Radiation Oncology, Neurosurgery, and Neurology at Brown University. He was interviewed by Dr. Christoph Stretz, a Vascular and Critical Care neurologist at Brown. Series 5, Episode 6 Featuring: Guest: Dr. Eric Wong, Brown University Interviewer: Dr. Christoph Stretz, Brown University

Brain death is one of the most controversial and ethically complex topics in neurology, but it's a regular part of our clinical practice. Late last year, a new set of guidelines was published that address some of the thorniest technical and ethical issues in the clinical determination of brain death. For this discussion, we are joined by Dr. Ariane Lewis, a professor in the departments of Neurology and Neurosurgery, as well as the director of the Division of Neurocritical Care at NYU Langone Medical Center, and Dr. Matthew Kirschen, an assistant professor of Anesthesiology and Critical Care at the hospital of the University of Pennsylvania and the Children's Hospital of Philadelphia. They were interviewed by Dr. Masoom Desai of the University of New Mexico. Series 5, Episode 5 Featuring: Guests: Dr. Ariane Lewis & Dr. Matthew Kirschen Interviewer: Dr. Masoom Desai Disclosures: None

Small fiber neuropathy is one of those conditions in neurology that can feel frustratingly intangible. Even for patients with severe neuropathic pain and autonomic symptoms, in about half of cases, the usual lab testing doesn't reveal a cause. There's increasing evidence that autoimmunity may be a factor in some of these cases of idiopathic small fiber neuropathy, but how to test and who to treat with immunosuppression is less clear. Our guest today, Anne Louise Oaklander, is an Associate Professor of Neurology at Massachusetts General Hospital and an Assistant in Neuropathology. She's known for her work on small fiber neuropathies and in this episode we'll talk about new autoantibodies associated with small fiber neuropathy and where we are in treating this challenging condition. Series 5, Episode 4 Featuring: Guest: Dr. Anne Louise Oaklander Interviewer: Dr. Adeline Goss Disclosures: None

The recent FDA approval of lecanemab, an amyloid-sequestering agent, has been hailed as a breakthrough in the treatment of Alzheimer disease. Critics of the drug have pointed to its cost, risks, and treatment burden. Now that lecanemab is being administered in clinics across the country - how is it changing the lives of people with Alzheimers and their families? Dr. Megan Richie, neurohospitalist at UCSF, spoke to Dr. Seth A. Gale, Co-Director of the Brain Health Program and Assistant Professor of Neurology at Harvard Medical School. Dr. Gale has been involved in creating the clinical program that is delivering lecanemab to patients at Brigham and Women's Hospital and Massachusetts General Hospital, with the first patients receiving the drug this month. Series 5, Episode 3 Featuring: Guest: Seth A. Gale, MD - Co-Director of the Brain Health Program, and Assistant Professor of Neurology at Harvard Medical School Interviewer: Megan Richie, MD - Neurohospitalist at UCSF and Chair of the ANA Education Innovation Committee Disclosures: Dr. Gale disclosed that he is a site Principal Investigator or Sub-Investigator (at Brigham and Women's Hospital) for several clinical trials in Alzheimer disease. Sponsors for those studies include Biogen, Eisai, Roche, Genentech, and Eli Lilly. I am on a scientific advisory board for MindAhead DE, with the opportunity for honoraria.

Chronic pain can be incredibly challenging -- for patients, of course, and also for their physicians. On this episode of ANA investigates, Dr. Adeline Goss talks to Dr. Prasad Shirvalkar of UCSF about a new possible strategy for treating chronic pain: deep brain stimulation. Series 5, Episode 2 Featuring: Guest: Dr. Prasad Shirvalkar of UCSF Interviewer: Dr. Adeline Goss Disclosures: Dr. Shirvalkar disclosed that Medtronic Inc, donated devices for research, but no direct financial support

