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In this episode, we will be talking with Dr Chris Meyer about the neurology of sleep. Dr Meyer is one of the newest GCSS Board Members, but he is also one of the newest Fellows. I think you will find him to be very deep and thorough in his insight into the process of sleep and how we might help our patients to improve it.
Dr. Jeff Ratliff talks with Dr. Claire Henchcliffe about the study's key findings while emphasizing the importance of educating patients about stem cell therapies and the ongoing advancements in this field. Read the related article in Nature. Disclosures can be found at Neurology.org.
In this powerful episode of The Red Light Report, I'm joined by the brilliant Dr. Joy Kong — stem cell specialist, anti-aging physician, and founder of Chara Health and the American Academy of Integrative Cell Therapy. We dive deep into: The science and clinical use of stem cell therapy Why umbilical cord-derived stem cells are safer and more potent than adult sources The truth about exosomes, cytokine storms, and foreign DNA fears How stem cells can transfer mitochondria, reverse tissue damage, and modulate immunity The importance of prepping your terrain with nutraceuticals, detox, and nitric oxide The role of red, green, and yellow light in stem cell activation and targeting Synergy between red light therapy and BioLight's enhanced methylene blue (BioBlue) Whether you're exploring stem cells for longevity, healing, or neuroregeneration, this episode will reshape your understanding of what's truly possible.
In this episode, we review the high-yield topic of Cerebrospinal Fluid (CSF) from the Neurology section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this two-part episode of the Brain & Life Podcast, co-host Dr. Katy Peters is joined by Elizabeth Ansell, founder and director of #NotJustFatigue. #NotJustFatigue is a nonprofit organization shining a light on myalgic encephalomyelitis/chronic fatigue syndrome, also known as ME/CFS, and educates patients, clinicians, and health organizations about the condition. Elizabeth shares her diagnosis journey and explains why education around ME/CFS is so vital. Dr. Peters is then joined by Dr. W. Ian Lipkin, who is known internationally for his research and is the John Snow Professor of Epidemiology, Professor of Neurology, and Professor of Pathology and Cell Biology at Columbia University Irving Medical Center, Mailman School of Public Health. Dr. Lipkin explains what ME/CFS is and how it differs from other conditions with similar symptoms, like long COVID. Make sure to tune in next week for part two to hear about what's next in ME/CFS research and the importance of care partners. Additional Resources #NotJustFatigue How to Fight Fatigue Understanding the Impact of Invisible Illnesses on Daily Life How Families Are Leading the Charge in Rare Disease Advocacy Other Brain & Life Podcast Episodes on Similar Topics Rare Thoughts on a Rarer Neurologic Condition Shedding Light and Love on a Rare Genetic Condition with Deborah Vauclare Neurofibromatosis Advocacy and Community Building with the Gilbert Family Foundation 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: Elizabeth Ansell @notjustfatigue; Dr. W. Ian Lipkin @columbiapublichealth Guests: Hosts: Dr. Daniel Correa @neurodrcorrea; Dr. Katy Peters @KatyPetersMDPhD
In today's episode, we are going to talk with Dr Denny O'Hara. Dr O'Hara is someone that of the guests on this podcast would tell you he is their favorite person to talk to. Dr O'Hara is always observant and always insightful, but he does it in a simple way that is easy to grasp. If you find neurology to be an intimidating subject, I think you will find that Dr O'Hara is the perfect person to listen to as he talks about how the body works.
In this episode, we review the high-yield topic of Neurofibromatosis Type I from the Neurology section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
Normal pressure hydrocephalus (NPH) is a clinical syndrome of gait abnormality, cognitive impairment, and urinary incontinence. Evaluation of CSF dynamics, patterns of fludeoxyglucose (FDG) uptake, and patterns of brain stiffness may aid in the evaluation of challenging cases that lack typical clinical and structural radiographic features. In this episode, Katie Grouse, MD, FAAN, speaks with Aaron Switzer, MD, MSc, author of the article “Radiographic Evaluation of Normal Pressure Hydrocephalus” in the Continuum® June 2025 Disorders of CSF Dynamics issue. Dr. Grouse is a Continuum® Audio interviewer and a clinical assistant professor at the University of California San Francisco in San Francisco, California. Dr. Switzer is a clinical assistant professor of neurology in the department of clinical neurosciences at the University of Calgary in Calgary, Alberta, Canada. Additional Resources Read the article: Radiographic Evaluation of Normal Pressure Hydrocephalus 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 Full episode transcript available here 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 Grouse: This is Dr Katie Grouse. Today I'm interviewing Dr Aaron Switzer about his article on radiographic evaluation of normal pressure hydrocephalus, which he wrote with Dr Patrice Cogswell. This article appears in the June 2025 Continuum issue on disorders of CSF dynamics. Welcome to the podcast, and please introduce yourself to our audience. Dr. Switzer: Thanks so much for having me, Katie. I'm a neurologist that's working up in Calgary, Alberta, Canada, and I have a special interest in normal pressure hydrocephalus. So, I'm very happy to be here today to talk about the radiographic evaluation of NPH. Dr Grouse: I'm so excited to have you here today. It was really wonderful to read your article. I learned a lot on a topic that is not something that I frequently evaluate in my clinic. So, it's really just a pleasure to have you here to talk about this topic. So, I'd love to start by asking, what is the key message that you hope for neurologists who read your article to take away from it? Dr. Switzer: The diagnosis of NPH can be very difficult, just given the clinical heterogeneity in terms of how people present and what their images look like. And so, I'd like readers to know that detailed review of the patient's imaging can be very helpful to identify those that will clinically improve with shunt surgery. Dr Grouse: There's another really great article in this edition of Continuum that does a really great job delving into the clinical history and exam findings of NPH. So, I don't want to get into that topic necessarily today. However, I'd love to hear how you approach a case of a hypothetical patient, say, where you're suspicious of NPH based on the history and exam. I'd love to talk over how you approach the imaging findings when you obtain an MRI of the brain, as well as any follow-up imaging or testing that you generally recommend. Dr. Switzer: So, I break my approach down into three parts. First, I want to try to identify ventriculomegaly and any signs that would support that, and specifically those that are found in NPH. Secondly, I want to look for any alternative pathology or evidence of alternative pathology to explain the patient's symptoms. And then also evaluate any contraindications for shunt surgery. For the first one, usually I start with measuring Evans index to make sure that it's elevated, but then I want to measure one of the other four measurements that are described in the article, such as posterior colossal angle zed-Evans index---or z-Evans index for the American listeners---to see if there's any other features that can support normal pressure hydrocephalus. It's very important to identify whether there are features of disproportionately enlarged subarachnoid space hydrocephalus, or DESH, which can help identify patients who may respond to shunt surgery. And then if it's really a cloudy clinical picture, it's complicated, it's difficult to know, I would usually go through the full evaluation of the iNPH radscale to calculate a score in order to determine the likelihood that this patient has NPH. So, the second part of my evaluation is to rule out evidence of any alternative pathology to suggest another cause for the patient's symptoms, such as neurodegeneration or cerebrovascular disease. And then the third part of my evaluation is to look for any potential contraindications for shunt surgery, the main one being cerebral microbleed count, as a very high count has been associated with the hemorrhagic complications following shunt surgery. Dr Grouse: You mentioned about your use of the various scales to calculate for NPH, and your article does a great job laying them out and where they can be helpful. Are there any of these scales that can be reasonably relied on to predict the presence of NPH and responsiveness to shunt placement? Dr. Switzer: I think the first thing to acknowledge is that predicting shunt response is still a big problem that is not fully solved in NPH. So, there is not one single imaging feature, or even combination of imaging features, that can reliably predict shunt response. But in my view and in my practice, it's identifying DESH, I think, is really important---so, the disproportionately enlarged subarachnoid space hydrocephalus---as well as measuring the posterior colossal angle. I find those two features to be the most specific. Dr Grouse: Now you mentioned the concept of the NPH subtypes, and while this may be something that