THE ANNUAL MEETING NEWS DAILY
Wednesday, April 26, 2017
Inside
8
Poster Session IV Opens This Morning at 8:30, Posters Grouped by Topic “Neighborhoods”
Meeting Science 10 Annual Garners International Coverage
Brain 20 American Foundation Launches New Crowdfunding Platform
the End of a 22 Celebrate Great Meeting at Friday’s
Run/Walk for Brain Research Results
Hollywood Themed Closing Party
More than 500 Annual Meeting attendees took steps to support brain disease research and get us one step closer to cures during yesterday morning’s 5k run/1k walk along the beautiful Boston waterfront. Continued on page 21 u
Translational Research Highlighted in Today’s Plenary Session This morning’s Frontiers in Neuroscience Plenary Session focuses on translational research related to clinical issues of importance. Randolph S. Marshall, MD, FAAN, moderates the session, which runs from 9:15 a.m. to 11:30 a.m. Continued on page 6 u
New Neuroscience in the Clinic Sessions Integrate Scientific Research with Clinical Application Through Case Discussions The New Neuroscience in the Clinic Sessions today, Thursday, and Friday will feature a mix of scientists and clinicians engaged in lively case discussions to integrate scientific research with clinical application. A moderator will introduce and provide background on a case and invited speakers will Continued on page 12 u
Wednesday, April 26, 2017 • AANextra
1
HARNESSING SCIENCE
to improve lives
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Discover our current efforts at Booth 721
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Inspired by patients. Grounded in science.
Š 2017 MT Pharma America, Inc. All rights reserved. CP-MTPA-US-0002 04/17
Wednesday, April 26 1 1 1 5 7 8
Run/Walk for Brain Research Results New Neuroscience in the Clinic Sessions Integrate Scientific Research with Clinical Application Through Case Discussions Translational Research Highlighted in Today’s Plenary Session Attend Rare Public Interview with Nobel Laureate Prusiner
10 New to the Annual Meeting? This
The Vision of the AAN is to be indispensable to our members.
14 Today’s Experiential Learning Area
The Mission of the AAN is to promote the highest quality patient-centered neurologic care and enhance member career satisfaction.
Morning’s Orientation Session Is for You! Highlights
20 American Brain Foundation Launches New Crowdfunding Platform
22 Celebrate the End of a Great Meeting at Friday’s Hollywood Themed Closing Party
Read Summary of AAN Successes in 2016 Annual Report
25 Ringel Lauded for
Poster Session IV Opens This Morning at 8:30, Posters Grouped by Topic “Neighborhoods”
26 Tweets of the Day 26 Special Pricing on Annual Meeting
8 Daily Reminders 10 Annual Meeting Science Garners International Coverage
Dedication to Neurology Today
On Demand Through End of Week
28 What Are People Saying? 30 Upcoming AAN Conference Opportunities
Contact Information: American Academy of Neurology 201 Chicago Avenue Minneapolis, MN 55415 USA
(800) 879-1960 (Toll Free) or (612) 928-6100 (International) (612) 454-2744 memberservices@aan.com AAN.com
Phone:
Fax: Email: Website:
AAN Executive Director/CEO:
Catherine M. Rydell, CAE
Managing Editor: Angela Babb, CAE Editor: Tim Streeter Writers: Ryan Knoke, Sarah Parsons Designer: Jim Hopwood Photography: Siu Lee Printing: Universal Wilde, Inc. Email: aannews@aan.com AANextra is published by the American Academy of Neurology.
Boxed Lunch Menu Wednesday, April 26 Lemon-Basil Chicken Salad Sandwich Dried cranberries, grapes, and roasted peppers with citrus aioli on wheat bulkie roll Shaved Turkey and Gruyere (GF) GF Mayonnaise, caramelized onions, and arugula on GF bulkie roll, greens
The American Academy of Neurology’s registered trademarks and service marks are registered in the United States and various other countries around the world. “American Brain Foundation” is a registered service mark of the American Brain Foundation and is registered in the United States.
Roasted Root Vegetable Caesar Salad (V, GF) Tuscan kale, traditional dressing, GF croutons Each lunch includes: Country potato salad – red pepper vinaigrette, mandarin oranges, carrot cake – cream cheese icing
DAY, AprIL WEDNES
THE ANNUAL
MEETING
NEWS
26, 2017
Inside
9
DAILY
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10 can Brain hes New Launc 20 Ameri Foundation g Platform Crowdfundin
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Today’s AAN Section Meetings Wednesday, April 26—Westin Galleria 12:00 p.m.–1:00 p.m.
LGBTQI Section Neural Repair & Rehabilitation Section Pain & Palliative Care Section Spine Section
4
Wednesday, April 26, 2017 • AANextra
5:30 p.m.–6:30 p.m.
Critical Care & Emergency Neurology Section History of Neurology Section Neuro-oncology Section Sports Neurology Section
day, April
26, 2017
extra • AAN
1
Wednes
The American Academy of Neurology sincerely thanks Universal Wilde, Inc. for its exceptional service, steadfast professionalism, and high-quality standards, as well as its generous donation of the 2017 Brain Health Fair program guide.
Attend Rare Public Interview with Nobel Laureate Prusiner Stanley B. Prusiner, MD, FAAN, recipient of the 1997 Nobel Prize for Physiology or Medicine for his groundbreaking and controversial work identifying the prion, will be interviewed onstage in the Navigating Your Career Experimental Learning Area on Thursday at 1:00 p.m. Prusiner will take questions from Douglas J. Lanska, MD, FAAN, as he shares “the prion story” and covers key aspects of his remarkable research career. Prusiner has been widely honored for his work. The AAN has bestowed on him the George Cotzias Award for outstanding research in neurology (1987); the Potamkin Prize for Research in Pick’s, Alzheimer’s, and Related Diseases (1991); the Presidential Award (1993); the Distinguished Achievement Award (1998); and Honorary membership (2003). Other accolades include the Albert Lasker Award for basic medical research, membership in the National Academy of Sciences and the Institute of Medicine, honorary membership in
the American Neurological Association, and 12 honorary degrees from institutions in the United States, Israel, France, Italy, Belgium, and Spain. Seating is limited for this event, so arrive early!
Douglas J. Lanska, MD, FAAN
Stanley B. Prusiner, MD, FAAN
Driving quality improvement and demonstrating the value of neurology. The AAN’s new Axon Registry™ provides a seamless, discrete collection of timely data that can show quality improvement by individual neurologists and collectively confirm the crucial value of neurologists in the care of patients with brain disease.
Learn more and participate: AAN.com/view/axon
Translational Research Highlighted in Today’s Plenary Session continued from cover The topics and speakers are: The Promise of Immunotherapy for Neurodegenerative Disorders: Progress and Challenges Eliezer Masliah, MD National Institute on Aging, Bethesda, MD
Plenaries Focusing on Controversies and Year in Review Set to Round Out Week of Premier Lectures You won’t want to miss these highly popular lectures on the most cutting-edge advances in neuroscience rounding out an impressive week of Annual Meeting Plenary Sessions.
Controversies in Neurology Plenary Session Thursday, April 27 / 9:15 a.m.–11:30 a.m.
Features experts discussing the most current and controversial issues in neuroscience. This debate format includes two speakers arguing one side of a single topic, followed by a rebuttal. Is Focused Ultrasound Better Than Deep Brain Stimulation? Yes: Paul S. Fishman, MD, PhD University of Maryland School of Medicine, Baltimore, MD
Genome and Epigenome Eliezer Masliah, MD Editing for Gene Therapy and Cell Programming Charles A. Gersbach, PhD Duke University, Durham, NC
No: Michael S. Okun, MD University of Florida, Gainesville, FL
Should Disease-modifying Therapies Be Stopped in Progressive MS? Yes: John Corboy, MD, FAAN University of Colorado School of Medicine, Aurora, CO Charles A. Gersbach, PhD
Epilepsy at the Cutting Edge: Using Novel Models for Therapeutic Advances Amy Brooks-Kayal, MD University of Colorado School of Medicine, Aurora, CO
Vesicle Communication in the Tumor‑bearing Brain Xandra O. Breakefield, PhD Massachusetts General Hospital, Charlestown, MA
Yes: Reisa Sperling, MD Brigham and Women’s Hospital and Massachusetts General Hospital, Boston, MA No: George Perry, PhD University of Texas at San Antonio, San Antonio, TX
Friday, April 28 / 9:15 a.m.–11:30 a.m.
