2017 Annual Meeting AANextra—Monday, April 24 by American Academy of Neurology

THE ANNUAL MEETING NEWS DAILY

Monday, April 24, 2017

Inside

Concussion Featured in Today’s Neuroscience in the Clinic Session

Tomorrow’s 11 Experience Office Today at New Office of the Future Pavilion in the Exhibit Hall

Your Mark, Get Set… 21 On Help Cure Brain Disease at Tomorrow’s Run/Walk for Brain Research

Annual Meeting Gets off to High-octane Start with Eventful Opening Party

B. Smith and Dan Gasby at Commitment to Cures Event

The Annual Meeting got off to a dynamic start with a big turnout and lots of fun at last night’s Opening Party. Energized attendees gathered to socialize and make connections, eat, drink, and enjoy a host of exciting entertainment options throughout the evening. Continued on page 14 u

Public Leadership 28 Celebrate in Neurology Award Winners

This Morning’s Contemporary Clinical Issues Plenary Session to Highlight Issues Most Critical to Practicing Neurologists Beginning at 9:15 a.m. in the Exhibit Hall A, three abstract presenters and three invited speakers will highlight issues most critical to practicing neurologists during the Contemporary Clinical Issues Plenary Session. Speakers will present abstracts related to new therapeutic developments, clinical applications of basic and translational research, and innovative technical developments, followed by commentary and discussion.

Abstract Presentations: Nusinersen in Infants Diagnosed with Spinal Muscular Atrophy (SMA): Study Design and Initial Interim Efficacy and Safety Findings from the Phase 3 International ENDEAR Study Presenter: Nancy L. Kuntz, MD Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL

Continued on page 8 u

Trainees: Network, Discuss Opportunities at Tonight’s Faculty and Trainee Reception A premier networking event for those in undergraduate and graduate medical education will take place tonight in the BCEC Ballrooms East and West from 6:00 p.m. to 9:00 p.m. Don’t miss this unique opportunity to meet and Continued on page 17 u

Monday, April 24, 2017 • AANextra

HARNESSING SCIENCE

to improve lives

At MT Pharma America, we understand that people with debilitating neurological diseases are determined to live life on their own terms. This is especially true for people living with amyotrophic lateral sclerosis, or ALS, our current focus. That is why we have paired a global expertise in research and development with veterans in the US life sciences industry. We are working together with advocacy organizations to expand disease education and elevate awareness that may lead to improvements in diagnosis, treatment, and discovery.

Discover our current efforts at Booth 721

and mt-pharma-america.com

Inspired by patients. Grounded in science.

Monday, April 24 1 1 1 5 5 6 7

20 Visit Experiential Learning Area to

The Vision of the AAN is to be indispensable to our members.

21 On Your Mark, Get Set…Help Cure

Annual Meeting Gets off to Highoctane Start with Eventful Opening Party

The Mission of the AAN is to promote the highest quality patient-centered neurologic care and enhance member career satisfaction.

22 Enjoy Today’s Spanish-language

Contact Information:

Trainees: Network, Discuss Opportunities at Tonight’s Faculty and Trainee Reception

22 New to the Annual Meeting?

This Morning’s Contemporary Clinical Issues Plenary Session to Highlight Issues Most Critical to Practicing Neurologists

Poster Session II Opens This Morning at 8:30, Posters Grouped by Topic “Neighborhoods”

Learn How to Live Well

Brain Disease at Tomorrow’s Run/ Walk for Brain Research Hot Topics Session and Additional Resources

Congress Comes to the Annual Meeting

9 Boxed Lunch Menu Monday, April 24 9 Daily Reminders 11 Experience Tomorrow’s Office Today at New Office of the Future Pavilion in the Exhibit Hall

12 New Fellows of the AAN Honored at Breakfast

Catherine M. Rydell, CAE

Managing Editor: Angela Babb, CAE Editor: Tim Streeter

AAN Mentor Connect

Writers: Ryan Knoke, Sarah Parsons

29 Today’s Experiential Learning Area

Designer: Jim Hopwood

Highlights

Photography: Siu Lee

30 Tweets of the Day 33 New ALS Book Available for Patients,

Printing: Universal Wilde, Inc. Email: aannews@aan.com

Caregivers

AANextra is published by the American Academy of Neurology.

34 Annual Meeting Networking:

Good for All Stages of Your Career

43 What Are People Saying? 45 Get Ready to Join the Axon Registry 46 Academy Honors Members for

Event

AAN Executive Director/CEO:

28 Find Professional Guidance Through

11 Join Us at This Evening’s Networking

(800) 879-1960 (Toll Free) or (612) 928-6100 (International) (612) 454-2744 memberservices@aan.com AAN.com

Fax: Email: Website:

Neurology Award Winners B. Smith and Dan Gasby at Commitment to Cures Event

41 Industry Sponsors Help Support the

Presented at Today’s Invited Science Session

28 Celebrate Public Leadership in

11 Headache Research Highlights

Phone:

Wednesday’s Orientation Session Is for You!

Concussion Featured in Today’s Neuroscience in the Clinic Session Neurology Podcasts Mark 10th Anniversary

American Academy of Neurology 201 Chicago Avenue Minneapolis, MN 55415 USA

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.

AAN’s Programs and Events

Quality Improvement Innovations

16 Presidential Plenary Speakers

Discuss Most Significant, Timely Research

, AprIL MoNDAY

THE ANNUAL

MEETING

NEWS

24, 2017

DAILY

Inside

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Today’s AAN Section Meetings Monday, April 24—Westin Galleria 7:00 a.m.–8:00 a.m.

Neuromuscular Section 12:00 p.m.–1:00 p.m.

Autonomic Nervous System Section Clinical Neurophysiology Section Child Neurology Section Neuroendocrinology Section Neuroepidemiology Section

Monday, April 24, 2017 • AANextra

ed on Continu

5:30 p.m.–6:30 p.m.

A.B. Baker Section on Neurological Education Government Service Section Neuro-ophthalmology/Neurootology Section

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.

Poster Session II Opens This Morning at 8:30, Posters Grouped by Topic “Neighborhoods” You won’t want to miss today’s Poster Session II, opening at 8:30 a.m. in Exhibit Hall B. Look for all topic-related posters clustered together into “neighborhoods” to enhance your discussions and make the posters easier to navigate. Today’s session will be open until 7:00 p.m., with presenter standby from 5:30 p.m. to 7:00 p.m.

Topics include: Group A: Movement Disorders Group B: History of Neurology; Research Methodology and Education; Practice, Policy, and Ethics; MS and CNS Inflammatory Disease ePosters Group C: Aging and Dementia Group D: MS and CNS Inflammatory Disease Poster Discussion Group E: Neuromuscular and Clinical Neurophysiology (EMG) Group F: Headache; General Neurology Group G: Epilepsy/Clinical Neurophysiology (EEG) Group H: Cerebrovascular Disease and Interventional Neurology; Infectious Disease Group I: MS and CNS Inflammatory Disease

MS and CNS Inflammatory Disease ePoster Session Be sure and check out today’s interactive, touchscreen ePosters at the virtual hall kiosk for another great opportunity to further explore scientific posters. MS and CNS Inflammatory Disease 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 fiveminute data blitz with a moderator leading stimulating discussion on the content of the selected posters.

Remaining Poster Session Schedule Poster Session III Tuesday, April 25: 8:30 a.m.–7:00 p.m. / author standby from 5:30 p.m.–7:00 p.m. Poster Session IV Wednesday, April 26: 8:30 a.m.–7:00 p.m. / author standby from 5:30 p.m.–7:00 p.m. Poster Session V Thursday, April 27: 8:30 a.m.–7:00 p.m. / author standby from 5:30 p.m.–7:00 p.m. Poster Session VI Friday, April 28: 8:30 a.m.–5:30 p.m. / author standby from 4:00 p.m.–5:30 p.m.

Concussion Featured in Today’s Neuroscience in the Clinic Session Concussion data from the NCAA-Department of Defense Grand Alliance will be presented in today’s Neuroscience in the Clinic Session, which features a mix of scientists and clinicians engaged in lively case discussions to integrate scientific research with clinical application.

Neuroscience in the Clinic: Cutting Edge Concussion Data from the NCAA-DoD Grand Alliance 1:00 p.m.–3:00 p.m. Coordinators: Christopher Giza, MD; Brian W. Hainline, MD, FAAN

To date, there is a paucity of data to define the natural history of concussion, and even less to define neurobiological recovery in concussion. The NCAA-DoD CARE Consortium is the largest, prospective, longitudinal study of concussion ever conducted. Athletes from all NCAA sports, including non-contact sports, are part of the study. In 1.5 years, approximately 20,000 studentathletes have been evaluated and over 1,000 concussions have been evaluated. In this session, cutting-edge, newly released data will be presented, including advanced research data of neuroimaging, blood biomarkers, genomics, and helmet/head sensors. Clinical and policy implications of the emerging data will be discussed.

1:00 p.m.–1:05 p.m. Introduction—Brian W. Hainline, MD, FAAN 1:05 p.m.–1:15 p.m. Concussion as a Public Health Matter: Setting the Stage—Brian W. Hainline, MD, FAAN 1:15 p.m.–1:35 p.m. Concussion Pathophysiology: What We Know and What We Need to Know—Christopher Giza, MD 1:35 p.m.–2:00 p.m. CARE Consortium: Emerging Results and Implications for Concussion Management and Policy—Michael McCrea, PhD 2:00 p.m.–2:15 p.m. N3.001: Migraine History and Associated Comorbidities in High School Athletes—Katherine Breedlove 2:15 p.m.–2:30 p.m. N3.002: Between Trial Reliability of the King Devick Test—Magdalena Wojtowicz, PhD 2:30 p.m.–3:00 p.m. Panel Discussion

Monday, April 24, 2017 • AANextra

Neurology Podcasts Mark 10th Anniversary First aired in September 2007, the AAN’s Neurology ® Podcasts have been downloaded more than 12 million times—and the number continues to grow. Neurology Podcast Editors Ted M. Burns, MD, and Andrew M. Southerland, MD, Ted M. Burns, MD selected some of the more notable podcasts to highlight for the occasion: “It’s impossible to select favorite podcasts out of a list of more than 1,200 interviews—around 250 hours—done over the decade. But below is a list of perhaps some of our more memorable moments. As always, we thank our podcast team, our panel of interviewers, those whom we’ve interviewed, and especially all our listeners. It’s been a great 10-year ride and we look forward to the next 10.” Sample the deep wisdom and farAndrew M. Southerland, MD ranging insights of some of the world’s most eminent neurologists in these compelling podcasts. With each podcast, listeners can earn 0.5 AMA PRA Category 1 CME Credits™ by answering the multiple-choice questions related to Neurology content in the online Podcast Quiz. September 4, 2007: “Relevance of the Antibody Index to Diagnose Lyme Neuroborreliosis Among Seropositive Patients.” Our first podcast back in the days when nobody even knew what a podcast was! September 18, 2007: “Limbic Encephalitis as a Precipitating Event in Adult-onset Temporal Lobe Epilepsy.” The first podcast of Robert A. Gross, MD, PhD, FAAN! Who knew what great things lay ahead? June 3, 2008, and July 6, 2010: Interviews with the great Robert J. Joynt, MD, FAAN, the late dean and chair at the University of Rochester, about his career and other topics.

September 6, 2011: “A Man’s Reach Must Exceed His Grasp.” 60th anniversary of the Neurology journal. Robert C. Griggs, MD, FAAN, interview. November 6, 2012: “Neurodegenerative Causes of Death Among Retired National Football League Players.” A controversial and timely topic, especially today. September 24, 2013: “The Complexities of Acute Stroke Decisionmaking.” Brett M. Kissela, MD, MS, FAAN, interviews the great Louis R. Caplan, MD. October 29, 2013: An interview with neurologist and podcaster Lara Marcuse, MD, about her own personal experience being a patient. September 23, 2014: “Concussed.” An interview with Ben Utecht, former NFL player and past spokesman for the American Brain Foundation, about his concussions and worries about developing CTE. November 25, 2014: Andrew M. Southerland, MD, interviews novelist Esmerelda Santiago on her own stroke and rehabilitation experience. September 2015: Oliver Sacks Tribute: Interviews with Oliver Sacks, MD. Lesson of the week interviews from January 2011. September 27, 2016: “The Terrorist Inside My Husband’s Brain.” Susan Schneider-Williams, widow of Robin Williams, discusses her husband’s life before and during his battle with Lewy body disease. February 14, 2017: An interview with the CEO and President of Mayo Clinic, John Noseworthy, MD, FAAN, about the US health care system, his late 2016 meeting with President Trump, and his own career in MS care and research. Just about any interview with Alberto J. Espay, MD, FAAN, especially one of his interviews about a hot topic from the AAN Annual Meetings.

December 2, 2008: “The US Health Care System, Part 1: Our Current System and Its Problems.” Marc R. Nuwer, MD, PhD, FAAN, and Thomas R. Swift, MD, FAAN, discuss the US health care system in context of the 2008 election.

Win Free Bose Headphones Courtesy of Neurology

February 3, 2009; March 3, 2009; April, 12, 2011: Interviews with the legendary stroke neurologist C. Miller Fisher, MD.