many of our listeners are familiar with, I suspect that, like myself when I was reading this article, there are many who maybe have not been keeping up to date on these various subtypes. Could you briefly tell us more about these NPH subtypes? Dr. Switzer: Sure. The Japanese guidelines for NPH have subdivided NPH into three different main categories. So that would be idiopathic, delayed onset congenital, and secondary normal pressure hydrocephalus. And so, I think the first to talk about would be the secondary NPH. We're probably all more familiar with that. That's any sort of pathology that could lead to disruption in CSF dynamics. These are things like, you know, a slow-growing tumor that is obstructing CSF flow or a widespread meningeal process that's reducing absorption of CSF, for instance. So, identifying these can be important because it may offer an alternative treatment for what you're seeing in the patient. The second important one is delayed onset congenital. And when you see an image of one of these subtypes, it's going to be pretty different than the NPH because the ventricles are going to be much larger, the sulcal enfacement is going to be more diffuse. Clinically, you may see that the patients have a higher head circumference. So, the second subtype to know about would be the delayed onset congenital normal pressure hydrocephalus. And when you see an image of one of these subtypes, it's going to be a little different than the imaging of NPH because the ventricles are going to be much larger, the sulcal enfacement is going to be more diffuse. And there are two specific subtypes that I'd like you to know about. The first would be long-standing overt ventriculomegaly of adulthood, or LOVA. And the second would be panventriculomegaly with a wide foramen of magendie and large discernomagna, which is quite a mouthful, so we just call it PAVUM. The importance of identifying these subtypes is that they may be amenable to different types of treatment. For instance, LOVA can be associated with aqueductal stenosis. So, these patients can get better when you treat them with an endoscopic third ventriculostomy, and then you don't need to move ahead with a shunt surgery. And then finally with idiopathic, that's mainly what we're talking about in this article with all of the imaging features. I think the important part about this is that you can have the features of DESH, or you can not have the features of DESH. The way to really define that would be how the patient would respond to a large-volume tap or a lumbar drain in order to define whether they have this idiopathic NPH. Dr Grouse: That's really helpful. And for those of our listeners who are so inclined, there is a wonderful diagram that lays out all these subtypes that you can take a look at. I encourage you to familiarize yourself with these different subtypes. Now it was really interesting to read in your article about some of the older techniques that we used quite some time ago for diagnosing normal pressure hydrocephalus that thankfully we're no longer using, including isotope encephalography and radionuclide cisternography. It certainly made me grateful for how we've come in our diagnostic tools for NPH. What do you think the biggest breakthrough in diagnostic tools that are now clinically available are? Dr. Switzer: You know, definitely the advent of structural imaging was very important for the evaluation of NPH, and specifically the identification of disproportionately enlarged subarachnoid space hydrocephalus, or DESH, in the late nineties has been very helpful for increasing the specificity of diagnosis in NPH. But some of the newer technologies that have become available would be phase-contrast MRI to measure the CSF flow rate through the aqueduct has been very helpful, as well as high spatial resolution T2 imaging to actually image the ventricular system and look for any evidence of expansion of the ventricles or obstruction of CSF flow. Dr Grouse: Regarding the scales that you had referenced earlier, do you think that we can look forward to more of these scales being automatically calculated and reported by various software techniques and radiographic interpretation techniques that are available or going to be available? Dr. Switzer: Definitely yes. And some of these techniques are already in development and used in research settings, and most of them are directed towards automatically detecting the features of DESH. So, that's the high convexity tight sulci, the focally enlarged sulci, and the enlarged Sylvian fissures. And separating the CSF from the brain tissue can help you determine where CSF flow is abnormal throughout the brain and give you a more accurate picture of CSF dynamics. And this, of course, is all automated. So, I do think that's something to keep an eye out for in the future. Dr Grouse: I wanted to ask a little more about the CSF flow dynamics, which I think may be new to a lot of our listeners, or certainly something that we've only more recently become familiar with. Can you tell us more about these advances and how we can apply this information to our evaluations for NPH? Dr. Switzer: So currently, only the two-dimensional phase contrast MRI technique is available on a clinical basis in most centers. This will measure the actual flow rate through the cerebral aqueduct. And so, in NPH, this can be elevated. So that can be a good supporting marker for NPH. In the future, we can look forward to other techniques that will actually look at three-dimensional or volume changes over time and this could give us a more accurate picture of aberrations and CSF dynamics. Dr Grouse: Well, definitely something to look forward to. And on the topic of other sort of more cutting-edge or, I think, less commonly-used technologies, you also mentioned some other imaging modalities, including diffusion imaging, intrathecal gadolinium imaging, nuclear medicine studies, MR elastography, for example. Are any of these modalities particularly promising for NPH evaluations, in your opinion? Do you think any of these will become more popularly used? Dr. Switzer: Yes, I think that diffusion tract imaging and MR elastography are probably the ones to keep your eye out for. They're a little more widely applicable because you just need an MR scanner to acquire the images. It's not invasive like the other techniques mentioned. So, I think it's going to be a lot easier to implement into clinical practice on a wide scale. So, those would be the ones that I would look out for in the future. Dr Grouse: Well, that's really exciting to hear about some of these techniques that are coming that may help us even more with our evaluation. Now on that note, I want to talk a little bit more about how we approach the evaluation and, in your opinion, some of the biggest pitfalls in the evaluation of NPH that you've found in your career. Dr. Switzer: I think there are three of note that I'd like to mention. The first would be overinterpreting the Evans index. So, just because an image shows that there's an elevated Evans index does not necessarily mean that NPH is present. So that's where looking for other corroborating evidence and looking for the clinical features is really important in the evaluation. Second would be misidentifying the focally enlarged sulci as atrophy because when you're looking at a brain with these blebs of CSF space in different parts of the brain, you may want to associate that to neurodegeneration, but that's not necessarily the case. And there are ways to distinguish between the two, and I think that's another common pitfall. And then third would be in regards to the CSF flow rate through the aqueduct. And so, an elevated CSF flow is suggestive of NPH, but the absence of that does not necessarily rule NPH out. So that's another one to be mindful of. Dr Grouse: That's really helpful. And then on the flip side, any tips or tricks or clinical pearls you can share with us that you found to be really helpful for the evaluation of NPH? Dr. Switzer: One thing that I found really helpful is to look for previous imaging, to look if there were features of NPH at that time, and if so, have they evolved over time; because we know that in idiopathic normal pressure hydrocephalus, especially in the dash phenotype, the ventricles can become larger and the effacement of the sulci at the convexity can become more striking over time. And this could be a helpful tool to identify how long that's been there and if it fits with the clinical history. So that's something that I find very helpful. Dr Grouse: Absolutely. When I read that point in your article, I thought that was really helpful and, in fact, I'm guessing something that a lot of us probably aren't doing. And yet many of our patients for one reason or other, probably have had imaging five, ten years prior to their time of evaluation that could be really helpful to look back at to see that evolution. Dr. Switzer: Yes, absolutely. Dr Grouse: It's been such a pleasure to read your article and talk with you about this today. Certainly a very important and helpful topic for, I'm sure, many of our listeners. Dr. Switzer: Thank you so much for having me. Dr Grouse: Again, today I've been interviewing Dr Aaron Switzer about his article on radiographic evaluation of normal pressure hydrocephalus, which he wrote with Dr Patrice Cogswell. This article appears in the most recent issue of Continuum on disorders of CSF dynamics. 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.