Features six speakers, each focusing on the latest research that has happened in the last year within a specific subspecialty topic. Movement Disorders Susan Fox, MD Toronto Western Hospital, Toronto, ON, Canada Xandra O. Breakefield, PhD
The Lives of a Gene: Diverse Roles in Diseases of Developing and Mature Brain M. Elizabeth Ross, MD, PhD Weill Cornell Medical College, New York, NY
Neurocritical Care Paul M. Vespa, MD, FAAN University of California Los Angeles, Los Angeles, CA Pediatric Neurology Erika Augustine, MD, MS University of Rochester Medical Center, Rochester, NY Multiple Sclerosis Peter A. Calabresi, MD, FAAN Johns Hopkins University, Baltimore, MD
M. Elizabeth Ross, MD, PhD
Epilepsy Cynthia L. Harden, MD Mount Sinai Beth Israel PACC, New York, NY
Axonopathies: What Next? Mary Reilly, MD, FRCP, FRCPI National Hospital for Neurology and Neurosurgery, London, United Kingdom
Stroke Brett M. Kissela, MD, MS, FAAN University of Cincinnati Gardner Neuroscience Institute, Cincinnati, OH Mary Reilly, MD, FRCP, FRCPI
Wednesday, April 26, 2017 • AANextra
Does Removal of Amyloid Improve Cognition in Alzheimer’s Disease?
Neurology Year in Review Plenary Session
Amy Brooks-Kayal, MD
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No: Robert T. Naismith, MD Washington University in St. Louis, St. Louis, MO
Read Summary of AAN Successes in 2016 Annual Report If you are wondering what the AAN has done for you recently, you’re invited to take a look at the 2016 Annual Report: We’ve Got Your Back, conveniently posted online at AAN.com/ view/2016AnnualReport. The report covers many of the Academy’s major accomplishments in 2016 on behalf of members in practice, public policy, conferences, CME and MOC, and more. The organization’s financial results for the year are reviewed as well. The report looks forward to 2017 with an outline of the AAN’s strategic plan.
Stay connected to what the AAN is doing for you by reading your monthly issue of AANnews®, checking your inbox for AANe-news® and other Academy emails, and regularly visiting AAN.com. GUIDELINES
PRACTICE
ACADEMIC
CME & MOC
Research is always a focal point at the Annual Meeting. More than 2,700 science abstracts were shared in Vancouver, poster halls were open daily, and each day featured a plenary session. Attendees were invited to Frontiers in Child Neurology, a new, free half-day program that brought together leading experts to explore the latest science in pediatric neurology.
AAN Research Program The Academy’s board and staff put into place a significant expansion of our investment in research via the AAN Research Program, which includes money from the AAN Institute, the American Brain Foundation, association partners, the pharmaceutical industry, and AAN members. The amount for 2016 was $2.6 million—an increase of $200,000 over 2015.
In their introduction to the report, AAN President Terrence L. Cascino, MD, FAAN, and Executive Director and CEO Catherine M. Rydell, CAE, reinforce the association’s commitment to members. “The AAN exists for the benefit of members like you, to do the things collectively that would be nearly—if not completely—impossible to do individually. With the dogged commitment and passion of thousands of volunteer members and leaders working in tandem with our professional staff, we had your back in 2016, and we’re happy to highlight some of our most significant successes of the year in this annual report.”
Novartis Neuroscience
RESEARCH & AWARDS
PUBLIC POLICY
CONFERENCES
LEADERSHIP
MEMBERSHIP
PUBLICATIONS
RESEARCH & AWARDS Three new awards underscore the AAN’s pledge to support all types of research across all career levels and discovery stages: the three-year, $450,000 Career Development Award; the two-year, $130,000 Neurology Research Training Scholarship; and the Future Clinical Researchers in Neurology and Neuroscience Scholarship, which offers to medical students/junior residents/junior fellows who are interested in a career in clinical research the possibility of receiving a $1,000 scholarship to reimburse expenses associated with attending the AAN Annual Meeting.
Animals in Research The AAN collaborated with the Foundation for Biomedical Research, Society for Neuroscience, and other organizations to publish a white paper advocating the continued importance of the use of nonhuman primates in medical research. “The Critical Role of Nonhuman Primates in Medical Research” makes the case for continued need of animals in research, particularly nonhuman primates. It cites a number of major medical accomplishments that were assisted by research monkeys, notably the development of brain-machine interfaces and advances in pregnancy outcomes, organ transplants, and mapping brain function. The paper states that because of significant differences between the brains of primates and rodents, it is necessary to rely on monkeys to continue to make advances in medical research.
Neuroscience Is…
GUIDELINES PRACTICE ACADEMIC CME & MOC Neuroscience Is…™ is a campaign by the AAN to build public awareness and demonstrate the importance of neuroscience research in care of neurology patients and the development of cures for brain diseases. Four new work groups were established to help direct this initiative, which demonstrates how Neuroscience Is… New Leadership “Cool,” “Rewarding,” “Essential,” andPrograms “Critical.” In 2016, the AAN outestablished to the public at the Thereached Academy a new overarching 2016 Brain Health Fairfor with games, branding its resources, AAN Leadership Programs, and social media whichopportunities are designed to to demonstrate develop and hone why neuroscience is range cool, and held a a diverse of leadership skills over a Neuroscience Is Cool video contest,Leadership which lifetime of membership. courses encouragedoffered students to submit short videos at the Annual Meeting and regional about why neuroscience is cool help Leadership shape conferences are nowto called a lifelong interest in theApplications field. Neuroscientists University. were strong for the of all careernew stages sat for interviews to program, discuss an elite Transforming Leaders why neuroscience is aprogram rewarding career to identify and 10-month designed path. These videos will be available on AAN.com and will be shown at the 2017 Annual Meeting. Compelling timelines demonstrating the amount of effort and tenacity required to go from hypothesis to therapy have been displayed at AAN conferences, and plans are underway to transform them to patient materials so the public can understand why neuroscience is essential to brain health.
RESEARCH & AWARDS
PUBLIC POLICY
CONFERENCES
LEADERSHIP
MEMBERSHIP
PUBLICATIONS
LEADERSHIP
develop talent among experienced members for future leadership roles in the AAN and the field of neurology. A six-month program designed for mid-career female neurologists— Women Leading in Neurology—was retooled for 2017. Other programs for members include Diversity Leadership, Emerging Leaders, Palatucci Advocacy Leadership, Enhanced Resident Scholarship, and Minority Medical Student Scholarship.
GUIDELINES
PRACTICE
ACADEMIC
CME & MOC
RESEARCH & AWARDS
Breakdown of US Members
53.9%
3.5%
15.2%
1.0%
Neurologist
PUBLIC POLICY
CONFERENCES
LEADERSHIP
MEMBERSHIP
PUBLICATIONS
Membership Growth
32,000
Researcher
24,000 Junior
15.7%
Non-neurologist Clinician
19,500 17,000
3.1%
Student
Nurse Practitioner/ Physician Assistant
6.4%
1.2%
14,000 Senior and Honorary
1995
Business Administrator
2000
2005
2010
2016
Based on 2016 year-end data.
Report 2016 AnnuWae’vle Got Your Back
GUIDELINES
PRAC TICE
ACADEMIC
CME & MOC
RESE ARCH & AWA
RDS
PUBLIC POLICY
CONFERENCES
LEADERSHIP
MEMBERSHIP
PUBLICATIONS
Changing the practice of medicine At Novartis, we harness the innovation power of science to address some of society’s most challenging healthcare issues. We are passionate about discovering new ways to improve and extend people’s lives.
© 2017 Novartis Pharma AG GMCC: GLNS/GILE/0193m eMED: M-GYA-1342959 Date of preparation: March 2017
Novartis Pharma AG CH-4056 Basel, Switzerland www.novartis.com
Poster Session IV Opens This M Today’s Poster Session IV will run from 8:30 a.m. to 7:00 p.m. in Exhibit Hall B of the convention center, with presenter standby from 5:30 p.m. to 7:00 p.m.
Introducing...
