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Many people worry about memory loss and cognitive decline as they age. In this episode of Health Matters, host Courtney Allison speaks with Dr. Matthew Fink, neurologist-in-chief at NewYork-Presbyterian and Weill Cornell Medicine, about how lifestyle choices—especially diet—can help protect the brain. Dr. Fink explains the MIND diet, a combination of the Mediterranean and DASH diets, which emphasizes whole foods like leafy greens, berries, fish, nuts, and olive oil while limiting salt, sugar, and ultra-processed foods. He breaks down how key nutrients such as B vitamins and antioxidants support brain metabolism, reduce inflammation, and may slow the aging process. The conversation also highlights the brain's high energy demands and why proper nutrition is essential for cognitive function. Dr. Fink shares research showing that healthy lifestyle interventions can significantly lower the risk of dementia and discusses the broader benefits of the MIND diet for heart health and stroke prevention. Finally, Dr. Fink outlines additional habits that support brain health, including regular physical activity, quality sleep, and social connection, emphasizing that even small, gradual changes can lead to meaningful long-term benefits. Chapters 00:00 – Why Brain Health Is in Your Control How lifestyle choices can reduce dementia risk and why prevention starts early 03:00 – What Is the MIND Diet? Key components of the Mediterranean and DASH diets and how they support the brain 06:00 – Brain-Boosting Nutrients and Foods to Avoid The role of B vitamins, antioxidants, and which foods increase risk 10:30 – Beyond Diet: Exercise, Sleep, and Daily Habits How movement, rest, and social connection contribute to cognitive health Key Topics Covered MIND diet overview Mediterranean diet and DASH diet Brain metabolism and energy use B vitamins and brain health Antioxidants and inflammation Foods that support cognitive function Foods to limit (salt, sugar, processed foods) Dementia and Alzheimer's prevention Stroke and heart disease connection Exercise and brain function Sleep and cognitive health Lifestyle changes for healthy aging Takeaway Message You have more control over your brain health than you might think. By focusing on whole, nutrient-rich foods, limiting processed options, staying active, and getting enough sleep, you can significantly reduce your risk of cognitive decline and support a healthier brain as you age. Doctor Bios Matthew E. Fink, MDis currently the Louis and Gertrude Feil Professor and chair of the Department of Neurology at Weill Cornell Medicine, and neurologist-in-chief at NewYork Presbyterian/Weill Cornell Medical Center. In addition, he is chief of the Division of Stroke and Critical Care Neurology at NewYork-Presbyterian/Weill Cornell Medical Center, and vice chair of the medical board. Dr. Fink attended college at the University of Pennsylvania, medical school at the University of Pittsburgh, and served as resident and chief resident in internal medicine at the Boston City Hospital. He came to New York and trained in neurology at the Neurological Institute of NewYork-Presbyterian/Columbia University Irving Medical Center, and served as chief resident under Dr. Lewis P. Rowland. Subsequently, he joined the faculty of Columbia University and became the founding director of the Neurology-Neurosurgery Intensive Care Unit at NewYork-Presbyterian and was appointed associate professor of clinical neurology and neurosurgery while at Columbia. Dr. Fink was a founding member and chair of the critical care section of the American Academy of Neurology, and the research section for neurocritical care of the World Federation of Neurology. He is board-certified in internal medicine, neurology, critical care medicine, vascular neurology, and neurocritical care. He has been elected as a Fellow of the American Neurological Association, the American Academy of Neurology, and the Stroke Council of the American Heart Association. Throughout his career, Dr. Fink has been involved in the education and training of students, residents and fellows in the field of stroke and critical care neurology, as well as an active participant in clinical research within this field. He is a leader in this new specialty, has lectured widely, and has published many research and clinical articles in the field of stroke and critical care. In addition, he currently serves as editor of the monthly publication, NEUROLOGY ALERT, and is a past-president of the New York State Neurological Society.
Dr. Madeline Russell discusses a common complication faced by patients with acute ischemic stroke. Show citation: Schwarz G, Cascio Rizzo A, Ambler G, et al. Contrast-Associated Acute Kidney Injury After Thrombectomy for Ischemic Stroke: Prognostic Impact and CAN-REST Predictive Score. Neurology. 2026;106(6):e214655. doi:10.1212/WNL.0000000000214655
Carepoint Journal Club is a quarterly series with discussions about a medical topic, brought to you by Carepoint's Emergency Physicians.
Dr. Stacey Clardy talks with Dr. John Ney about wait times for new neurology office visits among commercially insured persons in the United States. Read the related article in Neurology®. Disclosures can be found at Neurology.org.
Dr. Bradley Ong discusses the use of eptinezumab in combination with patient education is an effective treatment for reducing disease burden in patients living with chronic migraine complicated by medication overuse. Show citation: Jensen RH, Lundqvist C, Schytz HW, et al. Eptinezumab With Patient Education for Chronic Migraine and Medication-Overuse Headache: The Randomized, Placebo-Controlled RESOLUTION Trial. Neurology. 2026;106(8):e214863. doi:10.1212/WNL.0000000000214863
Dr. Michael Park shares stories from a Proof-of-Concept study that combined lumbar or lumbosacral decompression and fusion surgery and neuromodulation. Dr. Park is a former principal investigator of the SynerFuse® proof-of-concept clinical trial and primary inventor of SynerFuse® technology. Dr. Park is a board-certified neurosurgeon, an associate professor, MnDRIVE neuromodulation scholar, William P. Van Wagenen Fellow, and director of stereotactic and functional neurosurgery in the Department of Neurosurgery and Neurology at the University of Minnesota. He has extensive experience with neuromodulation – deep brain stimulation. This surgical therapy for brain conditions such as Parkinson's disease, essential tremor, and dystonia modulates brain activity to treat symptoms. He also uses neuromodulation such as spinal cord stimulation and intrathecal drug delivery to treat cancer pain and chronic pain. In addition, working with epilepsy specialists, Dr. Park performs procedures such as surgical placement of depth and grid electrodes in the brain to identify abnormal epileptic brain areas and offer treatments which include resection, response neural stimulator (NeuroPace) placement, laser ablation, and vagal nerve stimulation. If patients are unable to have surgery, Dr. Park is able to treat some of the conditions using Gamma Knife radiosurgery as well. Dr. Park received his dual Bachelor of Arts and Sciences in economics and electrical engineering from Cornell University and a Bachelor of Arts in biology from the University of Kansas. He holds an M.D. and Ph.D. from the School of Medicine and Graduate Studies, Department of Molecular and Integrative Physiology, at the University of Kansas. He completed his neurosurgery residency at the Rhode Island Hospital/Brown University. He was awarded the prestigious William P. Van Wagenen Fellowship from the American Association of Neurological Surgeons and completed his fellowship with Dr. Jean Régis at the Université de la Méditerranée Aix-Marseille II, Assistance Publique L'Hôpital d'Adulte de la Timone in Marseille, France, in 2010. He was an Assistant Professor and the Director of Functional Neurosurgery and Pain in the Department of Neurosurgery at University of Louisville until 2014. Resources: Integrating Dorsal Root Ganglion Stimulation with Transforaminal Lumbar Interbody Fusion: Proof of Concept Study SynerFuse University of Minnesota Sponsor The Cox 8 Table by Haven Medical
This Is Not About Running: Highlighting Abuse In Youth Sports When youth running prodigy Mary Cain was scouted by top universities in the eighth grade, she thought she was chasing her athletic dreams – but the reality of the elite sports pipeline would cost her far more than she ever imagined. This week she pulls back the curtain on the toxic culture of high-stakes youth athletics, detailing how top-tier programs often exploit young prodigies. Guest: Mary Cain, author, This Is Not About Running Before The World Forgot: A Look At The Women Who've Advanced Society Throughout history, the female trailblazers who have made monumental achievements in science, literature, and innovation have been systemically minimized or forgotten. Our guests this week discuss how societal biases erased women's intellectual contributions and why recognizing these female geniuses is essential to completing our understanding of human progress. Guests: Janice Kaplan, author, The Genius of Women Catherine Whitlock, author, Ten Women Who Changed Science and the World Facebook: ingoodhealthpodX: @ ingoodhealthpodIG: @ingoodhealthpodYouTube: @ingoodhealthpodSpotify Apple Podcast In Good Health PodcastSubscribed to the newsletterFull ArchiveContact UsBecome an Affiliate Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
Before The World Forgot: A Look At The Women Who've Advanced Society Throughout history, the female trailblazers who have made monumental achievements in science, literature, and innovation have been systemically minimized or forgotten. Our guests this week discuss how societal biases erased women's intellectual contributions and why recognizing these female geniuses is essential to completing our understanding of human progress. Guests: Janice Kaplan, author, The Genius of Women Catherine Whitlock, author, Ten Women Who Changed Science and the World Host: Greg Johnson Producer: Polly Hansen Facebook: ingoodhealthpodX: @ ingoodhealthpodIG: @ingoodhealthpodYouTube: @ingoodhealthpodSpotify Apple Podcast In Good Health PodcastSubscribed to the newsletterFull ArchiveContact UsBecome an Affiliate Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
Dr. Josh Turknett — neurologist and author of The Genius and the Impostor — introduces the show, the framework, and the two characters living inside your brain that determine whether you rise to the moment or fall apart. In this episode: What performance neurology is and how it differs from clinical neurology What's happening in your brain when you collapse under pressure Meet the Genius and the Impostor — two systems in your brain fighting for control What to expect from this podcast Links: Pre-order The Genius and the Impostor (August 2026): GeniusAndImpostor.com Learn more about Performance Neurology at performanceneurology.institute Subscribe to the newsletter: Brains, Banjos and Beyond on Substack Instagram: @brainjojosh
Dr. Dan Ackerman talks with Dr. Reza Bavarsad Shahripour about the diagnostic performance of 4 major modalities: TCD, TTE, TEE, and cardiac CT in patients with embolic stroke of undetermined source. Read the related article in Neurology® Clinical Practice. Disclosures can be found at Neurology.org.