In honor of the Neurology Podcast’s 10th anniversary, the AAN will hold a drawing to give away a set of BOSE headphones. Annual Meeting attendees can enter the drawing at the Neurology booth in the Education and Publications Station on level 1 in the convention center Northwest lobby. The drawing will be held on Wednesday, April 26, at 5:00 p.m. Winners will be notified via the email or phone number provided on the entry form. It is not necessary to be present to win, however, you must personally pick up the prize by Thursday, April 27, at 5:00 p.m. or the prize is forfeited. If that happens, a second drawing will be held at that time, and that winner must personally pick up the prize by 12:00 p.m. on Friday, April 27, or the prize is forfeited.

February 17, 2009: “Teaching the Next Generation of Neurologists.” A focus on neurology training with Mitchell S.V. Elkind, MD, MS, MPhil, FAAN, highlighting the great work of the Neurology Resident & Fellow Section. November 9, 2010: “Retrospective Analysis of NMDA Receptor Antibodies in Encephalitis of Unknown Origin.” An early interview with Josep Dalmau, MD, PhD, on NMDA encephalitis, a relative newcomer to the scene at the time. January 4, 2011: “The Past, Present, and Future of Neurology in the United States.” An interview with former Neurology editors Lewis P. Rowland, MD, FAAN; Robert B. Daroff, MD, FAAN; and Robert C.

Griggs, MD, FAAN, on the first paper published in the journal, as well as the history of neurology and advice for our younger listeners.

Monday, April 24, 2017 • AANextra

Congress Comes to the Annual Meeting If you have concerns about neurology issues in Congress, take this opportunity to meet Rep. Ami Bera, MD (D-CA), one of only two Democratic physicians currently serving in Congress, and Rep. Ron Kind (D-WI), a member of the House Ways & Means Committee. They will be available today from 2:30 p.m. to 3:15 p.m. in the Experiential Learning Area Advocacy to Action: Empowering Patients and Physicians. Rep. Ami Bera, MD, represents the 7th district of California, which includes suburbs of Sacramento. Bera was trained in internal medicine and practiced in the Sacramento area prior to joining Congress in 2013. He was a strong supporter of the 21st Century Cures Act, which included $4.8 billion investment in to NIH and was enacted into law in 2016, and is a proponent of legislation to reduce the cost of prescription drugs.

Rep. Ron Kind (left) and former Vice President Walter F. Mondale visited with AAN Executive Director Catherine M. Rydell at the AAN headquarters in 2014.

Rep. Ron Kind is a strong supporter of the AAN and has introduced legislation to improve health care at the Veterans Administration and enhance affordability of care for individuals with long-term illness. He looks forward to sharing his insights and taking your questions.

Rep. Ami Bera with AAN Senior Congressional Affairs Representative Derek Brandt.

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

This Morning’s Contemporary Clinical Issues Plenary Session to Highlight Issues Most Critical to Practicing Neurologists continued from cover Invited Speakers: A Woman “Found Down” Discussant: Charlotte J. Sumner, MD Johns Hopkins Medical School, Baltimore, MD

Louise D. McCullough, MD, PhD University of Texas Health Science Center, Houston, TX

Resumption of Oral Anticoagulation After Intracerebral Hemorrhage Is Associated with Decreased Mortality and Favorable Functional Outcome Presenter: Alessandro Biffi, MD Massachusetts General Hospital, Boston, MA Discussant: Daniel F. Hanley, MD, FAAN Johns Hopkins Medical School, Baltimore, MD

Targeting Neuronal Activity-regulated Neuroligin-3 Secretion for Glioma Therapy Presenter: Michelle Monje Deisseroth, MD, PhD Stanford University, Stanford, CA Discussant: Tracy T. Batchelor, MD, MPH Massachusetts General Hospital, Boston, MA

Tomorrow’s Clinical Trials Plenary Session Will Cover Important Topics Identified from Other Society Meetings Tuesday morning’s Clinical Trials Plenary will cover important clinical topics identified from other society meetings that affect patient care. The latest updates within several clinical trials conducted over the course of the last year will be presented with an open panel discussion at the conclusion. The session will begin at 9:15 a.m. in Exhibit Hall A.

Monday, April 24, 2017 • AANextra

The Era of Targeted Preventive Treatment for Migraine: CGRP Monocloncal Antibodies Amaal J. Starling, MD Mayo Clinic, Scottsdale, AZ

High Drug Prices: The Elephant in the Clinic Dennis N. Bourdette, MD, FAAN Oregon Health and Science University, Portland, OR

Boxed Lunch Menu Monday, April 24

Italian Flatbread Sandwich Smoked roast beef, salami, roasted peppers with provolone, giardineria relish, and herb aioli Country Chicken Salad (GF) Cranberries, green grapes, and fresh basil with pesto aioli Ancient Grain Salad (V, GF) Quinoa, lentils, and roasted tomatoes with EVOO and white balsamic reduction Each lunch includes: fire-roasted vegetable and basil salad – fresh mozzarella, balsamic strawberries – fresh mint and vanilla bean, angel food cake – lemon curd and mixed berries *V–vegan · GF–gluten free

Annual Meeting Mobile App

Now Available

Tap into the meeting from anywhere and start planning your 2017 experience:

Daily Reminders Education Program Syllabi and Slides Available Online Only

• View and customize your program schedule • Access program syllabi and slide materials • Access program evaluations and submit CME • Find room locations • Access information about Boston Available for iPhone®, iPad®, or Android®

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 receive 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.

AAN.com/view/app

Sponsored by:

The Treatment Experience Is Going Wireless.

Coming Soon Be one of the first to know. www.mytreatmentexperience.com/hcp BAYER and the Bayer Cross are registered trademarks of Bayer. The Bluetooth® word mark and logos are registered trademarks owned by Bluetooth SIG, Inc. and any use of such marks by Bayer® is under license. Other trademarks and trade names are those of their respective owners. ©2017 Bayer HealthCare Pharmaceuticals Inc. Whippany, NJ 07981. All rights reserved. PP-721-US-0681 March 2017

Experience Tomorrow’s Office Today at New Office of the Future Pavilion in the Exhibit Hall Join us for a new and exciting concept at this year’s Exhibit Hall. Open Sunday, Monday, Tuesday, and Wednesday during regular Exhibit Hall hours, the Office of the Future will let you experience technology that you can utilize in your practice today. Reimagine your own exam room with the latest equipment and cutting-edge technology that engages your patients and encourages shared decision-making. Stop by the presentation stage to hear presentations on how technologies are being used today to improve patient care and streamline office processes. Learn about new tools to communicate about patient and family education Hear presentations on how these technologies can improve patient care Update your professional headshot in the complimentary headshot lounge— sponsored by SK biopharmaceuticals Office of the Future is sponsored by Outcome Health, Health Monitor Network, Ricoh Company, LTD., and Sunovion Pharmaceuticals.

Join Us at This Evening’s Networking Event Don’t forget to attend this special reception in the Exhibit Hall from 4:30 p.m. to 6:00 p.m. today. Meet and mingle with exhibitors and poster authors while enjoying hors d’oeuvres and beverages sponsored by Sunovion Pharmaceuticals.

Headache Research Highlights Presented at Today’s Invited Science Session Top abstracts previously presented at the American Headache Society Annual Meeting will be presented by their authors in 20-minute platform presentations at today’s Invited Science Session from 3:30 p.m. to 5:30 p.m. Select abstracts from their “best of” lineups emphasize basic, clinical, and translational science as they evolve toward a more complete understanding of headache with the overall goal of developing more effective prevention and treatment. 3:30 p.m.–3:50 p.m. Early Life Stress Increases Susceptibility to Cortical Spreading Depression and Anxiety in Rodents Stuart Collins, PhD, Toledo, OH 3:50 p.m.–4:10 p.m. Posttraumatic Headache Five Years After Traumatic Brain Injury Sylvia M. Lucas, MD, PhD, Seattle, WA 4:10 p.m.–4:30 p.m. Epidemiology of Migraine in Men: Results from the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study Ann Scher, PhD, Bethesda, MD

4:30 p.m.–4:50 p.m. Perspectives of Adolescents on the Burden of their Parent’s Migraine: Results from the Chronic Migraine Epidemiology and Outcomes Study Richard B. Lipton, MD, FAAN, Bronx, NY 4:50 p.m.–5:10 p.m. CRP and Migraine in Young Adults—Results from the Add Health Study Gretchen E. Tietjen, MD, Toledo, OH 5:10 p.m.–5:30 p.m. Altered Pupillary Light Responses in Migrainous Photophobia Melissa M. Cortez, DO, Salt Lake City, UT

Monday, April 24, 2017 • AANextra

New Fellows of the AAN Honored at Breakfast In 2016, nearly 150 Academy members listed below were elevated to Fellows of the American Academy of Neurology (FAAN) member category. Those new Fellows present at the Annual Meeting had the opportunity to come together for a celebratory breakfast in their honor on Sunday morning. “I’m pleased to recognize these members, who are among the record number of members who received this prestigious designation last year,” said AAN President Terrence L. Cascino, MD, FAAN, who welcomed the breakfast attendees. “The Academy values their dedication to our profession and their contributions to the field of neurology. Also, by attaining this status, these members now are eligible to serve on the AAN Board of Directors. We look forward to more members taking the opportunity in 2017 to apply for Fellow status.” Other AAN leaders joining Cascino at the breakfast were David J. Capobianco, MD, FAAN, Chair of the Membership Application Review Subcommittee; Gregory D. Cascino, MD, FAAN, board member and chair of the Member Engagement Committee; and Executive Director/CEO Catherine M. Rydell, CAE. You may apply to become a fellow, or nominate a colleague. To learn about qualifications or apply, visit the Membership booth at the Annual Meeting, go online at AAN.com/view/FAAN, or contact AAN Member Services at memberservices@aan.com or (800) 879-1960.

2016 New Fellows of the AAN Fadi Karim Abou-Mrad, MD, PhD, FAAN

Amy R. Brooks-Kayal, MD, FAAN

Richard E. Ferguson, MD, FAAN

Joshua P. Klein, MD, PhD, FANA, FAAN

Jason Lamar Aldred, MD, FAAN

Kevin J. Callerame, MD, FAAN

Elizabeth Finger, MD, FAAN

Olga Klepitskaya, MD, FAAN

Marc Cantillon, MD, FAAN

Stanley Fisher, MD, FAAN

Benzi Kluger, MD, FAAN

Adel Alhazzani, MD, FRCPC, FAAN

Geetha Chari, MD, FAAN

Jeffrey Fletcher, MD, FAAN

Melissa W. Ko, MD, FAAN

Claudia J. Chaves, MD, FAAN

Brent L. Fogel, MD, PhD, FAAN

Sanjeev V. Kothare, MD, FAAN

Anne Foundas, MD, FAAN

Stephen Krieger, MD, FAAN

Tanuja Chitnis, MD, FAAN

Peter Fuhr, MD, FAAN

Jai Kumar, MD, FACP, FAAN

John Y. Choi, MD, FAAN

Jeffrey Marc Gelfand, MD, MAS, FAAN

Jennifer M. Kwon, MD, FAAN

David Corbin, MB, FRCP, FAAN

David J. Gill, MD, FAAN

Julius Latorre, MD, FAAN

David Gloss, MD, FAAN

Vivien H. Lee, MD, FAAN

Asha Das, MD, FAAN

Mary Goodsett, MD, FAAN

Maureen Leehey, MD, FAAN

Ted M. Dawson, MD, PhD, FAAN

Patrick M. Grogan, MD, FAAN

Bruce R. LeForce, MD, FAAN

Ann M. Hake, MD, FAAN

Thomas J. Derbes, MD, FAAN

Roy H. Hamilton, MD, MS, FAAN

Thomas Leist, MD, PhD, FAAN

Shireen Al-Qureshi, MD, FRCP, FAAN Beau M. Ances, MD, PhD, MS, FAAN Hossein Ansari, MD, FAAN Hany M. Aref, MD, FAAN Abdulaziz Ashkanani, FAAN, BMBCH, FRCPC Erika Fullwood Augustine, MD, FAAN Amer Awad, MD, FAAN Brenda Banwell, MD, FAAN Reza Behrouz, DO, PhD, FAAN Dario Beltran, MD, FAAN Sheldon Benjamin, MD, FAAN Bibiana Bielekova, MD, FAAN David M. Biondi, DO, FAAN Andrew Biondo, DO, FAAN Borna Bonakdarpour, MD, FAAN Thomas H. Brannagan III, MD, FAAN K.C. Brennan, MD, FAAN Steven M. Bromley, MD, FAAN