Join Neurology’s Global Conversation! Connect with neurologists and neuroscience professionals in your area of interest. Get started at AAN.com/Synapse
New this year, we’ve clustered all topic-related posters together into “neighborhoods” to enhance your discussions and make the posters easier to navigate. Neighborhoods include: Group A: Movement Disorders Group B: Neuro-rehabilitation; General Neurology; Child Neurology and Epilepsy/Clinical Neurophysiology (EMG) ePosters Group C: Aging and Dementia Group D: Epilepsy/Clinical Neurophysiology (EEG) Poster Discussion Group E: Neuromuscular and Clinical Neurophysiology (EMG) Group F: Child Neurology; Behavioral and Cognitive Neurology; Neuro-rehabilitation Group G: Epilepsy/Clinical Neurophysiology (EEG) Group H: Cerebrovascular Disease and Interventional Neurology; Neuroepidemiology Group I: MS and CNS Inflammatory Disease Child Neurology and Epilepsy/Clinical Neurophysiology (EEG) ePoster Session
Be sure to check out today’s interactive, touchscreen ePosters at the virtual hall kiosk for another great opportunity to further explore scientific posters. Epilepsy/Clinical Neurophysiology (EEG) Lunchtime Poster Discussion Session
If you can’t get enough cutting-edge science, join today’s lunchtime Poster Discussion Session at the poster discussion stage between 11:45 a.m. and 12:45 p.m., where a group of 10 abstracts will be presented by their authors in a five-minute data blitz with a moderator leading stimulating discussion on the content of the selected posters.
Daily Reminders Education Program Syllabi and Slides Available Online Only Education Program syllabi and slides are available online only at AAN.com/view/syllabi or through the Annual Meeting Mobile App at AAN.com/view/app.
May 8 Is Deadline to Submit Online Evaluations for Annual Meeting CME Complete your evaluations to get your CME hours by using the Annual Meeting Mobile App at AAN.com/view/app or by visiting AAN.com/view/CME. CME requests may be made until May 8, 2017.
Save 10 Percent Shopping Online at The AAN Store®! This year, Annual Meeting attendees can receivet 10 percent off online orders placed by April 28 at AAN.com/AANStore. Go online, shop, and use Promo Code AM10 at checkout for your Annual Meeting discount.
Morning at 8:30, Posters Grouped by Topic “Neighborhoods” Remaining Poster Session Schedule Poster Session V
Poster Session VI
Thursday, April 27: 8:30 a.m.–7:00 p.m. author standby from 5:30 p.m.–7:00 p.m.
Friday, April 28: 8:30 a.m.–5:30 p.m. author standby from 4:00 p.m.–5:30 p.m.
Group A: Movement Disorders Group B: Neurocritical Care; Neuromuscular and Clinical Neurophysiology (EMG) ePosters Group C: Aging and Dementia Group D: Neuromuscular and Clinical Neurophysiology (EMG) Poster Discussion Group E: Neuromuscular and Clinical Neurophysiology (EMG) Group F: Neuro-rehabilitation; Neuro-oncology; Neuroophthalmology/Neuro-otology; Neuro Trauma and Sports Neurology Group G: Epilepsy/Clinical Neurophysiology (EEG) Group H: Cerebrovascular Disease and Interventional Neurology; Autonomic Disorders Group I: MS and CNS Inflammatory Disease
Group A: Movement Disorders Group B: Neuro-ophthalmology/Neuro-otology; Neurocritical Care; Aging, Dementia, Behavioral, and Cognitive Neurology ePosters Group C: Aging and Dementia Group D: Aging and Dementia Poster Discussion Group E: Neuromuscular and Clinical Neurophysiology (EMG) Group F: Neuro Trauma and Sports Neurology; Neurooncology; General Neurology; Behavioral and Cognitive Neurology Group G: Epilepsy/Clinical Neurophysiology (EEG) Group H: Cerebrovascular Disease and Interventional Neurology; Behavioral and Cognitive Neurology Group I: MS and CNS Inflammatory Disease
Neuromuscular and Clinical Neurophysiology (EMG) ePoster Session 8:30 a.m.–5:30 p.m.
Aging Dementia, Behavioral, and Cognitive Neurology ePoster Session 8:30 a.m.–5:30 p.m.
Neuromuscular and Clinical Neurophysiology (EMG) Lunchtime Poster Discussion Session 11:45 a.m.–12:45 p.m.
Aging Dementia, Behavioral, and Cognitive Neurology Lunchtime Poster Discussion Session 11:45 a.m.–12:45 p.m.
Visit our booth for information about a treatment option for a rare disease Learn more about KEVEYIS® and Strongbridge CareConnection patient support at Booth 889. 900 Northbrook Drive, Suite 200 Trevose, PA 19053 United States www.KEVEYIS.com www.strongbridgebio.com © 2017 Strongbridge Biopharma plc STRONGBRIDGE BIOPHARMA™ is a trademark of Strongbridge Biopharma plc. KEVEYIS® is a registered trademark licensed exclusively in the US to Strongbridge Biopharma plc. KEV026-05 03/2017
Annual Meeting Science Garners International Coverage More than 100 reporters are on-site this week in Boston covering the latest scientific breakthroughs in neurology. Annual Meeting science is gaining worldwide attention, from U.S. News & World Report, Houston Chronicle, and Pittsburgh Post-Gazette to United Press International and South China Morning Post.
Emerging Science
Sudden Unexpected Death in Epilepsy (SUDEP) Guideline
Coverage of Emerging Science— especially related to a cannabis-based medicine for the treatment of epilepsy— has resulted in 1,226 news articles garnering an incredible 509,662,134 impressions. Some of the top highlights include:
The Houston Chronicle, San Francisco Gate, San Antonio Express-News, Pittsburgh Post-Gazette, Neurology Advisor, and MedPage were among the nearly 240 news agencies across the globe that covered the AAN and American Epilepsy Society’s new “Practice Guideline: Sudden Unexpected Death in Epilepsy Incidence Rates and Risk Factors,” which was announced during Monday’s
“A Drug Derived from Marijuana May be the First of its Kind to Treat a Rare Form of Epilepsy”—South China Morning Post Marijuana-based Medicine Can Reduce Epilepsy, Seizures, Researchers Say”—Healthline Cannabis Derivative Cannabidiol Dramatically Reduces Seizures in Lennox-Gastaut Epilepsy”—The San Diego Union Tribune “’Off Time’” for Parkinson’s Patients May be Shortened with 150-year-old Drug”—United Press International “Immune-based Therapy Shows Early Promise Against MS”—U.S. News and World Report
on-site press conference in the convention center. The press coverage has resulted in 72,628,860 impressions to date. The SUDEP guideline was published online in Neurology ® on April 24, and in print in Neurology on April 25.
New to the Annual Meeting? This Morning’s Orientation Session Is for You! Get the most out of your first Annual Meeting experience at this morning’s Annual Meeting Orientation Session taking place from 7:00 a.m. to 8:00 a.m. at the HeadTalks Stage. Led by host Maisha T. Robinson, MD, MS, this informative and interactive session is designed to highlight a basic overview of the Annual Meeting, including: Programs and events going on throughout the week Information on networking opportunities Valuable AAN resources designed for all member types and career stages How to use the Annual Meeting Mobile App Tips on can’t-miss social and networking events
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Wednesday, April 26, 2017 • AANextra
NOW APPROVED
SEE WHAT WE’RE DOING NOW AT
BOOTH 501
© 2017 Genentech USA, Inc. All rights reserved. Printed in the USA. OCR/030117/0027 03/17
New Neuroscience in the Clinic Sessions Integrate Scientific Research with Clinical Application Thro frame the case in scientific and clinical context. Thematic abstract presentations will provide additional framework. The session will conclude with a panel discussion.
Neuroscience in the Clinic: Stress and Neurologic Diseases: What Is It, and What Is the Provider to Do?
5:00 p.m.–5:30 p.m. Panel Discussion
1:00 p.m.–3:00 p.m., Wednesday, April 26 Coordinators: Riley Bove, MD; Thomas Neylan, MD
Neuroscience in the Clinic: Dopamine Transporter (DaT) Imaging
1:00 p.m.–1:10 p.m. Clinical Examples of Stress Across the Lifespan—Case Presentation Marie E. Pasinski, MD
1:00 p.m.–3:00 p.m., Thursday, April 27 Coordinator: Ryan R. Walsh, MD, PhD, FAAN 1:00 p.m.–1:05 p.m. Introduction Ryan R. Walsh, MD, PhD, FAAN
1:10 p.m.–1:40 p.m. How Stress Influences the Brain Throughout the Lifespan Tallie Z. Baram, MD, PhD 1:40 p.m.–1:50 p.m. Clinician Follow Up Marie E. Pasinski, MD 1:50 p.m.–2:00 p.m. Scientific Wrap Up Tallie Z. Baram, MD, PhD 2:00 p.m.–2:15 p.m. N5.001: Cingulo-Insular Structural Alterations Associated with Psychogenic Symptoms, Childhood Abuse and PTSD in Functional Neurological Disorders David L. Perez, MD 2:15 p.m.–2:30 p.m. N5.002: Does Psychological Stress Affect the Progression of Parkinson’s Disease Amie L. Hiller, MD 2:30 p.m.–3:00 p.m. Discussion Session: Mitigating the Impact of Stress in the Neurology Clinic: What Works?