Dr. Shuvro Roy and Dr. Amanda Piquet discuss a brief overview of stiff person syndrome, as well as the trial and the trial results. Read more about this abstract on the AAN website. Show transcript: Dr. Shuvro Roy: Hi, this is Shuvro Roy from the University of Washington and welcome to today's Neurology Minute. I just wrapped a longer conversation with Amanda Piquet from the University of Colorado Anschutz School of Medicine. We were just talking about the recent Phase 2 trial evaluating Miv-cel Kyverna Therapeutics' anti-CD19 CAR T-cell therapy in patients with Stiff Person Syndrome. Amanda, would you mind taking us through a brief overview of SPS as well as the trial and their trial results? Dr. Amanda Piquet: So Stiff Person Syndrome, or SPS, is a rare disabling autoimmune neurologic disease with a major unmet need. About 80% of patients ultimately lose their mobility and we currently have no FDA approved therapies. Existing treatments like IVIG, rituximab, and plasmapheresis are all used off label, often requiring chronic dosing and frequently failing to stop progression. KYSA-8 is a registrational Phase 2 study of 26 patients with refractory SPS. Patients experienced rapid, statistically significant and clinically meaningful improvement across all primary and secondary endpoints. Primary endpoint was the timed 25-foot walk. And this improved by a median of 46% at 16 weeks. Of patients requiring walking aids at baseline, about two thirds no longer needed them by week 16 to complete that 25-foot walk. Some patients who had struggled to walk were even able to run again after treatment. Another key finding was that all patients discontinued chronic immune therapies and remained off treatment as of the last follow-up. From a safety standpoint, miv-cel was generally well tolerated, with no high grade CRS or ICANS observed. In my opinion, these outcomes are unlike anything we've seen previously with Stiff Person Syndrome and may represent a paradigm shift, not only for SPS, but potentially for other antibody-mediated neurologic diseases more broadly. Dr. Shuvro Roy: Just curious, are there any upcoming implications for the application of this treatment for patients, you think, in the coming year or so? Dr. Amanda Piquet: Kyverna, the company who developed miv-cel, has initiated a rolling BLA with the FDA for potential approval and this would be, if approved, the first CAR-T therapy for SPS. So we're anxiously awaiting the outcome of that process. Dr. Shuvro Roy: Fantastic. Amanda, thank you so much for your time. And if you are intrigued and want to know more details behind the findings in the study as well as a conversation around CAR-T therapy for autoimmune neurologic disease as a whole, I encourage you to check out the Neurology Podcast feed for our full conversation there. Thanks for tuning in.
Dr. Shuvro Roy and Dr. Amanda Piquet discuss a brief overview of stiff person syndrome, as well as the trial and the trial results. Read more about this abstract on the AAN website. Show transcript: Dr. Shuvro Roy: Hi, this is Shuvro Roy from the University of Washington and welcome to today's Neurology Minute. I just wrapped a longer conversation with Amanda Piquet from the University of Colorado Anschutz School of Medicine. We were just talking about the recent Phase 2 trial evaluating Miv-cel Kyverna Therapeutics' anti-CD19 CAR T-cell therapy in patients with Stiff Person Syndrome. Amanda, would you mind taking us through a brief overview of SPS as well as the trial and their trial results? Dr. Amanda Piquet: So Stiff Person Syndrome, or SPS, is a rare disabling autoimmune neurologic disease with a major unmet need. About 80% of patients ultimately lose their mobility and we currently have no FDA approved therapies. Existing treatments like IVIG, rituximab, and plasmapheresis are all used off label, often requiring chronic dosing and frequently failing to stop progression. KYSA-8 is a registrational Phase 2 study of 26 patients with refractory SPS. Patients experienced rapid, statistically significant and clinically meaningful improvement across all primary and secondary endpoints. Primary endpoint was the timed 25-foot walk. And this improved by a median of 46% at 16 weeks. Of patients requiring walking aids at baseline, about two thirds no longer needed them by week 16 to complete that 25-foot walk. Some patients who had struggled to walk were even able to run again after treatment. Another key finding was that all patients discontinued chronic immune therapies and remained off treatment as of the last follow-up. From a safety standpoint, miv-cel was generally well tolerated, with no high grade CRS or ICANS observed. In my opinion, these outcomes are unlike anything we've seen previously with Stiff Person Syndrome and may represent a paradigm shift, not only for SPS, but potentially for other antibody-mediated neurologic diseases more broadly. Dr. Shuvro Roy: Just curious, are there any upcoming implications for the application of this treatment for patients, you think, in the coming year or so? Dr. Amanda Piquet: Kyverna, the company who developed miv-cel, has initiated a rolling BLA with the FDA for potential approval and this would be, if approved, the first CAR-T therapy for SPS. So we're anxiously awaiting the outcome of that process. Dr. Shuvro Roy: Fantastic. Amanda, thank you so much for your time. And if you are intrigued and want to know more details behind the findings in the study as well as a conversation around CAR-T therapy for autoimmune neurologic disease as a whole, I encourage you to check out the Neurology Podcast feed for our full conversation there. Thanks for tuning in.
In this episode of Talk Dizzy To Me, vestibular physical therapists Dr. Abbie Ross, PT, NCS and Dr. Danielle Tolman, PT sit down with neurologist Dr. Kristin Steenerson to unpack Persistent Postural Perceptual Dizziness, also known as 3PD or PPPD.If you feel dizzy, floaty, rocking, disoriented, or visually overwhelmed most days — especially in places like grocery stores, airports, busy restaurants, or while scrolling screens — this episode explains what may be happening in the brain and nervous system.Dr. Steenerson breaks down the diagnostic criteria for 3PD, why symptoms can continue even after the original vestibular problem improves, how 3PD overlaps with vestibular migraine, and why treatment often requires a combination of education, vestibular therapy, medication, cognitive strategies, lifestyle support, and gradual exposure.This conversation also addresses why 3PD is sometimes misunderstood, how hypervigilance plays a role, and why there is real hope for recovery and improved quality of life. Hosted by:
This episode of the Brain & Life Podcast was recorded live at the American Academy of Neurology's Annual Meeting. Co-hosts Dr. Daniel Correa and Dr. Katy Peters were joined by Jen Pollack from Alzheimer's Association, Rich Brennan from ALS Association, and Julienne Verdi from Alliance for Headache Disorders Advocacy to discuss how advocacy and sharing stories makes a difference. Tune in to hear these field experts share the positive effects of collaboration and advocacy! Additional Resources Become a Brain Health Advocate The Why Behind Your Weakness- ALS Association ASAP Act- Alzheimer's Association HEADACHE Act- Alliance for Headache Disorders Advocacy We want to hear from you! Have a question or want to hear a topic featured on the Brain & Life Podcast? · Record a voicemail at 612-928-6206 · Email us at BLpodcast@brainandlife.org Social Media Guests: ALS Association @als; Alzheimer's Association @alzassociation; Alliance for Headache Disorders Advocacy @allianceforheadacheadvocacy Hosts: Dr. Daniel Correa @neurodrcorrea; Dr. Katy Peters @KatyPetersMDPhD
What's the real difference between a night owl and a morning lark? The Editors' Choice paper for the June 2026 issue of Practical Neurology is a review of all the ways sleep intersects with neurological practice. Last author Prof. Guy Leschziner¹ joins PN podcast editor Dr. Amy Ross Russell to the wide variety of sleep-related disorders: insomnia, hypersomnolence, and sleep-related movement disorders. Each category contains pitfalls to be avoided when treating, like overlooking critical signs or reaching for drugs too eagerly. You'll also learn about "sleep reactivity", teenage sleep patterns in the animal kingdom, and diagnostic insight that can be gained from partners. Sleep neurology: pearls and pitfalls 1. Sleep Disorders Centre, Guy's and St Thomas' Hospitals NHS Trust, London, England, UK Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest episodes. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol. This episode was hosted by PN's podcast editor Dr. Amy Ross Russell. Production by Amy Ross Russell and Brian O'Toole. Editing by Brian O'Toole. Thank you for listening.
In this episode, we review the high-yield topic of Basal Ganglia from the Neurology section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In recognition of Alzheimer's & Brain Awareness Month, this episode of the Research Insights Podcast revisits "Dementia Neurology Deserts and Long-Term Care Insurance Claims Experience in the United States." The discussion explores how limited access to neurology specialists—often referred to as dementia neurology deserts—may correlate with long-term care insurance claims experience. Geography can influence the timing of diagnosis, access to treatment, and the progression of care needs, with meaningful implications for both health outcomes and financial security. As dementia affects individuals, families, and care systems alike, this episode offers important perspective on how gaps in specialty care intersect with long-term care planning. Listen now to revisit this timely and impactful conversation.