Jerome H. Chin, MD, PhD, MPH, FAAN

Kelvin L. Chou, MD, FAAN

Mark T. D’Esposito, MD, FAAN

Lindsey Lee Lair, MD, FAAN

Michael Levy, MD, FAAN

Chad R. Heatwole, MD, FAAN

Kara Stuart Lewis, MD, FAAN

David W. Dodick, MD, FAAN

Vanessa K. Hinson, MD, PhD, FAAN

Jun Li, MD, PhD, FAAN

Daniel A. Drubach, MD, FAAN

Teresa L. Jacobs, MD, FAAN

Barbara A. Dworetzky, MD, FAAN

Cheryl Ann Jay, MD, FAAN Kristen Jessen, MD, FAAN

Mark Mu-Quan Lin, MD, PhD, FAAN

Ronald J. Ellis, MD, PhD, FAAN

Sayona John, MD, FAAN

Rafael H. Llinas, MD, FAAN

Diana M. Escolar, MD, FAAN

Kathleen Kennelly, MD, PhD, FAAN

Catherine Lomen-Hoerth, MD, PhD, FAAN

Gregory J. Esper, MD, MBA, FAAN

Raja B. Khan, MD, FAAN

Christian J. Lueck, MD, FAAN

Richard D. King, MD, PhD, FAAN

Raman K. Malhotra, MD, FAAN

Elliot Dimberg, MD, FAAN

Amtul Farheen, MD, FAAN

David J. Likosky, MD, SFHM, FAAN

Justin A. Malone, MD, FAAN Farrah J. Mateen, MD, PhD, FAAN Paul G. Mathew, MD, FAHS, FAAN Michelle L. Mauermann, MD, FAAN

Jonathan S. Rutchik, MD, MPH, FAAN Mustafa S. Siddiqui, MD, FAAN Mohammad Salajegheh, MD, FAAN Keith Sanders, MD, FAAN

AT THE AAN ANNUAL MEETING

DISCOVER ADVANCED NEUROMUSCULAR TESTING Muscle biopsy Acid a-glucosidase

Olga L. McAbee, MD, FAAN

Lauren Seeberger, MD, FAAN

Keith James McAvoy, MD, FAAN

Manuel Seijo-Martinez, MD, PhD, FAAN

Jeffrey C. McClean II, MD, FAAN

Raad A. Shakir, MD, FRCP, FAAN

Nerve conduction tests

Mark Mintz, MD, FAAN

Amitabh Y. Shukla, MD, FAAN

Reflex testing

Augusto A. Miravalle, MD, FAAN

Abdelazim Sirelkhatim, MD, FAAN

X-rays

Bruce T. Monastersky, MD, FAAN

Nicholas W. Stanek, MD, FAAN

Sleep studies

Sameh Morkous, MD, FAAN

Gorazd B. Stokin, MD, PhD, FAAN

Tara Morrison, MD, FAAN

Various blood tests Electrocardiograms Pulmonary function tests

Magnetic resonance imaging Targeted DNA analysis1 Learn more about panel testing for neuromuscular

Stephen P. Suggs, MD, FAAN

disorders—including Pompe disease. A complimentary 31 separate conditions.1

Ashkan Mowla, MD, FAAN

Bradford Lynn Talcott, MD, PhD, FAAN

Peter J. Myers, MD, FAAN

Yutaka Tanaka, MD, FAAN

Testing early can help impact a 13-year diagnostic delay for Pompe disease.* 2-4

Kazuma Nakagawa, MD, FAAN

Pariwat Thaisetthawatkul, MD, FAAN

Visit Sanofi Genzyme at Booth #729 to learn more.

Beau Katsuki Nakamoto, MD, PhD, MBA, FAAN

John B. Townsend, MD, FAAN

Katherine H. Noe, MD, PhD, FAAN

Mark H. Tuszynski, MD, PhD, FAAN

Paul Alan Nyquist, MD, MPH, FAAN

Roxanne M. Valentino, MD, FAAN

Bjorn E. Oskarsson, MD, FAAN

Paul C. Van Ness, MD, FAAN

Heather Moss, MD, PhD, FAAN

Maryam Oskoui, MD, FAAN

Gregory P. Van Stavern, MD, FAAN

Yi Pan, MD, PhD, FAAN

Bert B. Vargas, MD, FAAN

Joseph J. Pysh, DO, PhD, FAAN

Galina Vorobeychik, MD, FRCPC, FAAN

Mary Ellen Quiceno, MD, FAAN

Ryan R. Walsh, MD, PhD, FAAN

Nima Ramezan-Arab, MD, FAAN

Pedro Weisleder, MD, PhD, FAAN

John Matthew Ringman, MD, FAAN

Lawrence A. Zeidman, MD, FAAN

Matthew S. Robbins, MD, FAAN

Charles Zollinger, MD, FAAN

program is available for targeted DNA analysis of up to

* 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.

Kirk Roberts, MD, FAAN Wendy M. Robertson, MD, FAAN Michael Rosenbloom, MD, FAAN Bruce S. Rubin, MD, FAAN

Annual Meeting Gets off to High-octane Start with Eventful Opening Party continued from cover The always popular Neurobowl® kicked off the night’s festivities with former AAN president Thomas R. Swift, MD, FAAN, along with Kapil D. Sethi, MD, FRCP, FAAN, and Bert B. Vargas, MD, FAAN, hosting the best and brightest in neurology as they vied for the enviable Neurobowl trophy. Team Boston included Aaron Berkowitz, MD, FAAN; Jeremy D. Schmahmann, MD, FAAN; Janice Wiesman, MD, FAAN; David Thaler, MD, PhD, FAHA; William DeBassio, MD, PhD; and alternate Anthony Amato, MD, FAAN. The All Stars (Canada) team was made up of Anthony E. Lang, MD, FAAN; Ann Yeh, MD; Hans Katzberg, MD; Michael Hill, MD; Catherine Maurice, MD; and alternative David Tang-Wai, MDCM, FRCPC. And Norman Ajiboye, MD; Abdelazim Sirelkhatim, MD, FAAN; Hannah Klein, MD, PhD; Jordan Raynor, MD; Umair Saeed, MD; and alternate Raymond Price created The Road Scholars. Team Boston emerged victorious. At 8:30, attendees took in a dazzling performance by Trinity Irish Dance Company. The ensemble’s high-energy

Monday, April 24, 2017 • AANextra

show exemplified the kind of hard-driving percussive power, lightning-fast agility, aerial grace, and awe-inspiring precision that has won them an unprecedented 17 World Championships for the US

and appearances in feature films and television. After such a rousing, toetapping performance, attendees were primed for some dancing of their own to popular tunes courtesy of a live DJ.

There’s an important question being asked at the 2017 AAN Annual Meeting

UNCOVERING THE UNMET NEEDS IN MULTIPLE SCLEROSIS

Celgene invites you to share your thoughts about the unmet needs in the treatment of MS at BOOTH #779.

To participate: STOP by the Celgene booth • SCAN your badge • SUBMIT a word or phrase that best states a current unmet need in MS •

In addition to an initial $10,000 donation, for every visitor who contributes an unmet need to the discussion, Celgene will donate to the Multiple Sclerosis Association of America (MSAA).

Presidential Plenary Speakers Discuss Most Significant, Timely Research The diversity of the AAN membership, the importance of standing up for neurology patients and the profession, and the factors leading to burnout and strategies to combat it were the focus of the Presidential Lecture by AAN President Terrence L. Cascino, MD, FAAN, yesterday. The Presidential Plenary Session, moderated by Natalia Sana Rost, MD, FAAN, vice chair of the AAN Science Committee, lived up to its tradition for presenting top expert views on the most recent, significant, and clinically relevant research in neurology.

Presidential Lecture Burnout, Wellness, and the Future of Our Profession Terrence L. Cascino, MD, FAAN Mayo Clinic, Rochester, MN

H. Houston Merritt Lecture Ophthalmoscopy in the 21st Century Nancy J. Newman, MD, FAAN Emory University School of Medicine, Atlanta, GA

Sidney Carter Award in Child Neurology Improving Outcomes in Childhood Epilepsy J. Helen Cross, PhD UCL-Institute of Child Health, London, United Kingdom

Robert Wartenberg Lecture How Early Can We Diagnose Alzheimer’s Disease? Ronald C. Petersen, PhD, MD, FAAN Mayo Clinic, Rochester, MN Ralph L. Sacco, MD, MS, FAHA, FAAN, left, assumes the AAN presidency from Terrence L. Cascino, MD, FAAN, on April 29.

Nancy J. Newman, MD, FAAN

Monday, April 24, 2017 • AANextra

J. Helen Cross, PhD

Ronald C. Petersen, PhD, MD, FAAN

Trainees: Network, Discuss Opportunities at Tonight’s Faculty and Trainee Reception continued from cover

network with your peers, institutions, and program/clerkship/fellowship directors. Trainees will have the opportunity to view residency, fellowship, academic/research positions, or private and group practice positions. The event kicks off with award presentations and recognition of scholarship recipients. Jaffar Khan, MD, FAAN, chair of the AAN Graduate Education Subcommittee, chair of the AAN Consortium of Neurology Program Directors, and member of the AAN Education Committee, will serve as the master of ceremonies.

Lounge, where clerkship and program directors will be available to answer questions and provide insight on what resources are available at the reception. Attendees can also find out more information about the Consortium of Neurology Residents and Fellows (CNRF), Student Interest Group in Neurology (SIGN), Consortium of Neurology Clerkship Directors (CNCD) and the Consortium of Neurology Program Directors (CNPD) and how these groups can help you in your neurology career.

Neurology ® Resident & Fellow Section editors and editorial team members will be on hand to answer questions about Medical students, residents, and fellows the journal and provide details about looking for answers to general questions writing and reviewing opportunities, and can stop by the Career Networking AAN Career Center representatives will be available to demonstrate the AAN’s free Salary Calculator Tool—an exclusive benefit to AAN resident and fellow members, and your starting point Make your way to the Exhibit Hall between 4:30 p.m. to in your negotiations 6:00 p.m. today for a special networking reception. The before signing an event is a great way to check out the Exhibit Hall and employment contract. mingle with exhibitors and poster authors while enjoying hors d’oeuvres and beverages sponsored by Sunovion Pharmaceuticals.

Trainees: Check out Talks at Experiential Learning Area Medical students and residents should check out the Navigating Your Career Experiential Learning Area for talks on topics such as “Choosing a Career in Neurocritical Care,” “Navigating Fellowship in Neurology,” “SIGN up for a Career in Neurology” about the SIGN program for medical students, and “Interviewing Skills: Negotiation.” The Experiential Learning Area will also be the site of a meet and greet session for resident and fellow members from 12:00 p.m. to 12:30 p.m. on Tuesday, April 25, hosted by Eugene L. Scharf, MD, and Abhimanyu Mahajan, MD. A meet and greet session for international residents and fellows will be from 11:30 a.m. to 12:00 p.m. on Thursday, April 27.

Looking for More Networking Opportunities? Make Your Way to Today’s Networking Reception in the Exhibit Hall

The Navigating Your Career Experiential Learning Area is in the North East Lobby of the convention center.

Monday, April 24, 2017 • AANextra

Enhance your Annual Meeting experience with Annual Meeting On Demand. There is no better place than the AAN Annual Meeting for a high-quality educational experience in neurology. With the robust offering of concurrent courses available during the meeting, it is impossible to attend every one. Annual Meeting On Demand delivers captured content from the Annual Meeting to your doorstep so that you can experience the full value of the meeting. Annual Meeting On Demand is a CME accredited comprehensive digital library with more than 500 hours1 of presentations from the 2017 AAN Annual Meeting including syllabi for 200+ programs. Features of Annual Meeting On Demand include: • Online access to content within 24 hours of live presentations. • Integrated online CME testing. • An advanced search engine that delivers a direct link to the specific presentations and slides containing your search terms. • 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. • A complimentary portable hard drive2 for offline viewing when internet is not available. 1

Specific presentations within a session may not be available or may be audio only if the presenter has confidential patient information or otherwise declines to be recorded. Hard drive does not include all the functionality available online, such as Advanced Search, MP3/PDF Downloads, Bookmarks, Recently Viewed and CME testing.

Order Annual Meeting On Demand by April 28 and save $1,150 or more off the regular price! All attendees will receive complimentary online access to Syllabi for one-year. Upgrade to a USB drive for permanent use. Annual Meeting On Demand

Syllabi On Demand (USB Upgrade)

LIST PRICE

$1,749

$299

MEMBER, SENIOR & HONORARY

$399 Save $1,350

$39 Save $260

NONMEMBER

$599 Save $1,150

$59 Save $240

JUNIOR & NON-NEUROLOGIST MEMBER

$199 Save $1,550

$29 Save $270

Order In Person: The Education & Publications Station located on Meeting Level 1 Order Online: AANonDemand.com/Boston Order by Phone: (800) 501-2303 (US only) or (818) 844-3299 Meeting discounts expire April 28, 2017.

Visit Experiential Learning Area to Learn How to Live Well

Understanding and reducing burnout in neurologists has been a key initiative of President Terrence L. Cascino, MD, FAAN, during his term. To help AAN members identify and mitigate stress in their professional and personal lives, the Academy created the Live Well program, providing a host of online resources and tools. This week, you can take advantage of a plethora of Live Well opportunities when you visit the Experiential Learning Area. Between daily all-level Vinyasa yoga sessions at 7:00 a.m. and guided meditation at 5:00 p.m., you can get insightful tips from your colleagues on nutrition, sleep, mindfulness, exercise, acupuncture, and much more. Several speakers will share how you can apply these resources to your patients living with Parkinson’s disease, multiple sclerosis, stroke, neurodegenerative disease, and chronic pain. Chair massages will be available from noon to 4:00 p.m. through Thursday.