Neuroscience in the Clinic: Functional Recovery in Neurology and Neuroscience 3:30 p.m.–5:30 p.m., Wednesday, April 26 Coordinators: Deborah Hall, MD, PhD, FAAN; Massimo Pandolfo, MD, FAAN 3:30 p.m.–3:40 p.m. Case Presentations Brian Edlow, MD 3:40 p.m.–4:00 p.m. Neural Plasticity and Regeneration: Mechanisms and Therapeutic Strategies Mark H. Tuszynski, MD, PhD, FAAN 4:00 p.m.–4:10 p.m. Neural Regeneration and Repair: Clinical Perspective Brian Edlow, MD 4:10 p.m.–4:30 p.m. Where Is the Research Heading: Latest Developments/Future Directions Faculty 4:30 p.m.–4:45 p.m. N6.001: Specific Human Antisense Oligonucleotide (ASO) Targeting TGF-flRII Rescues Proliferation of TGF-fl Arrested Human Neuronal Progenitor Cells (ReNcell CX) Sabrina Kuespert, PhD
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4:45 p.m.–5:00 p.m. N6.002: Promoting Network Recovery After Traumatic Brain Injury: Exploring the Targeted Application of Transcranial Direct Current Stimulation Lucia M Li
Wednesday, April 26, 2017 • AANextra
1:05 p.m.–1:15 p.m. Case Presentation Deborah Hall, MD, PhD, FAAN 1:15 p.m.–1:45 p.m. The Science Behind Dopamine Transporter (DaT) Imaging Joel S. Perlmutter, MD, FAAN 1:45 p.m.–2:00 p.m. Case Presentation Conclusion: Impact of DaT Imaging Deborah Hall, MD, PhD, FAAN 2:00 p.m.–2:30 p.m. The Future of DaT Imaging and Emerging Imaging Modalities in Parkinson’s Disease Joel S. Perlmutter, MD, FAAN 2:30 p.m.–3:00 p.m. Panel Discussion
Neuroscience in the Clinic: Novel Therapeutic Targets in Critical Care Neurology: Intracerebral and Intraventricular Hemorrhage 3:30 p.m.–5:30 p.m., Thursday, April 27 Coordinators: David Y. Hwang, MD; Sherry Chou, MD 3:30 p.m.–3:40 p.m. Welcome and Case Presentation David Y. Hwang, MD; Sherry Chou, MD 3:40 p.m.–4:00 p.m. Intraventricular Hemorrhage: The History of Intraventricular tPA Use and the CLEAR III Trial Results Daniel F. Hanley, MD, FAAN 4:00 p.m.–4:15 p.m. After CLEAR III: When Might One Consider Using Intraventricular tPA? Alejandro A. Rabinstein, MD, FAAN 4:15 p.m.–4:30 p.m. The Future of Clinical Research in Intraventricular Hemorrhage Management Wendy C. Ziai, MD
rough Case Discussions
continued from cover
4:30 p.m.–4:45 p.m. N8.001: Association Between Leukocyte Count and Perihematomal Edema Growth After Primary Intracerebral Hemorrhage Aaron M. Gusdon, MD 4:45 p.m.–5:00 p.m. N8.002: Role of Sulfonylureas in Perihematomal Edema in Spontaneous Intracerebral Hemorrhage Shailesh Male, MD 5:00 p.m.–5:30 p.m. Panel Discussion
Neuroscience in the Clinic: Afferent and Efferent Visual Pathway Manifestations of Neurodegenerative Diseases: Implications for Diagnosis and Treatment 1:00 p.m.–3:00 p.m., Friday, April 28 Coordinators: Heather Moss, MD, PhD, FAAN; Gregory P. Van Stavern, MD, FAAN 1:00 p.m.–1:05 p.m. Introduction Heather Moss, MD, PhD, FAAN 1:05 p.m.–1:10 p.m. Case: Afferent Visual Dysfunction Faculty 1:10 p.m.–1:20 p.m. Clinical Aspects of Afferent Visual Dysfunction in Neurodegenerative Diseases Victoria S. Pelak, MD 1:20 p.m.–1:35 p.m. Scientific Aspects of Afferent Visual Dysfunction in Neurodegenerative Disease Geoffrey Karl Aguirre, MD, PhD 1:35 p.m.–1:45 p.m. N9.001: Retinal Thinning Is Uniquely Associated with Medial Temporal Lobe Atrophy in Neurologically Normal Older Adults Michael Ward, MD, PhD 1:45 p.m.–1:50 p.m. Case: Efferent Visual Dysfunction Faculty 1:50 p.m.–2:00 p.m. Clinical Aspects of Efferent Visual Dysfunction in Neurodegenerative Diseases Matthew J. Thurtell, MD 2:00 p.m.–2:15 p.m. Eye Movement and Reading Abnormalities in Parkinsonism Y. Joyce Liao, MD, PhD 2:15 p.m.–2:25 p.m. N9.002: What Are the Phenotypes of Brazilian Patients with Autossomal Recessive Spastic Ataxia of CharlevoixSaguenay (ARSACS)?: Neurological, Ophthalmological, and Neuroimaging Features of Seven Genetically Confirmed Cases Flavio Rezende Filho 2:25 p.m.–2:35 p.m. The Visual System as a Biomarker for Neurodegenerative Diseases Gregory P. Van Stavern, MD, FAAN
The Mount Sinai Hospital is ranked No.12 in Neurology &
Neurosurgery
by
U.S. News & World Report,
2016-17. Our world-class specialists are commi ed to the discovery of new treatments for neurological conditions and hold faculty appointments at the Icahn School of Medicine at Mount Sinai, ranked among the nation’s top medical schools by U.S. News & World Report. • Comprehensive Stroke Center • Bendheim Parkinson and Movement Disorders Center • Corinne Goldsmith Dickinson Center for Multiple Sclerosis • Center for Headache and Facial Pain • Neuromuscular Disease Division • Neurocritical Care • Neurovestibular and Balance Disorders • Center for Cognitive Health and Alzheimer’s Disease Research Center • Neuro-Infectious Diseases and NeuroAIDS Program • Epilepsy Center • Pediatric Neurology • Neuro-Oncology Program • Neuro-Ophthalmology Program
2:35 p.m.–3:00 p.m. Panel Discussion
1-800-MD-SINAI • mountsinai.org/msneuro
Wednesday, April 26, 2017 • AANextra
13
Today’s Experiential Learning Area Highlights Get ready to experience interactive—and totally flexible—new ways of exploring, engaging, and learning at today’s Experiential Learning Areas. Each area will offer a variety of real-world experiences designed to engage you intellectually, emotionally, and socially while serving up fresh ideas to help you personally and professionally.
Highlights: How to Evaluate a Practice 10:00 a.m.–10:30 a.m. Navigating Your Career Experiential Learning Area Sarah M. Benish, MD, FAAN FDA Introductory Seminar on Navigating the Regulatory Landscape for Neurological Devices and Moving Neurotechnologies to Patients and Caregivers 12:00 p.m.–12:30 p.m. Research Corner Experiential Learning Area William Heetderks, MD, PhD, and Katrina Gwinn, MD Adding a New Nurse Practitioner or Physician Assistant to Your Practice: Our Method of Getting Started 1:00 p.m.–2:00 p.m. Education and Publications Station Experiential Learning Area Charles Zollinger, MD, FAAN
How to Be a Lobbyist for a Day 2:30 p.m.–3:00 p.m. Advocacy in Action Experiential Learning Area Janice F. Wiesman, MD, FAAN
Check out the Rest of the Week’s Experiential Learning Area Highlights
Paint and Wine Hour
Thursday, April 27
3:30 p.m.–5:30 p.m.