In this episode, we review the high-yield topic of Hypothalamus from the Neurology section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this week's episode, Ané dives into a fascinating survey-based study that compares how veterinary neurologists and rehabilitation therapists approach the diagnosis and treatment of degenerative myelopathy in dogs. Ané explores key insights into diagnostic procedures, referral practices, assistive walking devices, rehabilitation goals and protocols, and how professionals support clients managing this progressive condition. Find out more about the Vet Rehab Summit: https://vetrehabsummit.com/ Learn more about Paw Prosper's special offer: https://pawprosper.com/OPH Learn more about Paw Prosper: https://pawprosper.com/ To learn about Onlinepethealth, watch a free webinar, or join any of our Facebook groups, click here: https://onlinepethealth.com/podcast
In this episode of The Dr. Joy Kong Podcast, Dr. Joy speaks with Dr. Mike Jamshidi, a naturopathic doctor at Chara Health, about natural, hands-on approaches to pain relief beyond pills and surgery. Dr. Mike shares his journey from healing his own chronic health issues to helping patients address root causes of pain through bodywork, acupuncture, nutrition, and lifestyle changes.They also discuss advanced regenerative treatments like stem cells and exosomes, and Dr. Mike shares powerful stories of patients finding relief from severe conditions. This conversation highlights the power of working with the body's innate healing abilities for deeper, long-lasting recovery.--Additional Resources:Visit My Clinic: Chara Health
Dr. Jason Crowell talks with Dr. Brian E. Emmert about the results from the 2022 AAN Resident Survey and explores areas for future improvement. Read the related article in Neurology® Education. Disclosures can be found at Neurology.org.
In the July episode of the President's Spotlight, Dr. Jason Crowell and Dr. Natalia Rost discuss the role science plays in what the AAN does. Show reference: https://www.aan.com/about-the-aan/presidents-spotlight
In today's episode, we will begin a week of neurology review by listening to Dr David Geary. Dr Geary is a Gonstead Diplomate and he is on the GCSS Board of Directors; he is also the co-chairman of the Meeting of the Minds committee along with myself. He has a deep love and interest in both the science of chiropractic and the field of Neurology. I think you will find he has some excellent insights for you as you think about the neurology of the subluxation.
In this episode, we review the high-yield topic of Circle of Willis from the Neurology section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
Join us for this special edition of the Rx Bricks Podcast, featuring a complete Rx Question Lab session designed to help medical students master high-yield neurological concepts for USMLE Step 1. In this interactive session, we work through four challenging board-style questions that cover essential neurology topics, including speech disorders, genetic syndromes affecting the nervous system, stroke recognition, and neurological pain conditions. Learn systematic approaches to neuroanatomy questions and develop the clinical reasoning skills needed to tackle even the most complex neurology scenarios on Step 1. Dr. Titus, a hematology/oncology fellow at the University of South Alabama, provides expert explanations that connect basic neuroanatomical concepts with clinical presentations, helping you understand not just the correct answers but the underlying pathophysiology. Whether you’re struggling with neuroanatomy or looking to refine your knowledge of neurological disorders, this Question Lab offers practical strategies and insights that will boost your confidence on exam day. Perfect for medical students and IMGs preparing for USMLE Step 1. For more USMLE-Rx resources, visit www.usmle-rx.com and use the code RXPOD for 30% off any new subscription. This special edition was recorded live during our regular Rx Question Lab series. Learn more at https://go.usmle-rx.com/question-lab
In part one of this three-part series, Dr. Justin Abbatemarco and Drs. John Chen and Smathorn Thakolwiboon discuss the outcomes following plasma exchange in MOGAD and explore how the findings from this study can inform patient care.
Dr. Justin Abbatemarco talks with Drs. John Chen and Smathorn Thakolwiboon about the outcomes following plasma exchange in MOGAD and explore how the findings from this study can inform patient care. Disclosures can be found at Neurology.org.
Dr. Dan Ackerman and Drs. Luuk Dekker and Jasper D. Daems discuss the analysis of various aLVO stroke detection scales to determine which one is the most useful for prehospital triage. Show reference: https://www.neurology.org/doi/10.1212/WNL.0000000000213570
In this episode of the Brain & Life Podcast, co-host Dr. Daniel Correa is joined by Phil Rosenthal. Phil is the award-winning creator, executive producer, and host of “Somebody Feed Phil,” as well as a two-time New York Times Best Selling Author, soon-to-be restaurant owner, and cared for his mother during her journey with Amyotrophic lateral sclerosis (ALS). Phil shares about his mother's journey and how his family worked with doctors to prioritize her needs. Dr. Correa is also joined by Dr. Bjorn E. Oskarsson, a neurologist at Mayo Clinic in Jacksonville, Florida who specializes in ALS. Dr. Oskarsson explains ALS, how it can affect people in differing ways, and what treatment options typically look like. Additional Resources Max and Helen's: A Neighborhood Diner Honoring Phil Rosenthal's Parents A Marathoner on a Quest to End ALS Tips on How to Choose and Pay for In-Home Health Care When is Palliative Care Appropriate? Other Brain & Life Podcast Episodes on Similar Topics Making the Years Count with Brooke Eby, Influencer Living with ALS Finding Strength in ALS Advocacy with Podcaster Lorri Carey Aaron Lazar on His ALS Journey and the Impossible Dream 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: Phil Rosenthal @phil.rosenthal; Dr. Bjorn E. Oskarsson @mayoclinic.flneuro Guests: Hosts: Dr. Daniel Correa @neurodrcorrea; Dr. Katy Peters @KatyPetersMDPhD
In this episode, editor-in-chief Joseph E. Safdieh, MD, FAAN, highlights articles on the association of shortened telomeres on risk for stroke, late-life depression and dementia; affect of research funding cuts on tenure/promotion opportunities; and herpes zoster vaccine and reduced dementia risk.
The July 2025 recall features four episodes on systems and innovation in delivering neurologic care. The episode begins with Dr. Scott Friedenberg discussing challenges faced by neurologists in balancing financial productivity with optimal patient care. The episode leads into a conversation with Dr. Marisa Patryce McGinley discussing the utilization of telemedicine in neurology, particularly focusing on disparities in access among different demographic groups. The conversation transitions to Dr. Lidia Moura talking about the implications of large language models for neurologic care. The episode concludes with Dr. Ashish D. Patel discussing headache referrals and the implementation of a design thinking approach to improve access to headache care. Podcast links: Empowering Health Care Providers Disparities in Utilization of Outpatient Telemedicine for Neurologic Care Large Language Models for Quality and Efficiency of Neurologic Care Using Design Thinking to Understand the Reason for Headache Referrals Article links: Empowering Health Care Providers: A Collaborative Approach to Enhance Financial Performance and Productivity in Clinical Practice Disparities in Utilization of Outpatient Telemedicine for Neurologic Care Implications of Large Language Models for Quality and Efficiency of Neurologic Care: Emerging Issues in Neurology Using Design Thinking to Understand the Reason for Headache Referrals and Reduce Referral Rates Disclosures can be found at Neurology.org.
In this episode of the Neurology Minute, Dr. Alison Christy delves into another women's history minute to discuss Mary Lasker.