The brain and its vasculature used to be considered separate domains. But in the last decade, we've learned more about the interplay between brain cells and vascular cells. Pathological studies are revealing a surprising degree of overlap between cerebrovascular disease and neurodegenerative disease. All of this has led to the coining of a new word: the neurovasculome. Our guest today is Dr. Eric Smith, an author of a recent scientific statement about the neurovasculome in the journal Stroke. Dr. Smith is a Professor of Neurology, Radiology, and Community Health Sciences at the University of Calgary, and the holder of the endowed Katthy Taylor Chair in Vascular Dementia. He was interviewed about the neurovasculome by Dr. Christoph Stretz, a Vascular and Critical Care neurologist at the Warren Alpert Medical School of Brown University. Series 5, Episode 1 Featuring: Guest: Eric Edward Smith, MD, MPH, FRCPC, FAHA, University of Calgary Interviewer: Christoph Stretz, MD, Brown University Disclosures: Dr. Smith disclosed that he receives personal consulting fees from Alnylam Pharmaceuticals and Eli Lilly

As the ANA's 2023 Annual Meeting comes to a close, we wanted to catch up with Frances Jensen Chair of the Department of Neurology at University of Pennsylvania and outgoing President of the ANA, and Rebecca Gottesman, Stroke Branch Chief of the National Institute of Neurological Disorders and Stroke and outgoing Chair of the Annual Meeting Planning Committee. Listen as these two leaders chat about the cutting-edge research, exciting sessions, and broader themes that have defined this year's meeting in Philadelphia.

A growing body of research suggests that people with insomnia are at higher risk of stroke. Listen today as we dive into how sleep health, stroke, and the nervous system all have an affect on each other. Series 4, Episode 11 Featuring: Guest: Dr. .Sonja Schuetz, University of Michigan Interviewer: Dr. Joseph Carerra, University of Michigan Disclosures: Dr. Schuetz reports funding from contracts between University of Michigan and Oura Health Ltd., Huxley Medical Inc., and Apple Inc.

Lysosomal storage diseases are progressive, inherited disorders of metabolism, many with devastating effects on the nervous system. Some of these diseases, like Infantile-Onset Pompe disease, can be treated to some degree in childhood by giving back the missing enzyme - a strategy called enzyme replacement therapy, or ERT. But a recent study reported in the New England Journal of Medicine goes a step farther -- by giving enzyme replacement therapy to a fetus with Pompe disease, for the first time, in an attempt to treat the disease before it does any serious damage. The paper's first author is Dr. Jennifer Cohen, a Pediatric Medical Genetics Physician-Scientist at Duke University Health System. During this episode, she'll walk us through the potential benefits of in-utero enzyme replacement therapy and other cutting-edge approaches to treating genetic neurologic conditions. A relatively new field called fetal therapy. Dr. Cohen was interviewed by Dr. Adeline Goss, the host of ANA Investigates. Series 4, Episode 10 Featuring: Guest: Dr. Jennifer Cohen, Duke University Health System Interviewer: Dr. Adeline Goss, Highland Hospital Disclosures: Dr. Cohen is a consultant with Bayer.

A recent study in JAMA Neurology found an association between contaminated water at a military base in the 1970s-80s and the risk of Parkinson's disease in military service members. What do we know about Parkinson's and environmental toxins? Series 4, Episode 9 Featuring: Guest: Dr. Ray Dorsey, University of Rochester Interviewer: Dr. Sara Stern-Nezer, UC Irvine Disclosures: This episode does not award CME credit.

There are trillions of bacteria living inside each of our gastrointestinal tracts and there's growing evidence that those bacteria communicate with the brain. Some researchers are even hopeful that drugs targeted at the gut microbiome could help treat diseases as diverse as Parkinson's disease, multiple sclerosis, or autism. The nature of this so-called “gut-brain axis” -- the extent to which bacteria might actually shape brain function and disease -- is the topic of our show today. Dr. Sarkis Mazmanian is the Luis and Nelly Sooks Professor of Microbiology in the Division of Biology and Biological Engineering at Caltech. He's the recipient of many awards, including a MacArthur Genius Grant, for his work on the gut microbiome axis. Series 4, Episode 8 Featuring: Guest: Dr. Sarkis Mazmanian, Caltech Interviewer: Dr. Adeline Goss, Highland Hospital Producer: Dr. Sara Stern-Nezer, UCI Health Disclosures: Dr. Mazmanian disclosed the following relationships related to this podcast topic: Axial Therapeutics: Board member and Consultant, Nuanced Health: Board member and Consultant, and Seed Health: Board member. This episode does not award CME credit.