Monday’s Schedule 8:00 a.m.–8:45 a.m. Enhanced Wellbeing Through Mentoring Joanne Smikle, PhD 1:00 p.m.–1:45 p.m. Physical Exercise and Cognitive Training in Neurology: Application in Aging and Neurodegenerative Disease Ergun Y. Uc, MD 2:00 p.m.–2:45 p.m. Acupuncture Demonstration Jennifer Bickel, MD

Monday, April 24, 2017 • AANextra

3:00 p.m.–3:45 p.m. Introduction to Acupuncture I: Conceptual Framework and Mechanism of Action Alexandra Dimitrova, MD 4:00 p.m.–4:45 p.m. StrengthsFinder™ Social Hour (Refreshments provided) Keri Bischoff and Julie Anderson 5:00 p.m.–5:30 p.m. Guided Meditation Divya Singhal, MD

Step up to the Step Challenge Need some incentive to stretch your legs between education courses and science programs? Participate in the Step Challenge! Each day through Friday, use your smartphone, fitness tracker, pedometer, etc. to document you’ve taken 10,000 steps or more at the Annual Meeting. By 6:00 p.m., share your day’s results (either in person or by emailing a screenshot of your device to livewell@aan.com) with staff at the Live Well area to be entered to win a prize! Each morning, a contestant will be selected by lottery and announced on our daily winner sign. Winners also will be notified via email.

On Your Mark, Get Set…Help Cure Brain Disease at Tomorrow’s Run/ Walk for Brain Research Join your colleagues and friends Tuesday morning on the beautiful Boston waterfront for a friendly 5k Run/1k Walk for Brain Research. Both occasional and seasoned runners and walkers are invited to take part in this popular event—a perfect way to kick off your day of Annual Meeting programming and raise money for the American Brain Foundation to help support vital research into brain disease.

Introducing...

The run/walk will begin promptly at 6:30 a.m. at Castle Island, and continue along a scenic waterfront route. Bus service to and from the event will be provided from designated hotels. The race is open to all meeting attendees and their families, and the fee to participate is $50. Water and refreshments will be available following the race. Be sure to stop by the Live Well Experiential Learning Area in the Boston Convention & Exhibition Center to pick up your t-shirt and to see the run/walk results. Thank you to the following sponsors: AveXis, Inc., Biogen, Eisai Inc., EMD Serono, Novartis Pharmaceuticals, Neurology ® , Sanofi Genzyme, Sage Therapeutics, Sunovion Pharmaceuticals, and Supernus Pharmaceuticals Inc.

Three-peat? Lisa Thomas and Corey R. Fehnel, MD, topped the field in both 2015 and 2016.

Join Neurology’s Global Conversation! Connect with neurologists and neuroscience professionals in your area of interest. Get started at AAN.com/Synapse

Enjoy Today’s Spanish-language Hot Topics Session and Additional Resources Visit the Experiential Learning Area this afternoon for Hot Topics en Español, presented on the HeadTalks stage from 3:00 p.m. to 5:00 p.m. Santiago OrtegaGutierrez MD, MSc; Edgar A. Samaniego, MD; and Alejandro Tobon, MD, will provide a neurology update in Spanish on neurocritical care, the Zika virus, and endovascular treatment of stroke. The AAN is reaching out to the Spanishspeaking community in several ways. During Saturday’s Brain Health Fair, Teresa Gomez-Isla, MD, PhD, director of the Memory Division at Massachusetts General Hospital and associate professor of neurology at Harvard University,

presented “El desafío de la enfermedad de Alzheimer en el siglo XXI” (“The Challenge of Alzheimer’s Disease in the 21st Century”). Free neurology resources in Spanish were available to attendees.

LA FUENTE DE INFORMACIÓN MÁS CONFIABLE PARA LA SALUD DE SU CEREBRO

Also, the AAN has published a Spanish pilot issue of its patient education magazine Neurology Now ® . The Spring 2017 issue, with its own exclusive content, is being mailed along with the April/May English issue to

US AAN members’ offices located in areas with high numbers of La presentadora de TV Elizabeth Espinosa habla por aquellos Spanish speakers. This con necesidades especiales pilot issue hopes to Una vida entre letras Esmeralda Santiago connect with some of comparte su recuperación de the 53 million people un ataque cerebral ¿Migraña? living in the US today Una guía con lo último Decisión who are Hispanic and informada Recomendaciones have a need for highpara tratar la esclerosis múltiple quality and trustworthy medical information. Visit the Education and Publications Station in the convention center to get a copy and share your thoughts with staff. PRIMAVERA 2017

ALZANDO LA VOZ

The Academy has collaborated with the Mexican Academy of Neurology on selected AAN clinical practice guidelines in Spanish. You can find these online ata. Look for more Spanish-language programming and resources at the 2018 Annual Meeting in Los Angeles!

Santiago Ortega-Gutierrez MD, MSc

Edgar A. Samaniego, MD

Alejandro Tobon, MD

New to the Annual Meeting? Wednesday’s Orientation Session Is for You! Get the most out of your first Annual Meeting experience at Wednesday’s Annual Meeting Orientation Session. This informative and interactive one-hour 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

When: Wednesday, April 26 Time: 7:00 a.m.–8:00 a.m. Location: HeadTalks Experiential Learning Area Host: Maisha T. Robinson, MD, MS

Monday, April 24, 2017 • AANextra

INDUSTRY THERAPEUTIC UPDATE FROM GENENTECH, INC. Join us for an Interactive Expert Panel Discussion featuring:

Stephen L. Hauser, MD Director, UCSF Weil Institute for Neurosciences Professor & Chair, Department of Neurology University of California, San Francisco School of Medicine San Francisco, California

Revere (Rip) Philip Kinkel, MD Director, UCSD MS Program Professor of Neurosciences & Clinical Neurology Director University of California, San Diego San Diego, California

Barry Singer, MD

Director of the MS Center for Innovations in Care at Missouri Baptist Medical Center Missouri Baptist Medical Center Saint Louis, MO

Westin Waterfront Hotel 425 Summer Street Boston, MA 02210

Waterfront Marina Ballroom Tuesday, April 25, 2017 7:00 PM â&#x20AC;&#x201C; 9:15 PM

In accordance with the PhRMA Code on Interactions with Healthcare Professionals, attendance at this promotional program is limited to healthcare professionals. Minnesota, Vermont, and Federal Entities have restrictions on receiving in-kind benefits (eg, meals, valet parking) at company-sponsored events. You are accountable for understanding such restrictions and complying with them. If you are licensed in or affiliated with any of these states or federal agencies, Genentech policies may restrict you from consuming any portion of the Genentech-sponsored meal at this program or from receiving any other in-kind benefit from Genentech (eg, valet parking) in connection with the program. Please note that this is a promotional, non-CME program, and no CME credits will be given for attendance. This is not an official event of the 2017 AAN Annual Meeting, and it is not sponsored or endorsed by AAN. This program is sponsored by Genentech, Inc.

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. NUPLAZIDÂŽ (pimavanserin) prescribing information, ACADIA. ÂŠ2017 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

Peripheral edema

Confusional state

Hallucination

Constipation

Gait disturbance

<1%

Hallucination includes visual, auditory, tactile, and somatic hallucinations

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.

9/27/16 6:01 PM

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

9/27/16 6:01 PM

Celebrate Public Leadership in Neurology Award Winners B. Smith and Dan Gasby at Commitment to Cures Event B. Smith and Dan Gasby will receive the Public Leadership in Neurology Award at the AAN Annual Meeting during the Commitment to Cures event, a fundraiser for the American Brain Foundation on Wednesday, April 26. Gasby recently joined the American Brain Foundation Board to help the Foundation make curing brain disease a public cause. Gasby’s wife, B. Smith, a nationally recognized celebrity chef, restaurateur, supermodel, and lifestyle maven, was diagnosed with early-onset Alzheimer’s in 2013. The moment Smith received her diagnosis, the couple decided that they would not hide; they would go public and advocate for Alzheimer’s patients and caregivers. Since then, they have crisscrossed the country, making more than 25 appearances at Alzheimer’srelated events. They co-authored the book Before I Forget: Love, Hope, and Acceptance in our Fight Against Alzheimer’s, released by Random House in January 2016.

In their book, which includes a forward by Rudolph Tanzi, PhD, of Harvard University and 1996 recipient of the Potamkin Prize for Research in Pick’s, Alzheimer’s, and Related Diseases, Smith and Gasby share their compelling personal journey with Alzheimer’s disease and make a strong case for research funding. They detail the particularly devastating impact of the disease on African Americans, who are twice as likely as non-Hispanic whites to develop late onset Alzheimer’s and less likely to have a diagnosis of their condition, which often results in little time for treatment and planning. Commitment to Cures will be at the Westin Boston Waterfront and includes a cocktail hour, dinner, and program with speakers Gasby and Smith and entertainment from the Delfeayo Jazz Quartet. For tickets, visit the American Brain Foundation booth in the North Lobby.

Dan Gasby and B. Smith

Find Professional Guidance Through AAN Mentor Connect AAN Mentor Connect is designed to help bring together younger neurologists who are seeking advice as they navigate career transitions and more experienced neurologists who are willing to provide guidance.

professional transitions. “There are MD, FAAN. “I have had a number of many paths a career can take. mentoring relationships in the Early on it is hard to truly know last 5-10 years and it is very all of your options, whether a satisfying to see neurologists in particular direction is right for training blossom and find their you, and how to get where you’d career directions. I mentor at Members who are interested in participating like to be even when the goal is the college, medical student, can go to careers.aan.com/ementor, where clear. A mentor can shed light neurology resident and fellowship they can apply to be a mentor or mentee, on your choices, challenge you levels and each stage is or search for a mentor. They will to understand yourself fascinating. There is so much receive an email when someone Jonathan Goldstein, more fully, use his or talent out there but direction MD, FAAN is a possible match and they her past experiences is often lacking. Many of my can view that person’s record to as a foundation for advice, mentees just need someone who has determine if it is a good fit. If it is, and help you make important been there before to bounce ideas off the two parties discuss the needs connections.” and to talk to as they progress along their of the mentee, frequency of training.” contact, length of the mentoring Mentors also gain something relationship, etc. from their relationships with Nesanet Mitiku, MD younger professionals. “I signed For Nesanet Mitiku, MD, the up for the mentorship program based on first mentee participant in the program, my experience with mentoring at Yale guidance from a mentor can help clarify Medical School,” said Jonathan Goldstein,

Monday, April 24, 2017 • AANextra

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:

AAN Awards Day

Neurological Exam Tips and Tricks 12:00 p.m.–2:00 p.m. HeadTalks Experiential Learning Area Thomas R. Swift, MD, FAAN Christopher H. Hawkes, MD, Bsc, FRCP

Research Corner Experiential Learning Area

Neurology and the 115th Congress 4:30 p.m.–5:00 p.m. Advocacy in Action Experiential Learning Area Derek Brandt Successful APP-Physician Team Models Panel 2:00 p.m.–2:45 p.m. Navigating Your Career Experiential Learning Area Paula Hardeman, PA-C Benjamin Greenberg, MD, FAAN Cheryl Wall, APRN Miriam Freimer, MD Emma Fields, APRN Ryan Hakimi, DO Hot Topics en Español 3:00 p.m.–5:00 p.m. HeadTalks Experiential Learning Area Santiago Ortega-Gutierrez, MD, MSc Edgar A. Samaniego, MD Alejandro Tobon, MD

8:30 a.m.–9:00 a.m. Why Study the History of Neurology?—A Panel Discussion Featuring the Lawrence C. McHenry Award and Roland P. Mackay Medical Student Essay Award Winners Christopher J. Boes, MD, FAAN Peter J. Koehler, MD, PhD, FAAN Douglas J. Lanska, MD, FAAN 4:00 p.m.–4:30 p.m. How Do Awards and Research Fit Into Your Career Path—A Panel Discussion Featuring Current and Former Potamkin Prize and Founders Award Winners Ronald C. Petersen, PhD, MD, FAAN Claudia Kawas, MD Emer McGrath, MD, PhD 2:00 p.m.–2:30 p.m. Your CV Is Talking About You Behind Your Back, and Your LORs Are Too! An Interactive Career Talk from a Past Minority Scholarship Award Recipient Na Tosha N. Gatson, MD, PhD

Monday, April 24, 2017 • AANextra

Tweets of the Day J

eff Kraakevik MD @ohsuneuro

Ramsey-Williams: 1-2 students going into neuro per yr when rotation in 4th yr, 4-6 going into neuro since switch to 3rd yr #AANAM

A hi

b @theabstractruth

This meeting is amazing for trainees! #AANAM

athrin LaFaver @LaFaverMD

Great talk on an innovative program for advanced PD care by Jori Fleisher! #AANAM

rainMDjmiyasaki @BrainMDmiyasaki Photo booth @experience area #AANAM

elissa Rayhill, MD @melissarayhill

We even write differently! Communication differences contribute to unintended #bias and #gendergap in #Neurology #AANAM @BertVargas

athy Foris MD @KathyForis

Great talk on #patient engagement #AANAM. The future: shared notes patients contribute to! #Neurology @ AANMember

Industry Therapeutic Update from Novartis Pharma AG The tightrope of MS: maintaining balance on the disease continuum Tuesday 25 April 2017, 19:00–20:30 Plaza Ballroom Seaport Hotel & World Trade Center, Boston, MA, USA This Industry Therapeutic Update could mention product data not aligned with the approved label in your country. For this reason we advise you that the contents are not intended for some countries, including the US. This is not a CME programme nor will CME credits be given for attendance.

This meeting is not an AAN-endorsed event.