Normal pressure hydrocephalus (NPH) is a clinical syndrome characterized by the triad of gait apraxia, cognitive impairment, and bladder dysfunction in the radiographic context of ventriculomegaly and normal intracranial pressure. Accurate diagnosis requires consideration of clinical and imaging signs, complemented by tests to exclude common mimics. In this episode, Lyell Jones, MD, FAAN speaks with Abhay R. Moghekar, MBBS, author of the article “Clinical Features and Diagnosis of Normal Pressure Hydrocephalus” in the Continuum® June 2025 Disorders of CSF Dynamics issue. 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. Moghekar is an associate professor of neurology at Johns Hopkins University School of Medicine in Baltimore, Maryland. Additional Resources Read the article: Clinical Features and Diagnosis of Normal Pressure Hydrocephalus 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: @LyellJ Full episode transcript available here 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 Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum: Lifelong Learning in Neurology. Today I'm interviewing Dr Abhay Moghekar, who recently authored an article on the clinical features and diagnosis of normal pressure hydrocephalus for our first-ever issue of Continuum dedicated to disorders of CSF dynamics. Dr Moghekar is an associate professor of neurology and the research director of the Cerebrospinal Fluid Center at Johns Hopkins University in Baltimore, Maryland. Dr Moghekar, welcome, and thank you for joining us today. Why don't you introduce yourself to our listeners? Dr Moghekar: Thank you, Dr Jones. I'm Abhay Moghekar. I'm a neurologist at Hopkins, and I specialize in seeing patients with CSF disorders, of which normal pressure hydrocephalus happens to be the most common. Dr Jones: And let's get right to it. I think most of our listeners who are neurologists in practice have encountered normal pressure hydrocephalus, or NPH; and it's a challenging disorder for all the reasons that you outline in your really outstanding article. If you were going to think of one single most important message to our listeners about recognizing patients with NPH, what would that be? Dr Moghekar: I think I would say there are two important messages. One is that the triad is not sufficient to make the diagnosis, and the triad is not necessary to make the diagnosis. You know these three elements of the triad: cognitive problems, gait problems, bladder control problems are so common in the elderly that if you pick 10 people out in the community that have this triad, it's unlikely that even one of them has true NPH. On the other hand, you don't need all three elements of the triad to make the diagnosis because the order of symptoms matters. Often patients develop gait dysfunction first, then cognitive dysfunction, and then urinary incontinence. If you wait for all three elements of the triad to be present, it may be too late to offer them any clear benefit. And hence, you know, it's neither sufficient nor necessary to make the diagnosis. Dr Jones: That's a really great point. I think most of our listeners are familiar with the fact that, you know, we're taught these classic triads or pentads or whatever, and they're rarely all present. In a way, it's maybe a useful prompt, but it could be distracting or misleading, even in a way, in terms of recognizing the patient. So what clues do you use, Dr Moghekar, to really think that a patient may have NPH? Dr Moghekar: So, there are two important aspects about gait dysfunction. Say somebody comes in with all three elements of the triad. You want to know two things. Which came first? If gate impairment precedes cognitive impairment, it's still very likely that NPH is in the differential. And of the two, which are more- relatively more affected? So, if somebody has very severe dementia and they have a little bit of gait problems, NPH is not as likely. So, is gait affected earlier than cognitive dysfunction, and is it affected to a more severe degree than cognitive dysfunction? And those two things clue me in to the possibility of NPH. You still obviously need to get imaging to make sure that they have large ventricles. One of the problems with imaging is large ventricles are present in so many different patients. Normal aging causes large ventricles. Obviously, many neurodegenerative disorders because of cerebral atrophy will cause large ventricles. And there's an often-used metric called as the events index, which is the ratio of the bitemporal horns- of the frontal horns of the lateral ventricles compared to the maximum diameter of the skull at that level. And if that ratio is more than 0.3, it's often used as a de facto measure of ventriculomegaly. What we've increasingly realized is that this ratio changes with age. And there's an excellent study that used the ADNI database that looked at how this ratio changes by age and sex. So, in fact, we now know that an 85-year-old woman who has an events index of 0.37 which would be considered ventriculomegaly is actually normal for age and sex. So, we need to start adopting these more modern age- and sex-appropriate age cutoffs of ventriculomegaly so as not to overcall everybody with big ventricles as having possible NPH. Dr Jones: That's very helpful. And I do want to come back to this challenge that we've seen in our field of overdiagnosis and underdiagnosis. But I think most of us are familiar with the concept of how hydrocephalus could cause neurologic deficits. But what's the latest on the mechanism of NPH? Why do some patients get this and others don't? Dr Moghekar: Very good question. I don't think we know for sure. And it for a long time we thought it was a plumbing issue. Right? And that's why shunts work. People thought it was impaired CSF absorption, but multiple studies have shown that not to be true. It's likely a combination of impaired cerebral blood flow, biomechanical factors like compliance, and even congenital factors that play a role in the pathogenesis of NPH. And yes, while putting in shunts likely drains CSF, putting in a shunt also definitely changes the compliance of the brain and affects blood flow to the subcortical regions of the brain. So, there are likely multiple mechanisms by which shunts benefit, and hence it's very likely that there's no single explanation for the pathogenesis of NPH. Dr Jones: We explored this in a recent Continuum issue on dementia. Many patients who have cognitive impairment have co-pathologies, multiple different causes. I was interested to read in your article about the genetic risk profile for NPH. It's not something I'd ever really considered in a disorder that is predominantly seen in older patients. Tell us a little more about those genetic risks. Dr Moghekar: Yeah, everyone is aware of the role genetics plays in congenital hydrocephalus, but until recently we were not aware that certain genetic factors may also be relevant to adult-onset normal pressure hydrocephalus. We've suspected this for a long time because nearly half of our patients who come to us to see us in clinic with NPH have head circumferences that are more than 90th percentile for height. And you know, that clearly indicates that this started shortly at the time after birth or soon afterwards. So, we've suspected for a long time that genetic factors play a role, but for a long time there were not enough large studies or well-conducted studies. But recently studies out of Japan and the US have shown mutations in genes like CF43 and CWH43 are disproportionately increased in patients with NPH. So, we are discovering increasingly that there are genetic factors that underlie even adult onset in patients. There are many more waiting to be discovered. Dr Jones: Really fascinating. And obviously getting more insight into the risk and mechanisms would be helpful in identifying these patients potentially earlier. And another thing that I learned in your article that I thought was really interesting, and maybe you can tell us more about it, is the association between normal pressure hydrocephalus and the observation of cervical spinal stenosis, many of whom require decompression. What's behind that association, do you think? Dr Moghekar: That's a very interesting study that was actually done at your institution, at Mayo Clinic, that showed this association. You know, as we all get older, you know, the incidence of cervical stenosis due to osteoarthritis goes up, but the incidence of significant, clinically significant cervical stenosis in the NPH population was much higher than what we would have expected. Whether this is merely an association in a vulnerable population or is it actually causal is not known and will need further study. Dr Jones: It's interesting to speculate, does that stenosis affect the flow of CSF and somehow predispose to a- again, maybe a partial degree for some patients? Dr Moghekar: Yeah, which goes back to the possible hydrodynamic theory of normal pressure hydrocephalus; you know, if it's obstructing normal CSF flow, you know, are the hydrodynamics affected in the brain that in turn could lead to the development of hydrocephalus. Dr Jones: One of the things I really enjoyed about your article, Abhay, was the very strong clinical focus, right? We can't just take an isolated biomarker or radiographic feature and rely on that, right? We really do need to have clinical suspicion, clinical judgment. And I think most of our listeners who've been in practice