Krissy Dilger of SRNA welcomed University of Washington neuroimmunologist Dr. Shuvro Roy for an open Q&A on transverse myelitis (TM). Dr. Roy explained how TM can be both a presentation and a diagnosis, with “idiopathic TM” used when extensive testing finds no underlying cause and noted that recurrence should prompt reevaluation for conditions like NMOSD, MOGAD, or neurosarcoidosis and consideration of preventive immunotherapy [00:06:16]. He addressed audience questions about lifestyle and rehabilitation topics including diet, metabolic health, exercise, sleep issues, and safe considerations around CBD or THC-containing gummies, and reviewed approaches to chronic pain, spasticity, physical therapy timelines, and spinal cord stimulation (including ArcX) [00:13:20]. Dr. Roy also discussed the current status of peptides and stem cells, highlighted emerging cell-based therapies like CAR-T, and answered a case question about a high MOG antibody titer and its diagnostic implications [00:24:53].Shuvro Roy, MD is an Assistant Professor of Neurology at the University of Washington, specializing in neuroimmunology, with a specific focus on multiple sclerosis (MS) and related neuroimmunologic disorders. He is Co-Director of the UW SRNA Center of Excellence for Rare Neuroimmune disorders. He is also a core teaching faculty member for the UW Medicine Multiple Sclerosis Center's fellowship program, contributing to clinical education and research initiatives like the ECHO MS program in collaboration with the National MS Society. Dr. Roy is actively engaged in projects aimed at improving access to care, addressing healthcare disparities, and enhancing patient safety for individuals living with MS and related conditions. He has co-authored recent research articles in medical journals on a variety of topics, including studies on stiff person syndrome, encephalomyelitis, MOG-antibody disorder, and multiple sclerosis treatment protocols. Dr. Roy is dedicated to helping his patients thrive amid challenging, lifelong neurological conditions.00:00:00 Welcome and Introductions00:01:24 What Is Transverse Myelitis00:03:30 Common Causes and Mechanisms00:06:16 Diagnosis Versus Presentation00:10:39 Monophasic or Recurrent00:13:20 Diet Do's and Don'ts00:17:25 Aging and Long-Term Health00:24:53 Peptides and Stem Cells00:33:07 Fatigue Sleep and CBD or THC-containing gummies00:37:58 Chronic Pain Options00:43:55 Physical Therapy Recovery00:47:56 Spinal Cord Stimulation ArcX00:51:46 Stopping Pregabalin Safely00:52:59 Trials and Rehab at Any Age00:56:00 MOG Titer and Diagnosis01:00:02 Closing
Social determinants of health, including housing, food access, insurance status, and structural inequities, significantly influence stroke prevention, recovery, and long term outcomes. These factors affect biological risk, treatment adherence, and disparities in care, even when traditional clinical measures are addressed. This episode highlights practical strategies for integrating screening, leveraging multidisciplinary teams, and identifying opportunities for advocacy to improve patient outcomes. In this episode, Teshamae Monteith, MD, FAAN, speaks with Nneka L. Ifejika, MD, MPH, author of the article "Social Determinants of Health and Their Impacts on Stroke Prevention and Outcomes" in the Continuum® June 2026 Cerebrovascular Disease issue. Dr. Monteith is the associate editor of Continuum® Audio and an associate professor of clinical neurology at the University of Miami Miller School of Medicine in Miami, Florida. Dr. Ifejika is an adjunct professor of physical medicine and rehabilitation at UT Southwestern Medical Center in Dallas, Texas, and the chief scientific officer of the Division of Academics at Ochsner Health System in New Orleans, Louisiana. Additional Resources Read the article: Social Determinants of Health and Their Impacts on Stroke Prevention and Outcomes Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @headacheMD Full episode transcript available here Dr Monteith: Two patients have the same stroke, but when they return, they have very different outcomes. We can look into some of their comorbidities, but something we don't spend enough time talking about is the social determinants of health. Stay tuned to this discussion. I promise you, you'll become a better neurologist. Dr Jones: This is Dr. Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Monteith: This is Dr. Teshamae Monteith. Today I'm interviewing Dr. Nneka Ifejika about her article on social determinants of health and their impacts on stroke prevention and outcomes. This article appears in the June 2026 Continuum issue on cerebrovascular disease. How are you? Welcome to our podcast. Dr Ifejika: Thanks for having me. I'm doing great. Dr Monteith: Great. So, can you introduce yourself to our audience? Dr Ifejika: Sure. I'm Dr. Nneka Ifejika. I am the Chief Scientific Officer of Ochsner Health System in New Orleans, Louisiana. But I'm also a cerebrovascular rehabilitation doctor. I've been practicing for about nineteen years, and am happy and honored to be a contributor to this Continuum Neurology article. It's a really important topic. Dr Monteith: Great. So, what got you into this field, first of all? Dr Ifejika: Well, I was deciding between PM&R and neurology, and I was putting in both match lists. And I thought about it and I leaned toward PM&R, but stroke still had a grasp on my heart and my mind. And so, after I finished my residency, I joined the UT Houston stroke team, and I did a, thankfully did a two-year fellowship and became cross-trained in stroke as well as physical medicine rehab. So, I am a jack of both trades. Dr Monteith: So, you got your way in a way. Dr Ifejika: I did. Dr Monteith: You know, we have a lot of learners that are listening, so it's always, uh, nice for them to be inspired, I think, by people's career paths. So why don't we talk about the objectives of your article? Dr Ifejika: Sure. So, one of the most important things that we wanted to do was make sure that medical students, residents, faculty, and fellows understood the impact of social determinants of health on stroke recovery and stroke rehabilitation. It's not as simple as you have hypertension, hyperlipidemia, we're going to manage your stroke risk factors. Oh, you had an ischemic stroke. You presented in time for the window. We're going to give you endovascular therapy and then modified Rankin scale at hospital discharge in ninety days. No, no, no. The stroke survivor and their caregivers and their family have a lot more to deal with outside of what we look at during the acute stroke hospitalization and post-acute rehabilitation. Things like, can they afford the medication that we're prescribing? Antiplatelet agents or anticoagulation can be extremely expensive. Do they have housing insecurity? Is there food insecurity? What's going on behind the scenes that we are not addressing that can directly impact the admission rate and the readmission rate after we take care of a stroke survivor? Dr Monteith: I love the article because you took a real deep dive into social determinants of health, what they are, why they matter, and what we can do about them. And so why don't we talk a little bit about the NINDS framework for social determinants of health? I think many of us might not be familiar with the framework per se. Dr Ifejika: So, the framework consists of multiple domains specifically that relate to social determinants of health that were published in Neurology a couple of years ago. So, I do hope that people who are hearing this recording actually read them. There are interpersonal domains, there are classic medical domains, there are indeterminate domains, and there are six total domains. And health domains are the last domain. So, things like when it comes to housing insecurity, food insecurity, that's a domain of social determinants of health. When it comes to chronic racism, when it comes to biases that patients experience, those actually impact outcomes. So, there are six separate indices that we're going to get into in detail and how we address them as clinicians, whether it be at the medical student level, resident level, faculty level, to integrate the social determinants of health in our care plans, because we could be doing a much better job. And I think it'll be really important from the interpersonal perspective when we really relate to our patients and their families that we ask these questions. For example, if we're prescribing someone to have treatment for their diabetes mellitus and ha- and, and be taking insulin, if they have housing insecurity and they're in a homeless shelter, they have to leave the homeless shelter during the day. So, what happens to the insulin that we prescribe? These are variables that we are not considering on a regular basis, but they directly relate to compliance. Dr Monteith: Great. So that was one thing I wanted to bring up. We're very good at measuring blood pressure and trying to determine, uh, the association between stroke outcomes and things that we can measure, glucose, lipids, blood pressure. What is the evidence for social determinants of health and stroke outcome? Dr Ifejika: The evidence is growing, and there have been many publications that have come out that are, are going to be highlighted in this article related to structural determinants of health inequities, like structural racism, as well as disparities related to ethnicity and race. There's geographical disparities. For example, a lot of patients are, are primarily concerned about rural versus urban, whether you have access to different post-acute rehabilitation, whether you have access to secondary stroke prevention because you simply don't have the transportation from a, a rural area to get to a drugstore to get things available to you. Social status. There are actually publication related to socioeconomic status and the concerns when it comes to air pollution. So particulate matter 2.5, we know that that has a direct impact on stroke outcomes and health overall, but we don't really think about it as a structural determinant of health inequity. There's several multiple layers of research that have gone on specifically that have been cited in the literature that relate directly to social determinants of health and how we can address them moving forward. Dr Monteith: And what I found interesting in your article in that you gave at least a few examples where social factors like income, education were controlled for, and maybe in large part it is, but even when you control for some of these very obvious social risk factors, you still have inequities. Dr Ifejika: Absolutely. And I think it was really important to show that we had strong peer review evidence behind this, as it wasn't just something that we were creating or hypothesizing about. There have been studies that have been done over this over decades of time, showing the impacts of social determinants of health on outcomes. But the question and concern that we have is we know this growing body of literature continues to expand. What are we doing about it when it comes to education of the future generations of providers who will be caring for this population? Dr Monteith: Before we get into how, you know, what we're going to do about that, let's just kind of put that link, cause the evidence is there. How does it drive biology? Dr Ifejika: It's a great question. So, for example, particulate matter 2.5 in air pollution has been shown to have an existing impact on hypertension, raising your blood pressure. So that's a direct effect of a social determinant of health related to socioeconomic status because people who live in areas with higher air pollution are... They're not green spaces. They live near highways. Those are areas that unfortunately are also impacted by food deserts. Food deserts, if you're not able to get fresh fruits, vegetables, whole foods, increases your risk of developing diabetes, hyperlipidemia, also increases your sodium intake, again, increasing hypertension. These things are all connected to biological determinants. It's just that we're not asking about them necessarily within the social history when we're taking people into the hospital, but they have direct effects. Dr Monteith: Great. Neurologists tend to be busy and, you know, we're... have all of these things that we're being asked to do and chart and click and all of that stuff. And so how can we more readily integrate screening for social determinants of health and that conversation into the work we do? We recognize it's important. We recognize it's an important risk factor. There's a lot of these determinants. So, what is a good way to do so? And I, I know that in the paper you've, you've given different roles to different team players, so I want you to talk about that too, but just kind of even a regular routine office visit. Walk us through a way we can more easily integrate that kind of conversation. Dr Ifejika: It's an excellent question, and what I've recommended that we do in a standard office visit is utilize the time before the visit to send out screeners. So, for example, usually with an electronic medical record, you can send documents before the visit even starts, where people can check off whether they have any concerns regarding housing, food insecurity. They can check out their location of where they live, whether they live near a highway or not near a highway. It's specifically related to socioeconomic status. We can ask about insurance status, whether they have insurance, insured versus uninsured, but then also types of insurance, whether they have Medicaid insurance versus Medicare insurance. Then even drilling even further, type of Medicare insurance, Medicare Advantage versus traditional Medicare, cause all of those things actually play a role in this. Dr Ifejika: And evaluate these things and don't take time during your office visit. Send these screeners out beforehand. Have them be assimilated by your medical staff. Make sure you're utilizing every resource that you have at your disposal to help streamline things, so by the time the person comes in for the visit, you've primed the pump. You have this information already in your hands at your fingertips cause it was sent out in advance, and you have your medical staff already have an understanding of. If they didn't fill it out electronically, give it to them in the lobby. Make sure they have a handwritten copy in the lobby so that when they come into the office visit, you have the information at your fingertips. Dr Monteith: Are there any particular resources that you recommend for those types of screeners? Dr Ifejika: What I've used in the past, if you have patient-reported outcomes, so the PROMIS instruments, that's a good start. It doesn't get into the details of housing insecurity, food insecurity, but it's a good start to help prime questions and to start the conversation during your office visit. In my clinics, I do a PROMIS 27 on every patient, as well as a PHQ-9 for depression on everyone. And then I collect data longitudinally, and I can always drill down on factors that I noticed that could become a problem moving forward. Dr Monteith: Yeah. And then also in your article, you spoke a bit about this impact from the acute presentation in the hospital to rehab. Dr Ifejika: Yeah. Dr Monteith: So why don't you talk about these different entry points where we can really engage our patients and try and help reduce their burden? Dr Ifejika: Sure. So, healthcare can be quite fragmented, and the stroke patient, stroke survivor, and their family member have no grasp of that. They've had a