Recently on the podcast we've been talking about neurotechnology -- devices that interface with the brain to treat disease, for example by restoring speech function in people with locked-in syndrome, or motor function in people with paralyzed limbs. But listen to the media, and you'll also hear buzz about neurotechnology for healthy people... Series 4, Episode 7 Featuring: Guest: Philip Sabes, PhD, UCSF Interviewer: Rohini Samudralwar, MD, UPENN Disclosures: This episode is non-CME.

Among several highlights of the recent International Stroke Conference was new evidence supporting endovascular thrombectomy for patients with so-called “large core” ischemic strokes. In current practice, thrombectomy is considered for patients with occlusions of the internal carotid or middle cerebral artery who are less than 24 hours since the last known well and have a small “core” of ischemia on non-contrast head CT or CT or MR perfusion imaging -- in other words, there's radiographic evidence that only a small core of the brain has suffered permanent injury and a larger penumbra of tissue can be saved. SELECT-2 is a multicenter randomized controlled trial that examined whether patients with LARGE cores of ischemic tissue could ALSO benefit from thrombectomy. On our show today we have SELECT-2 principal investigator Dr. AM-rou sou-RAJ, who is also Professor of Neurology at Case Western Reserve University School of Medicine. He was interviewed by Dr. Michelle Johansen, vascular neurologist at Johns Hopkins University, about what the study results might mean for stroke care -- and stroke imaging -- going forward. Series 4, Episode 6. Featuring: Guest: Amrou Sarraj, MD FAHA, Professor of Neurology, Case Western Reserve University School of Medicine, George M. Humphrey II Endowed Chair, University Hospitals Neurological Institute, Director, Comprehensive Stroke Center and Stroke Systems, University Hospitals Interviewer: Dr. Michelle Johansen, Johns Hopkins Medicine Producer: Dr. Joseph Carrera, University of Michigan Disclosures: Dr. Sarraj discloses the following relationships: SELECT2 principal investigator - funded by Stryker Neurovascular with research grant to University Hospitals Cleveland Medical Center and UT McGovern Medical School SELECT principal investigator - funded by Stryker Neurovascular with research grant to UT McGovern Medical School Member, Speaker bureau and advisory board - Stryker Neurovascular Provided advisory services to AstraZeneca, Genentech and Lumosa Theraputics

Concussion, or mild acute traumatic brain injury, is incredibly common -- 1 in 5 of adolescents report having suffered a concussion at some point in their lifetime (JAMA. 2021;325(17):1789-1791)... and an estimated 1 in 5 players of contact sports suffer a concussion each season. Sports neurologists are rare enough that most people suffering concussions are never seen by one. And general neurologists aren't always well-trained to treat this condition, especially as the science of concussion is advancing. Our guest today, Dr. Jose Posas is a sports neurologist and residency program director at Ochsner Medical Center in New Orleans and he spoke to ANA producer Dr. Mandy Jagolino-Cole of The University of Texas Health Science Center at Houston about recent findings in concussion research and how we can apply that research at the bedside. Series 4, Episode 5. Featuring: Guest: Dr. Jose Posada, Ochsner Medical Center Interviewer/Producer: Dr. Amanda Jagolino Cole, The University of Texas Health Science Center at Houston Disclosures: none Publication mentioned in the episode: McAllister TW, Broglio SP, Katz BP, Perkins SM, LaPradd M, Zhou W, McCrea MA; Concussion Assessment, Research and Education (CARE) Consortium. Characteristics and Outcomes of Athletes With Slow Recovery From Sport-Related Concussion: A CARE Consortium Study. Neurology. 2023 Jan 18:10.1212/WNL.0000000000206853. doi: 10.1212/WNL.0000000000206853. Epub ahead of print. PMID: 36653178. https://pubmed.ncbi.nlm.nih.gov/36653178/