Head Talks Experiential Learning Area Arrive early—this event is only open to the first 25 people! Physician Resiliency in the Face of Patient Death 4:00 p.m.–4:45 p.m. Live Well Experiential Learning Area Justin T. Jordan, MD Negotiation Skill: You Do Not Get What You Deserve, You Get What You Negotiate For 5:00 p.m.–5:30 p.m. Navigating Your Career Experiential Learning Area Jonathan P. Hosey, MD, FAAN
Training in Neurology While on a Visa: Challenges and Possible Solutions for Foreign Medical Graduates 2:00 p.m.–2:45 p.m. Navigating Your Career Experiential Learning Area Ahmed Obeidat, MD, PhD
Friday, April 28 Advancing Your Leadership Skill: Tips for the Successful Chief Resident 11:45 a.m.–12:30 p.m. Navigating Your Career Experiential Learning Area Mona Bahouth, MD
Medication Is About to Meet Communication. Coming Soon Be one of the first to know. www.mytreatmentexperience.com/hcp
BAYER and the Bayer Cross are registered trademarks of Bayer. Š2017 Bayer HealthCare Pharmaceuticals Inc. Whippany, NJ 07981. All rights reserved. PP-721-US-0681 March 2017
TR ANSFOR M THE TR E ATMENT OF PARKINSON’S DISEASE PSYCHOSIS NUPLAZID® (pimavanserin) IS THE FIRST AND ONLY FDA-approved therapy proven to reduce the symptoms of hallucinations and delusions without impacting motor function1
Change your outlook on Parkinson’s disease psychosis. In vitro, NUPLAZID targets 5-HT2A and 5-HT2C receptors while demonstrating no appreciable binding affinity for dopamine, histamine, muscarinic, or adrenergic receptors. With a proven safety profile and no impact on motor function, once-daily NUPLAZID 34 mg can be prescribed with confidence.1
Visit booth #489 to experience the transformation with the Oculus virtual reality headset.
Indication NUPLAZID is an atypical antipsychotic indicated for the treatment of hallucinations and delusions associated with Parkinson’s disease psychosis.
Important Safety Information for NUPLAZID (pimavanserin) 17-mg Tablets WARNING: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. NUPLAZID is not approved for the treatment of patients with dementia-related psychosis unrelated to the hallucinations and delusions associated with Parkinson’s disease psychosis. QT Interval Prolongation: NUPLAZID prolongs the QT interval. The use of NUPLAZID should be avoided in patients with known QT prolongation or in combination
with other drugs known to prolong QT interval including Class 1A antiarrhythmics or Class 3 antiarrhythmics, certain antipsychotic medications, and certain antibiotics. NUPLAZID should also be avoided in patients with a history of cardiac arrhythmias, as well as other circumstances that may increase the risk of the occurrence of torsade de pointes and/or sudden death, including symptomatic bradycardia, hypokalemia or hypomagnesemia, and presence of congenital prolongation of the QT interval. Adverse Reactions: The most common adverse reactions (≥2% for NUPLAZID and greater than placebo) were peripheral edema (7% vs 2%), nausea (7% vs 4%), confusional state (6% vs 3%), hallucination (5% vs 3%), constipation (4% vs 3%), and gait disturbance (2% vs <1%). Drug Interactions: Strong CYP3A4 inhibitors (eg, ketoconazole) increase NUPLAZID concentrations. Reduce the NUPLAZID dose by one-half.
Strong CYP3A4 inducers may reduce NUPLAZID exposure, only if the potential benefit justifies the potential risk to monitor for reduced efficacy. Increase in NUPLAZID dosage the mother and fetus. may be needed. Pediatric Use: Safety and efficacy have not been established Renal Impairment: No dosage adjustment for NUPLAZID is in pediatric patients. needed in patients with mild to moderate renal impairment. Dosage and Administration Use of NUPLAZID is not recommended in patients with Recommended dose: 34 mg per day, taken orally as two severe renal impairment. 17-mg tablets once daily, without titration. Hepatic Impairment: Use of NUPLAZID is not You are encouraged to report negative side effects of recommended in patients with hepatic impairment. prescription drugs to the FDA. Visit www.fda.gov/medwatch NUPLAZID has not been evaluated in this patient or call 1-800-FDA-1088. You can also call ACADIA population. Pharmaceuticals Inc. at 1-844-4ACADIA (1-844-422-2342). Pregnancy: Use of NUPLAZID in pregnant women has not been evaluated and should therefore be used in pregnancy See Brief Summary of Prescribing Information on adjacent pages. Reference: 1. NUPLAZIDŽ (pimavanserin) prescribing information, ACADIA. Š2017 ACADIA Pharmaceuticals Inc. All rights reserved. NU-0584 03/17.
T:6.875”
NUPLAZID™ (pimavanserin) tablets, for oral use. Rx only Brief Summary: This information is not comprehensive. Visit www.NUPLAZID.com to obtain the FDA-approved product labeling or call 1-844-422-2342. WARNING: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. NUPLAZID is not approved for the treatment of patients with dementia-related psychosis unrelated to the hallucinations and delusions associated with Parkinson’s disease psychosis. 1 INDICATIONS AND USAGE NUPLAZID™ is an atypical antipsychotic indicated for the treatment of hallucinations and delusions associated with Parkinson’s disease psychosis.
and/or sudden death, including symptomatic bradycardia, hypokalemia or hypomagnesemia, and the presence of congenital prolongation of the QT interval. 6 ADVERSE REACTIONS The following serious adverse reactions are discussed elsewhere in the labeling: • Increased Mortality in Elderly Patients with DementiaRelated Psychosis • QT Interval Prolongation Clinical Trial Experience The clinical trial database for NUPLAZID consists of over 1200 subjects and patients exposed to one or more doses of NUPLAZID. Adverse reactions that occurred in 6-week, placebo-controlled studies and that were reported at an incidence of ≥2%, and >placebo are presented in the following table.
2 DOSAGE AND ADMINISTRATION The recommended dose of NUPLAZID is 34 mg, taken orally as two 17-mg strength tablets once daily, without titration.
Adverse Reactions (≥2% and >Placebo)
• Coadministration with Strong CYP3A4 Inhibitors The recommended dose of NUPLAZID when coadministered with strong CYP3A4 inhibitors (e.g., ketoconazole) is 17 mg, taken orally as one tablet once daily. • Coadministration with Strong CYP3A4 Inducers Monitor patients for reduced efficacy if NUPLAZID is used concomitantly with strong CYP3A4 inducers; an increase in NUPLAZID dosage may be needed.
5 WARNINGS AND PRECAUTIONS Increased Mortality in Elderly Patients with DementiaRelated Psychosis Antipsychotic drugs increase the all-cause risk of death in elderly patients with dementia-related psychosis. Analyses of 17 dementia-related psychosis placebo-controlled trials (modal duration of 10 weeks and largely in patients taking atypical antipsychotic drugs) revealed a risk of death in the drug-treated patients of between 1.6- to 1.7-times that in placebo-treated patients. Over the course of a typical 10-week controlled trial, the rate of death in drug-treated patients was about 4.5%, compared to a rate of about 2.6% in placebo-treated patients. Although the causes of death were varied, most of the deaths appeared to be either cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) in nature. NUPLAZID is not approved for the treatment of patients with dementia related psychosis unrelated to the hallucinations and delusions associated with Parkinson’s disease psychosis. QT Interval Prolongation NUPLAZID prolongs the QT interval. The use of NUPLAZID should be avoided in patients with known QT prolongation or in combination with other drugs known to prolong QT interval including Class 1A antiarrhythmics (e.g., quinidine, procainamide) or Class 3 antiarrhythmics (e.g., amiodarone, sotalol), certain antipsychotic medications (e.g., ziprasidone, chlorpromazine, thioridazine), and certain antibiotics (e.g., gatifloxacin, moxifloxacin). NUPLAZID should also be avoided in patients with a history of cardiac arrhythmias, as well as other circumstances that may increase the risk of the occurrence of torsade de pointes
NUPL16CDLA0961_Brief_Summary_ASize_r3.indd 1
Placebo
N = 202
N = 231
Nausea
7%
4%
Peripheral edema
7%
2%
Confusional state
6%
3%
Hallucination
5%
3%
Constipation
4%
3%
Gait disturbance
2%
<1%
Hallucination includes visual, auditory, tactile, and somatic hallucinations
a
7 DRUG INTERACTIONS QT Interval Prolongation Concomitant use of drugs that prolong the QT interval may add to the QT effects of NUPLAZID and increase the risk of cardiac arrhythmia. Avoid the use of NUPLAZID in combination with other drugs known to prolong QT interval. Strong CYP3A4 Inhibitors Concomitant use of NUPLAZID with a strong CYP3A4 inhibitor increases pimavanserin exposure. If NUPLAZID is used with a strong CYP3A4 inhibitor, reduce the dosage of NUPLAZID. Strong CYP3A4 Inducers Concomitant use of a strong CYP3A4 inducer may reduce pimavanserin exposure resulting in a potential decrease in efficacy. Patients should be monitored for reduced efficacy and an increase in dosage may be needed if NUPLAZID is used concomitantly with strong CYP3A4 inducers. 8 USE IN SPECIFIC POPULATIONS Pregnancy: There are no data on NUPLAZID use in pregnant women that would allow assessment of the drug-associated risk of major congenital malformations or miscarriage. In animal reproduction studies, no adverse developmental effects were seen when pimavanserin was administered orally to rats or rabbits during the period of organogenesis at doses up to 10- or 12-times the maximum recommended human dose (MRHD) of 34 mg/day, respectively. Administration of pimavanserin to pregnant rats during pregnancy and lactation resulted in maternal toxicity and lower pup survival and body weight at doses which are 2-times the MRHD of 34 mg/day.