stroke, and they may be going from the ER to the ICU to the stroke unit to the floor to the rehab unit, and we see it as multiple levels of care, multiple types of providers. They see it as one hospital. And the concern that we have is, at those branch points, things get dropped, and we have the opportunity to pick things up at those branch points. So, during the acute care hospitalization-Primarily, that's the establishment of what has happened, how we're gonna treat it, what are the variables that we can control for right now to address those determinants of health moving forward, and to specifically looking at whether they were taking medications before, whether they could afford medications before, what that looks like at hospital discharge. Is there any duplication of medications? If a person is taking Coreg and you prescribe metoprolol, but they still have the Coreg at home, should we have really prescribed the metoprolol? We're just spending money that they may have concerns when it comes to access to care and the cost of these prescriptions. So, it's the responsibility of the acute care physician to kind of look at that. Those are subtle things that we think are subtle, but they add up quickly for the family when it comes to having one group of medications that's the same class and having to buy another type. When it comes to post-acute rehabilitation, it's really an important time to screen for whether the caregiver can handle what's occurring. So specifically, if the caregiver is already burning out and the average length of stay for a stroke patient is five days and they've come to rehab for two weeks, what's gonna happen in the next two years or the next four years? So, during the post-acute rehabilitation phase, it's time to kind of look at that and drill down on those kind of questions. Also, the levels of care, Dr Ifejika: it's really important to look at other levels of rehabilitation, so skilled nursing facilities, making sure people have access to that if they need to, if the caregiver is burned out and they don't have the ability to go straight home. Because acute inpatient rehab, the goal of it afterwards, is to go straight home. It's not to go to another facility. So, you need to have that screener in place when it comes to whether the family can take care of this person, and whether the family can do it in an effective way to prevent them being readmitted. Dr Monteith: Great. I also like that you spoke about kind of the team approach and different roles, both for screening and for intervention, both being very important, especially the intervention. And so why don't you give us a few examples how the team could break up the responsibility and how also for the intervention component that can be done. Dr Ifejika: Sure. So, I broke up the team into several levels. So, the team medically is the medical student, resident, and faculty physician. However, the team also includes the support staff, so your case manager, your social worker, the therapist, physical therapy, occupational therapy, speech therapy, the pastoral services, all these members of the team. You know, sometimes as physicians, we don't read those notes. There's a lot of information in the notes from social work, care coordination, and the therapist. They get down to subtleties cause they're asking questions, for example, "What kind of equipment do you have at home? How many stairs do you have at home? What level of house do you have, one story, two story? If you live in an apartment, do you have an elevator access?" That's important for someone with hemiparesis. When it comes to medications, when it comes to insurance status, when it comes to your ability to have the mechanisms to pay for care as an outpatient, social workers are required to ask these questions cause they have to figure out resources for the patient and their family to help facilitate improved outcomes. So, they have to ask questions regarding these tasks. The concerns are, do we read what they're saying? So, it's really important to interact with them, and if it's not something that you're looking at in the chart, cause we're all so tied to our computers, find where they are in the hospital. Walk by their office and have a chat. Run your list with them, especially for people who you're concerned have vulnerabilities, and make sure that you're setting an example for your medical students with your faculty doing so. If you're looking at it from the medical student, resident, faculty perspective, medical students, listen. This is your opportunity to really contribute to the team as well as learn about social determinants of health and research in their fields. You are the boots on the ground for the medical team. You are the ones who should be priming the pump and asking these questions of the family members. We're sending you into the rooms to do a history and physical. Social determinants of health should be a part of your history and physical, and you should be taking what we're saying in this article and asking these questions and tying it into your resident. Now, the resident is the work person of the hospital. We all know this. Things run through the resident. Things run through the fellow. It's really important that they have this information in a manner that is negotiable. The list keeps getting longer, and a resident doesn't need to be overburdened. It needs to be synthesized in a manner that can help facilitate the resident being able to act as well as communicate any concerns to the faculty. And at the faculty level, we are the voices that can affect change. So, if there's any concerns when it comes to advocacy, research, making sure that people are accessing care in a way that makes sense, particularly when it comes to the ability for us to galvanize change on a national level, that's kind of our job. Dr Monteith: Great, and so let's talk about intervention. What are things that, let's say, the neurologist can do to deal with some of these social factors? Dr Ifejika: From the neurology perspective, I think it's really important to identify missed opportunities and making sure that we address them. For example, the conversations around the ability to have access to care related to insurance versus no insurance. There are many, many ways that neurologists are able to advocate for a person being able to get to Medicare insurance, particularly in the outpatient setting. When we see patients in clinic, it takes two years, them, to qualify for Medicare, two years at a minimum. But there's a gap there that can be filled by us making sure that we document what's happened, contact their providers, facilitate communication with their employers, if they're employees, they can get some short-term disability benefits to help bridge that gap prior to receiving Medicare insurance. It behooves us to do this because if we do not, they fall into the gap and they get readmitted and they're back on service anyway. So, what's important is the outpatient that we really kind of focus on things that we can impact and things like insurance and getting people transitioned from having employer-based insurance versus getting to Medicare is a really important way that we can effect change in a, in a way that's viable and, and replicable. So, in the outpatient setting, neurologists have a wonderful opportunity to effect change in social determinants of health. When it comes to employed persons, who had a stroke transitioning to Medicare, it takes two years to do so. So, in the outpatient clinic, if you have an employed person, make sure that you fill out their short-term disability benefits forms, their long-term disability benefits form. Bridge the gap. Get that information to their employer so they can maintain constant coverage. Because if they do not, if they have to choose between refilling medications and putting food on the table, they're going to choose putting food on the table, and that's going to directly impact their outcomes if they're not taking the medication that we recommend. Dr Monteith: I think that's a great point. I mean, there's a lot that we can do, and in some ways, it may not take that much to document and to be able to ask the questions and to include some of that information into the assessment and plan is really a, a great idea. Dr Ifejika: And you know, if we don't bring these things up and have these conversations, it doesn't get addressed. And that's why I'm very, very thankful that I had the opportunity to do so, cause this is a part of what I do all day. I think that if I wasn't integrating these kind of conversations into my practice, I wouldn't have the ability to share these tips and these abilities to move things forward in a manner that will be constructive for our field overall and for our patients. Dr Monteith: And towards the end of the article, you brought up something I think we don't see in many articles, and that's the role of advocacy and getting involved in health policy. So, can you talk a little bit about that? Dr Ifejika: You know, it's really important to facilitate change when you see that there are things that need to be changed. And the best way to do that is through advocacy at the local or state or federal level. A lot of these variables that we're dealing with can be addressed through legal changes. I'll give you an example. End-stage renal disease, if you have immediate hemodialysis and you have that requirement upon hospital discharge, you qualify for Medicare immediately. Immediately. Before you even leave the hospital. Why wouldn't something be similar for a stroke? Well, the reason why is because there was a level of advocacy that came around end-stage renal disease and a member of Congress's wife had hemodialysis requirements. And so, a law was passed to make sure Medicare covered it immediately after hospital discharge. So, it requires advocacy in some significant ways to get things done, but we have the bandwidth to do this. We take care of a population that has some of the highest rates of preventable disability. That's not going away. We need to make sure that we're effecting change for this group to make sure that they have the best possible outcomes they can experience. Dr Monteith: So, any final messages for our listeners? Dr Ifejika: I look forward to hearing everyone's feedback about our issue. I am thankful for the opportunity to talk about, address, and write about this important topic, and look forward to everyone's feedback. Dr Monteith: Well, thank you so much for being on our podcast. It was a really wonderful summary and we had a very thorough conversation, but you didn't give away too much, so I think they're going to have to read the article. Dr Ifejika: You're going to have to read the article. And we want medical students, residents, fellows, faculty, all of our ancillary staff within the hospitals, please read this article. We really appreciate it. Dr Monteith: Again today, I've been interviewing Dr. Nneka Ifejika about her article on social determinants of health and their impacts on stroke prevention and outcomes. This article appears in the June 2026 Continuum issue on cerebrovascular disease. Be sure to check out Continuum Audio episodes from this and other issues. And thank you to our listeners for joining today. Dr Monteith: This is Dr. Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.
Send us Fan MailWhat makes you you?Is it your memories? Your personality? Your sense of humor? Your motivation? What happens when a neurological disease changes one of those things?In this episode of Causes or Cures, Dr. Eeks talks with neurologist, neuroscientist, and author Dr. Masud Husain about his new book, Our Brains, Our Selves: What a Neurologist's Patients Taught Him About the Brain.Drawing on the stories of seven patients with different neurological conditions, Dr. Husain explores how changes in the brain can profoundly affect identity, behavior, memory, motivation, humor, and our relationships with others.We discuss pathological apathy after stroke, personality changes caused by frontotemporal dementia, memory and Alzheimer's disease, the neurological basis of humor, and how cultural and spiritual beliefs shape the way people understand illness. We also explore bigger questions about free will, responsibility, consciousness, and whether there may be aspects of human experience that lie beyond a purely biological explanation.Dr. Husain shares what decades of caring for patients with neurological disorders have taught him about the brain—and about what it means to be human.Dr. Masud Husain is Professor of Neurology and Cognitive Neuroscience at the University of Oxford and a Professorial Fellow at New College, Oxford. His work spans neurology, neuroscience, psychology, and brain imaging, with a focus on understanding how the brain supports cognition in both healthy individuals and people with neurological disorders. He is also Editor-in-Chief of Brain, one of the world's leading and most influential neurology journals. Our Brains, Our Selves is his first book.Work with me? Perhaps we are a good match. Keep Causes or Cures Ad-Free with Listener SupportYou can contact Dr. Eeks at bloomingwellness.com.Follow Eeks on Instagram here.Follow Public Health is WeirdOr Facebook here.On Youtube.Or TikTok.SUBSCRIBE to her Newsletter here! (the bits not posted on socia media)Support the showSupport the show
In this episode, we review the high-yield topic of Brainstem from the Neurology section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
Seeking Balance: Neuroplasticity, Brain Health and Wellbeing
Joey Remenyi talks with Shannon Presson about the unexpected stories that shape our lives and impact our symptoms. Our bodies hold stories—are we listening and tuning in to them? What changes when you build the skills to connect with your body and your internal stories? Learn more about Joey at https://www.seekingbalance.com.au Learn about Shannon here: https://theunexpectedstory.com
Dr. Aleksandra Pikula is quadruple board-certified in Medicine, Neurology, Vascular Neurology, and Lifestyle Medicine… with Neurology and Vascular Neurology Fellowship and postdoctoral training at Boston University, Harvard University, and the Framingham Heart Study.Dr. Pikula holds a status of an Associate Professor of Medicine, a Clinician-Investigator, and Co-Director of the Women's Neurology Fellowship Program at the University of Toronto.Since 2023, she had been appointed as the Inaugural Jay & Sari Sonshine Chair in Stroke Prevention and Cerebrovascular Brain Health at the University of Toronto, University Health Network, and Krembil Brain Institute… and serves as the founding director of the Jay and Sari Sonshine Centre at UHN.Her clinical and research focus is on stroke prevention and outcomes in younger adults, particularly emphasizing women's brain health during midlife. Dr. Pikula advocates for a holistic approach to brain care, targeting stroke and dementia prevention through evidence-based lifestyle medicine programs.Plant-Based Canada was also privileged to feature her as a speaker for our 2026 Conference, where she discussed plant-forward nutrition for the brain across the lifespan. That talk will be available to participants for three months.RESOURCES Through HER Prism Facebook Instagram Linkedin Framingham Heart Study Jay and Sari Sonshine Centre Women's Neurology Fellowship Program at the U of T Support the show
Dr. Shuvro Roy talks with Dr. Amanda L. Piquet about the efficacy and safety of miv-cel in patients with stiff person syndrome. Read more about this abstract on the AAN website. Disclosures can be found at Neurology.org.