On our December show, we talked about ethical issues surrounding brain-computer interfaces. We'll pick up the topic again this month with a discussion about one type of brain-computer interface: neuroprosthetics. Our guest is Dr. Edward Chang, Professor and Chair of Neurological Surgery at the University of California San Francisco. Dr. Chang is an expert in brain mapping during neurosurgery, with the aim of preserving the brain areas responsible for language, speech, movement and emotion. His research focuses on neuro-prosthetics that can restore movement in people who are paralyzed and speech in people with speech disorders. As we'll talk about today, this research raises interesting ideas about the neural representation of speech and language and the ethics surrounding brain-computer interfaces. Dr. Chang was interviewed by ANA Producer Dr. Amanda Jagolino-Cole of The University of Texas Health Science Center at Houston. Series 4, Episode 4. Featuring: Guest: Edward Chang, MD, Professor, Neurological Surgery, UCSF Weill Institute for Neurosciences, School of Medicine Interviewer/Producer: Amanda L Jagolino-Cole, MD, FAHA, FAAN, Associate Professor of Neurology, Director of UT Teleneurology, Vascular Neurology Fellowship Program Director, UTHealth | The University of Texas Health Science Center at Houston, McGovern Medical School Disclosures: Dr. Chang and UCSF have intellectual property related to algorithms for BCI, Dr. Chang is a consultant for Synchron

Football audiences were shaken on January 2nd when Buffalo Bills safety Damar Hamlin suffered a cardiac arrest after a tackle during a Monday Night Football game. He was resuscitated on the field and then transferred to the University of Cincinnati Medical Center in critical condition. Thus began a waiting period, all too familiar to neurologists, while the world wondered to what extent Mr. Hamlin's brain would recover. But remarkably, just 4 days later, Mr. Hamlin was able to communicate in writing. He was extubated the following day and discharged home on January 11th. Our guest on today's podcast, ANA Vice President and Johns Hopkins University neurointensivist Dr. Romer Geocadin, says that Mr. Hamlin's story should inspire hope... not only for families of survivors of cardiac arrest but also for researchers and physicians. Romer was interviewed by ANA Education Innovation committee Chair and UCSF Neurohospitalist Dr. Megan Richie for this special episode of ANA Investigates.... on cardiac arrest and paths to recovery. Series 4, Episode 3. Featuring: Guest: Dr. Romer Geocadin, ANA Vice President and Johns Hopkins University neurointensivist Interviewer/Producer: Dr. Megan Richie, ANA Education Innovation committee Chair and UCSF Neurohospitalist

The emergence of the syndrome known as long COVID has brought new attention to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). In this episode, we explore the advances in science that may soon lead to answers. Series 4, Episode 2. Featuring: Guests: Drs. Sonya Marshall-Gradisnik & Kiran Thapaliya from the National Centre for Neuroimmunology and Emerging Diseases (NCNED), Griffith University, Queensland, Australia Interviewer/Producer: Dr. Megan Richie, UCSF

Neurotechnology like DBS or transcranial magnetic stimulation have clear benefits in diagnosis and therapy and are largely embraced by the medical community. But what about recent accelerated development from tech entrepreneurs to harness cognitive pathways for everyday tasks? This is referred to as brain computer interface technology or BCI. Commercial products such as Neuralink, attempt to implant chips promising to link brain activity with tasks such as accessing phones or cars. This brings up real questions on autonomy, privacy, and medical implications, but is there more to these technological advancements that could provide medical benefit for our patients? We discuss the commercial and medical aspects surrounding BCI technology and the physician and scientist's role in this rapidly evolving field with Dr. Karen Rommelfanger, the founder and director of the Neuroethics Program at Emory University and now the founder of the world's first think and DO tank dedicated wholly to neuroethics called the Institute of Neuroethics. She also serves as a member of the BRAIN Initiative's Neuroethics Working Group and was on the advisory council to the director of the National Institutes of Health (NIH) for BRAIN 2025. Series 4, Episode 1. Featuring: Guest: Dr. Karen Rommelfanger, Emory University & Institute of Neuroethics Interviewer/Producer: Rohini Samudralwar, University of Pennsylvania