are familiar with the use and the importance of the large-volume lumbar puncture to determine who may have, and by exclusion not have, NPH, and then who might respond to CSF diversion. And I think those of us who have been in this situation are also familiar with the scenario where you think someone may have NPH and you do a large-volume lumbar puncture and they feel better, but you can't objectively see a difference. How do you make that test useful and objective in your practice? What do you do? Dr Moghekar: Yeah, it's a huge challenge in getting this objective assessment done carefully because you have to remember, you know, subconsciously you're telling the patients, I think you have NPH. I'm going to do this spinal tap, and if you walk better afterwards, you're going to get a shunt and you're going to be cured. And you can imagine the huge placebo response that can elicit in our subjects. So, we always like to see, definitely, did the patient subjectively feel better? Because yes, that's an important metric to consider because we want them to feel better. But we also wanted to be grounded in objective truths. And for that, we need to do different tests of speed, balance and endurance. Not everyone has the resources to do this, but I think it's important to test different domains. Just like for cognition, you know, we just don't test memory, right? We test executive function, language, visuospatial function. Similarly, walking is not just walking, right? It's gait speed, it's balance, and it's endurance. So, you need to ideally test at least most of these different domains for gait and you need to have some kind of clear criteria as to how are you going to define improvement. You know, is a 5% improvement, is a 10% improvement in gait, enough? Is 20%? Where is that cutoff? And as a field, we've not done a great job of coming up with standardized criteria for this. And it varies currently, the practice varies quite significantly from center to center at the current time. Dr Jones: So, one of the nice things you had in your article was helpful tips to be objective if you're in a lower-resource setting. For you, this isn't a common scenario that someone encounters in their practice as opposed to a center that maybe does a large volume of these. What are some relatively straightforward objective measures that a neurologist or someone else might use to determine if someone is improving after a large-volume LP? Dr Moghekar: Yeah, excellent question, Dr Jones, and very practically relevant too. So, you need to at least assess two of the domains that are most affected. One is speed and one is balance. You know, these patients fall ultimately, right, if you don't treat them correctly. In terms of speed, there are two very simple tests that anybody can do within a couple of minutes. One is the timed “up-and-go” test. It's a test that's even recommended by the CDC. It correlates very well with faults and disability and it can be done in any clinic. You just need about ten feet of space and a chair and a stopwatch, and it takes about a minute or slightly more to do that test. And there are objective age-associated norms for the timed up-and-go test, so it's easy to know if your patient is normal or not. The same thing goes for the 10-meter walk test. You do need a slightly longer walkway, but it's a fairly easy and well-standardized test. So, you can do one of those two; you don't need to do both of them. And for balance, you can do the 30-second “sit-to-stand”; and it's literally, again, 30 seconds. You need a chair, and you need somebody to watch the patient and see how many times they can sit up and stand up from a seated position. Then again, good normative data for that. If you want to be a little more sophisticated, you can do the 4-stage balance test. So, I think these are tests that don't add too much time to your daily assessment and can be done with even trained medical assistants in any clinic. And you don't need a trained physical therapist to do these assessments. Dr Jones: Very practical. And again, something that is pretty easily deployed, something we do before and then after the LP. I did see you mentioned in your article the dual timed up-and-go test where it's a simultaneous gait and executive function test. And I've got to be honest with you, Dr Moghekar, I was a little worried if I would pass that test, but that may be beyond the scope of our time today. Actually, how do you do that? How do you do the simultaneous cognitive assessment? Dr Moghekar: So, we asked them to count back from 100, subtracting 3. And we do it particularly in patients who are mildly impaired right? So, if they're already walking really good, but then you give them a cognitive stressor, you know, that will slow them down. So, we reserve it for patients who are high-performing. Dr Jones: That's fantastic. I'm probably aging myself a little here. I have noticed in my career, a little bit of a pendulum swing in terms of the recognition or acceptance of the prevalence of normal pressure hydrocephalus. I recall when I was a resident, many, many people that we saw in clinic had normal pressure hydrocephalus. Then it seemed for a while that it really faded into the background and was much less discussed and much less recognized and diagnosed, and less treated. And now that pendulum seems to have swung back the other way. What's behind that from your perspective? Dr Moghekar: It's an interesting backstory to all of this. When the first article about NPH was published in the Newman Journal of Medicine, it was actually a combined article with both neurologists and neurosurgeons on it. They did describe it as a treatable dementia. And what that did is it opened up the floodgates so that everybody with any kind of dementia started getting shunts left, right, and center. And back then, shunts were not programmable. There were no antibiotic impregnated catheters. So, the incidence of subdural hematomas and shunt-related infections was very high. In fact, one of our esteemed neurologists back then, Houston Merritt, wrote a scathing editorial that Victor and Adam should lose their professorships for writing such an article because the outcomes of these patients were so bad. So, for a very long period of time, neurologists stopped seeing these patients and stopped believing in NPH as a separate entity. And it became the domain of neurosurgeons for over two or three decades, until more recently when randomized trials started being done early on out of Europe. And now there's a big NIH study going on in the US, and these studies showed, in fact, that NPH exists as a true, distinct entity. And finally, neurologists have started getting more interested in the science and understanding the pathophysiology and taking care of these patients compared to the past. Dr Jones: That's really helpful context. And I guess that maybe isn't rare when you have a disorder that doesn't have a simple, straightforward biomarker and is complex in terms of the tests you need to do to support the diagnosis, and the treatment itself is somewhat invasive. So, when you talk to your patients, Dr Moghekar, and you've established the diagnosis and have recommended them for CSF diversion, what do you tell them? And the reason I ask is that you mentioned before we started recording, you had a patient who had a shunt placed and responded well, but continued to respond over time. Tell us a little bit more about what our patients can expect if they do have CSF diversion? Dr Moghekar: When we do the spinal tap and they meet our criteria for improvement and they go on to have a shunt, we tell them that we expect gait improvement definitely, but cognitive improvement may not happen in everyone depending on what time, you know, they showed up for their assessment and intervention. But we definitely expect gait improvement. And we tell them that the minimum gait improvement we can expect is the same degree of improvement they had after their large-volume lumbar puncture, but it can be even more. And as the brain remodels, as the hydrodynamics adapt to these shunts… so, we have patients who continue to improve one year, two years, and even three years into the course of the intervention. So, we're, you know, hopeful. At the same time, we want to be realistic. This is the same population that's at risk for developing neurodegenerative disorders related to aging. So not a small fraction of our patients will also have Alzheimer's disease, for example, or go on to develop Lewy body dementia. And it's the role of the neurologist to pick up on these comorbid conditions. And that's why it's important for us to keep following these patients and not leave them just to the neurosurgeon to follow up. Dr Jones: And what a great note to end on, Dr Moghekar. And again, I want to thank you for joining us, and thank you for such a wonderful discussion and such a fantastic article on the clinical diagnosis of normal pressure hydrocephalus. I learned a lot reading the article, and I learned a lot more today just in the conversation with you. So, thank you for being with us. Dr Moghekar: Happy to do that, Dr Jones. It was a pleasure. Dr Jones: Again, we've been speaking with Dr Abhay Moghekar, author of a wonderful article on the clinical features and diagnosis of NPH in Continuum's first-ever issue dedicated to disorders of CSF dynamics. 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. 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.