Novartis Pharma AG CH-4056 Basel, Switzerland www.novartis.com

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.

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

New ALS Book Available for Patients, Caregivers A new resource is available for your patients with ALS with the publication of Navigating Life with Amyotrophic Lateral Sclerosis by Mark B. Bromberg, MD, PhD, FAAN, and Diane Banks Bromberg, JD. The title is the latest in the AAN’s Neurology Now™ Books series. Navigating Life with Amyotrophic Lateral Sclerosis is unique because it covers two perspectives of these married authors: One is a neurologist with 30 years of experience treating ALS patients, and the other experienced firsthand the issues in providing care for a parent with ALS. “I have worked with patients with amyotrophic lateral sclerosis and followed research for the disease for over 30 years,” said Mark Bromberg. “This experience has been rewarding as I have come to understand how patients and their families manage a most challenging disease. The experience is also frustrating as an understanding of underlying causes and a cure remain elusive. Together with my wife, whose mother had ALS, we have written Navigating Life with Amyotrophic Lateral Sclerosis to communicate to affected families what we have learned about managing the disease.” Patients, family members, and caregivers will value this book for the accessible, comprehensive, and up-to-date information about the challenges they face when confronted by ALS. This guide covers all aspects of managing ALS, from the onset of symptoms, diagnosis, treatments, and coping strategies, to the use of home health care or hospice,

and new research in the field. The book also sheds light on difficult topics, such as end-of-life care and managing legal affairs. Formatted in a question-andanswer style, peppered throughout with patient stories, and with sections devoted to family members and caregivers, this compassionate resource provides guidance to those seeking to understand how to live with this disease. “Even in today’s fast-paced digital world, there’s no replacement for a trustworthy and authoritative reference book,” said Editor-in-Chief Lisa M. Shulman, MD, FAAN. “Neurology Now Books fill that need for the many patients and families who are managing neurologic conditions. As editor-in-chief of the book series, it’s particularly rewarding to add a patient book focused on ALS to our many previous volumes, including epilepsy, MS, and Parkinson disease. When patients experience unfamiliar symptoms, manage functional limitations, and weigh the pros and cons of difficult treatment decisions, this new book will foster patient self-management skills and enhance their self-efficacy to manage their condition.” Navigating Life with Amyotrophic Lateral Sclerosis is available from all major booksellers or order online at AAN.com/ view/NeurologyNowBooks.

Steer Your Patients to These Other Neurology Now Books Navigating Life with Parkinson’s Disease Sortirios A. Parashos, MD, PhD; Rose Wichmann, PT; and Todd Melby Navigating Life with a Brain Tumor Lynne P. Taylor, MD, FAAN; Alyx B. Porter Umphrey, MD; and Diane Richard Navigating the Complexities of Stroke Louis R. Caplan, MD, FAAN Navigating Life with Multiple Sclerosis Kathleen Costello, MS, ANP-BC, MSCN; Ben W. Thrower, MD; and Barbara S. Giesser, MD Navigating Life with Epilepsy David C. Spencer, MD, FAAN

UPCOMING BOOKS Navigating Life with Migraine and Other Headaches William B. Young, MD, FAHS, FAAN, and Stephen D. Silberstein, MD, FACP, FAHS, FAAN New Edition Navigating Life with Parkinson’s Disease

Both the Neurology Now Books series and Neurology Now ® magazine focus on the needs of people with neurologic disorders. The goal is to provide patients and their families and caregivers with the information they need to confront the day-to-day challenges of living with a neurologic condition.

COMING SOON

NEW

Monday, April 24, 2017 • AANextra

Annual Meeting Networking: Good for All Stages of Your Career

When you head out the door for a professional conference—such as the American Academy of Neurology’s Annual Meeting—how much thought do you give to networking? That was a trick question. If your purpose for attending is to present information to fellow neurology professionals, learn from others who are presenting, meet up with friends and colleagues, or make the acquaintance of neurologists you haven’t met yet, you’re about to engage in networking without needing to call it that. So in fact, you may be thinking deeply about this important career-building process even if you answered “none at all” to the question above.

More than just job search That’s the problem with networking: It’s a common term that’s often interchanged with “job search.” And while networking is very important for job search, that’s just one of many purposes for this powerful tool. Here are examples of when networking can be helpful to your career. Research collaboration. Ever wonder how some people come to form alliances that lead to major research projects or coauthorship on papers? In a word, networking. When one neurologist recognizes that another neurologist is interested in the same question, the seed is planted. Emailing is a good tool, but attending a meeting where the two can meet in person can put the collaboration on the fast track. Work-life issues. Some things are just easier to discuss with someone who’s been there—and having the conversation in “real time” rather than by email is a key advantage of attending live events. Connecting with others for advice about balancing home and work, for tips on seeking promotions or handling call duties, for guidance on dissecting thorny issues concerning a work visa…these are all examples of topics you can navigate using networking to help you. Practice tools and tips. What if you’re part of a rural practice and wondering how others handle issues related to patients’ transportation issues? Or maybe you’ve been struggling with reimbursement tangles for certain procedures. These are exactly

Monday, April 24, 2017 • AANextra

the kinds of topics you want to discuss with neurologists who have solved similar problems in their own practices. Even a brief and casual encounter can be helpful when you’re talking with someone who’s been in your shoes. Job search. And of course, there’s job search. If you’re currently in the market for a new position, you should be especially interested in meeting department heads, recruiters, practice managers, or anyone else who can provide good information about different positions, or connect you to the decision-makers in the employment process. Be sure you have copies of your resume or CV along if this is your purpose for attending the event. And if the event is an AAN Annual Meeting, make a beeline for the Neurology Career Center display so you can find out about special opportunities at the conference or register your job search profile for employers to review.

Easy steps to prepare for networking Remember the trick question posed earlier? When you head out the door for the AAN Annual Meeting or other professional gatherings, how much thought do you give to networking? Now you know the answer should be: “I think strategically about networking for each event I attend, and I prepare accordingly.” To make that preparation easier, follow these five easy steps. 1. Determine networking goals for the event. Do you want to meet employers and recruiters? Or others researching in your specialty area? Or…? 2. Review conference announcements to identify speakers, exhibitors, and attendees you would like to meet. Whenever possible, reach out in advance to request a meeting at the event. 3. Prepare materials (printed or uploaded to a cloud server) that would be helpful in your networking. Depending on your goals for the event, this could include CVs, research data, articles you’d like to share, etc. If you don’t have business cards, now is the time to print them, regardless of your networking goals. Go online for vendors of inexpensive, quick-order cards.

4. Plan time for networking. Resist the urge to “be efficient” by flying in the morning of an event and flying out before it ends. Likewise, don’t schedule yourself for back-to-back sessions with no air time. Recognize how rare it is to get so many colleagues together in one space and make use of this special opportunity by providing margin in your itinerary. 5. Relax. Even if your networking goals are quite serious to you, remember that people are drawn to those who are relaxed, open, and friendly. When you’re packing for the event, bring the appropriate business wear but slip in a few casual items as well. You might find that your best networking happens after hours at a local restaurant or on an optional sightseeing tour.

Follow up to strengthen networking relationships One final tip to help you make the best of your networking experiences: Stay in touch. One quick email after the event will help cement a budding relationship, while occasional touch-backs will help it blossom. In the initial email, you can be as brief as “It was delightful to meet, and to learn more about your research. I’m looking forward to seeing the publication this summer.” Another email sent every few months, perhaps with a link to an interesting article, will strengthen the connection. The payback for a very minimal amount of effort? Finding that you know even more people at each event you attend. When you return to next year’s AAN Annual Meeting, you may even find that others are seeking you out.

Monday, April 24, 2017 • AANextra

For adjunctive treatment of partial-onset seizures with or without secondarily generalized seizures and primary generalized tonic-clonic seizures in patients with epilepsy 12 years of age and older

Change the Course of Epilepsy Treatment for Your Patients

EXPERIENCE THE

STRENGTH OF FYCOMPA®

76%

FYCOMPA ACHIEVED A STATISTICALLY SIGNIFICANT (N=81) median reduction in seizure frequency vs placebo (38%; N=81) (P<0.0001)1,2

48% (n=39) of patients taking FYCOMPA exhibited a 75% to 100% REDUCTION IN PGTC SEIZURE FREQUENCY vs placebo (24%; n=19)1,3

31% (n=25) of patients taking FYCOMPA experienced PGTC SEIZURE-

FREE STATUS in the maintenance phase of the trial vs placebo (12%; n=10)2,3* *Prespecified exploratory endpoint.2

• 50% to <75%: FYCOMPA, 16% (n=13) of patients; placebo, 16% (n=13) of patients3 • 25% to <50%: FYCOMPA, 15% (n=12) of patients; placebo, 20% (n=16) of patients3 • 0 to <25%: FYCOMPA, 11% (n=9) of patients; placebo, 12% (n=10) of patients3 • Seizure frequency increase: FYCOMPA, 10% (n=8) of patients; placebo, 28% (n=23) of patients3

Learn more at the

American Academy of Neurology 69th Annual Meeting

BOOTH 301 Boston Convention & Exhibition Center April 22-28, 2017

PHASE 3 STUDY DESIGN Multicenter, randomized, double-blind, placebo-controlled, parallel-group study on effectiveness of FYCOMPA as adjunctive therapy in patients 12 years of age and older. The total treatment period was 17 weeks (4: titration; 13: maintenance). Inclusion criteria included taking 1 to 3 concomitant AEDs at baseline and ≥3 PGTC seizures experienced in 8-week baseline period.1

ADVERSE REACTIONS in PGTC seizure study1 The most frequently (≥4%) reported adverse reactions for placebo (n=82) and FYCOMPA 8 mg (n=81), respectively: dizziness (6% and 32%), fatigue (6% and 15%), headache (10% and 12%), somnolence (4% and 11%), irritability (2% and 11%), vertigo (2% and 9%), vomiting (2% and 9%), weight gain (4% and 7%), contusion (4% and 6%), nausea (5% and 6%), abdominal pain (1% and 5%), anxiety (4% and 5%), urinary tract infection (1% and 4%), ligament sprain (0% and 4%), balance disorder (1% and 4%), and rash (1% and 4%). REFERENCES: 1. FYCOMPA US Prescribing Information. Woodcliff Lake, NJ: Eisai Inc. 2. French JA, Krauss GL, Wechsler RT, et al. Perampanel for tonic-clonic seizures in idiopathic generalized epilepsy: a randomized trial. Neurology. 2015;85(11):950-957. 3. Data on file. Eisai Inc., Woodcliff Lake, NJ; 2015.

Please see Important Safety Information, including Boxed WARNING, and Brief Summary of full US Prescribing Information on the following pages. VISIT FYCOMPA.COM/HCP FOR MORE INFORMATION

INDICATION

FYCOMPA® (perampanel) is indicated as adjunctive therapy for the treatment of partial-onset seizures with or without secondarily generalized seizures and primary generalized tonic-clonic seizures in patients with epilepsy 12 years of age and older.

IMPORTANT SAFETY INFORMATION WARNING: SERIOUS PSYCHIATRIC AND BEHAVIORAL REACTIONS • Serious or life-threatening psychiatric and behavioral adverse reactions including aggression, hostility, irritability, anger, and homicidal ideation and threats have been reported in patients taking FYCOMPA • These reactions occurred in patients with and without prior psychiatric history, prior aggressive behavior, or concomitant use of medications associated with hostility and aggression • Advise patients and caregivers to contact a healthcare provider immediately if any of these reactions or changes in mood, behavior, or personality that are not typical for the patient are observed while taking FYCOMPA or after discontinuing FYCOMPA • Closely monitor patients particularly during the titration period and at higher doses • FYCOMPA should be reduced if these symptoms occur and should be discontinued immediately if symptoms are severe or are worsening

SERIOUS PSYCHIATRIC AND BEHAVIORAL REACTIONS In the partialonset seizures clinical trials, hostility- and aggression-related adverse reactions occurred in 12% and 20% of patients randomized to receive FYCOMPA at doses of 8 mg and 12 mg per day, respectively, compared to 6% of patients in the placebo group. These effects were dose-related and generally appeared within the first 6 weeks of treatment, although new events continued to be observed through more than 37 weeks. These effects in FYCOMPA-treated patients led to dose reduction, interruption, and discontinuation more frequently than placebotreated patients. The combination of alcohol and FYCOMPA significantly worsened mood and increased anger. Homicidal ideation and/or threat have also been reported postmarketing in patients treated with FYCOMPA. Patients taking FYCOMPA should avoid the use of alcohol. Patients, their caregivers, and families should be informed that FYCOMPA may increase the risk of psychiatric events. Patients should be monitored during treatment and for at least one month after the last dose of FYCOMPA, and especially when taking higher doses and during the initial few weeks of drug therapy (titration period) or at other times of dose increases. Similar serious psychiatric and behavioral events were observed in the primary generalized tonic-clonic (PGTC) seizure clinical trial. SUICIDAL BEHAVIOR AND IDEATION Antiepileptic drugs (AEDs), including FYCOMPA, increase the risk of suicidal thoughts or behavior in patients. Anyone considering prescribing FYCOMPA or any other AED must balance the risk of suicidal thoughts or behavior with the risk of untreated illness. Epilepsy and many other illnesses for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, their caregivers, and families should be informed of the risk and advised to monitor and immediately report the emergence or worsening of depression, suicidal thoughts or behavior, thoughts about self-harm and/or any unusual changes in mood or behavior. Should suicidal thoughts and behavior emerge during treatment, consider whether the emergence of these symptoms in any given patient may be related to the illness being treated.

