Neurology® Podcast

1. Featured Article: Primary angiitis of the CNS and reversible cerebral vasoconstriction syndrome: A comparative study 2. What’s Trending: Cannabis and chronic neuropathic pain Dr. Andy Southerland talks with Dr. Anne Ducros about her paper on primary angiitis of the CNS and reversible cerebral vasoconstriction syndrome. In the second part of the podcast, Dr. Heather Harle focuses her interview with Dr. Haggai Sharon on the use of cannabis analgesia in chronic neuropathic pain. DISCLOSURES: Dr. Ducros has served on scientific Advisory Boards for Novartis, Eli Lilly, and TEVA;has served on editorial boards for Cephalalgia: Associate Editor, Headache: editorial advisory board member, Journal of Headache and Pain: editorial advisory board member. Dr. Sharon reports no disclosures Dr. Southerland has served on editorial boards for Journal Neurology, Section Editor Neurology Podcast Patents Intellectual property unrelated to current work: U.S. Patent Application No. 14/910,890 (iTREAT study) U.S. Provisional Patent Application No. 62/620,096 (BANDIT study). Dr. Southerland's consultancies include National Stroke Association - helped develop website for resources regarding telestroke and teleneurology, Research Support, Commercial Entities. Dr. Southerland's Edwards Lifesciences include perform neurological assessments for the PARTNER clinical trials of transcatheter aortic valve replacement. Dr. Southerland's Research Support, Government Entities include Stroke Hyperglycemia Insulin Network Effort (SHINE) NINDS/NIH U-01 NS 069498, Health Resources Services Administration - Evidence based tele-emergency network grant (RURAL EQUIT-E Project) HRSA G01RH27869, and NHLBI/NINDS - Cardiothoracic Surgical Trials Network (CTSN) - performed neurological assessments in conjunction with the neuroprotection trial of aortic valve replacement. Dr. Southerland's Research Support, Foundations and Societies include American Heart Association-American Stroke Association National Clinical Research Program, Cervical Artery Dissection Expression (CADEX) AHA 3CRP141400001, American Academy of Neurology - Education Research Grant, American Board of Psychiatry and Neurology - Faculty Fellowship Award. Dr. Southerland's legal proceedings include Legal Expert Review - perform expert review, on behalf of the UVA University Physician's Group, pertaining to stroke and vascular neurology questions for both plaintiff and defense cases.

1. Featured Article: Neurology: Clinical Practice: Presentation and management of community onset vs. hospital onset first seizures 2. What’s Trending: Acute viral encephalitis In the first segment, Dr. Katherine Zarroli talks with Dr. Emma Foster about her paper comparing the presentation and management of patients with community- and hospital-onset first seizures attending the same hospital. In the second part of the podcast, Dr. Stacey Clardy and Dr. Kenneth Tyler review the diagnosis and treatment of acute viral encephalitis. DISCLOSURES: Dr. Zarroli reports no disclosures. Dr. Foster has received research support from National Health and Medical Research Council (NHMRC) Medical / Dental Research Postgraduate Scholarship, APP1150482, CIA, funding 2018-2020 and Royal Australasian College of Physicians (RACP) Research entry scholarship, 2018. Dr. Clardy has received research support from Western Institute for Biomedical Research (WIBR). Dr. Tyler serves as an Associate Editor for Journal of Neurovirology and Neurology Today; serves as an editorial board member for Annals of Neurology, Apoptosis, JAMA Neurology, Experimental Neurology, Journal of Infectious Disease, Microbial Pathogenesis, Virology, Neurology ALL Current; serves on the scientific advisory board for DNAtrix (DSMB, active), LPath (DSMB)(completed), and PML Consortium (Scientific Advisory Board, completed); is a consultant for Hoffman La Roche; receives royalties from the publication of the books: Handbook of Clinical Neurology and Harrison's Principles & Practices of Internal Medicine; receives research support from Taiga Biotechnologies and the NIH/NIAID, 1R01 NS101208, PI, 2018-2022, Dept. of Veterans Affairs Merit Grant (BX000963, Role: PI, 2017-21), NIH/NINDS, (5R21NS103186, PI, 2017-2019); and serves as Officer (Treasurer) and Member Board of Directors American Neurological Association (ANA)- Uncompensated.