This is Sara, and I remember the time 20 years ago when I got schooled by a psychoanalyst. It must have been the fall, because I was supremely agitated that I was having to write, design, and send holiday cards out to a huge list of people all by myself, without the help of my fiancé. If you know me, you know that cards were a staple of my winter growing up, with cards from my parents' friends stapled onto long felt ribbons hanging down each doorway, surrounding us with love and smiling faces for weeks on end. The therapist asked if I could just not do them, if it was annoying me so much, and my instant fury was revealed: Are you kidding? I have to send these cards out, it's the nice thing to do!! Cut to the point, and it's this - nice according to who? Nice for whom? Certainly not nice for me if I were going to be resentful and pissy about it. I came to terms with the fact that I actually just really enjoyed writing and sending cards out to people who warmed my heart that year, and that my partner wasn't a nice person for not agreeing to send these cards out with me. But it leads us to ask this. What do we mean by niceness - and what, more importantly, is its not-as-related-as-it-seems and so much more important character trait of kindness? How can understanding this difference and leaning into kindness help us be better people? What to listen for: How a medically trained doctor got into a “touchy-feely” thing like kindness The shockingly tremendous impact that kindness has on our individual health and our societal wellbeing What's the difference between niceness vs kindness? Ways to begin practicing more kindness About our guest: Kelli Harding, MD, MPH, is dedicated to creating a kinder and healthier world for all. An expert in mental health, medicine, and public health, she teaches at Columbia University's Vagelos College of Physicians and Surgeons (VP&S) in New York City and is a diplomate of the American Board of Psychiatry and Neurology, also boarded in the sub-specialty of consultation-liaison psychiatry or psychosomatic (mind-body) medicine. Known for making complex scientific research understandable to general audiences, she's the author of the critically acclaimed book The Rabbit Effect: Live Longer, Happier, and Healthier with the Groundbreaking Science of Kindness. Dr. Harding has appeared on Today, Good Morning America, BBC, The New York Times, The Washington Post, Prevention, LA Times, Oprah Magazine, Parents, Medscape, Sesame Street Workshop, and The World Economic Forum. Additionally, she has spoken at global events at the United Nations and World Happiness Summits and served on the Boards of Organizations such as the Association of American Medical Colleges (AAMC) and social media platform Nextdoor. Dr. Harding lives in New York City with her husband and three sons—an eleventh-grader, a ninth-grader, and a sixth-grader, and beloved rescue pup, Athena. Her next book, Different, co-authored with Sara Blanchard, will be out in Fall 2026. Website kellihardingmd.com LinkedIn Kelli Harding MD MPH Instagram @kellihardingmd
In the final episode of this three-part series, Dr. Andy Southerland and Dr. Seemant Chaturvedi discuss the PINGS-2 Trial, which was presented at the 2025 European Stroke Organization Conference. Show reference: https://eso-stroke.org/wp-content/uploads/Curtain-Raiser-2-1.pdf
The Cognitive Crucible is a forum that presents different perspectives and emerging thought leadership related to the information environment. The opinions expressed by guests are their own, and do not necessarily reflect the views of or endorsement by the Information Professionals Association. During this episode, Dr. James Giordano discusses a broad range of topics related to national security from biopsychology to complexity to neurotechnology to enactivism. Recording Date: 25 Jun 2025 Research Question: James Giordano suggests an interested student or researcher examine: “How might the convergence of neurotech, big data, and AI lead to improved human and multinational relations, and in these ways, contribute to avoiding conflict and warfare?” Resources: Cognitive Crucible Podcast Episodes Mentioned #72 Noah Komnick on Cybernetics and the Age of Complexity James Giordano NDU Website Enactivism Architectonics Heilmeier Catechism N3: Next-Generation Nonsurgical Neurotechnology Bioethics and Brains, published by MIT Press, which I co-authored with my longtime colleague Dr John Shook Neuroscience, Neuroculture and Neuroethics, published by Springer, which I co-authored with John Shook and Dr Roland Benedikter Link to full show notes and resources Guest Bio: Dr. James Giordano is the Director of the Center for Disruptive Technologies and Future Warfare of the Institute for National Strategic Studies at the National Defense University. He is Professor Emeritus in the Departments of Neurology and Biochemistry, and Senior Scholar Emeritus of the Pellegrino Center for Clinical Bioethics of Georgetown University Medical Center, Washington, DC. Dr. Giordano has served as Senior Scientific Advisory Fellow of the Strategic Multilayer Assessment Branch of the Joint Staff, Pentagon; Senior Bioethicist of the Defense Medical Ethics Center; Distinguished Fellow in Science, Technology and Ethics of the Stockdale Center for Ethics at the United States Naval Academy; and as an appointed member of the Neuroethics, Legal and Social Advisory Panel of the Defense Advanced Research Project Agency (DARPA), and an appointed member of the Department of Health and Human Services' Secretary's Advisory Committee for Human Research Protections. Dr Giordano is internationally recognized for his research on the use – and ethical guidance and governance - of neurocognitive sciences and technology in military, intelligence and global security operations A widely published author of over 350 peer-reviewed papers in the international scientific literature, 25 governmental reports, 37 book chapters, and 10 books - which most recently include Bioethics and Brains; Neuroscience, Neuroculture and Neuroethics; and Neurotechnology in National Security and Defense: Technical Considerations, Neuroethical Concerns. Dr. Giordano is a former Fulbright Fellow; an elected Fellow of the Hastings Center for Ethics; the European Academy of Science and Arts; and the Royal Society of Medicine (UK); and frequently lectures in German and Italian. A former United States Naval officer, he was winged as a Naval Aerospace Physiologist, co-designated as a Research Physiologist and Psychologist, and served with US Navy and US Marine Corps. About: The Information Professionals Association (IPA) is a non-profit organization dedicated to exploring the role of information activities, such as influence and cognitive security, within the national security sector and helping to bridge the divide between operations and research. Its goal is to increase interdisciplinary collaboration between scholars and practitioners and policymakers with an interest in this domain. For more information, please contact us at communications@information-professionals.org. Or, connect directly with The Cognitive Crucible podcast host, John Bicknell, on LinkedIn. Disclosure: As an Amazon Associate, 1) IPA earns from qualifying purchases, 2) IPA gets commissions for purchases made through links in this post.
Michael Kentris discusses with Dr. Lyell Jones, Editor of Continuum: Lifelong Learning in Neurology, what is important to learn and how to stay up to date throughout your career in a world where medicine is evolving more rapidly than ever before. They discuss a variety of tools including high-yield summaries, conference attendance, discussing cases with colleagues, podcasts, AI chatbots, and more.
In this solo episode, Dr. Joy Kong breaks down the 5 biggest mistakes patients make when undergoing stem cell therapy—and how to avoid them to get the most out of your investment. Learn why using your own cells may not be ideal, the dangers of over-expanded lab-grown cells (especially from overseas clinics), and how lifestyle habits like overexertion, alcohol, and poor diet can sabotage your results. If you're considering regenerative therapy, this is essential listening for safer, more effective outcomes.Additional Resources:Visit My Clinic: Chara Health
Dr. Dan Ackerman talks with Drs. Luuk Dekker and Jasper D. Daems about analyzing various anterior-circulation large-vessel occlusion (aLVO) stroke detection scales to determine which one is the most useful for prehospital triage. Read the related article in Neurology®. Disclosures can be found at Neurology.org.
In part two of this three-part series, Dr. Andy Southerland and Dr. Seemant Chaturvedi discuss the OPTIMISTmain Trial, which was presented at the 2025 European Stroke Organization Conference. Show reference: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)00549-5/abstract
Send us a textThis bonus episode features a conversation with Dr. Smitha Vijayan on episode 3, "The Abducens Nerve." We're testing out this experimental format to bring the material to life in a new way. Please text me to let me know whether you like it.Support the showSay hello to us on X, Instagram, Facebook, and YouTube. Those who like reading more than listening to neurology can follow us on Medium and Substack. For notes and images of the podcast, visit Neurology Teaching Club.