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T:9.75”
4 CONTRAINDICATIONS None.
NUPLAZID 34 mg
Preferred Term
T:6.875”
Lactation: There is no information regarding the presence of pimavanserin in human milk, the effects on the breastfed infant, or the effects on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for NUPLAZID and any potential adverse effects on the breastfed infant from NUPLAZID or from the underlying maternal condition. Pediatric Use Safety and effectiveness of NUPLAZID have not been established in pediatric patients. Geriatric Use No dose adjustment is required for elderly patients. Parkinson’s disease is a disorder occurring primarily in individuals over 55 years of age. The mean age of patients enrolled in the 6-week clinical studies with NUPLAZID was 71 years, with 49% 65-75 years old and 31% >75 years old. In the pooled population of patients enrolled in 6-week, placebocontrolled studies (N=614), 27% had MMSE scores from 21 to 24 compared to 73% with scores ≥25. No clinically meaningful differences in safety or effectiveness were noted between these two groups.
17 PATIENT COUNSELING INFORMATION Concomitant Medication Advise patients to inform their healthcare providers if there are any changes to their current prescription or over-thecounter medications, since there is a potential for drug interactions.
CAUTION: Federal law prohibits dispensing without prescription. NUPLAZID™ is a trademark of ACADIA Pharmaceuticals Inc. Distributed by: ACADIA Pharmaceuticals Inc. San Diego, CA 92130 NU-0381 09/16.
Renal Impairment No dosage adjustment for NUPLAZID is needed in patients with mild to moderate (CrCL ≥30 mL/min, Cockcroft-Gault) renal impairment. Use of NUPLAZID is not recommended in patients with severe renal impairment (CrCL <30 mL/min, Cockcroft-Gault). NUPLAZID has not been evaluated in this patient population. T:9.75”
Hepatic Impairment Use of NUPLAZID is not recommended in patients with hepatic impairment. NUPLAZID has not been evaluated in this patient population. 9 DRUG ABUSE AND DEPENDENCE Controlled Substance NUPLAZID is not a controlled substance. Abuse NUPLAZID has not been systematically studied in humans for its potential for abuse, tolerance, or physical dependence. While short-term, placebo-controlled and long-term, openlabel clinical trials did not reveal increases in drug-seeking behavior, the limited experience from the clinical trials do not predict the extent to which a CNS-active drug will be misused, diverted, and/or abused once marketed. 10 OVERDOSAGE Human Experience The pre-marketing clinical trials involving NUPLAZID in approximately 1200 subjects and patients do not provide information regarding symptoms with overdose. In healthy subject studies, dose limiting nausea and vomiting were observed. Management of Overdose There are no known specific antidotes for NUPLAZID. In managing overdose, cardiovascular monitoring should commence immediately and should include continuous ECG monitoring to detect possible arrhythmias. If antiarrhythmic therapy is administered, disopyramide, procainamide, and quinidine should not be used, as they have the potential for QT-prolonging effects that might be additive to those of NUPLAZID. Consider the long plasma half-life of pimavanserin (about 57 hours) and the possibility of multiple drug involvement.
NUPL16CDLA0961_Brief_Summary_ASize_r3.indd 2
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American Brain Foundation Launches New Crowdfunding Platform The American Brain Foundation has launched a new online neuroscience research crowdfunding platform that will allow members of the public to search for and give money to research projects addressing brain diseases. To see a demo of the platform, visit the American Brain Foundation booth in the North Lobby.
The Foundation has been working with the Diabetes Research Connection, which launched a crowdfunding site for diabetes research in 2012. The American Brain Foundation, which was founded in 1992 as the charitable arm of the AAN, has invested more than $20 million in funding for clinical research in its quest to find cures for brain and nervous system diseases affecting nearly 50 million Americans.
The platform is part of the Foundation’s new strategic plan to reach out to the public for support. “This inventive, new initiative has the potential to unlock significant new funds for our cause, and we all understand the urgency of attracting new money to brain disease research,” said Robert C. Griggs, MD, FAAN, chair of the foundation’s Research Advisory Committee, which is developing guidelines Robert C. Griggs, MD, FAAN for researcher applications and for the scientific review of applications to determine which projects meet the criteria to be posted on the crowdfunding site.
For more information about the new crowdfunding platform, including how to submit a project for funding, visit the American Brain Foundation booth in the North Lobby.
The American Brain Foundation has launched its new crowdfunding platform.
B:8.5” T:8.25” S:7.25”
FIGHT BACK EARLY WITH GILENYA® (fingolimod) 4/23–4/26 | Boston, MA
KRISTIN
“I got the tears out of my system and got ready for my fight.”
STACEY “My story is a comeback story.”
People who have experience with GILENYA. They have been compensated for their time.
GILENYA is a registered trademark of Novartis AG.
Step inside the ring at booth 547
Novartis Pharmaceuticals Corporation East Hanover, New Jersey 07936-1080
JAMES “You can keep going after your diagnosis.”
Hear from real GILENYA patients in the Patient Video Center Explore the MOA module, and watch the immersive MOA video See “The Story of GILENYA: Inspired by Nature, Refined by Science”
© 2017 Novartis
3/17
T-GYA- 1342233
Run/Walk for Brain Research Results continued from cover
A good time was had by all in this friendly trek for a good cause, with Bjorn Evertsson, MD, taking home the trophy in the men’s division and Lisa Thomas for the third consecutive year topping the women’s division.
AT THE AAN ANNUAL MEETING
DISCOVER ADVANCED NEUROMUSCULAR TESTING Muscle biopsy Acid a-glucosidase Various blood tests Electrocardiograms Nerve conduction tests Pulmonary function tests Reflex testing X-rays Magnetic resonance imaging Sleep studies Targeted DNA analysis1 Learn more about panel testing for neuromuscular disorders—including Pompe disease. A complimentary program is available for targeted DNA analysis of up to 31 separate conditions.1
Testing early can help impact a 13-year diagnostic delay for Pompe disease.* 2-4 Visit Sanofi Genzyme at Booth #729 to learn more.
* Based on the median diagnostic gap. References: 1. Limb Girdle Muscular Dystrophy Consortium. http://www. lgmd-diagnosis.org/physician-portal. Accessed March 30, 2015. 2. Toscano A, Montagnese F, Musumeci O. Early is better? A new algorithm for early diagnosis in late-onset Pompe disease (LOPD). Acta Myol. 2013;32(2):78-81. 3. Kishnani PS, Amartino HM, Lindberg C, Miller TM, Wilson A, Keutzer J; Pompe Registry Boards of Advisors. Timing of diagnosis of patients with Pompe disease: data from the Pompe Registry. Am J Med Genet A. 2013;161A(10):2431-2443. 4. Winkel LP, Hagemans ML, van Doorn PA, et al. The natural course of non-classic Pompe’s disease; a review of 225 published cases. J Neurol. 2005;252(8):875-884.
www.pompe.com ©2017 Genzyme Corporation. All rights reserved. GZUS.PD.15.07.1915(1)
Celebrate the End of a Great Meeting at Friday’s Hollywood Themed Closing Party All Annual Meeting attendees are invited to join friends and colleagues this Friday from 5:30 p.m. to 7:00 p.m. in the East Ballroom of the convention center to cap off a great meeting at a special, Hollywood themed happy hour. The event will offer a taste of what’s in store for you at next year’s Annual Meeting in Los Angeles while serving up drinks, socializing, and your favorite movie theme music performed live by NEURO JAZZ, a five-piece ensemble led by AAN member Phillip Pearl, MD, FAAN. Walk the “red carpet” and enter the drawing for two tickets to Universal Studios Hollywood and a $100 gift card to Hard Rock Café. Winners will be announced at 7:00 p.m.; early enough to offer plenty of opportunity to get out and explore beautiful, historic Boston afterwards!
2O17
EARN up to
20 CME
Your Ticket for the Latest in Diagnosis, Treatment, and Prevention
July 14 –16 • Jacksonville, FL
July 14-16
•
Jacksonville, FL
Learn about the latest science and research advances in the rapidly evolving field of sports concussion!