DIZZINESS AND GAIT DISTURBANCE FYCOMPA caused dose-related increases in events related to dizziness and disturbance in gait or coordination. Dizziness and vertigo were reported in 35% and 47% of patients in the partial-onset seizure trials randomized to receive FYCOMPA at doses of 8 mg and 12 mg per day, respectively, compared to 10% of placebo-treated patients. Gait disturbance related events were reported in 12% and 16% of patients in the partial-onset seizure clinical trials randomized to receive FYCOMPA at doses of 8 mg and 12 mg per day, respectively, compared to 2% of placebo-treated patients. These adverse reactions occurred mostly during the titration phase. These adverse reactions were also observed in the PGTC seizure clinical trial. SOMNOLENCE AND FATIGUE FYCOMPA caused dose-dependent increases in somnolence and fatigue-related events. Somnolence was reported in 16% and 18% of patients in the partial-onset seizure trials randomized to receive FYCOMPA at doses of 8 mg and 12 mg per day, respectively, compared to 7% of placebo patients. Fatigue-related events were reported in 12% and 15% of patients in the partial-onset seizure trials randomized to receive FYCOMPA at doses of 8 mg and 12 mg per day, respectively, compared to 5% of placebo patients. These adverse reactions occurred mostly during the titration phase. These adverse reactions were also observed in the PGTC seizure clinical trial. Patients should be advised against engaging in hazardous activities requiring mental alertness, such as operating motor vehicles or dangerous machinery, until the effect of FYCOMPA is known. FALLS Falls were reported in 5% and 10% of patients in the partial-onset seizure clinical trials randomized to receive FYCOMPA at doses of 8 mg and 12 mg per day, respectively, compared to 3% of placebo-treated patients. WITHDRAWAL OF AEDs A gradual withdrawal is generally recommended with AEDs to minimize the potential of increased seizure frequency, but if withdrawal is a response to adverse events, prompt withdrawal can be considered. MOST COMMON ADVERSE REACTIONS The most common adverse reactions in patients receiving FYCOMPA (≥5% and ≥1% higher than placebo) include dizziness, somnolence, fatigue, irritability, falls, nausea, weight gain, vertigo, ataxia, headache, vomiting, contusion, abdominal pain, and anxiety. DRUG INTERACTIONS FYCOMPA may decrease the efficacy of contraceptives containing levonorgestrel. Plasma levels of FYCOMPA were decreased when administered with carbamazepine, phenytoin, or oxcarbazepine. Concomitant use of FYCOMPA with other strong CYP3A inducers (e.g., rifampin, St. John’s wort) should be avoided. Multiple dosing of FYCOMPA 12 mg per day enhanced the effects of alcohol on vigilance and alertness, and increased levels of anger, confusion, and depression. These effects may also be seen when FYCOMPA is used in combination with other CNS depressants. PREGNANCY AND LACTATION Physicians are advised to recommend that pregnant patients taking FYCOMPA enroll in the North American Antiepileptic Drug (NAAED) Pregnancy Registry. Caution should be exercised when FYCOMPA is administered to pregnant or nursing women as there are no adequate data on the developmental risk associated with use in pregnant women, and no data on the presence of perampanel in human milk, the effects on the breastfed child, or the effects of the drug on milk production. HEPATIC AND RENAL IMPAIRMENT Use in patients with severe hepatic or severe renal impairment is not recommended. Dosage adjustments are recommended in patients with mild or moderate hepatic impairment. Use with caution in patients with moderate renal impairment. DRUG ABUSE AND DEPENDENCE FYCOMPA is a Schedule III controlled substance and has the potential to be abused and lead to drug dependence.

You are encouraged to report side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088. FYCOMPA® is a registered trademark of Eisai R&D Management Co., Ltd., licensed to Eisai Inc. Manufactured and marketed by Eisai Inc., 100 Tice Blvd., Woodcliff Lake, NJ 07677 ©2017 Eisai Inc. All rights reserved. FYCO-US0827 March 2017

FYCOMPA® (perampanel) tablets, for oral use, CIII FYCOMPA® (perampanel) Oral Suspension, CIII Initial U.S. Approval: 2012 Brief Summary of Full Prescribing Information dated April 2016 WARNING: SERIOUS PSYCHIATRIC AND BEHAVIORAL REACTIONS • Serious or life-threatening psychiatric and behavioral adverse reactions including aggression, hostility, irritability, anger, and homicidal ideation and threats have been reported in patients taking FYCOMPA (5.1). • These reactions occurred in patients with and without prior psychiatric history, prior aggressive behavior, or concomitant use of medications associated with hostility and aggression (5.1). • Advise patients and caregivers to contact a healthcare provider immediately if any of these reactions or changes in mood, behavior, or personality that are not typical for the patient are observed while taking FYCOMPA or after discontinuing FYCOMPA (5.1). • Closely monitor patients particularly during the titration period and at higher doses (5.1). • FYCOMPA should be reduced if these symptoms occur and should be discontinued immediately if symptoms are severe or are worsening (5.1). WARNINGS AND PRECAUTIONS Serious Psychiatric and Behavioral Reactions In the controlled partial-onset seizure clinical trials, hostilityand aggression-related adverse reactions occurred in 12% and 20% of patients randomized to receive FYCOMPA at doses of 8 mg and 12 mg per day, respectively, compared to 6% of patients in the placebo group. These effects were dose-related and generally appeared within the first 6 weeks of treatment, although new events continued to be observed through more than 37 weeks. FYCOMPA-treated patients experienced more hostility- and aggression-related adverse reactions that were serious, severe, and led to dose reduction, interruption, and discontinuation more frequently than placebo-treated patients. In general, in placebo-controlled partial-onset seizure clinical trials, neuropsychiatric events were reported more frequently in patients being treated with FYCOMPA than in patients taking placebo. These events included irritability, aggression, anger, and anxiety, which occurred in 2% or greater of FYCOMPA-treated patients and twice as frequently as in placebo-treated patients. Other symptoms that occurred with FYCOMPA and were more common than with placebo included belligerence, affect lability, agitation, and physical assault. Some of these events were reported as serious and life-threatening. Homicidal ideation and/or threat were exhibited in 0.1% of 4,368 FYCOMPA-treated patients in controlled and open label trials, including non-epilepsy trials. Homicidal ideation and/or threat have also been reported postmarketing in patients treated with FYCOMPA. In the partial-onset seizure clinical trials, these events occurred in patients with and without prior psychiatric history, prior aggressive behavior, or concomitant use of medications associated with hostility and aggression. Some patients experienced worsening of their pre-existing psychiatric conditions. Patients with active psychotic disorders and unstable recurrent affective disorders were excluded from the clinical trials. The combination of alcohol and FYCOMPA significantly worsened mood and increased anger. Patients taking FYCOMPA should avoid the use of alcohol [see Drug Interactions (7.3)]. Similar serious psychiatric and behavioral events were observed in the primary generalized tonic-clonic seizure clinical trial. In healthy volunteers taking FYCOMPA, observed psychiatric events included paranoia, euphoric mood, agitation, anger, mental status changes, and disorientation/confusional state. In the non-epilepsy trials, psychiatric events that occurred in perampanel-treated patients more often than placebo-treated patients included disorientation, delusion, and paranoia. In the postmarketing setting, there have been reports of psychosis in patients treated with FYCOMPA. Patients, their caregivers, and families should be informed that FYCOMPA may increase the risk of psychiatric events. Patients should be monitored during treatment and for at least 1 month after the last dose of FYCOMPA, and especially when taking higher doses and during the initial few weeks of drug therapy (titration period) or at other times of dose increases. Dose of FYCOMPA should be reduced if these symptoms occur. Permanently discontinue FYCOMPA for persistent severe or worsening psychiatric symptoms or behaviors and refer for psychiatric evaluation. Suicidal Behavior and Ideation Antiepileptic drugs (AEDs), including FYCOMPA, increase the risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Patients treated with any AED for any indication should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior. Pooled analyses of 199 placebo-controlled clinical trials (monoand adjunctive therapy) of 11 different AEDs showed that patients randomized to one of the AEDs had approximately twice the risk (adjusted Relative Risk 1.8, 95% CI: 1.2, 2.7) of suicidal thinking or behavior compared to patients randomized to placebo. In these trials, which had a median treatment duration of 12 weeks, the estimated incidence of suicidal behavior or ideation among 27,863 AED-treated patients was 0.43%, compared to 0.24% among 16,029 placebo-treated patients, representing an increase of approximately one case of suicidal thinking or behavior for every 530 patients treated. There were four suicides in drug-treated patients in the trials and none in placebo-treated patients, but the number is too small to allow any conclusion about drug effect on suicide. The increased risk of suicidal thoughts or behavior with AEDs was observed as early as 1 week after starting drug treatment with AEDs and persisted for the duration of treatment assessed. Because most trials included in the analysis did not extend beyond 24 weeks, the risk of suicidal thoughts or behavior beyond 24 weeks could not be assessed. The risk of suicidal thoughts or behavior was generally consistent among drugs in the data analyzed. The finding of increased risk with AEDs of varying mechanisms of action and across a range of indications suggests that the risk applies to all AEDs used for any indication. The risk did not vary substantially by age (5-100 years) in the clinical trials analyzed. Table 1 shows absolute and relative risk by indication for all evaluated AEDs. Table 1. Risk by indication for antiepileptic drugs in the pooled analysis Indication

Placebo Patients with Events per 1000 Patients

Drug Patients with Events per 1000 patients

Epilepsy Psychiatric Other Total

1.0 5.7 1.0 2.4

3.4 8.5 1.8 4.3

Relative Risk: Incidence of Events in drug Patients/ Incidence in Placebo Patients 3.5 1.5 1.9 1.8

Risk Difference: Additional Drug Patients with Events per 1000 Patients 2.4 2.9 0.9 1.9

The relative risk for suicidal thoughts or behavior was higher in clinical trials for epilepsy than in clinical trials for psychiatric or other conditions, but the absolute risk differences were similar for the epilepsy and psychiatric indications. Anyone considering prescribing FYCOMPA or any other AED must balance the risk of suicidal thoughts or behavior with the risk of untreated illness. Epilepsy and many other illnesses for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Should suicidal thoughts and behavior emerge during treatment, the prescriber needs to consider whether the emergence of these symptoms in any given patient may be related to the illness being treated. Patients, their caregivers, and families should be informed that AEDs increase the risk of suicidal thoughts and behavior and should be advised of the need to be alert for the emergence or worsening of the signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts, behavior, or thoughts about self-harm. Behaviors of concern should be