Climate change is no longer a distant worry—it's showing up in neurology clinics across the US, from Lyme meningitis in the Midwest to worsening migraines during heat waves, climate-linked and vector-borne neurological conditions are entering the differential. Our guests today are two experts on climate change and neurological health: Dr. Beth Malow, Professor of Neurology and Pediatrics at Vanderbilt University Medical Center, and Dr. Monica Diaz, Assistant Professor of Neurology at the University of North Carolina at Chapel Hill. They'll explore the clinical impact of climate change on neurology, and how neurologists can adapt through patient care, advocacy, and research. Drs. Malow and Diaz were interviewed by Dr. Sara Stern-Nezer, Associate Professor of Neurology at the University of California, Irvine. Interviewer: Dr. Sara Stern-Nezer, Associate Professor of Neurology at the University of California, Irvine Guests: Dr. Beth Ann Malow, Professor of Neurology and Pediatrics at Vanderbilt University Medical Center, and Dr. Monica Diaz, Assistant Professor of Neurology at the University of North Carolina at Chapel Hill Disclosure: Dr. Malow serves as a consultant for Neurim Pharmaceuticals. Resources: Neurologists Interested in Climate and Health (NICHE) Climate Change and Brain Health: What Do We Know and What Can We Do? http://nichebrainhealth.com/what-we-can-do/
In part one of this three-part series, Dr. Andy Southerland and Dr. Seemant Chaturvedi discuss the BRIDGE-TNK Trial, which was presented at the 2025 European Stroke Organization Conference. Show reference: https://www.nejm.org/doi/full/10.1056/NEJMoa2503867
Pria Anand speaks to managing editor Emily Everett about her story “The Elephant's Child,” which appears in The Common's spring issue. The piece is a vivid retelling of a Hindu myth, the origin story of the elephant-headed god Ganesh. Pria talks about the process of writing and revising many versions of this ancient myth, why she felt inspired by it, and how her literary writing intersects with her career as a neurologist. Pria also discusses her debut book, The Mind Electric: A Neurologist on the Strangeness and Wonder of Our Brains, out this month from Simon & Schuster. The book explores how story and storytelling can illuminate the rich, complex gray areas within the science of the brain, weaving case study, history, fable, and memoir. Pria Anand is a neurologist and the author of The Mind Electric, out from Simon & Schuster in the U.S. and Little, Brown in the U.K. Her stories and essays have appeared in the Los Angeles Review of Books, Time Magazine, The Boston Globe, The Washington Post, The New York Times, Ploughshares, and elsewhere. She is a graduate of Yale University and Stanford Medical School, and she trained in neurology, neuro-infectious diseases, and neuroimmunology at the Johns Hopkins Hospital and the Massachusetts General Hospital. She is now an Assistant Professor of Neurology at the Boston University School of Medicine, and she cares for patients at the Boston Medical Center. Read Prias's story “The Elephant's Child” in The Common at thecommononline.org/the-elephants-child. Order The Mind Electric in all formats via Simon & Schuster at simonandschuster.com/books/The-Mind-Electric/. Learn more about Pria at www.priaanand.com. The Common is a print and online literary magazine publishing stories, essays, and poems that deepen our collective sense of place. On our podcast and in our pages, The Common features established and emerging writers from around the world. Read more and subscribe to the magazine at thecommononline.org, and follow us on Instagram, Bluesky, and Facebook. Emily Everett is managing editor of the magazine and host of the podcast. Her new debut novel All That Life Can Afford is the Reese's Book Club pick for April 2025. Her work has appeared in The New York Times Modern Love column, the Kenyon Review, Electric Literature, Tin House, and Mississippi Review. She was a 2022 Massachusetts Cultural Council Fellow in Fiction. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/new-books-network
Pria Anand speaks to managing editor Emily Everett about her story “The Elephant's Child,” which appears in The Common's spring issue. The piece is a vivid retelling of a Hindu myth, the origin story of the elephant-headed god Ganesh. Pria talks about the process of writing and revising many versions of this ancient myth, why she felt inspired by it, and how her literary writing intersects with her career as a neurologist. Pria also discusses her debut book, The Mind Electric: A Neurologist on the Strangeness and Wonder of Our Brains, out this month from Simon & Schuster. The book explores how story and storytelling can illuminate the rich, complex gray areas within the science of the brain, weaving case study, history, fable, and memoir. Pria Anand is a neurologist and the author of The Mind Electric, out from Simon & Schuster in the U.S. and Little, Brown in the U.K. Her stories and essays have appeared in the Los Angeles Review of Books, Time Magazine, The Boston Globe, The Washington Post, The New York Times, Ploughshares, and elsewhere. She is a graduate of Yale University and Stanford Medical School, and she trained in neurology, neuro-infectious diseases, and neuroimmunology at the Johns Hopkins Hospital and the Massachusetts General Hospital. She is now an Assistant Professor of Neurology at the Boston University School of Medicine, and she cares for patients at the Boston Medical Center. Read Prias's story “The Elephant's Child” in The Common at thecommononline.org/the-elephants-child. Order The Mind Electric in all formats via Simon & Schuster at simonandschuster.com/books/The-Mind-Electric/. Learn more about Pria at www.priaanand.com. The Common is a print and online literary magazine publishing stories, essays, and poems that deepen our collective sense of place. On our podcast and in our pages, The Common features established and emerging writers from around the world. Read more and subscribe to the magazine at thecommononline.org, and follow us on Instagram, Bluesky, and Facebook. Emily Everett is managing editor of the magazine and host of the podcast. Her new debut novel All That Life Can Afford is the Reese's Book Club pick for April 2025. Her work has appeared in The New York Times Modern Love column, the Kenyon Review, Electric Literature, Tin House, and Mississippi Review. She was a 2022 Massachusetts Cultural Council Fellow in Fiction. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/literary-studies
Pria Anand speaks to managing editor Emily Everett about her story “The Elephant's Child,” which appears in The Common's spring issue. The piece is a vivid retelling of a Hindu myth, the origin story of the elephant-headed god Ganesh. Pria talks about the process of writing and revising many versions of this ancient myth, why she felt inspired by it, and how her literary writing intersects with her career as a neurologist. Pria also discusses her debut book, The Mind Electric: A Neurologist on the Strangeness and Wonder of Our Brains, out this month from Simon & Schuster. The book explores how story and storytelling can illuminate the rich, complex gray areas within the science of the brain, weaving case study, history, fable, and memoir. Pria Anand is a neurologist and the author of The Mind Electric, out from Simon & Schuster in the U.S. and Little, Brown in the U.K. Her stories and essays have appeared in the Los Angeles Review of Books, Time Magazine, The Boston Globe, The Washington Post, The New York Times, Ploughshares, and elsewhere. She is a graduate of Yale University and Stanford Medical School, and she trained in neurology, neuro-infectious diseases, and neuroimmunology at the Johns Hopkins Hospital and the Massachusetts General Hospital. She is now an Assistant Professor of Neurology at the Boston University School of Medicine, and she cares for patients at the Boston Medical Center. Read Prias's story “The Elephant's Child” in The Common at thecommononline.org/the-elephants-child. Order The Mind Electric in all formats via Simon & Schuster at simonandschuster.com/books/The-Mind-Electric/. Learn more about Pria at www.priaanand.com. The Common is a print and online literary magazine publishing stories, essays, and poems that deepen our collective sense of place. On our podcast and in our pages, The Common features established and emerging writers from around the world. Read more and subscribe to the magazine at thecommononline.org, and follow us on Instagram, Bluesky, and Facebook. Emily Everett is managing editor of the magazine and host of the podcast. Her new debut novel All That Life Can Afford is the Reese's Book Club pick for April 2025. Her work has appeared in The New York Times Modern Love column, the Kenyon Review, Electric Literature, Tin House, and Mississippi Review. She was a 2022 Massachusetts Cultural Council Fellow in Fiction. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/literature
What if your blood pressure — even just a little too high — is quietly damaging your brain? What if it's increasing your risk of a heart attack or stroke, without you ever feeling a thing? In this episode, Professor Tim Spector reveals why blood pressure is one of the most overlooked – and most dangerous – health issues today. He explains why “normal for your age” might not be safe at all, why medication alone isn't the full answer, and how small, daily changes could dramatically reduce your risk of serious disease. Can your gut microbes raise your blood pressure? Can a banana be as powerful as a pill? Is beetroot juice really three times more effective than cutting salt? You'll also learn why 80% of the salt we eat isn't from the shaker, how stress and sleep secretly push your pressure up, and what most doctors still miss when treating hypertension. If you've ever been told your blood pressure's “fine” — or never measured it at all — this episode might change the way you think about your future health.
Dr. Andy Southerland talks with Dr. Seemant Chaturvedi about several studies presented at the 2025 European Stroke Organization Conference (ESOC). Disclosures can be found at Neurology.org.
Dr. Elizabeth Coon and Dr. Peter Novak discuss how central sensitization plays a role in the autonomic symptoms-sings dichotomy and the importance of addressing both conditions for optimal treatment. Show references: https://www.neurology.org/doi/10.1212/CPJ.0000000000200463
Matias and Greg interview Ying-Hui Fu, PhD, is a Professor of Neurology at UCSF and a world leader in the genetics of sleep. Her lab has discovered the first-known genes behind “natural short sleepers”. Her work bridges human genetics and neuroscience to uncover how to modulate sleep for brain health, aging, and neurodegenerative diseases.In this episode, we discuss:How some people thrive on 4–6 hours of sleep with rare genetic mutationsWhy sleep efficiency is more important than total hours sleptWhat short sleeper genes reveal about preventing Alzheimer's and autismWhy current sleep research tools miss deeper brain activity patternsWhat's next in sleep science with potential therapiesCredits:Created by Greg Kubin and Matias SerebrinskyHost: Matias Serebrinsky & Greg KubinProduced by Caitlin Ner & Nico V. Rey Find us at businesstrip.fm and psymed.venturesFollow us on Instagram and Twitter!Theme music by Dorian LoveAdditional Music: Distant Daze by Zack Frank
New studies show cannabis use is rising among older adults. Clinicians have been able to provide medical marijuana to eligible patients since 2016. But the legalization of cannabis in 2021 means increasing numbers of people are using it for a variety of symptoms and conditions including pain, anxiety, cancer symptoms and seizures. Guest host Racquel Stephen talks with local clinicians and a patient about this trend and about what patients should consider when requesting and using cannabis. Our guests: Leonid Vilensky, M.D., medical director of Upstate Pain Clinic Al Bain, patient who uses cannabis Paul Vermilion, M.D., assistant professor of palliative care in the Departments of Medicine, Pediatrics, and Neurology at the University of Rochester Medical Center Take our audience survey to help us learn more about you, and make a better show for you.