This week, our coverage of the Consortium of MS Centers annual meeting continues with my guest, Dr. Stephen Krieger. In a wide-ranging conversation, Dr. Krieger offers a very encouraging clinical trial update, shares his thoughts on what treating someone living with advanced MS ought to look like, and points out potential obstacles to implementing the updated criteria for diagnosing MS. Dr. Krieger is a Professor of Neurology at the Icahn School of Medicine at Mount Sinai in New York, and a Multiple Sclerosis Specialist at the Corinne Coldsmith Dickinson Center for MS. We're also sharing results of a study that revealed some surprising connections between caffeine, alcohol, opioids, and MS symptoms. And if you're living with MS and you're the parent of a young child, we'll tell you about a book that belongs on your bookshelf. We have a lot to talk about! Are you ready for RealTalk MS??! This Week: We're at the CMSC annual meeting with Dr. Stephen Krieger :22 Study reveals the connection between caffeine, alcohol, and opioids and your MS symptoms 1:12 My Superhero with Wheels is the book you need if you're living with MS and have young children 5:15 Dr. Stephen Krieger discusses exciting clinical trial results, treating people with advanced MS, and potential challenges in implementing the updated criteria for diagnosing MS 8:39 Share this episode 30:22 Next week 30:41 SHARE THIS EPISODE OF REALTALK MS Just copy this link & paste it into your text or email: https://realtalkms.com/458 ADD YOUR VOICE TO THE CONVERSATION I've always thought about the RealTalk MS podcast as a conversation. And this is your opportunity to join the conversation by sharing your feedback, questions, and suggestions for topics that we can discuss in future podcast episodes. Please shoot me an email or call the RealTalk MS Listener Hotline and share your thoughts! Email: jon@realtalkms.com Phone: (310) 526-2283 And don't forget to join us in the RealTalk MS Facebook group! LINKS If your podcast app doesn't allow you to click on these links, you'll find them in the show notes at www.RealTalkMS.com STUDY: Daily Temporal Associations Between Psychoactive Substances and Fatigue, Pain, Stress, and Depressive Symptoms in People with Multiple Sclerosis https://archives-pmr.org/article/S0003-9993(26)00035-3/fulltext BOOK: My Superhero with Wheels https://amazon.com/My-Superhero-wheels-True-Story/dp/B0GWVGSWX5/ref=sr_1_1 JOIN: The RealTalk MS Facebook Group https://facebook.com/groups/realtalkms REVIEW: Give RealTalk MS a rating and review http://www.realtalkms.com/review Follow RealTalk MS on X, @RealTalkMS_jon, and subscribe to our newsletter at our website, RealTalkMS.com. RealTalk MS Episode 458 Guest: Dr. Stephen Krieger Privacy Policy
In this episode, we review the high-yield topic of Syringomyelia from the Neurology section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
Deep brain stimulation (DBS) was developed as a targeted, adjustable therapy for movement disorders to improve earlier hard-to-control procedures. Victor Sung, M.D., discusses how UAB began performing DBS in 1997 and built one of the nation's highest-volume programs, now performing six surgeries a week. Learn how advances such as directional stimulation, brain-sensing devices, and remote programming are shaping care, and how DBS plays an important role in the future of UAB's Movement Disorders Division.
A simple test with 12 questions may help predict your risk of dementia, stroke, or depression says Dr Jonathan Rosand. He's the founder and director of the Brain Care Labs at Mass General Brigham and Harvard, and professor of Neurology at Harvard Medical School. He's developed the Brain Care Score that measures factors such as sleep, exercise, stress, blood pressure, and social connection. The goal is to show how small changes to everyday habits may help protect brain health and reduce the risk of disease. Now, through the Global Brain Care Consortium, that work is expanding worldwide, inviting people to track their brain health and contribute to long-term research. To learn your Brain Care Score go HERE or visit the Global Brain Care Coalition website to learn more about its work and how to get involved HERE
In this episode, we review the high-yield topic of Wernicke Korsakoff Syndrome from the Neurology section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic of Glaucoma from the Neurology section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In part two of this series, Dr. Andy Southerland and Dr. Dan Ackerman discuss a few rapid‑fire concepts from the 2026 guidelines, focusing on what is new and how emerging data may shape patient care. Show transcript: Dr. Andy Southerland: Hello, everyone. This is Andy Southerland from the University of Virginia. And for today's Neurology Minute, I'm speaking with my friend and colleague, Dan Ackerman, Chief of Neurology and Director of Stroke at St. Luke's University Health System. We've been speaking in the main neurology podcast on tips for updated clinical practice related to the 2026 American Heart Association guidelines for the early management of patients with acute ischemic stroke. I'm going to hit Dan with a few rapid fire concepts that were touched on the guidelines that I think are new or provide some new insights, new based on the data and to how we treat patients. So Dan, you ready for it? Rapid fire, acute stroke treatment decision making? Dr. Dan Ackerman: Absolutely. Hit me. Dr. Andy Southerland: All right, Dan. I'm a resident going to my first stroke alert on July one this year and I've got a patient coming in, they're having disabling stroke symptoms and they're, in every other way, eligible to receive thrombolysis, but they have a history of paroxysmal atrial fibrillation. They are on apixaban and they took a dose of that apixaban. They forgot to take one yesterday, but they took one the day before, had the evening before. And so 36 hours ago, they took a dose of their apixaban. So based on previous dogma, I think prior guidelines might've said if it's within that 48 hour window, that's a relative contraindication of thrombolysis. What, say, you based on the new guidelines and then how do they inform us about making that decision? Dr. Dan Ackerman: I would actually say the new guidelines are a little bit more aligned with what you just said. You mentioned it as a relative contraindication to thrombolysis. I think before these guidelines came out, a lot of people would've said, "No, that is a strict contraindication to thrombolysis." And a lot of folks would run a stroke code or a stroke lid a little slower knowing that, hey, this person is on, whether it's apixaban, rivaroxaban, edoxaban, dabigatran, et cetera, any of these direct oral anticoagulants and say, "Well, no, we know that person's not a candidate for thrombolytics." Well, no, the newer guidelines would suggest that that is a relative contraindication, not a strict contraindication. And when we look back at studies on this, it has not been suggested that there is a big contribution in terms of exactly how long ago that last dose was. Was it two hours ago, 12 hours ago, 20 hours ago? And there has not been shown to be a clear benefit of testing for factor Xa activity levels, bleeding time and the like. So the guidelines do suggest that, hey, we need more data on this. It's not to, say, that this is 100% perfectly fine. Remember, that's a relative contraindication, so it's still a risk benefit discussion, but studies have not shown an increased risk for hemorrhagic complications in patients who have had recent DOAC exposure who receive IV thrombolysis otherwise according to the guidelines. So I would tend to offer it in that situation and make sure that we document what drugs someone's on, how long ago was their last dose, all of this kind of information in addition to what we might normally otherwise get down. Dr. Andy Southerland: Does that change, Dan, if they took the DOAC in the last 24 hours or even 12 hours? They took it last night, and they're presenting in the morning with their stroke-like symptoms? Dr. Dan Ackerman: The guideline just suggests less than 48 hours, and the data, to my knowledge, doesn't really delineate, at this point, any particular timeframe where we would say, no, there's a cutoff there at two hours or eight hours or 12 hours. So at this point, I would not use that as a way to decide not to offer thrombolysis based on that timeframe. Dr. Andy Southerland: Fair enough. I think that's very reasonable. And I think, again, it's always a good conversation to have either with your attending, if you're that resident on July 1, but particularly with the patient and their family on the risk-benefit of what we know based on the data. Well, that's all the time we have for this Neurology Minute. We hope this discussion will continue to help everyone out there in the hyperacute management of patients with acute ischemic stroke, making those difficult treatment decisions. Good luck.
In this episode, we review the high-yield topic of Neural Tube Defects from the Neurology section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
Amy talks with Dr. Joe Galati about whether Ozempic is altering the brain.See omnystudio.com/listener for privacy information.
In part two of this series, Dr. Andy Southerland talks with Dr. Dan Ackerman about a few rapid‑fire concepts from the 2026 guidelines, focusing on what is new and how emerging data may shape patient care. Disclosures can be found at Neurology.org.