Register Now! AAN.com/view/ConcussionConference
F O R A D U LT S W I T H TA R D I V E D Y S K I N E S I A ( T D ) , T H E F I R S T A N D O N LY I N D I C AT E D T R E AT M E N T
I N T R O D U C I N G
NO FDA-APPROVED TREATMENT HAS EXISTED—UNTIL NOW.
Discover a new treatment for your adult TD patients Visit us at booth #585 Important Information INDICATION & USAGE INGREZZA™ (valbenazine) capsules is indicated for the treatment of adults with tardive dyskinesia.
IMPORTANT SAFETY INFORMATION WARNINGS & PRECAUTIONS Somnolence INGREZZA can cause somnolence. Patients should not perform activities requiring mental alertness such as operating a motor vehicle or operating hazardous machinery until they know how they will be affected by INGREZZA.
QT Prolongation INGREZZA may prolong the QT interval, although the degree of QT prolongation is not clinically significant at concentrations expected with recommended dosing. INGREZZA should be avoided in patients with congenital long QT syndrome or with arrhythmias associated with a prolonged QT interval. For patients at increased risk of a prolonged QT interval, assess the QT interval before increasing the dosage.
ADVERSE REACTIONS The most common adverse reaction (≥5% and twice the rate of placebo) is somnolence. Other adverse reactions (≥2% and >placebo) include: anticholinergic effects, balance disorders/ falls, headache, akathisia, vomiting, nausea, and arthralgia. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch at www.fda.gov/medwatch or call 1-800-FDA-1088. Please see the adjacent page for brief summary of Prescribing Information and visit www.INGREZZA.com for full Prescribing Information. REFERENCE: INGREZZA [package insert]. San Diego, CA: Neurocrine Biosciences, Inc; 2017.
©2017 Neurocrine Biosciences, Inc. All Rights Reserved. CP-VBZ-US-0112 04/17
for oral use
Brief Summary: for full Prescribing Information and Patient Information, refer to package insert. INDICATIONS AND USAGE
INGREZZA is a vesicular monoamine transporter 2 (VMAT2) inhibitor indicated for the treatment of adults with tardive dyskinesia.
WARNINGS AND PRECAUTIONS
Somnolence INGREZZA can cause somnolence. Patients should not perform activities requiring mental alertness such as operating a motor vehicle or operating hazardous machinery until they know how they will be affected by INGREZZA. QT Prolongation INGREZZA may prolong the QT interval, although the degree of QT prolongation is not clinically significant at concentrations expected with recommended dosing. In patients taking a strong CYP2D6 or CYP3A4 inhibitor, or who are CYP2D6 poor metabolizers, INGREZZA concentrations may be higher and QT prolongation clinically significant. For patients who are CYP2D6 poor metabolizers or are taking a strong CYP2D6 inhibitor, dose reduction may be necessary. For patients taking a strong CYP3A4 inhibitor, reduce the dose of INGREZZA to 40 mg once daily. INGREZZA should be avoided in patients with congenital long QT syndrome or with arrhythmias associated with a prolonged QT interval. For patients at increased risk of a prolonged QT interval, assess the QT interval before increasing the dosage.
Endocrine Disorders: blood glucose increased General Disorders: weight increased Infectious Disorders: respiratory infections Neurologic Disorders: drooling, dyskinesia, extrapyramidal symptoms (non-akathisia) Psychiatric Disorders: anxiety, insomnia During controlled trials, there was a dose-related increase in prolactin. Additionally, there was a dose-related increase in alkaline phosphatase and bilirubin, suggesting a potential risk for cholestasis.
DRUG INTERACTIONS
Drugs Having Clinically Important Interactions with INGREZZA Table 2: Clinically Significant Drug Interactions with INGREZZA Monoamine Oxidase Inhibitors (MAOIs) Clinical Implication:
Prevention or Management: Examples: isocarboxazid, phenelzine, selegiline Strong CYP3A4 Inhibitors Clinical Implication:
ADVERSE REACTIONS
The following adverse reactions are discussed in more detail in other sections of the labeling: • Somnolence • QT Prolongation Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.
Prevention or Management: Examples: Strong CYP2D6 Inhibitors
The safety of INGREZZA was evaluated in 3 placebo-controlled studies, each 6 weeks in duration (fixed dose, dose escalation, dose reduction), including 445 patients. Patients were 26 to 84 years of age with moderate to severe tardive dyskinesia and had concurrent diagnoses of mood disorder (27%) or schizophrenia/schizoaffective disorder (72%). The mean age was 56 years. Patients were 57% Caucasian, 39% African-American, and 4% other. With respect to ethnicity, 28% were Hispanic or Latino. All subjects continued previous stable regimens of antipsychotics; 85% and 27% of subjects, respectively, were taking atypical and typical antipsychotic medications at study entry. Adverse Reactions Leading to Discontinuation of Treatment A total of 3% of INGREZZA treated patients and 2% of placebo-treated patients discontinued because of adverse reactions. Common Adverse Reactions Adverse reactions that occurred in the 3 placebo-controlled studies at an incidence of ≥2% and greater than placebo are presented in Table 1. Table 1: Adverse Reactions in 3 Placebo-Controlled Studies of 6-week Treatment Duration Reported at ≥2% and >Placebo INGREZZA (n=262) (%)
Placebo (n=183) (%)
Concomitant use of INGREZZA with strong CYP2D6 inhibitors may increase the exposure (Cmax and AUC) to valbenazine’s active metabolite compared with the use of INGREZZA alone. Increased exposure of active metabolite may increase the risk of exposure-related adverse reactions.
Prevention or Management:
Consider reducing INGREZZA dose based on tolerability when INGREZZA is coadministered with a strong CYP2D6 inhibitor.
Examples:
paroxetine, fluoxetine, quinidine
10.9%
4.2%
Anticholinergic effects (dry mouth, constipation, disturbance in attention, vision blurred, urinary retention)
5.4%
4.9%
Balance disorders/fall (fall, gait disturbance, dizziness, balance disorder)
4.1%
2.2%
Headache Akathisia (akathisia, restlessness)
3.4% 2.7%
2.7% 0.5%
2.6% 2.3%
0.6% 2.1%
2.3%
0.5%
Strong CYP3A4 Inducers Clinical Implication:
Prevention or Management: Examples: Digoxin
General Disorders Somnolence (somnolence, fatigue, sedation) Nervous System Disorders 1
Gastrointestinal Disorders Vomiting Nausea Musculoskeletal Disorders Arthralgia 1
Within each adverse reaction category, the observed adverse reactions are listed in order of decreasing frequency.
Other Adverse Reactions Observed During the Premarketing Evaluation of INGREZZA Other adverse reactions of ≥1% incidence and greater than placebo are shown below. The following list does not include adverse reactions: 1) already listed in previous tables or elsewhere in the labeling, 2) for which a drug cause was remote, 3) which were so general as to be uninformative, 4) which were not considered to have clinically significant implications, or 5) which occurred at a rate equal to or less than placebo.
Concomitant use of INGREZZA with strong CYP3A4 inhibitors increased the exposure (Cmax and AUC) to valbenazine and its active metabolite compared with the use of INGREZZA alone. Increased exposure of valbenazine and its active metabolite may increase the risk of exposure-related adverse reactions. Reduce INGREZZA dose when INGREZZA is coadministered with a strong CYP3A4 inhibitor. itraconazole, ketoconazole, clarithromycin
Clinical Implication:
Variable and Fixed Dose Placebo-Controlled Trial Experience
Adverse Reaction1
Concomitant use of INGREZZA with MAOIs may increase the concentration of monoamine neurotransmitters in synapses, potentially leading to increased risk of adverse reactions such as serotonin syndrome, or attenuated treatment effect of INGREZZA. Avoid concomitant use of INGREZZA with MAOIs.
Concomitant use of INGREZZA with a strong CYP3A4 inducer decreased the exposure of valbenazine and its active metabolite compared to the use of INGREZZA alone. Reduced exposure of valbenazine and its active metabolite may reduce efficacy. Concomitant use of strong CYP3A4 inducers with INGREZZA is not recommended. rifampin, carbamazepine, phenytoin, St. John’s wort1
Clinical Implication:
Concomitant use of INGREZZA with digoxin increased digoxin levels because of inhibition of intestinal P-glycoprotein (P-gp).
Prevention or Management:
Digoxin concentrations should be monitored when co-administering INGREZZA with digoxin. Increased digoxin exposure may increase the risk of exposure related adverse reactions. Dosage adjustment of digoxin may be necessary.
The induction potency of St. John’s wort may vary widely based on preparation.