The role of genetics in both pediatric and adult epilepsies is expanding. Now, making a genetic diagnosis in epilepsy isn't just important for family planning and prognostication - these diagnoses can also improve patients' care starting at the moment of diagnosis. Our guest today, Ingrid Scheffer, is a leader in gene discovery in epilepsy. Dr. Scheffer is a Laureate Professor of Pediatric Neurology at the University of Melbourne, and she directs the Children's Epilepsy Research Center at Austin Health. She says while there's still a long way to go before precision medicine is available for the hundreds of known genetic epilepsies, her patients are already benefiting from genetic testing, in many ways. Dr. Scheffer was interviewed by ANA Investigates Producer and epileptologist Dr. Rohit Das of UT Southwestern Medical Center. Series 3, Episode 12. Featuring: Guest: Ingrid Scheffer, AO FRS FAA FAHMS, University of Melbourne Interviewer/Producer: Rohit Das, MD, UT Southwestern Disclosures: In the past 24 months, Ingrid Scheffer has consulted for Atheneum Partners, Biohaven Pharmaceuticals Inc, Care Beyond Diagnosis, Epilepsy Consortium and Zynerba Pharmaceuticals, has served as an investigator for Anavex Life Sciences, Cerebral Therapeutics, Cerecin Inc, Cereval Therapeutics, Eisai, Encoded Therapeutics, EpiMinder Inc, Epygenyx, ES-Therapeutics, GW Pharma, Marinus, Neurocrine BioSciences, Ovid Therapeutics, Takeda Pharmaceuticals, UCB, Ultragenyx, Xenon Pharmaceutical, Zogenix and Zynerba; received speaker honoraria from Biocodex, BioMarin, Chiesi, Liva Nova and UCB; received funding for travel from Biomarin, Eisai and UCB; and served on scientific advisory boards for Bellberry Ltd, BioMarin, Chiesi, Eisai, Encoded Therapeutics, Knopp Biosciences, Rogcon, Takeda Pharmaceuticals and UCB. Ingrid Scheffer may accrue future revenue on pending patent WO2009/086591: Diagnostic And Therapeutic Methods For EFMR (Epilepsy And Mental Retardation Limited To Females); has a patent for SCN1A testing held by Bionomics Inc and licensed to various diagnostic companies (WO/2006/133508); she has a patent for a molecular diagnostic/therapeutic target for benign familial infantile epilepsy (BFIE) [PRRT2] WO/2013/059884 with royalties paid.

Equitable tele-neurologic care starts with first identifying disparities, then identifying how to overcome them – learn about both with Dr. Lee Schwamm on the latest ANA Investigates. Series 3, Episode 11. Featuring: Guest: Dr. Lee Schwamm, C Miller Fisher Endowed Chair in Vascular Neurology and the Director of the Center for TeleHealth at Massachusetts General Hospital, Professor of Neurology at Harvard Medical School and Vice President for Digital Patient Experience at the Mass General Brigham Health System. Interviewer/Producer: Amanda Jagolino-Cole, Director of the UT Teleneurology Division at McGovern Medical School at the University of Texas Health Science Center in Houston. Disclosures: None

Late last month, the journal Science published an investigative report that accused a much-cited publication in Alzheimer's disease... of fabricating scientific images. The study under scrutiny was published in Nature in 2006 by Sylvain Lesné and colleagues. It claimed that an amyloid oligomer called Aβ*56 impaired memory in mice. The recent Science report found potential fabrication in the images used in that paper... and concluded that this potential fabrication threatens the amyloid hypothesis in Alzheimer's disease. Here at ANA Investigates, we decided we needed to ask the experts about that. Their conversation will help us understand the impact of the recent investigative report on the field of Alzheimer's research. Series 3, Episode 10. Featuring:  - Guest: Dr. Richard O'Brien, Alzheimer's researcher, Chair of the Department of Neurology at Duke University - Interviewer/Producer: Dr. Erik Roberson, Alzheimer's researcher, endowed Professor of Neurology, and Director of the Alzheimer's Disease Center at the University of Alabama at Birmingham

Last month on the podcast, we talked about updates in the diagnosis of autoimmune encephalitis. This month we turn to advances in the treatment of autoimmune encephalitis. Treating these conditions has traditionally been practitioner-dependent, and currently no FDA-approved therapies exist. But that's beginning to change. Series 3, Episode 9. Featuring: Guest: Dr. Maarten Titulaer, Erasmus MC University Medical Center Interviewer/Producer: Dr. Rohini Samudralwar, University of Pennsylvania Disclosures: Dr. Titulaer disclosed that his institution receives consulting funds form UCB, Viela Bio (Horizon), and CSL Behring, he is the co-investigator on the ExTinguish trial funded in part by Horizon, and a PI IVIG trial funded by CSL Behring.