In part one of this series, Dr. Andy Southerland and Dr. Dan Ackerman discuss what stands out in the latest thrombolysis guidelines, how these decisions are applied in stroke center practice, and how to educate residents and fellows on incorporating new evidence into treatment choices. Show transcript: Dr. Andy Southerland: Hi. This is Andy Southerland from the University of Virginia, and for today's Neurology Minute, I'm speaking with my friend and colleague, Dan Ackerman, Chief of Neurology and Director of Stroke at St. Luke's University Health System. I've been speaking with Dan on the main neurology podcast regarding updates to acute stroke treatment related to the 2026 American Heart Association guidelines that came out in late January of this year on the early management of patients with acute ischemic stroke. For our episode today, we might focus our discussion around thrombolytic therapy thrombolysis, which is at the core of what we do as acute stroke neurologists when it comes to treatment decision-making. So maybe as a first prompt, Dan, when you look at these guidelines, what stands out to you as you're thinking about how you practice, how you all are practicing at your stroke center, and then specifically how we educate our residents, our fellows on what they need to know, particularly the newness of it when it comes to making thrombolysis treatment decisions? Dr. Dan Ackerman: With all the discussions we've had in the past, there have been a lot of specifics about certain studies and how they might affect practice, but this guideline really opened up a lot and gave us an opportunity to do things in a way that makes really good clinical sense and really brings a lot of practices that have now become common at some centers into the fore so that we can get that information out to everyone and make sure everyone has that same really high level of stroke care everywhere they go. I think the first thing that stands out to me is what did not change. And want to reinforce that, particularly for people who are just getting into this, stroke alert is a screening tool, not a severity score. It's not like an MI alert where you do an EKG and you see the tombstone wave and you say, "Oh, there's an MI and we're taking them to treatment." This is a screening tool, so it is meant to be highly sensitive at the cost of being specific. At our shop for a long time now, we have initiated stroke alert for anyone who presents either within 24 hours of acute onset of neurologic symptoms or has an unknown onset of acute neurologic symptoms and they are still symptomatic to some degree at the time of their presentation, and that's it. We don't make any other statements about how severe something is or what kinds of symptoms someone necessarily has to have. We purposely keep it as broad as possible, again, because we're trying to screen. And the other thing that has not changed, time is still brain. So with all of these different nuances on how we can treat patients and who might be candidates for intervention, it is still a matter of understanding these guidelines, applying our best evidence, but doing it as quickly as possible to make sure that we are rescuing as much of that ischemic penumbra as we possibly can. Now, aside from that, in terms of what stands out that is different, I think one of the early things for me are the recommendations for extended time window for IV thrombolysis. So when you look at the original studies, we understand that when you get out beyond four and a half hours, if you just take all-comers, the risk is going to start to outweigh the benefit. But that doesn't mean there's zero benefit or that no one would receive benefit, but it's a question of, well, how do we cherry-pick those patients who may still receive benefit? And there are a few real specifics in the guideline that help us figure that out. One is for patients who have an unknown time of onset, but they're within four and a half hours of symptom discovery. And for those patients, they would suggest that doing a stat MRI and comparing a DWI lesion with the corresponding area flare to determine if you see DWI hyper-intensity and the flare image is nice and normal, that would suggest that stroke is young enough that it may still be appropriate to treat that patient. But we would also say for folks who have salvageable ischemic penumbra, so again, brain at risk that is not core yet, who either awoke with stroke symptoms within nine hours from the midpoint of sleep or, and this is the kicker, are within four and a half to nine hours from last known well. So in other words, they may have been symptomatic already for more than four and a half hours. If those patients have an appropriate ischemic penumbra, it may be reasonable to treat them with IV thrombolysis to improve functional outcomes. Dr. Andy Southerland: Well, that's all for this Neurology Minute. We hope this vibrant conversation will help all those who are out looking to make the best treatment decisions for their patients, both based on established evidence and most recent evidence in our new guidelines.
In this episode, we review the high-yield topic of Intravenous Anesthetics from the Neurology section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this episode of the Brain & Life Podcast, co-host Dr. Katy Peters is joined by novelist and disability advocate Sabina Nordqvist. Sabina discusses her personal 12-year battle with idiopathic intracranial hypertension (IIH), POTS, and Ehlers-Danlos syndrome. She shares the profound impact of misdiagnosis, the importance of self-advocacy, and how her experiences in support groups led her to write a novel called It's All in Your Head that puts disabled characters front and center. Dr. Peters is then joined by Dr. Jeremy Cutsforth-Gregory, an Assistant Professor of Neurology at Mayo Clinic in Rochester, Minnesota, working in the Division of Neurologic Education. Dr. Cutsforth-Gregory explains cerebrospinal fluid and IIH, highlighting the treatments that are available and where research is going next. Additional Resources Sabina Nordqvist- It's All in Your Head Understanding the Mysteries of POTS and Other Autonomic Disorders A Swimmer Returns to the Pool After Ehlers-Danlos Syndrome Diagnosis Brain & Life Podcast Episodes on Similar Topics Parenting and Writing While Disabled with Jessica Slice Outdoors Woman Crystal Gail Welcome on Nature and Chronic Pain Author Samantha Lee Schmall on Life Beyond the Shunt We want to hear from you! Have a question or want to hear a topic featured on the Brain & Life Podcast? · Record a voicemail at 612-928-6206 · Email us at BLpodcast@brainandlife.org Social Media Guests: Sabina Nordqvist @nordqvistbooks; Dr. Cutsforth-Gregory @mayoclinic Hosts: Dr. Daniel Correa @neurodrcorrea; Dr. Katy Peters @KatyPetersMDPhD
In this episode, editor in chief Joseph E. Safdieh, MD, FAAN, highlights articles about a link between higher meat and slower cognitive decline in APOE34/44 carriers, the geographic distribution of research funding, and how artificial intelligence is reshaping neurology.
In this episode, Lyell K. Jones Jr, MD, FAAN, speaks with Cheryl Bushnell, MD, MHS, who served as the guest editor of the June 2026 Cerebrovascular Disease issue. They provide a preview of the issue, which publishes on June 3, 2026. Dr. Jones is the editor-in-chief of Continuum: Lifelong Learning in Neurology® and is a professor of neurology at Mayo Clinic in Rochester, Minnesota. Dr. Bushnell is a Professor of Neurology and Director of the Center for Transformative Stroke Care at Wake Forest University School of Medicine in Winston-Salem, North Carolina. Additional Resources Read the issue: continuum.aan.com Subscribe to Continuum®: shop.lww.com/Continuum Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @LyellJ Guest: @CBushnellMD Full episode transcript available here Dr Jones: One of the core tenets of our field is that we learn neurology one stroke at a time. But what do we have to learn about preventing them altogether? The science of stroke prevention, acute treatment, and recovery are evolving rapidly, and it's hard to keep up. Today, we're speaking with Dr. Cheryl Bushnell, guest editor of our latest Continuum issue on Cerebrovascular Disease, to discuss these topics and much more. Dr Jones: This is Dr. Lyell Jones, editor-in-chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about subscribing to the journal, listening to verbatim recordings of the articles, and exclusive access to interviews not featured on the podcast. Dr Jones: This is Dr. Lyell Jones, editor-in-chief of Continuum: Lifelong Learning in Neurology. Today, I'm interviewing Dr. Cheryl Bushnell, who is Continuum's guest editor for our latest issue on Cerebrovascular Disease. Dr. Bushnell is a professor of neurology and the director of the Center for Transformative Stroke Care at the Wake Forest University School of Medicine in Winston-Salem, North Carolina, where she specializes in the care of stroke patients and their social and functional determinants of recovery and health, and is an internationally recognized expert on those topics. Dr. Bushnell, welcome. Thank you for joining us today. Why don't you introduce yourself to our listeners? Dr Bushnell: Absolutely. Thank you for the invitation. It's really an honor to be here. So, as you mentioned, I am the director of the Center for Transformative Stroke Care at Wake Forest. It's a really fun transition for me to be involved with different care models for stroke, and I think a lot of the Continuum topics are directly relevant to some of the things that I'm doing now as an administrator and sort of a facilitator of new research. So, thanks again for having me. Dr Jones: Yeah, and, and you have a wonderful perspective, and we're gonna pull that out today in our interview questions, and I'm looking forward to sharing that with our listeners. But before we get to the questions, we're gonna start off today's podcast with another Continuum Audio trivia question for our listeners. Anticoagulation has played a critical role in secondary ischemic stroke prevention for a long time now. While direct oral anticoagulants have taken on a greater role in the treatment of prevention of stroke, there are still some use cases for vitamin K antagonists like warfarin. The trivia question for our listeners is this: How was warfarin discovered, and how did it get its name? Stick around and we'll share the answer to that question toward the end of our interview today. So, Dr. Bushnell, let's get right to it. You alluded to your various roles, and your leadership in the field has been exemplary. The interventions for acute ischemic stroke have really exploded over the last decade or so, and they get a lot of attention and discussion, but prevention and recovery are just as important in the care of these patients. Tell us a little more about how you approached this issue, about the article topics you chose, etc. Dr Bushnell: Well, once I was chosen to lead the guest editorship, I wanted to come up with a group of topics that were maybe a little bit different from previous issues. So, I kind of looked at the previous issues and saw, as you said, an emphasis on acute stroke, and that's really important because it has been evolving. But my thought was, how about what happens to patients after they get the intervention and they're discharged home? And because a lot of trainees may not get to see these patients ever again, or it's months before they might see them, or if they're readmitted, which is what we don't want to see, but that certainly is a lot of the exposure is in the inpatient setting. So, I thought I would kind of transport the education into the outpatient and transitional setting, as well as prevention, not only secondary, but primary prevention, with an emphasis on brain health. Some of the populations that may not get as much attention. So, sex differences, stroke in women, pregnancy, the transitions of care, and also the emphasis on holistic view of patients and their challenges, which includes the non-medical factors that drive health, otherwise known as social determinants of health. Dr Jones: I appreciate that perspective, and obviously th-this is an area of your deep expertise, and it's great to have an issue that really digs into some of those topics a little more deeply. As an educator, I'm really glad you mentioned that about the trainee's perspective. You know, especially junior neurology trainees that are in the hospital all the time. They're seeing patients in the middle of a cerebrovascular catastrophe. But there's a long tail of recovery, right? And they'll get to see that in continuity clinic, but it's a good message to share from an evidence and, um, experiential perspective in the issue. So, appreciate that perspective. You've just read all these articles and edited them. Was there anything that you ran across that was a surprise to you? Dr Bushnell: Well, I personally chose a lot of the authors based on my knowledge of their work. So, I wouldn't say that it was completely surprising, but I do think that I was just genuinely impressed with the quality of the writing and the synthesis of information. I just was incredibly proud of the work that these co-authors have put together. I'd say that that was-- it wasn't surprising so much as just a sense of pride that I had with the product that's coming out. But of course, there have been some new trials that had to be incorporated at the last minute, some of which were presented at the International Stroke Conference just a few weeks ago. Dr Jones: Yeah. We try to be as up-to-date as we can, and I will completely agree with you. We have some really good writers in our field, and it's really just a pleasure when you read an article that's by an expert, and it's a joy to read. I can tell you it's one of the best parts of this job, and you get to learn a lot. I think one of the more challenging scenarios that I hear about from colleagues in recent years has been optimal management of patients with asymptomatic extracranial atherosclerosis. The pivotal trials that inform how we manage those patients were from a long time ago, decades ago, predating a lot of the more intensive medical management tools that we have today. In that scenario, Dr. Bushnell, what's the latest on that, and what should our listeners know? Dr Bushnell: Well, obviously, the CREST 2 trial has been long awaited. It's been going on for over ten years, I believe. Of course, it's, uh, two different trials all in one, the carotid stenting and angioplasty versus intensive medical management. And of course, each of the carotid vascularization arms of the trial also had intensive medical management. And then