A generation ago, a big clot in the brain meant paralysis or worse. Today, doctors can diagnose clots on AI-enabled brain scans; provide life-saving, targeted medications; or snake a catheter from a patient's groin into the brain to vacuum out the clot. If they intervene in time, they can watch speech and movement return before the sedatives wear off. How did that happen—and what's still missing?In this episode of From Our Neurons to Yours, Stanford neuroscientist and neurocritical care specialist Marion Buckwalter, MD, PhD retraces the 70-year chain of curiosity-driven research—biochemistry, imaging, materials science, AI—behind today's remarkable improvements in stroke care. She also warns what future breakthroughs are at stake if support for basic science stalls.Learn MoreBuckwalter Lab siteHistory of Stroke Care:Tissue Plasminogen Activator for Acute Ischemic Stroke (NINDS) On the development of the first-gen clot-busting drug, tPA Optimizing endovascular therapy for ischemic stroke (NINDS) On the development of mechanical clot clearance using thrombectomy.Mechanical Thrombectomy for Large Ischemic Stroke (Neurology, 2023) A literature meta-analysis shows that thrombectomy improves stroke outcomes by 2.5X, on top of 2X improvements from clot-busting drugsThe uncertain future of federal support for scienceThe Gutting of America's Medical Research: Here Is Every Canceled or Delayed N.I.H. Grant (New York Times, 2025)Trump Has Cut Science Funding to Its Lowest Level in Decades (New York Times, 2025)We want to hear from your neurons! Email us at at neuronspodcast@stanford.edu or... Send us a text!Thanks for listening! If you're enjoying our show, please take a moment to give us a review on your podcast app of choice and share this episode with your friends. That's how we grow as a show and bring the stories of the frontiers of neuroscience to a wider audience. Learn more about the Wu Tsai Neurosciences Institute at Stanford and follow us on Twitter, Facebook, and LinkedIn.
Today on the show, we're joined by Noland Arbaugh — the first publicly known human to receive Neuralink's brain-computer interface implant. After a diving accident left him paralyzed from the shoulders down, Noland volunteered for one of the most experimental technologies of our time. Now, he can control digital devices with his mind. We'll explore the procedure, how the tech works, its ethical implications, and how merging with a machine is reshaping his view of identity, ability, consciousness, and human potential. This is a conversation about risk, resilience, and the future of the mind. Join us as we get rebelliously curious. Watch the YouTube interview - https://www.youtube.com/@RebelliouslyCurious Follow Chrissy Newton: Winner of the Canadian Podcast Awards for Best Science Series. YouTube: https://www.youtube.com/channel/UCM32gjHqMnYl_MOHZetC8Eg Instagram: https://www.instagram.com/beingchrissynewton/ X: https://twitter.com/chrissynewton?lang=en Facebook: https://www.facebook.com/BeingChrissyNewton Chrissy Newton's Website: https://chrissynewton.com Top Canadian Science Podcast: https://podcasts.feedspot.com/canadian_science_podcasts/
This episode of RCM Insights features Bo Bowman, VP of Strategic Accounts at Infinx, in a conversation with a neurology practice leader. Bo shares practical insights on optimizing revenue cycle management with proven strategies in charge capture, coding, system integration, and analytics—delivering better outcomes for neurology practices of any size.
William Sauvé, MD is Chief Medical Officer at Osmind, where he focuses on driving the success of Osmind's nationwide network of 800+ independent psychiatry practices and expanding access to cutting-edge psychiatric care. Dr. Sauvé brings extensive experience in interventional psychiatry, particularly in expanding access to treatments like Transcranial Magnetic Stimulation (TMS) and esketamine. Prior to joining Osmind, he served as Regional Medical Director for Greenbrook TMS NeuroHealth Centers, where he helped grow the organization's network to nearly 200 dedicated interventional psychiatry centers nationwide. His journey in psychiatry began with 11 years of distinguished service as an active-duty Navy psychiatrist. Following his residency, he was deployed to Iraq's Al Anbar Province as the regimental psychiatrist for the 7th Marine Regiment. During his time in the military, he started a procedural psychiatry program that included ECT and patient engagement in post-traumatic stress disorder (PTSD) treatment. After his military service, he served as Military Clinical Director at Poplar Springs Hospital for three years before founding Virginia Interventional Psychiatry, one of the first interventional psychiatry practices in the Mid-Atlantic region. His practice, dedicated to advancing TMS treatment, was the first practice acquired into what is now Greenbrook TMS NeuroHealth Centers, contributing to their nationwide expansion in providing TMS and esketamine treatments. Dr. Sauvé received his medical degree from the Uniformed Services University of the Health Sciences in Bethesda, Maryland. He completed his residency in adult psychiatry through the National Capital Consortium, which includes the Walter Reed National Military Medical Center, Fort Belvoir Community Hospital, and USUHS. He earned his undergraduate degrees in Biology and Biochemistry from Mercyhurst College in Erie, Pennsylvania. He is certified by the American Board of Psychiatry and Neurology and serves as faculty at the Neuroscience Education Institute. He maintains an active membership in the American Psychiatric Association and the Clinical Transcranial Magnetic Stimulation Society. Website: https://www.osmind.org/ Timestamps: 00:00 Trailer 00:37 Introduction 03:39 Osmind as a comprehensive EMR solution 06:49 Brain stimulation boosts neuroplasticity 11:53 Military vs. academic medical experience 15:12 Weight loss for athletic pursuits 17:33 Reaching full speed safely 19:58 "Carnivorish" diet approach 24:08 Historic orchard ranch's new life 25:53 Rare bear sightings, abundant deer 31:15 Empowering independent mental health practitioners 32:25 Evolving psychiatric treatments 36:35 Pioneering comprehensive psychiatry 40:33 Weight loss without nutrition education 42:53 Where to find Will Join Revero now to regain your health: https://revero.com/YT Revero.com is an online medical clinic for treating chronic diseases with this root-cause approach of nutrition therapy. You can get access to medical providers, personalized nutrition therapy, biomarker tracking, lab testing, ongoing clinical care, and daily coaching. You will also learn everything you need with educational videos, hundreds of recipes, and articles to make this easy for you. Join the Revero team (medical providers, etc): https://revero.com/jobs #Revero #ReveroHealth #shawnbaker #Carnivorediet #MeatHeals #AnimalBased #ZeroCarb #DietCoach #FatAdapted #Carnivore #sugarfree Disclaimer: The content on this channel is not medical advice. Please consult your healthcare provider.
In this episode of the Neurology Minute, Dr. Alison Christy delves into another women's history minute to discuss Jean Holowach-Thurston.
In the second installment of this two-part series, Dr. Jeff Ratliff and Dr. Brin E. Freund discuss clinical guidance for managing patients who may experience neurotoxicity from CAR T-cell, with a specific focus on seizure risk. Show reference: https://www.neurology.org/doi/10.1212/WNL.0000000000213535
Dr. Elizabeth Coon talks with Dr. Peter Novak about how central sensitization plays a role in the autonomic symptoms-sings dichotomy and the importance of addressing both conditions for optimal treatment. Read the related article in Neurology® Clinical Practice. Disclosures can be found at Neurology.org.
In the June episode of the President's Spotlight, Dr. Jason Crowell and Dr. Natalia Rost discuss advocacy opportunities. Show reference: https://www.aan.com/about-the-aan/presidents-spotlight
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