This month’s Delayed Recall episode includes interviews on drug pricing. The episode starts with Dr. Jason Crowell’s interview with Dr. Gordon Smith from September 26, 2017 on orphan drug pricing. Following this clip, we have the full-length interview from the December 5, 2017 episode where Dr. Ted Burns speaks with Dr. John Mytinger on the drug Achtar for infantile ataxia. Next, in an interview from the July 4, 2017 podcast, Dr. Stacey Clardy focuses her interview with Dr. Dennis Bourdette on new immunotherapies. In the fourth and final interview, Dr. Ted Burns and reporter Ike Swetlitz discuss drug pricing practices and the different players in determining drug prices, which first aired in the May 1, 2018 episode of the podcast.

1. Featured Article: Nusinersen in spinal muscular atrophy type 1 patients older than 7 months: a cohort study 2. What’s Trending: MRI-guided thrombolysis for stroke with unkown time of onset (WAKE-UP study) In the first segment, Dr. Ted Burns talks with Dr. Laurent Servais about his paper on safety and efficacy of nusinersen treatment in patients with SMA type 1 older than 7 months. In the second part of the podcast, we are featuring a discussion with Dr. Jim Siegler and Dr. Christian Gerloff on the results of the WAKE-UP stroke trial. DISCLOSURES: Dr. Servais has served as scientific consultant in the S.A.B of Roche, Biomarin, aTyr Pharma, Dynacure, Biogen, Bamboo, Sarepta, and Avexis; has received speaker honoraria gave lecture sponsored by Biomarin, Biogen, and Sarepta; holds patents as co-inventor of the Moviplate device, and of Actimyo; has consulted for Bamboo therapeutics, Pfizzer, Anagenesis, Avexis, and Dynacure; has received research support from NHS, Valerion, Dynacure, Avexis, Biogen, Roche, FP7 programs Skip and Scope, Université de Liège, and Association Française contre les Myopathies. Dr. Burns

1. Antiepileptic Drug Clearances during Pregnancy and Clinical Implications for Women with Epilepsy 2. AAN Position Statement: Lawful physician-hastened death In the first segment, Dr. Derek Bauer talks with Dr. Paula Emanuela Voinescu about her paper on antiepileptic drug (AED) clearances during pregnancy and the relationship between AED serum concentration and seizure frequency. In the second part of the podcast, we are featuring a discussion with Dr. Jason Crowell and Dr. James Russell on the recent AAN position statement regarding lawful physician-hastened death. DISCLOSURES: Dr. Voinescu has received speaker honoraria from SUNOVION, and has received research support from American Academy of Neurology, Susan Spencer Clinical Training Fellowship. Dr. Russell has received funding for travel from the Mexican Academy of Neurology; receives publishing royalties from Neuromuscular Disorders (McGraw-Hill, 2nd ed, 2015) and honorarium for a published article in Continuum Peripheral Neuropathy 2017; has received compensation for market research interviews regarding ALS therapeutics; and has received reimbursement for record review of medical legal proceedings without testimony or document authorship. All other participants report no disclosures.

1. Cerebello-spinal tDCS in ataxia: A randomized, double-blind, sham-controlled, crossover trial 2. What’s Trending: Emerging therapies for spinal muscular atrophy and Duchenne muscular dystrophy Dr. Jeff Ratliff talks with Dr. Alberto Benussi about his paper on cerebellar anodal and spinal cathodal transcranial direct current stimulation as a therapeutic approach for reducing symptoms in patients with neurodegenerative ataxia. In the second part of the podcast, we are featuring a discussion with Dr. Ted Burns and Stat reporter Adam Feuerstein on two emerging therapies for spinal muscular atrophy and Duchenne muscular dystrophy. DISCLOSURES: Dr. Ratliff has received speaker honoraria from Teva and US WorldMeds LLC; is the deputy editor for the Neurology Podcast; has been a consultant for UCB Pharmaceuticals, US WorldMeds LLC, Medscape, and Retrophin Inc; and has served on speakers' bureaus for Teva and US WorldMeds LLC. Dr. Burns has served on scientific advisory boards for Argenx, UCB, and CSL Behring; has received travel funding/speaker honoraria from Argenx and Alexion; and has received support for consulting activities from UCB Pharma and CSL Behring. Dr. Benussi and Mr. Feuerstein report no disclosures.