On today's episode, Dr. Adeline Goss interviews Dr. Andrew McKeon on updates on diagnostics for part one of a two-part series on autoimmune encephalitis. Series 3, Episode 8. Featuring: Guest: Andrew McKeon, M.B., B.Ch., M.D., Mayo Clinic College of Medicine and Science Interviewer/Producer: Adeline Goss, MD, Highland Hospital Disclosures: Dr. McKeon disclosed that he is a consultant for Johnson & Roche Genentech; and receives royalties from Euroimmun

On today's episode, we discuss the term "TIA" and the current debate as it pertains to advances in stroke diagnostics that have led some to propose that we retire the term. Series 3, Episode 7. Featuring: Guest: Clay Johnston, MD, PhD, The University of Texas at Austin Interviewer/Producer: Megan Richie, MD, UCSF Disclosures: Dr. Johnston disclosed research support from AstraZeneca for the THALES trial.

Burnt out by talking about burnout? Please join us for a podcast with Dr. Amy Arnsten, Professor of Neuroscience and Psychology at Yale University, to investigate what goes on in the brain that leads to burnout and how this can direct our efforts to reduce burnout. Series 3, Episode 6. Featuring: Guest: Dr. Amy Arnsten, Professor of Neuroscience and Psychology at Yale University - Interviewer/Producer: Dr. Amanda Jagolino-Cole of the McGovern Medical at the University of Texas Health Science Center in Houston Dr. Arnsten provided additional resources, and these may be found on the ANA website: https://myana.org/education/ana-investigates-podcast-series

On today's show, we'll focus on the future of biomarkers in Alzheimer's disease. We know that amyloid beta and tau protein deposit long before patients with Alzheimer's develop symptoms. If we could use biomarkers to detect this pathology early, and treat patients early, could we prevent the progression to dementia? Our guests today are leaders in the development of biomarkers for Alzheimer's disease - Dr. Suzanne Schindler, Associate Professor of Neurology at Washington University in St. Louis and Dr. Gil Rabinovici, Professor of Neurology and Radiology at the University of California San Francisco. They'll talk with Dr. Doug Ney of UC Denver about the expanding role of biomarkers in Alzheimer's prevention and treatment. Series 3, Episode 5 Featuring: Guests: Dr. Suzanne Schindler, Washington University at St. Louis & Dr. Gil Rabinovici, University of California at San Francisco Interviewer/Producer: Dr. Douglas Ney, University of Colorado Disclosures: Dr. Schindler disclosed that C2N Diagnostics provided data free of cost for her team to analyze. Dr. Rabinovici disclosed that he leads the New IDEAS study and has received research funding from Avid Radiopharmaceuticals, GE Healthcare, Life Molecular Imaging, Genentech; and is on scientific advisory boards for Eisai, J&J, Genentech, Eli Lilly, and Roche.