reported immediately to healthcare providers. Neurologic Effects Dizziness and Gait Disturbance FYCOMPA caused dose-related increases in events related to dizziness and disturbance in gait or coordination [see Adverse Reactions (6.1)]. In the controlled partial-onset seizure clinical trials, dizziness and vertigo were reported in 35% and 47% of patients randomized to receive FYCOMPA at doses of 8 mg and 12 mg per day, respectively, compared to 10% of placebo-treated patients. The gait disturbance related events (including ataxia, gait disturbance, balance disorder, and abnormal coordination) were reported in 12% and 16% of patients randomized to receive FYCOMPA at doses of 8 mg and 12 mg per day, respectively, compared to 2% of placebo-treated patients. Elderly patients had an increased risk of these adverse reactions compared to younger adults and pediatric patients. These adverse reactions occurred mostly during the titration phase and led to discontinuation in 3% of FYCOMPA-treated patients compared to 1% of placebo-treated patients. These adverse reactions were also observed in the primary generalized tonic-clonic seizure clinical trial. Somnolence and Fatigue FYCOMPA caused dose-dependent increases in somnolence and fatigue-related events (including fatigue, asthenia, and lethargy). In the controlled partial-onset seizure clinical trials, 16% and 18% of patients randomized to receive FYCOMPA at doses of 8 mg and 12 mg per day, respectively, reported somnolence compared to 7% of placebo patients. In the controlled partial-onset seizure clinical trials, 12% and 15% of patients randomized to receive FYCOMPA at doses of 8 mg and 12 mg per day, respectively, reported fatigue-related events compared to 5% of placebo patients. Somnolence or fatiguerelated events led to discontinuation in 2% of FYCOMPA-treated patients and 0.5% of placebo-treated patients. Elderly patients had an increased risk of these adverse reactions compared to younger adults and pediatric patients. In the controlled partial-onset seizure clinical trials, these adverse reactions occurred mostly during the titration phase. These adverse reactions were also observed in the primary generalized tonic-clonic seizure clinical trial. Risk Amelioration Prescribers should advise patients against engaging in hazardous activities requiring mental alertness, such as operating motor vehicles or dangerous machinery, until the effect of FYCOMPA is known. Falls An increased risk of falls, in some cases leading to serious injuries including head injuries and bone fracture, occurred in patients being treated with FYCOMPA (with and without concurrent seizures). In the controlled partial-onset seizure clinical trials, falls were reported in 5% and 10% of patients randomized to receive FYCOMPA at doses of 8 mg and 12 mg per day, respectively, compared to 3% of placebo-treated patients. Falls were reported as serious and led to discontinuation more frequently in FYCOMPA-treated patients than placebo-treated patients. Elderly patients had an increased risk of falls compared to younger adults and pediatric patients. Withdrawal of Antiepileptic Drugs There is the potential of increased seizure frequency in patients with seizure disorders when antiepileptic drugs are withdrawn abruptly. FYCOMPA has a half-life of approximately 105 hours so that even after abrupt cessation, blood levels fall gradually. In epilepsy clinical trials FYCOMPA was withdrawn without down-titration. Although a small number of patients exhibited seizures following discontinuation, the data were not sufficient to allow any recommendations regarding appropriate withdrawal regimens. A gradual withdrawal is generally recommended with antiepileptic drugs, but if withdrawal is a response to adverse events, prompt withdrawal can be considered. ADVERSE REACTIONS 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 clinical practice. Partial-Onset Seizures A total of 1,038 patients receiving FYCOMPA (2, 4, 8, or 12 mg once daily) constituted the safety population in the pooled analysis of the placebo-controlled trials (Studies 1, 2, and 3) in patients with partial-onset seizures. Approximately 51% of patients were female, and the mean age was 35 years. Adverse Reactions Leading to Discontinuation In controlled clinical trials (Studies 1, 2, and 3), the rate of discontinuation as a result of an adverse reaction was 3%, 8%, and 19% in patients randomized to receive FYCOMPA at the recommended doses of 4 mg, 8 mg, and 12 mg per day, respectively, and 5% in patients randomized to receive placebo [see Clinical Studies (14)]. The adverse reactions most commonly leading to discontinuation (≥1% in the 8 mg or 12 mg FYCOMPA group and greater than placebo) were dizziness, somnolence, vertigo, aggression, anger, ataxia, blurred vision, irritability, and dysarthria [see Warnings and Precautions (5.1, 5.3)]. Most Common Adverse Reactions Table 2 gives the incidence in the controlled clinical trials (Studies 1, 2, and 3) of the adverse reactions that occurred in ≥2% of patients with partial-onset seizures in the FYCOMPA 12 mg dose group and more frequent than placebo (in order of decreasing frequency for the 12 mg dose group). The most common dose-related adverse reactions in patients receiving FYCOMPA at doses of 8 mg or 12 mg (≥4% and occurring at least 1% higher than the placebo group) included dizziness (36%), somnolence (16%), fatigue (10%), irritability (9%), falls (7%), nausea (7%), ataxia (5%), balance disorder (4%), gait disturbance (4%), vertigo (4%), and weight gain (4%). For almost every adverse reaction, rates were higher on 12 mg and more often led to dose reduction or discontinuation. Table 2. Adverse Reactions in Pooled Placebo-Controlled Trials in Patients with Partial-Onset Seizures (Studies 1, 2, and 3) (Reactions ≥ 2% of Patients in Highest FYCOMPA Dose (12 mg) Group and More Frequent than Placebo) Placebo n=442 % Dizziness Somnolence Headache Irritability Fatigue Falls Ataxia Nausea Vertigo Back pain Dysarthria Anxiety Blurred vision Gait disturbance Weight gain Cough Upper respiratory tract infection Vomiting Hypersomnia Anger Aggression Balance disorder Diplopia Head injury Hypoaesthesia Pain in extremity Constipation Myalgia Coordination abnormal

9 7 11 3 5 3 0 5 1 2 0 1 1 1 1 3 3 3 0 <1 1 1 1 1 1 1 2 2 0

4 mg n=172 % 16 9 11 4 8 2 1 3 4 2 1 2 1 1 4 1 3 2 1 0 1 0 1 1 0 0 2 1 1

FYCOMPA 8 mg n=431 % 32 16 11 7 8 5 3 6 3 2 3 3 3 4 4 1 3 3 2 1 2 5 1 1 0 2 2 1 <1

12 mg n=255 % 43 18 13 12 12 10 8 8 5 5 4 4 4 4 4 4 4 4 3 3 3 3 3 3 3 3 3 3 2

Table 2. Adverse Reactions in Pooled Placebo-Controlled Trials in Patients with Partial-Onset Seizures (Studies 1, 2, and 3) (Reactions ≥ 2% of Patients in Highest FYCOMPA Dose (12 mg) Group and More Frequent than Placebo) (cont.) Euphoric mood Confusional state Hyponatremia Limb injury Mood altered Arthralgia Asthenia Contusion Memory impairment Musculoskeletal pain Oropharyngeal pain Paraesthesia Peripheral edema Skin laceration

0 <1 <1 <1 <1 1 1 1 1 1 1 1 1 1

0 1 0 1 1 0 1 0 0 1 2 0 1 0

<1 1 0 1 <1 3 2 2 1 1 2 1 1 2

2 2 2 2 2 2 2 2 2 2 2 2 2 2

Primary Generalized Tonic-Clonic Seizures A total of 81 patients receiving FYCOMPA 8 mg once daily constituted the safety population in the placebo-controlled trial in patients with primary generalized tonic-clonic seizures (Study 4). Approximately 57% of patients were female, and the mean age was 27 years. In the controlled primary generalized tonic-clonic seizure clinical trial (Study 4), the adverse reaction profile was similar to that noted for the controlled partial-onset seizure clinical trials (Studies 1, 2, and 3). Table 3 gives the incidence of adverse reactions in patients receiving FYCOMPA 8 mg (≥4% and higher than in the placebo group) in Study 4. The most common adverse reactions in patients receiving FYCOMPA (≥10% and greater than placebo) were dizziness (32%), fatigue (15%), headache (12%), somnolence (11%), and irritability (11%). The adverse reactions most commonly leading to discontinuation in patients receiving FYCOMPA 8 mg (≥2% and greater than placebo) were vomiting (2%) and dizziness (2%). Table 3. Adverse Reactions in a Placebo-Controlled Trial in Patients with Primary Generalized Tonic-Clonic Seizures (Study 4) (Reactions ≥ 4% of Patients in FYCOMPA Group and More Frequent than Placebo)

Dizziness Fatigue Headache Somnolence Irritability Vertigo Vomiting Weight gain Contusion Nausea Abdominal pain Anxiety Urinary tract infection Ligament sprain Balance disorder Rash

Placebo n=82 % 6 6 10 4 2 2 2 4 4 5 1 4 1 0 1 1

FYCOMPA 8 mg n=81 % 32 15 12 11 11 9 9 7 6 6 5 5 4 4 4 4

Weight Gain Weight gain has occurred with FYCOMPA. In controlled partial-onset seizure clinical trials, FYCOMPA-treated adults gained an average of 1.1 kg (2.5 lbs) compared to an average of 0.3 kg (0.7 lbs) in placebo-treated adults with a median exposure of 19 weeks. The percentages of adults who gained at least 7% and 15% of their baseline body weight in FYCOMPA-treated patients were 9.1% and 0.9%, respectively, as compared to 4.5% and 0.2% of placebo-treated patients, respectively. Clinical monitoring of weight is recommended. Similar increases in weight were also observed in adult and pediatric patients treated with FYCOMPA in the primary generalized tonic-clonic seizure clinical trial. Elevated triglycerides Increases in triglycerides have occurred with FYCOMPA use. Comparison of Sex and Race No significant sex differences were noted in the incidence of adverse reactions. Although there were few non-Caucasian patients, no differences in the incidence of adverse reactions compared to Caucasian patients were observed. Postmarketing Experience The following adverse reactions have been identified during post approval use of FYCOMPA. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Dermatologic: Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS). Psychiatric: acute psychosis, hallucinations, delusions, paranoia, delirium, confusional state, disorientation, memory impairment. DRUG INTERACTIONS Contraceptives With concomitant use, FYCOMPA at a dose of 12 mg per day reduced levonorgestrel exposure by approximately 40% [see Clinical Pharmacology (12.3)]. Use of FYCOMPA with oral or implant contraceptives containing levonorgestrel may render them less effective. Additional non-hormonal forms of contraception are recommended. Cytochrome P450 Inducers The concomitant use of known cytochrome P450 (CYP) enzyme inducers including carbamazepine, phenytoin, or oxcarbazepine with FYCOMPA decreased the plasma levels of perampanel by approximately 50-67% [see Clinical Pharmacology (12.3)]. The starting doses for FYCOMPA should be increased in the presence of enzyme-inducing AEDs [see Dosage and Administration (2.3)]. When these enzyme-inducing AEDs are introduced or withdrawn from a patient’s treatment regimen, the patient should be closely monitored for clinical response and tolerability. Dose adjustment of FYCOMPA may be necessary [see Dosage and Administration (2.3)]. Concomitant use of FYCOMPA with other strong CYP3A inducers (e.g., rifampin, St. John’s wort) is not recommended. Alcohol and Other CNS Depressants The concomitant use of FYCOMPA and CNS depressants including alcohol may increase CNS depression. A pharmacodynamic interaction study in healthy subjects found that the effects of FYCOMPA on complex tasks such as driving ability were additive or supra-additive to the impairment effects of alcohol [see Clinical Pharmacology (12.3)]. Multiple dosing of FYCOMPA 12 mg per day also enhanced the effects of alcohol to interfere with vigilance and alertness, and increased levels of anger, confusion, and depression. These effects may also be seen when FYCOMPA is used in combination with other CNS depressants. Care should be taken when administering FYCOMPA with these agents. Patients should limit activity until they have experience with concomitant use of CNS depressants (e.g., benzodiazepines, narcotics, barbiturates, sedating antihistamines). Advise patients not to drive or operate machinery until they have gained sufficient experience on FYCOMPA to gauge whether it adversely affects these activities. USE IN SPECIFIC POPULATIONS Pregnancy To provide information regarding the effects of in utero exposure to FYCOMPA, physicians are advised to recommend that pregnant patients taking FYCOMPA enroll in the North American Antiepileptic