1. Featured Article: Dual antiplatelet therapy pretreatment in intravenous thrombolysis for acute ischemic stroke 2. What’s Trending: Recurrent glioblastoma treated with recombinant poliovirus Dr. Dan Ackerman talks with Dr. Andrei Alexandrov about his paper on dual antiplatelet therapy pretreatment. In the second part of the podcast, Dr. Kait Nevel focuses her interview with Dr. Darrell Bigner on treatment for recurrent glioblastoma. DISCLOSURES: Dr. Alexandrov has served on a scientific advisory board and consulted for Cerevast Therapeutics, Inc.; has served on editorial boards for Cerebrovascular Diseases and Interventional Neurology; holds a patent, and receives associated license fee and royalty payments, for "Therapeutic Methods and Apparatus for Use of Sonication to Enhance Perfusion of Tissue” (US patent 6,733,450 - May 11, 2004); receives publishing royalties for Cerebrovascular Ultrasound in Stroke Prevention and Treatment (Futura / Blackwell Publishing. 2003.), Cerebrovascular Ultrasound in Stroke Prevention and Treatment (Oxford: Blackwell Publishing (in Chinese) 2007), Cerebrovascular Ultrasound in Stroke Prevention and Treatment (2nd Edition) (Oxford: Wiley-Blackwell Publishers. 2011); has served on speakers' bureau for Genentech, Inc.; has received research support from Cerevast Therapeutics, Inc. and NINR (R01 pending); holds stock or stock options in Cerevast Therapeutics, Inc.; receives Board of Reagents compensation from Cerevast Therapeutics, Inc.; and serves as President-Elect for the American Society of Neuroimaging. All other participants report no disclosures.

1. Practice guideline recommendations summary: Disorders of consciousness 2. Multiscale Analysis of Independent Alzheimer’s Cohorts Finds Disruption of Molecular, Genetic, and Clinical Networks by Human Herpesvirus In the first segment, Dr. Jeff Burns talks with Dr. Joseph Giacino about the AAN Guideline update on disorders of consciousness. In the second part of the podcast, we are featuring a discussion with Dr. Jason Crowell and Dr. Joel Dudley discuss the detection of human herpesvirus genes in in a large cohort patients with Alzheimer disease. DISCLOSURES: Dr. Burns has served on the DSMB for NIH-funded trials (non-profit entities); serves on the editorial board for Journal of Alzheimer's Disease; has consulted for Grifols, USA; has served on Eli Lilly Amyvid Speaker's Bureau; and has received research support from Eli Lilly, Avid Radiopharmaceuticals, Toyama Chemical Company, Merck, Biogen, AbbVie, Novartis, vTv Therapeutics, Janssen, and NIH (R01AG058557, R01AG053312, R01AG034614, R01AG03367, R01AG043962, P30AG035982, U10NS077356, UL1TR000001). Dr. Giacino has served on the scientific advisory board for the Traumatic Brain Injury Model Systems National Data and Statistical Center (federal agency); serves on the editorial board for Journal of Head Trauma Rehabilitation; serves as Director of the Spaulding Rehabilitation Network Disorders of Consciousness Program; has received research support from the U.S. Department of Defense, (Co-Investigator, W81XWH-11- 2-0210; Co-Investigator, W81XWH- 08-2-0159; Co-PI, W81XWH-14-2-0176), National Institute on Disability and Rehabilitation Research, (PI, H133A120085; site PI, 90DP0060; PI 4, 90DPTB0011), National Institutes of Health (Co-PI, 1U01NS086090-01; Co-PI, UH3NS095554), James S. McDonnell Foundation, and the The Barbara Epstein Foundation, Inc; and served as expert witness in legal proceedings for DeCorato Cohen Sheehan & Federico. Dr. Crowell and Dr. Dudley report no disclosures.