Can coma be “cured”? On this podcast, we talk to Dr. Claude Hemphill and Dr. Romer Geocadin of the Curing Coma Campaign. Series 3, Episode 4 https://www.curingcoma.org/events2/world-coma-day Featuring: Guests: Romer Geocadin, MD, Johns Hopkins University & Claude Hemphill, MD, University of California San Francisco Interviewer/Producer: Dr. Adeline Goss Below are articles the guests of this podcast wished to share with the listeners: Early Thalamocortical Reperfusion Leads to Neurologic Recovery in a Rodent Cardiac Arrest Model: https://doi.org/10.1007/s12028-021-01432-9 Proceedings of the First Curing Coma Campaign NIH Symposium: Challenging the Future of Research for Coma and Disorders of Consciousness: https://doi.org/10.1007/s12028-021-01260-x AHA SCIENTIFIC STATEMENT: Standards for Studies of Neurological Prognostication in Comatose Survivors of Cardiac Arrest: Circulation. 2019;140:e517–e542. DOI: 10.1161/CIR.0000000000000702 - https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000000702 Detection of Brain Activation in Unresponsive Patients with Acute Brain Injury; n engl j med 380;26 nejm.org June 27, 2019 Therapies to Restore Consciousness in Patients with Severe Brain Injuries: A Gap Analysis and Future Directions; Neurocrit Care (2021) 35:68–85; https://doi.org/10.1007/s12028-021-01227-y Mechanisms Underlying Disorders of Consciousness: Bridging Gaps to Move Toward an Integrated Translational Science; Neurocrit Care (2021) 35:37–54; https://doi.org/10.1007/s12028-021-01281-6

Treatment of stroke has changed dramatically in the past decade, with the advent of perfusion imaging and an expanded time window for mechanical thrombectomy. Thrombectomy is now standard of care for eligible patients. But while data clearly supports the use of thrombectomy for certain patients with anterior circulation strokes, the benefit of thrombectomy for patients with basilar artery occlusions remains unproven. Today we'll talk to a vascular neurologist and a neurointerventional surgeon who are trying to better define which patients with basilar artery occlusion may benefit from thrombectomy -- and which patients may not. Series 3, Episode 3   Featuring: - Guests: Dr. Carlo Cereda, vascular neurologist, head of the EOC Comprehensive Stroke Center at the Neurocenter of Southern Switzerland and Faculty of Biomedical Sciences, Università della Svizzera Italiana in Lugano & Dr. Jeremy Heit, Assistant Professor of Radiology and of Neurosurgery and the interim Chief of Neuroradiology at Stanford University - Interviewer/Producer: Dr. Michelle Johansen, Assistant Professor of Neurology, Johns Hopkins Medicine   Disclosures: Dr. Heit disclosed that he consults for Medtronic and MicroVention, and consults and is a member of medical and scientific advisory board for iSchemaView, Inc., and Dr. Cereda disclosed that he is a advisory board for iSchemaView, Inc.

On today's show we'll focus on functional neurological disorder, or FND -- a wide range of conditions including non-epileptic seizures and functional weakness, dystonia and tremor. These conditions are common and can cause serious disability. But what are these conditions, exactly? What have functional neuroimaging and other tools taught us about their pathophysiology, diagnosis, and treatment? Series 3, Episode 2 Featuring: - Guest: Dr. Sara Finkelstein, neurologist and specialist in functional neurological disorder at Massachusetts General Hospital - Interviewer/Producer: Dr. Adeline Goss, Neurohospitalist at Highland Hospital and the host and executive producer of ANA Investigates

Some patients with medically refractory epilepsy are offered surgeries to implant devices that electrically stimulate the nervous system and actually modulate neural networks over time. On this episode of ANA Investigates, Dr. Vikram Rao of the UCSF Weill Institute for Neurosciences discusses how these neurostimulation devices can reduce seizure burden, along with a range of other potential benefits.‌ Series 3, Episode 1. Featuring: Guest: Dr. Vikram Rao, epileptologist and Associate Professor of Neurology at the UCSF Weill Institute for Neurosciences Interviewer & Producer: Dr. Rohit Das, epileptologist at UT Southwestern Medical Center‌‌

Autonomic dysfunction often presents with subtle symptoms affecting multiple organ systems simultaneously. On this episode of ANA Investigates, we discuss bedside evaluation and advanced workup of dysautonomia and how to manage refractory symptoms. Series 2, Episode 11. Featuring: Guest: Safwan Jaradeh, MD, Professor of Neurology, Psychiatry and Behavioral Sciences and Director of the Autonomic Disorders Program at the Stanford Neuroscience Health Center Interviewer/Producer: Megan Richie, MD, Associate Professor, UCSF