the other trial is the carotid endarterectomy as the form of revascularization. And it interestingly did not show any benefit of carotid endarterectomy compared to intensive medical management. But of course, the somewhat surprising result was that carotid angioplasty and stenting truly was superior, although it was a small number of events in the trial overall. But that stenting plus intensive medical management was somewhat better than intensive medical management alone. And I think stenting has come a long way in terms of safety, and so I think that's been part of the evolution of the field. I do wanna say that I'm a huge fan of the intensive medical management, and I think that what the protocol does in terms of blood pressure management, cholesterol management is very much above and beyond what's done in private practice even. And the health coaching for all the other things related to diabetes and weight loss and smoking cessation and physical activity, that is what we need to be doing to actually decrease the risk of stroke, and I think that it's very effective. I can't say enough about the design of the study for that reason, that everyone gets the intensive medical management, and then you just layer on the type of revascularization on top of it. So, I wouldn't have been surprised if this was a completely negative trial overall. They just happened to have some better outcomes in the stenting arm. Dr Jones: I recall a few years ago when the series of endovascular therapy trials for acute stroke came out, and I think there was a, a period of time where the field had to adapt to that. I wonder what you think about with the CREST 2 findings on stenting. I mean, is that gonna be a big change? Because obviously atherosclerosis is highly prevalent. Is that gonna be a big change? Is the field ready for that? How much adjustment do we have in store? Dr Bushnell: I'm not sure it's gonna be a really big change. If you read the editorial that accompanied the trial in the New England Journal, just a few patients in either direction would have changed the outcome. I kind of look at it as an absolute difference that's relatively small. So, I'm not sure that it will have a huge impact on the field. I do think that the specialists who insert the stents may have some differences of opinion of who should be stented and who shouldn't. Because I think, you know, all of the specialists who do procedures were involved with the trial. But I would say there's a larger percentage of vascular surgeons who were involved, and so I'd say they may have a change of their practice. And neurologists may not even get involved at all. Dr Jones: Right. Dr Bushnell: That was one of the challenges for getting patients in the trial is that, you know, not all of us see the asymptomatic carotid stenosis, that they tend to get referred to vascular surgery. So, I think maybe in a corner of the practices of vascular surgeons is where you might see the differences. Dr Jones: Your point about the way the trial was designed or the trials were designed, that intensive medical management is really important, and we have huge gaps in that. In our specialty, it's, you know, we have probably an opportunity in primary care even to address that. And that leads me to my next question. You know, given your perspective and your expertise, what do you think is the biggest practice gap in the care of patients with stroke or with cerebrovascular disease of any kind? Dr Bushnell: I think by far the biggest gap is transitions of care and access to follow-up in a specialty clinic after discharge and continuous secondary prevention. We only call it secondary prevention because it happened to come after a stroke, but I really feel like we should just focus on prevention and call it that. There are a lot of people who are trying to kind of, get us away from primary versus secondary prevention. And, and Mitch Elkind is phenomenal and had a beautiful chapter weaving in prevention and brain health. So, I highly recommend that people, if they don't read any other chapters of the Continuum to read his, because I think that it's getting to your point about where the gaps are, and I think prevention is the biggest one. I think we could do so much more in models of care to ensure that there is a pathway once patients are discharged. We have no quality metrics. We have no measurement of how well people are doing after they're discharged. We have all of these fancy things and sophisticated acute treatments, but all of those are for naught if somebody goes home and they fall and they have a severe head injury or hip fracture because they weren't properly supervised or they didn't have the help that they needed at home. So, you got me on my soapbox here for a second, but that is definitely what I see as the gap. Dr Jones: That's an important soapbox, an important gap, and obviously, if it was a simple problem, we could solve it. But it's obviously something that education is a valuable tool for that, and that's part of why we are including so much content in this issue of Continuum. So, if we put that aside as a gap that we would love to close, when you look into the near future or distant future, Dr. Bushnell, and what's the next big thing on the horizon? New interventions, new prevention tools, or something else entirely? What do you think? Dr Bushnell: There are two things that I would mention. One is sort of the new category of anticoagulants, antithrombotics, the factor XIa inhibitors. We had an amazing presentation of the oceanic stroke trial at the International Stroke Conference, and this is probably going to be a game changer for the arsenal of antithrombotic therapies that we can offer to patients that do not have a reason for anticoagulation. So, they, they don't have atrial fibrillation, for example, or something else that requires anticoagulation. And so, the factor XI, asundexian, is the drug that they used in that trial. The safety profile is pretty amazing. There was very little bleeding complications and a great benefit in those patients with some degree of atherosclerosis, but, you know, of course, not enough to require carotid revascularization, but then also, um, small vessel disease and cryptogenic stroke. I think those are the three categories of patients, and that's a lot of the strokes that we see all benefited from this new drug. So, I think that's gonna be exciting. There, of course, it has to go through the FDA approval process, and so it might take a little bit of time before that's on the market, and we don't know how much it's gonna cost, but I think it is a, a major breakthrough. And of course, there are other similar medications in that category that are coming. And then I think the other thing is the emphasis on brain health and lifestyle factors and the things that we can do to prevent stroke and dementia because they are the same, essentially. Those are really important. And when we have someone in the hospital with a stroke or a TIA in particular, it's a great teaching opportunity for those patients to say, "Hey, here's what you can do to protect your brain." These are things that we always tell people to prevent a stroke, but just think about it as protecting your brain and keeping your brain as healthy as possible. Dr Jones: That's a great message, and one that you get to share with patients directly. You're joining us today for this interview. You're on stroke service, so you're actively involved in caring for patients with stroke. What in your practice is the most rewarding aspect of caring for these patients? What is it that you find most rewarding? Dr Bushnell: I've been involved in a clinical trial that has focused on managing blood pressure and also coaching and other aspects of stroke recovery. I think that has probably been the most rewarding aspect of my career. Until I was involved with this trial, I didn't necessarily do intensive blood pressure monitoring, but I'm seeing the benefits of having data from home, what those blood pressures are over a span of time. I see the immediate or intermediate effects of the blood pressure medication changes that I've made, and I see how the patients respond. So, I have to say that this is not part of usual practice, but I think it should be. And I think it's been incredible from the perspective of a neurologist who is really intensively trying to make the patients' lives better. And it's not just what I do, it's what the health coaches do as part of this intervention. And again, very similar to intensive medical management. So, I, I feel like I've been living it in a slightly different setting than in the CREST 2 trials. But there are other trials that have used the intensive medical management as approach as well. But I would say that's the most rewarding. I've seen people who've lost weight, who are physically fit, who are able to get off of blood pressure medications practically by the end of six months, and that's amazing. And then they continue doing it because they see the benefits. Dr Jones: You've had a front row seat to a lot of that. That's really got to feel rewarding. Dr Bushnell: It is, absolutely. Dr Jones: You know, when you put it that way, it makes me want to go home and check my blood pressure, which I haven't done in a while. But I think that's a message to all of our listeners that we do have plenty of opportunity for risk factor optimization and following the evidence that has been generated and is being generated. Huge opportunity, not only at the population level, but I think the, um, individual patient level too. Okay, so now we're back to our Continuum Audio trivia question, and I'll repeat it for our listeners. How was warfarin discovered, and how did it get its name? Dr. Bushnell and I were talking about this earlier, so I'll just go ahead and share the answer. So, in the early 20th century in the U.S. Midwest, there were epidemics of a hemorrhagic disease in cattle, of all places, and this was eventually traced to moldy cattle feed that was made from sweet clover. And in 1940, researchers at the University of Wisconsin discovered that the anticoagulant in the sweet clover was a compound that was later synthesized for therapeutic use in 1954 as warfarin. And the name came from, uh, the support for the research. The research support came from the Wisconsin Alumni Research Foundation, or WARF, and the end of the word came from the underlying compound, which was coumarin. So that was a little bit of trivia that I had never heard. It's not in the issue, everyone, so you're getting something extra here on the podcast. But been using the drug forever. It still has its uses, even though it's become less advantageous than some of the newer agents. But-- And of course, Dr. Bushnell already knew that when I brought it up, but I just thought that was an interesting bit of history. Well, Dr. Bushnell, thank you for joining us. Thank you for such a great conversation about the latest in cerebrovascular disease. I learned a lot today. I learned a lot in reading these wonderful articles. I hope our listeners learned a lot today as well. I'm really grateful for your hard work on the issue, which I think will come in handy for junior readers and subscribers, as well as our more experienced neurologists as well. Sometimes it's hard to keep up with a rapidly changing subspecialty of our field. So, thank you for joining us today. Dr Bushnell: Thank you for having me. It's been my pleasure. Dr Jones: Again, today we've been speaking with Dr. Cheryl Bushnell, guest editor of Continuum's most recent issue on cerebrovascular disease. Please check it out, and thank you to our listeners for joining today. Dr Monteith: This is Dr. Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. Thank you for listening to Continuum Audio.
Portable Neuromodulation Stimulator (PoNS) is a type of electrical stimulation that can theoretically increase rewiring in the brain (neuroplasticity). Small trials suggest that it can improve walking in MS but thus far there are no data in people living with ALS. Here we further discuss the mechanism, studies in other conditions, and potential risks.
Leading health experts have declared 2026 the Year of the Brain, and for good reason. Scientists are making exciting breakthroughs in understanding the body's command center, from prevention to diagnosis and treatment of neurological disorders. The brain enables us to think, see, learn, move, feel emotions and connect with our fellow humans, so keeping it healthy is essential at every stage of life. For a refresher on all that the brain does for us—and how to keep it performing at its best—we're joined by Dr. Anna Hohler, Director of Neurology for Northwell Health's Westchester Region. Dr. Hohler shares insights on brain development and milestones, and explains how exercise, good nutrition, adequate sleep and stress relief work together to support a healthy brain. She also shares simple strategies—some that may surprise you—that you can use to keep your brain healthy and strong for years to come. The Takeaway We want to hear from you! Please complete our survey: 1199SEIUBenefits.org/member-feedback. Drop us a line at our social media channels: Facebook// Instagram // YouTube. Get started on your health journey by making an appointment with your primary care physician to know your numbers: 1199SEIUBenefits.org/healthyrelationships Get to know your numbers at 1199SEIUBenefits.org/healthyhearts. Relieve stress with mindfulness classes at 1199SEIUBenefits.org/healthyminds. Find healthy recipes and meal-prep tips at 1199SEIUBenefits.org/food-as-medicine. Visit the Healthy Living Resource Center for wellness tips, information and resources: 1199SEIUBenefits.org/healthyliving. Get inspired by fellow members through our Members' Voices series: 1199SEIUBenefits.org/healthyliving/membervoices. Stop by our Benefits Channel to join webinars on building healthy meals, managing stress and more: 1199SEIUBenefits.org/videos. Visit our YouTube channel to view a wide collection of healthy living videos: youtube.com/@1199SEIUBenefitFunds/playlists. Sample our wellness classes to exercise body and mind: 1199SEIUBenefits.org/wellnessevents. Guest Bio Anna DePold Hohler, MD, FAAN, is a distinguished neurologist, researcher and educator who recently joined Northwell Health to lead and enhance neurology services for its Westchester Region, as well as launch a new virtual neurology program across the 28-hospital system. An internationally recognized expert in movement disorders, she is deeply involved in research furthering novel therapies to treat Parkinson's disease. Dr. Hohler began her career in the U.S. Army, serving for eight years and achieving the rank of major.