For the September 2018 Delayed Recall episode, we are featuring recordings of in-person interviews that took place at the April 2018 AAN Annual Meeting. All interviewees were plenary speakers who gave talks throughout Annual Meeting week. These recordings originally appeared as “What’s Trending” segments in July 2018 (July 17, 24, and 31, respectively). In the first interview, we will hear Dr. Alberto Espay speak with Dr. Jeff Lichtman about connectomics. Next, Dr. Stacey Clardy interviews Dr. Michael Wilson about his talk on next-generation sequencing and diagnosing meningitis and encephalitis. Last, Dr. Alberto Espay discusses the matter of who should be the primary caregivers for functional disorder patients with Dr. Andrea Leigh Haller and Dr. David Perez.

1. How Early Can We Diagnose Alzheimer’s Disease (And Is It Sufficient)? 2. What's Trending: Updates to the International Classification of Headache Disorders (ICHD-3) Dr. Stacey Clardy talks with Dr. Ronald Petersen about his paper on Alzheimer disease diagnosis. In the second part of the podcast, Dr. Tesha Monteith focuses her interview with Dr. Jes Olesen on what's new in the 3rd edition of the International Classification of Headache Disorders (ICHD-3). The full ICHD-3 can be found at https://www.ichd-3.org/wp-content/uploads/2018/01/The-International-Classification-of-Headache-Disorders-3rd-Edition-2018.pdf DISCLOSURES: Dr. Clardy has received research support from Western Institute for Biomedical Research (WIBR). Dr. Petersen receives publishing royalties from Mild Cognitive Impairment (Oxford University Press, 2003); has consulted for Roche Incorporated, Merck, Genentech, Biogen, and GE Healthcare (presentation); and has received research support from the National Institute on Aging (U01-AG006786, P50-AG016574, U01-AG024904, U01 AG016976). Dr. Monteith serves as an editorial advisory board member for Neurology Now and receives research support from the NIH. Dr. Olesen has consulted for Jannsen Pharmaceutical Products and served on speakers' bureaus for Allergan.

1. Featured Article: Silent infarct is a risk factor for infarct recurrence in adults with sickle cell anemia 2. What’s Trending: Neuropalliative Care: Priorities to move the field forward Dr. Justin Sattin talks with Dr. Lori Jordan about her paper on silent infarct and the risk of infarct recurrence in adults with sickle cell anemia. In the second part of the podcast, Dr. Maisha Robinson focuses her interview with Dr. Claire Creutzfeldt on neuropalliative care. DISCLOSURES: Dr. Jordan serves on the editorial boards of the Journal of Child Neurology, Pediatric Neurology and Stroke; and has received research support from Dr. Creutzfeldt has received research support from NINDS (K23 NS099421-01A1) and Cambia Health Foundation's Sojourn Scholars Program. Dr. Sattin and Dr. Robinson reports no disclosures.

1. Featured Article: Silent infarct is a risk factor for infarct recurrence in adults with sickle cell anemia 2. What’s Trending: Neuropalliative Care: Priorities to move the field forward Dr. Justin Sattin talks with Dr. Lori Jordan about her paper on silent infarct and the risk of infarct recurrence in adults with sickle cell anemia. In the second part of the podcast, Dr. Maisha Robinson focuses her interview with Dr. Claire Creutzfeldt on neuropalliative care. DISCLOSURES: Dr. Jordan serves on the editorial boards of the Journal of Child Neurology, Pediatric Neurology and Stroke; and has received research support from Dr. Creutzfeldt has received research support from NINDS (K23 NS099421-01A1) and Cambia Health Foundation's Sojourn Scholars Program. Dr. Sattin and Dr. Robinson reports no disclosures.