In July, the World Health Organization released its updated classification of Tumors of the Central Nervous System. The last update was in 2016. The update reflects the increasing role of molecular biomarkers in tumor characterization -- a change that has major implications for how we diagnose and treat patients with brain and spinal cord tumors. Joining us today to help us understand these changes is Dr. Lynne Taylor. Dr. Taylor is a professor of Neurology and Oncology at the University of Washington and co-director of the Alvord Brain Tumor Center at University of Washington Medical Center. Dr. Taylor was interviewed by ANA Investigates producer and neuro-oncologist, Dr. Doug Ney. Series 2, Episode #10

In recent years, the Food and Drug Administration approved several new treatments specifically for the treatment of multiple sclerosis and neuromyelitis optica spectrum disorder. But what about neuroimmunological conditions that do not have FDA approved options and require off-label use of immunomodulatory medications -- conditions like neurosarcoidosis, neuro-Behcet's, or central nervous system involvement of systemic rheumatologic conditions? There is often a lack of rigorous evidence to guide treatment of these conditions, leaving experts to rely on individual or institutional experience. Our guest on this episode is Dr. Jeffrey Gelfand, neuroimmunologist and Associate Professor of Neurology at UCSF. He specializes in treating patients with rare neuroinflammatory conditions, and he'll talk to us about the new drugs for NMO as well as off-label use of immunomodulatory therapies for a range of neurological conditions. Dr. Gelfand was interviewed by ANA producer Dr. Rohini Samudralwar. Series 2, Episode #9 Disclosures: Dr. Gelfand receives research support to UCSF for clinical trial from Rosch and Genetech; provides consulting to Biogen

For much of the history of neurology, diagnosing a genetic disease meant giving bad news. Genetic meant incurable, often fatal. On past shows, we've talked about how this narrative is changing for certain monogenic diseases like Huntington's Disease, where emerging gene therapies offer hope for a cure. But what hope can the field of neurogenetics offer to patients with more complex diseases with both genetic and environmental risk factors, like Alzheimer's? Our guest today, Dr. M. Elizabeth Ross, is Professor of Neurology and Neuroscience in the Brain and Mind Research Institute and Director of the Center for Neurogenetics at Weill Cornell Medicine. Her lab works on the genetics of neurologic diseases affecting humans at every stage of the lifecycle. Today she'll help us understand the role of genetics in a range of neurodegenerative diseases -- and how and when clinicians should incorporate genetic considerations into patient care. Series 2, Episode 8

Neurology and psychiatry: two fields, one organ system. Today, we’ll focus on the intersection between the two. We’ll discuss one common psychiatric disease -- depression -- and how new treatments for depression may inform how we treat other neurologic illnesses. ANA Investigates Producer Dr. Rohit Das interviewed Dr. Helen Mayberg, behavioral neurologist at the Icahn School of Medicine at Mt. Sinai, about her pioneering research in circuit-based treatment of depression, particularly deep brain stimulation, or DBS. Series 2, Episode 7

Current guidelines for management of carotid stenosis are based on a series of trials dating back to the 1990s. If you ask today’s guests, virtually no other area of neurology is so badly in need of an update. Dr. Seemant Chaturvedi, the Stewart Greenebaum Endowed Professor of Stroke Neurology at University of Maryland School of Medicine, and Dr. Cheryl Bushnell is Professor of Neurology, Vice Chair of Research, Stroke Division Chief at Wake Forest Baptist Health join us for a discussion of the major advances in medical therapy for stroke prevention and why these advances require new trials to refine patient selection for revascularization. They’ll also discuss the growing role of plaque imaging in treatment decisions. Series 2, Episode 6

The topic of today’s podcast is tenecteplase. This is a thrombolytic drug that is administered intravenously, for certain patients who present to the hospital with an acute ischemic stroke.  There is mounting evidence that intravenous tenecteplase is at least as safe and effective as intravenous alteplase, the current standard of care in ischemic stroke. Tenecteplase also less expensive and easier to administer. Our guest today is Dr. Bruce Campbell, who has played a pivotal role in the deployment of tenecteplase for stroke. Dr. Campbell was interviewed by Dr. Michelle Johansen, a vascular neurologist at Johns Hopkins. Series 2, Episode 5