Double board-certified Diplomate of the American Board of Psychiatry and Neurology and UCSF fellowship-trained Child, Alodescene, and Adult Psychiatrist, Dr.... The post Parent Child Relational Balance with Dr. Debbie Raphael MD appeared first on WebTalkRadio.net.
In part one of this series, Dr. Andy Southerland talks with Dr. Dan Ackerman about the latest guidelines for managing acute ischemic stroke, emphasizing thrombolytic therapy, imaging techniques, and decision-making regarding treatment in extended time windows. Disclosures can be found at Neurology.org.
The June 2026 Recall highlights four previously posted episodes on parkinsonian disorders. The episode begins with Dr. Valtteri Kaasinen discussing the clinical challenges of diagnosing Parkinson disease and how that diagnosis can evolve over time. The discussion continues with Dr. YuHong Fu, who addresses the importance of differentiating between dementia with Lewy bodies and Parkinson disease dementia. The third episode features Dr. Daniel Weintraub discussing clinical considerations and strategies for effective communication when addressing cognitive concerns in patients with Parkinson disease. The episode concludes with Prof. Franziska Hopfner discussing the frequency and disease trajectory of MSA patients who do not experience dysautonomia, compared with those who have autonomic involvement. Podcast links: Stability and Accuracy of a Diagnosis of Parkinson Disease Over 10 Years Dementia with Lewy Bodies and Parkinson Disease Dementia Clinical Approach to Dementia Risk in Patients with Parkinson Disease Multiple System Atrophy Without Dysautonomia Article links: Stability and Accuracy of a Diagnosis of Parkinson Disease Over 10 Years Dementia with Lewy bodies and Parkinson Disease Dementia — The Same or Different and is it Important? Long-Term Dementia Risk in Parkinson Disease Multiple System Atrophy Without Dysautonomia: An Autopsy-Confirmed Study Disclosures can be found at Neurology.org.
Dr. Gregg Day talks with Drs. Sonia Vallabh and Eric Minikel about scientific insights and the future of prion disease treatment, highlighting the importance of early diagnosis, personalized medicine, and hope for affected families. Learn about the clinical trial. Learn more about the Prion Alliance. Disclosures can be found at Neurology.org.
In this episode, we review the high-yield topic of Vascular Dementia from the Neurology section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
Balancing disease control with pregnancy and neonatal considerations in people with neuroinflammatory disease throughout the family planning, pregnancy, and postpartum periods is crucial. Modern treatment paradigms enable women to safely become pregnant and breastfeed alongside effective disease management. Shared decision making is an important part of this process. In this episode, Kait Nevel, MD, speaks with Ruth Dobson, MD and Kerstin Hellwig, MD, authors of the article "Family Planning in Neuroinflammatory Disease" in the Continuum® April 2026 Multiple Sclerosis and Related Disorders issue. Dr. Nevel is a Continuum® Audio interviewer and a neurologist and neuro-oncologist at Indiana University School of Medicine in Indianapolis, Indiana. Dr. Dobson is a professor in the Centre for Preventive Neurology at the Wolfson Institute of Population Health, Queen Mary University of London, and a consultant neurologist in the Department of Neurology at the Royal London Hospital, Barts Health NHS Trust, in London, United Kingdom. Dr. Hellwig is a professor in the Department of Neurology at Katholisches Klinikum, Ruhr‑Universität Bochum, in Bochum, Germany. Additional Resources Read the article: Family Planning in Neuroinflammatory Disease Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @IUneurodocmom Guest: @drruthdobson Full episode transcript available here
Contributor: Travis Barlock, MD Educational Pearls: Caffeine Geography and Types: Caffeine is found throughout the world and has evolved independently in various plants that are not evolutionarily related through direct lineage, but rather demonstrate convergent evolution (i.e. different species evolve the same traits). These plants use caffeine as an insecticide. Examples of caffeine sources include coffee, tea, yerba-mate, guaraná, cacao, and yaupon holly. Roughly 85% of Americans are estimated to consume caffeine daily. Caffeine Pharmacology in Humans: In humans, caffeine is a nonselective competitive antagonist (blocker) of adenosine receptors (A1 and A2A). During waking hours, neuronal metabolic activity consumes ATP, and a byproduct of ATP hydrolysis is created: adenosine. Adenosine proceeds to build a "sleep pressure". Acting on A1 and A2A adenosine receptors to induce sleep (on A1, it suppresses neuronal "wakefulness" and on A2A it is believed to be an inducer of sleep). Caffeine, by blocking those receptors, blunts sleep induction and feelings of being tired. Caffeine has a half-life of around 6 hours, and a quarter life of approximately 12 hours, which is when the caffeine will off-load and adenosine can once again occupy those receptors, potentially causing a "crash". Thus, for shift-workers, it is important to time caffeine intake roughly 10 hours before target bed time. Caffeine exerts other effects on the body. It is methylxanthine similar to theophylline, which works as a bronchodilator (via phosphodiesterase and adenosine pathways). Caffeine has clinical use to promote bronchodilation in pre-term infants. Caffeine exerts diuretic effects as well (blocking proximal renal tubule reabsorption). Recent ingestion of caffeine may blunt therapeutic use of adenosine in patients with SVT. Key Takeaway? Caffeine exerts a wide variety of effects beyond making us feel more awake. It has cardiovascular, pulmonary, and renal implications in its pharmacodynamics. References Benarroch EE. Adenosine and its receptors: multiple modulatory functions and potential therapeutic targets for neurologic disease. Neurology. 2008;70(3):231-236. doi:10.1212/01.wnl.0000297939.18236.ec Mitchell DC, Knight CA, Hockenberry J, Teplansky R, Hartman TJ. Beverage caffeine intakes in the U.S. Food Chem Toxicol. 2014;63:136-142. doi:10.1016/j.fct.2013.10.042 Bruschettini M, Brattström P, Russo C, Onland W, Davis PG, Soll R. Caffeine dosing regimens in preterm infants with or at risk for apnea of prematurity - Bruschettini, M - 2023 | Cochrane Library. Accessed May 23, 2026. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013873.pub2/full?cookiesEnabled Huang R, O'Donnell AJ, Barboline JJ, Barkman TJ. Convergent evolution of caffeine in plants by co-option of exapted ancestral enzymes. Proc Natl Acad Sci U S A. 2016;113(38):10613-10618. doi:10.1073/pnas.1602575113 Cabalag MS, Taylor DM, Knott JC, Buntine P, Smit D, Meyer A. Recent caffeine ingestion reduces adenosine efficacy in the treatment of paroxysmal supraventricular tachycardia. Acad Emerg Med. 2010;17(1):44-49. doi:10.1111/j.1553-2712.2009.00616.x Summarized by Dan Orbidan, OMS2 | Edited by Dan Orbidan & Ahmed Abdel-Hafiz, NREMT-P Donate: https://emergencymedicalminute.org/donate/ Join our mailing list: http://eepurl.com/c9ouHf
In the second episode of this series, Dr. Tesha Monteith and Dr. Peter Goadsby continue their conversation on advances in headache medicine, including brain health, migraine as a risk factor for dementia, and future directions in neurology. Disclosures can be found at Neurology.org.
May 30th is World MS Day! This year, the theme for World MS Day is "My MS Diagnosis," and I've been thinking about what happens right after that diagnosis. After an individual hears, "You have MS." This week, Dr. Nancy Sicotte joins me to discuss the things you should know, the things you should be thinking about, and the things you should be doing in the first 100 days following an MS diagnosis. Dr. Sicotte is the Chair of Neurology and Director of Multiple Sclerosis and Neuroimmunology at Cedars-Sinai in Los Angeles, and she's the past Chair of the National MS Society's National Medical Advisory Committee. We're also sharing results of a study that showed an exercise hormone protected neurons from inflammatory attack in a mouse model of MS. And we're sharing encouraging news about an experimental nasal spray that's been shown to delay disability progression and improve fatigue among people with non-active secondary progressive MS. We have a lot to talk about! Are you ready for RealTalk MS??! This Week: World MS Day! :22 Study reveals an exercise hormone has neuroprotective effects on a mouse model of MS 2:40 Tiziana shares evidence that Foralumab delays progression and improves fatigue in people with non-active secondary progressive MS 4:34 Dr. Nancy Sicotte looks at the first 100 days following an MS diagnosis 8:40 Share this episode 28:51 Next week 29:12 SHARE THIS EPISODE OF REALTALK MS Just copy this link & paste it into your text or email: https://realtalkms.com/456 ADD YOUR VOICE TO THE CONVERSATION I've always thought about the RealTalk MS podcast as a conversation. And this is your opportunity to join the conversation by sharing your feedback, questions, and suggestions for topics that we can discuss in future podcast episodes. Please shoot me an email or call the RealTalk MS Listener Hotline and share your thoughts! Email: jon@realtalkms.com Phone: (310) 526-2283 And don't forget to join us in the RealTalk MS Facebook group! LINKS If your podcast app doesn't allow you to click on these links, you'll find them in the show notes at www.RealTalkMS.com World MS Day Poster Maker https://worldmsday.org/poster-maker STUDY: The Exercise Hormone Irisin Has Neuroprotective Effects in a Mouse Model of Multiple Sclerosis https://www.nature.com/articles/s42255-026-01527-7 CLINICAL TRIAL: A Study of Nasal Foralumab in Non-Active Secondary Progressive Multiple Sclerosis Patients https://clinicaltrials.gov/study/NCT06292923 JOIN: The RealTalk MS Facebook Group https://facebook.com/groups/realtalkms REVIEW: Give RealTalk MS a rating and review http://www.realtalkms.com/review Follow RealTalk MS on X, @RealTalkMS_jon, and subscribe to our newsletter at our website, RealTalkMS.com. RealTalk MS Episode 456 Guest: Dr. Nancy Sicotte Privacy Policy
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