1. Neurology® Clinical Practice: Safety and efficacy of plasma exchange in pediatric transverse myelitis 2. Clopidogrel and aspirin in acute ischemic stroke and high-risk TIA (POINT study) Dr. Stacey Clardy talks with Dr. Benjamin Greenberg about his paper on therapeutic plasma exchange in a cohort of pediatric transverse myelitis patients. Next, Will Rondeau interviews Dr. Clay Johnston about findings from the POINT study on clopidogrel and aspirin in acute ischemic stroke. DISCLOSURES: Dr. Clardy has received research support from Western Institute for Biomedical Research (WIBR). Dr. Greenberg has received travel funding from the Transverse Myelitis Association; has filed has filed patents on the use of antibody biology in multiple sclerosis; has consulted for Novartis, Alexion, and EMD Serono; and has received research support from Medimmune, Chugai, Medday, Genentech, NIH (RO1 NS071463), Unviersity of Texas Southwestern, Guthy Jackson Foundation, PCORI, Transverse Myelitis Association, and the National MS Society. Dr. Johnston has received travel reimbursements from the National Academies of Sciences, US News, Austin Chamber of Commerce, Johns Hopkins, UT Health Science Center, University of Utah Medical School, Medtronic, Astrazeneca, University of Rochester NY, and Duke University; has received research support from AstraZeneca, NIH/NCATS (UL1 RR024131), UCSF Clinical-Translational Science Institute, and NIH/NINDS (U01 NS062835-01A1, U01 NS062835). Mr. Rondeau reports no disclosures.

1. Neurology® Clinical Practice: Safety and efficacy of plasma exchange in pediatric transverse myelitis 2. Clopidogrel and aspirin in acute ischemic stroke and high-risk TIA (POINT study) Dr. Stacey Clardy talks with Dr. Benjamin Greenberg about his paper on therapeutic plasma exchange in a cohort of pediatric transverse myelitis patients. Next, Will Rondeau interviews Dr. Clay Johnston about findings from the POINT study on clopidogrel and aspirin in acute ischemic stroke. DISCLOSURES: Dr. Clardy has received research support from Western Institute for Biomedical Research (WIBR). Dr. Greenberg has received travel funding from the Transverse Myelitis Association; has filed has filed patents on the use of antibody biology in multiple sclerosis; has consulted for Novartis, Alexion, and EMD Serono; and has received research support from Medimmune, Chugai, Medday, Genentech, NIH (RO1 NS071463), Unviersity of Texas Southwestern, Guthy Jackson Foundation, PCORI, Transverse Myelitis Association, and the National MS Society. Dr. Johnston has received travel reimbursements from the National Academies of Sciences, US News, Austin Chamber of Commerce, Johns Hopkins, UT Health Science Center, University of Utah Medical School, Medtronic, Astrazeneca, University of Rochester NY, and Duke University; has received research support from AstraZeneca, NIH/NCATS (UL1 RR024131), UCSF Clinical-Translational Science Institute, and NIH/NINDS (U01 NS062835-01A1, U01 NS062835). Mr. Rondeau reports no disclosures.

1. Diagnosing Cerebral Ischemia with Door-to-Thrombolysis Times Below 20 Minutes 2. What’s Trending: Tenecteplase versus Alteplase before Thrombectomy for Ischemic Stroke Dr. Jimmy Berthaud speaks with Drs. Olli Mattila and Perttu Lindsberg about their paper on the accuracy and consequences of rapid stroke diagnostics in a neurological emergency department. In the second segment of the podcast, Dr. Kevin Barrett interviews Dr. Bruce Campbell about the EXTEND-IA TNK trial of tenecteplase for patients with ischemic stroke. DISCLOSURES: Dr. Berthaud reports no disclosures. Dr. Mattila has recieved research support from the Maire Taponen Foundation, The Finnish Medical Foundation, The Finnish Foundation for Cardiovascular Research, Inkeri and Mauri Vänskä Foundation, and the Aarne and Aili Turunen Foundation. Dr. Lindsberg serves as Assistant Editor for the medical journal DUODECIM; serves as chairman of the ad hoc committee on Current Therapy Guidelines in Stroke for the Finnish Medical Society; and has recieved research support for Helsinki University Hospital District, the Sigrid Jusélius Foundation, the Jane and Aatos Erkko Foundation, and the Signe and Ane Gyllenberg Foundation. Dr. Barrett has received research support from Axovant Sciences, Inc., the Virginia Center of Alzheimer's and Related Diseases, and the Department of Defense. Dr. Campbell serves on the editorial board for Stroke Stroke; served as PI of the EXTEND-IA trial, partially funded by unrestricted grant from Medtronic; and has received research support from the National Health and Medical Research Council of Australia (GNT1111972 2016-2019) and the Heart Foundation, Australia.