Drug (NAAED) Pregnancy Registry. This can be done by calling the toll free number 1-888-233-2334, and must be done by patients themselves. Information on the registry can also be found at the website: http://www.aedpregnancyregistry.org. There are no adequate and well-controlled studies in pregnant women. In animal reproduction studies, perampanel induced developmental toxicity in pregnant rat and rabbit at clinically relevant doses. Oral administration of perampanel (1, 3, or 10 mg/kg/day) to pregnant rats throughout organogenesis resulted in an increase in visceral abnormalities (diverticulum of the intestine) at all doses tested. In a dose-ranging study at higher oral doses (10, 30, or 60 mg/kg/day), embryo lethality and reduced fetal body weight were observed at the mid and high doses tested. The lowest dose tested (1 mg/kg/day) is similar to a human dose of 8 mg per day based on body surface area (mg/m2). Upon oral administration of perampanel (1, 3, or 10 mg/kg per day) to pregnant rabbits throughout organogenesis, embryo lethality was observed at the mid and high doses tested; the no-effect dose for embryo-fetal developmental toxicity in rabbit (1 mg/kg/day) is approximately 2 times a human dose of 8 mg per day based on body surface area (mg/m2). Oral administration of perampanel (1, 3, or 10 mg/kg per day) to rats throughout gestation and lactation resulted in fetal and pup deaths at the mid and high doses and delayed sexual maturation in males and females at the highest dose tested. No effects were observed on measures of neurobehavioral or reproductive function in the offspring. The no-effect dose for pre- and postnatal developmental toxicity in rat (1 mg/kg/day) is similar to a human dose of 8 mg per day based on body surface area (mg/m2). Lactation There are no data on the presence of perampanel in human milk, the effects of perampanel on the breastfed child, or the effects of the drug on milk production. Perampanel and/or its metabolites are excreted in rat milk, and are detected at concentrations higher than that in maternal plasma. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for FYCOMPA and any potential adverse effects on the breastfed child from FYCOMPA or from the underlying maternal condition. Females and Males of Reproductive Potential Use of FYCOMPA with oral or implant contraceptives containing levonorgestrel may render them less effective. Additional non-hormonal forms of contraception are recommended. [see Clinical Pharmacology (12.3)]. Pediatric Use The safety and efficacy of FYCOMPA for the adjunctive therapy of partial-onset seizures in pediatric patients 12 years of age and older was established by three randomized double-blind, placebo-controlled, multicenter studies, which included 72 pediatric patients between 12 and 16 years of age exposed to FYCOMPA. The safety and efficacy of FYCOMPA for the adjunctive therapy of primary generalized tonic-clonic seizures in pediatric patients 12 years of age and older was established in a single randomized double-blind, placebo-controlled, multicenter trial (n=164), which included 11 pediatric patients 12 to 16 years of age exposed to FYCOMPA; an additional 6 patients were treated with FYCOMPA in the open label extension of the study. The safety and effectiveness of FYCOMPA in pediatric patients less than 12 years of age have not been established [see Clinical Pharmacology (12.3), Clinical Studies (14.1)]. Juvenile Animal Data Oral administration of perampanel (1, 3, 3/10/30 mg/kg/day; high dose increased on postnatal days [PND] 28 and 56) to young rats for 12 weeks starting on PND 7 resulted in reduced body weight, reduced growth, neurobehavioral impairment (water maze performance and auditory startle habituation) at the mid and high doses, and delayed sexual maturation at the high doses. CNS signs (reduced activity, incoordination, excessive grooming/scratching), pup death, decreased hindlimb splay, and decreased hindlimb grip strength were observed at all doses. Effects on pup body weight, pup growth, hindlimb splay, impairment in the water maze performance, and auditory startle persisted after dosing was stopped. A no-effect dose for postnatal developmental toxicity was not identified in this study. Oral administration of perampanel (1, 5, 5/10 mg/kg/day; high dose increased on PND 56) to juvenile dogs for 33 weeks, starting on PND 42, resulted in CNS signs (incoordination, excessive grooming/licking/scratching, spatial disorientation, and/or ataxic gait) at all doses tested. Geriatric Use Clinical studies of FYCOMPA did not include sufficient numbers of patients aged 65 and over to determine the safety and efficacy of FYCOMPA in the elderly population. Because of increased likelihood for adverse reactions in the elderly, dosing titration should proceed slowly in patients aged 65 years and older [see Dosage and Administration (2.5)]. Hepatic Impairment Use of FYCOMPA in patients with severe hepatic impairment is not recommended, and dosage adjustments are recommended in patients with mild or moderate hepatic impairment [see Dosage and Administration (2.4), Clinical Pharmacology (12.3)]. Renal Impairment Dose adjustment is not required in patients with mild renal impairment. FYCOMPA should be used with caution in patients with moderate renal impairment, and slower titration may be considered. Use in patients with severe renal impairment or patients undergoing hemodialysis is not recommended [see Dosage and Administration (2.5), Clinical Pharmacology (12.3)]. DRUG ABUSE AND DEPENDENCE Controlled Substance FYCOMPA contains perampanel and is listed as a Schedule III controlled substance. Abuse Prescription drug abuse is the intentional non-therapeutic use of a drug, even once, for its rewarding psychological or physiological effects. Drug addiction, which develops after repeated drug abuse, is characterized by a strong desire to take a drug despite harmful consequences, difficulty in controlling its use, giving a higher priority to drug use than to obligations, increased tolerance, and sometimes physical withdrawal. Drug abuse and drug addiction are separate and distinct from physical dependence (for example, abuse may not be accompanied by physical dependence) [see Drug Abuse and Dependence (9.3)]. Studies of human abuse potential were performed to evaluate the abuse potential of FYCOMPA (8 mg, 24 mg, and 36 mg) as compared to alprazolam C-IV (1.5 mg and 3 mg), and oral ketamine C-III (100 mg) in recreational polydrug users. Supra-therapeutic doses of FYCOMPA 24 and 36 mg produced responses for “Euphoria” that were similar to ketamine 100 mg and alprazolam 3 mg. For “High,” FYCOMPA 24 mg and 36 mg produced responses comparable to ketamine 100 mg and significantly higher than both doses of alprazolam on a visual analog scale (VAS). “Drug Liking,” “Overall Drug Liking,” and “Take Drug Again” for FYCOMPA were each statistically lower than ketamine 100 mg. In addition, for “Bad Drug Effects,” FYCOMPA 24 mg and 36 mg produced responses significantly higher than ketamine 100 mg. For “Sedation,” FYCOMPA 24 and 36 mg produced responses similar to alprazolam 3 mg and higher than ketamine 100 mg. Additionally, on VAS measures related to dissociative phenomena such as “Floating,” “Spaced Out,” and “Detached,” FYCOMPA at supra-therapeutic doses produced responses similar to ketamine 100 mg and greater than both doses of alprazolam tested. Of note, due to somnolence a number of subjects had missing data around Tmax of FYCOMPA. The above described data might represent an underestimate of FYCOMPA’s effects. The duration of effects of higher doses of FYCOMPA on the majority of measures was much greater than alprazolam 3 mg and ketamine 100 mg. In this study, the incidence of euphoria following FYCOMPA administration 8 mg, 24 mg, and 36 mg was 37%, 46%, 46%, respectively, which was higher than alprazolam 3 mg (13%) but lower than ketamine 100 mg (89%). Dependence Physical dependence is characterized by withdrawal symptoms after abrupt discontinuation or a significant dose reduction of a drug. The potential for FYCOMPA to produce withdrawal symptoms has not been adequately evaluated. OVERDOSAGE There is limited clinical experience with FYCOMPA overdose. The highest reported overdose (approximately 264 mg) was intentional. This patient experienced serious adverse reactions of altered mental status, agitation, and aggressive behavior and recovered without sequelae. In general, the adverse reactions associated with overdoses were similar to the reactions at therapeutic doses with dizziness reported most frequently. There were no reported sequelae. There is no available specific antidote to the overdose reactions of FYCOMPA. In the event of overdose, standard medical practice for the management of any overdose should be used. An adequate airway, oxygenation, and ventilation should be ensured; monitoring of cardiac rhythm and vital sign measurement is recommended. A certified poison control center should be contacted for updated information on the management of overdose with FYCOMPA. Due to its long half-life, the reactions caused by FYCOMPA could be prolonged.

FYCOMPA® is a registered trademark of Eisai R&D Management Co., Ltd., licensed to Eisai Inc. Manufactured and marketed by Eisai Inc., 100 Tice Blvd., Woodcliff Lake, NJ 07677 ©2016 Eisai Inc. All rights reserved. FYCO-US0112(1) May 2016

Industry Sponsors Help Support the The AAN has long recognized the value of partnering with industry on projects of common interest. Since 1994, the Industry Roundtable (IRT) of pharmaceutical, medical device, and imaging member companies has partnered with the AAN to share vision, intellect, and financial resources with the focus on improving the quality of patient care. When seeking high-quality industry relationships and sponsorship, the AAN first determines if the relationship is mutually advantageous. “The AAN’s relationships with industry are really about give and take,” said Jonathan P. Hosey, MD, FAAN, physician liaison to the AAN’s IRT. The AAN receives a financial benefit that defrays the cost of programs and substantially enhances programming and activities. At last year’s Annual Meeting, sponsoring Jonathan P. Hosey, MD, FAAN organizations helped to support the costs of education programing and provided equipment for workshops. In turn, the sponsoring organizations benefited by showing themselves as supporters of neurology, with increased visibility. The Mount Sinai Hospital is ranked No.12 in Neurology &

Neurosurgery

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

1-800-MD-SINAI • mountsinai.org/msneuro

More than $8 million revenue for the 2016 Annual Meeting was generated through the following industry relationships:

Nearly 200 exhibiting organizations 53 companies advertising and/or supporting program activities and social events 21 companies with Industry Roundtable membership 18 companies supporting CME

AAN’s Programs and Events Throughout the year, these organizations and companies continued to show their commitment to neurology by sponsoring the AAN’s regional conferences, leadership programs, and clinical research training scholarships.

Guidelines Ensure Ethics, Transparency All AAN industry support is governed by policies that outline the guiding ethical principles for these relationships and address conflict of interest. The AAN’s Principles Governing Academy Relationships with External Sources of Support have been in place for over 10 years. The AAN is a member of the Council of Medical Specialties Societies and follows its Code for Interaction with Companies. The AAN Meeting Management Committee, comprised of AAN leaders including Board members and committee chairs, carefully reviews and enforces all things related to specific sponsorships, including vetting new companies, and proposing, discussing, evaluating, and approving or rejecting new sponsorship ideas. Contractual agreements and guidelines monitor every transaction, with sanctions in place in the event the agreement is broken. Additionally, the AAN tries to avoid industry sponsorships that may result in Sunshine Act reporting and is committed to clearly communicating whenever an AAN activity could result in a report. Added Hosey, “The AAN’s relationships with industry are transparent, and communication with industry is done with mutual understanding and respect for each other’s values and shared commitment to patient care.”

Monday, April 24, 2017 • AANextra

What Are P Are there any particular courses or programs you came to attend?

Anil K. Kapoor, MD, MBBS Neurologist Member Elmhurst, NY

I'm doing my recertification next week. I'm interested in everything and anything after my 35, 36 years in practice. So, I'm attending everything!

How is this meeting different from other conferences?

I think it's interesting because it kind of hybrids pharmaceutical and the technology and the medical student as well as the past and future physicians. The difference about the other conferences is that it's more public health whereas this one, it’s innovative, it's different, you kind of understand how physicians are thinking in terms of policy perspectives and how does it integrate in terms of their clinical practices. This has been an interesting difference for me because as a researcher you only see what the policy and research does, but from a clinician point of view it’s kind of nice to see that perspective, which is unique.

Monday, April 24, 2017 • AANextra

Saeyoan Thiru, MPH, MHA Student Researcher Nonmember Manhasset, NY

People Saying? What advice would you give to someone attending for the first time?

Pre-schedule what you want to attend. Stay focused; it’s easy to get into the habit of spending most of the time with the people you know because you haven’t met in a while. But that can wait until after 5 p.m. While you’re at the meeting, you take advantage of the time you’re here.

Mahmoud AbdelRazek, MD Junior Member Boston, MA

I love the Annual Meeting On Demand. I think that saves you a lot of effort from just writing down notes. That makes it much simpler. And enjoy your time!

What do you think of all the changes that have taken place to the Annual Meeting since your first one in 1967? How do you like the changes in registration and the more interactive programs?

I love the informal, interactive programs. I think registration has improved tremendously. Today it was literally one click to register. In the past, like 10 years ago, we stood in long lines, so that’s really been great.

The changes are largely the result of the growing prominence of neurologists in this country and in the world. I’ve been impressed over the last maybe 10, maybe 15 years at the increasingly large number of folks from other countries that are attending. I saw somewhere that the membership of this organization has now reached 30,000. That’s quite a change. I hold membership number 001357.

David L. Camenga, MD, FAAN Neurologist Member Augusta, ME

Teesta B. Soman, MD, MBBS Neurologist Member Toronto, ON

Monday, April 24, 2017 • AANextra

TURNING NEUROLOGY RESEARCH INTO RECOVERY — FASTER. At Houston Methodist, we are pioneering research in neurostimulation and neuroregeneration to restore mobility and cognitive function in patients with neurological disorders. In both science and clinical trials, we are broadening our understanding of stroke, Parkinson’s disease, Alzheimer’s disease, amyotrophic lateral sclerosis (ALS), brain tumors, epilepsy, and spinal disorders, and getting new technologies and treatments to our patients — faster. Visit houstonmethodist.org/ni and explore all the ways we’re leading medicine.

Monday, April 24, 2017 • AANextra

Get Ready to Join the Axon Registry Having successfully completed its pilot phase, the AAN’s Axon Registry ® is open for more US neurologists in 2017. Participating in the Axon Registry provides significant benefits to those who join, says Registry Committee Chair Lyell K. Jones, MD, FAAN. “The Axon Registry,” he said, “is by far the most effective tool to date for neurologists to meet reporting Lyell K. Jones, MD, FAAN requirements, prove value to payers, satisfy Part IV PIP clinical module activity of the ABPN’s Maintenance of Certification, and work to assess and improve their quality of care.” The Academy is onboarding 30 practices each quarter in 2017. This makes it possible to work with many practices yet give each of the practices up to three months to work through the integration process before we bring on more.. It also gives the registry vendor, FIGMD, the time to provide more individualized support.

Due to the Centers for Medicare & Medicaid Services timelines for submitting data for quality reporting programs, practices that join the Axon Registry in the fourth quarter of 2017 will only be able to submit for the Merit Based Incentive Payment System (MIPS) if they are able to complete implementation by December 1. “Whether using the Axon Registry for 2017 MIPS reporting or not, new participants can start working on quality improvement initiatives and the AAN will help with options for practices unable to submit via the Axon Registry,” said Jones. AAN members interested in joining their colleagues in the Axon Registry should go to AAN.com/view/Axon and complete the three steps for enrollment. As practices sign up, they will be placed on a wait list and contacted when their number is reached. For more information about whether your EHR vendor is successfully working with the Axon Registry, review the EHR list available online at http://bit.ly/2heFB8G. For information about the process, contact registry@aan.com.

Monday, April 24, 2017 • AANextra

Academy Honors Members for Quality Improvement Innovations On April 22, the AAN Quality and Safety Subcommittee presented Safety and Quality Awards for four projects that demonstrated innovative approaches to improving quality in practice. David Do, MD, from the University of Pennsylvania was recognized for his work on automated solutions to improve nutrition in the critically ill. An automated system leveraged David Do, MD electronic data to assess nutritional needs, prompting providers to improve feeding, and thereby reducing underfeeding and subsequent muscle breakdown, infections, and mortality. Preston Douglas, MD, accepted on behalf of a Loyola University treatment team using simulation-based training to improve brain death determination and communication to family members. The team taught incoming residents how to diagnose brain death and communicate effectively with family members in an empathetic and Preston Douglas, MD professional manner.

Raghav Govindarajan, MD, FISQua, FACSc, FCPP, at University of Missouri was recognized for his work teaching other health care providers to identify myasthenia gravis exacerbation through telephone and telemedicine encounters. This work further developed a multidisciplinary team approach to intervene rapidly using non-traditional patient encounters during a time of patient crisis. James Siegler, MD, from the Hospital of the University of Pennsylvania received the award for his work using Scheduled Provider Alert-Response Raghav Govindarajan, MD, Communication System (SPARCS) FISQua, FACSc, FCPP to improve nurse and resident communica tion improving quality of life among treatment team members. For information about applying for Safety and Quality Awards for 2018, contact Amy Bennett at abennett@aan.com.

James Siegler, MD

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KRISTIN

“I got the tears out of my system and got ready for my fight.”

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