Drugs Having No Clinically Important Interactions with INGREZZA Dosage adjustment for INGREZZA is not necessary when used in combination with substrates of CYP1A2, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2E1, or CYP3A4/5 based on in vitro study results.
OVERDOSAGE
Human Experience The pre-marketing clinical trials involving INGREZZA in approximately 850 subjects do not provide information regarding symptoms with overdose. Management of Overdosage No specific antidotes for INGREZZA are known. In managing overdose, provide supportive care, including close medical supervision and monitoring, and consider the possibility of multiple drug involvement. If an overdose occurs, consult a Certified Poison Control Center (1-800-222-1222 or www.poison.org). For further information on INGREZZA, call 84-INGREZZA (844-647-3992). Distributed by: Neurocrine Biosciences, Inc. San Diego, CA 92130 INGREZZA is a trademark of Neurocrine Biosciences, Inc. CP-VBZ-US-0203 04/17
Ringel Lauded for Dedication to Neurology Today The 10-year tenure of Steven P. Ringel, MD, FAAN, as editor-inchief of Neurology Today ® was celebrated this week with his editors, staff, and others. Ringel officially steps down at the end of June. Joseph E. Safdieh, MD, FAAN, will assume the role on July 1.
Catherine M. Rydell, CAE, AAN CEO, and Terrence L. Cascino, MD, FAAN, AAN President, thank Ringel for his service.
From left, Steven P. Ringel, MD, FAAN; Neurology Editor-in-Chief Robert A. Gross, MD, PhD, FAAN; Neurology Today Associate Editors Kenneth L. Tyler, MD, FAAN, Orly Avitzur, MD, FAAN, and Robert G. Holloway Jr., MD, MPH, FAAN; and Neurology Today Editor Fay Jarosh Ellis.
Tweets of the Day R
achel Salas MD @RachelSalasMD
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Hearing about the neuro exam from Dr. Tom Swift #AANAM I love hearing these true stories.
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nthony G. Alessi,MD @dralessi
Proud to receive the AAN President's Award from my colleague and friend Terry Cascino #AANAM @UConnNeuroSport @UConnOrtho
olly Hinson, MD MCR @HollyEHinson
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#research #AANAM @AANMember @AANPublic
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quivocal Babinski @itscottd
eff Kraakevik MD @ohsuneuro
During Mendell's plenary on gene therapy for SMA w/ video of kid walking in hall. NM person beside me "2 yrs ago, he'd be dead.' #AANAM
I wish I was at #AANAM but with everyone in Boston, my meetings are very efficient! #somebodyhastoround
Special Pricing on Annual Meeting On Demand Through End of Week Don’t Risk Missing Your Favorite Sessions! With so much excellent programming this week, selecting which programs to attend can be difficult. Don’t miss out on your favorites—and save money—by ordering AAN Annual Meeting On Demand before April 28! Attendees save $1,150* or more by ordering this week. Annual Meeting On Demand gives you access to more than 500 hours** of presentations from the 2017 Annual Meeting education programs, including the syllabi for more than 200 programs. Watch presenters’ slides while listening to fully synchronized audio as if you were actually attending each session.
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Wednesday, April 26, 2017 • AANextra
Features of Annual Meeting On Demand include: Online access to content within 24 hours of live presentations The most advanced search engine in the industry that delivers a direct link to the specific presentations and slides containing your search terms— less time searching and more time learning Downloadable PDFs of presentation slides and syllabi summaries Downloadable MP3 files provide the option of listening to any—or all—lectures while driving, traveling, or any occasion where audio is most convenient
Complimentary portable hard drive for offline viewing when internet is not convenient or available Recently Viewed feature allows you to revisit presentations and pick up exactly where you left off Opportunity to earn additional CME credits! Order Today: Education and Publications Station located at Northwest Lobby Level 1 Order Online: AANonDemand.com/Boston Order by Phone: (800) 501-2303 (US only) or (818) 844-3299, Monday–Friday from 6:00 a.m.–5:00 p.m. PT *Savings vary by membership category ** Total hours available subject to speaker permissions
LOS ANGELES, CA •
APRIL 21–27, 2018
SEE YOU NEXT YEAR
ADVANCING NEUROLOGY. ADVANCING YOU.
What Are People Sayi What advice would you give to somebody attending the meeting for the first time?
Give yourself time—as far as days at the meeting—to get to enjoy every part of it. Enjoy the courses that are offered because they're wonderful. Enjoy the posters that are presented because they're wonderful. Enjoy the plenary sessions, which are absolutely fantastic. This year, in fact, I've taken the whole week off to really get absorbed in the meeting— something which I haven't done in the past. I will usually come in the beginning or in the end because of my practice and being available, but this was a unique year and I gave myself an entire week. There's so much diversity and so many wonderful things that are presented here that you can't get anywhere else. MEM: 16 Live Well Ads Ad—Half horizontal Page> AANextra
What's your favorite part of the meeting?
I love that we can interact with the authors. I like seeing the posters.
Nawal Hadhoum Nonmember Lille, France
Constantine Moschonas, MD Neurologist Member Scottsdale, AZ
Placed in AANextra 8.25 x 4.4375 +0.125 bleed, 4C
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ing? Verena C. Samara, MD Junior Member Salt Lake City, UT
What has been the most interesting thing you learned so far?
There’s been a variety of things. I actually got one of the Future Clinical Researcher scholarships. I have a basic science research background and I’ll be going into neuromuscular fellowship doing a two-year fellowship, clinical and research, so I’ve gone to a number of research events here. I’ve had great opportunities to connect with more senior level researchers and get some tips on how to advance my academic career, so that’s been really great. I’ve also gone to some of the “Best of” sessions and learned a lot about neurology.
Is this your first Annual Meeting?
This must be my 50th AAN Annual Meeting; I was a resident in 1969, so throughout my training and then my fellowship and then attending. I was an attending at Columbia for 50 years.
How do you like the changes at the meeting?
There are more options, there are more subspecialties covered, which I like, and there’s also a lot of basic courses. I have my nurse practitioner and PA here, and this is useful for them—it's like a nice educational tool. There are much more basic courses for residents and midlevel providers, which is nice.
So how does the meeting impress you now? Eugenia T. Gamboa, MD Senior Member Demarest, NJ
Rani U. Athreya, MD Neurologist Member Springfield, MA
One of the biggest differences is the way they charge for the courses. Before, every course was an additional fee—now it's covered. So, that's very good on the economic side. The quality of the presentations is excellent, and it’s getting better, especially with the new research going on, such as the big breakthrough in immunology for brain tumors, and more specifically about gene therapy.
Wednesday, April 26, 2017 • AANextra
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Upcoming AAN Conference Opportunities Sports Concussion Conference
Fall Conference
Breakthroughs in Neurology
July 14–16, 2017 Jacksonville, FL Hyatt Regency Jacksonville–Riverfront
October 20–22, 2017 The Cosmopolitan of Las Vegas
January 12–15, 2018 Caribe Royale in Orlando, FL
Quality CME, expert faculty, and the goal of improved patient care are on the docket for this always-popular conference. New this year will be expanded Neurology Update topics and a Neuro-ophthalmology/Neurootology Skills Workshop. The Fall Conference’s all-inclusive registration rate provides maximum value, flexibility, and customization. And the popular Neurology Update and Practice Management programs, offered in twelve 90-minute sessions (six Practice and eight Neurology Update programs), allow you to tailor a personal schedule to your specific interests and needs. The money-saving early registration and housing reservation deadline is September 8. Learn more and register at AAN.com/view/fall.
Escape the cold of winter for a year-inreview of the best neurology science and education and a chance to earn valuable CME, including self-assessment CME. Bring the entire family to the fourth annual Breakthroughs in Neurology conference, which will offer new family-friendly social events and programs—plus the convenience of nearby Orlando theme parks! Watch for more details in the coming months at AAN.com/view/ breakthroughs.
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Each year, 1.6 to 3.8 million concussions result from sports/recreation injuries in the United States, with the issue attracting significant media attention in recent years. New science is emerging quickly and breakthrough therapies are helping athletes recover from injuries previously thought untreatable. Stay up-to-date and discover the latest information on the prevention, diagnosis, and treatment— and earn up to 20 CME or CE credits— through interactive hands-on workshops, debates, and other engaging formats led by world-renowned expert faculty and keynote presenters. The Concussion Boot Camp will offer a lively, practical, hands-on experience on how to examine an athlete on the sideline or in the office. Early registration ends June 15. Learn more and register at AAN.com/view/ ConcussionConference.
July 14 –16 • Jacksonville, FL
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Wednesday, April 26, 2017 • AANextra
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