ANA Investigates Fetal Therapy

Brain death is one of the most controversial and ethically complex topics in neurology, but it's a regular part of our clinical practice. Late last year, a new set of guidelines was published that address some of the thorniest technical and ethical issues in the clinical determination of brain death. For this discussion, we are joined by Dr. Ariane Lewis, a professor in the departments of Neurology and Neurosurgery, as well as the director of the Division of Neurocritical Care at NYU Langone Medical Center, and Dr. Matthew Kirschen, an assistant professor of Anesthesiology and Critical Care at the hospital of the University of Pennsylvania and the Children's Hospital of Philadelphia. They were interviewed by Dr. Masoom Desai of the University of New Mexico. Series 5, Episode 5

Featuring:

• Guests: Dr. Ariane Lewis & Dr. Matthew Kirschen
• Interviewer: Dr. Masoom Desai
• Disclosures: None

Small fiber neuropathy is one of those conditions in neurology that can feel frustratingly intangible. Even for patients with severe neuropathic pain and autonomic symptoms, in about half of cases, the usual lab testing doesn't reveal a cause. There's increasing evidence that autoimmunity may be a factor in some of these cases of idiopathic small fiber neuropathy, but how to test and who to treat with immunosuppression is less clear. Our guest today, Anne Louise Oaklander, is an Associate Professor of Neurology at Massachusetts General Hospital and an Assistant in Neuropathology. She's known for her work on small fiber neuropathies and in this episode we'll talk about new autoantibodies associated with small fiber neuropathy and where we are in treating this challenging condition. Series 5, Episode 4

Featuring:

• Guest: Dr. Anne Louise Oaklander
• Interviewer: Dr. Adeline Goss
• Disclosures: None

The recent FDA approval of lecanemab, an amyloid-sequestering agent, has been hailed as a breakthrough in the treatment of Alzheimer disease. Critics of the drug have pointed to its cost, risks, and treatment burden. Now that lecanemab is being administered in clinics across the country - how is it changing the lives of people with Alzheimers and their families? Dr. Megan Richie, neurohospitalist at UCSF, spoke to Dr. Seth A. Gale, Co-Director of the Brain Health Program and Assistant Professor of Neurology at Harvard Medical School. Dr. Gale has been involved in creating the clinical program that is delivering lecanemab to patients at Brigham and Women’s Hospital and Massachusetts General Hospital, with the first patients receiving the drug this month. Series 5, Episode 3

Featuring:

• Guest: Seth A. Gale, MD - Co-Director of the Brain Health Program, and Assistant Professor of Neurology at Harvard Medical School
• Interviewer: Megan Richie, MD - Neurohospitalist at UCSF and Chair of the ANA Education Innovation Committee
• Disclosures: Dr. Gale disclosed that he is a site Principal Investigator or Sub-Investigator (at Brigham and Women's Hospital) for several clinical trials in Alzheimer disease. Sponsors for those studies include Biogen, Eisai, Roche, Genentech, and Eli Lilly. I am on a scientific advisory board for MindAhead DE, with the opportunity for honoraria.

Chronic pain can be incredibly challenging -- for patients, of course, and also for their physicians. On this episode of ANA investigates, Dr. Adeline Goss talks to Dr. Prasad Shirvalkar of UCSF about a new possible strategy for treating chronic pain: deep brain stimulation. Series 5, Episode 2

Featuring:

• Guest: Dr. Prasad Shirvalkar of UCSF
• Interviewer: Dr. Adeline Goss
• Disclosures: Dr. Shirvalkar disclosed that Medtronic Inc, donated devices for research, but no direct financial support

The brain and its vasculature used to be considered separate domains. But in the last decade, we’ve learned more about the interplay between brain cells and vascular cells. Pathological studies are revealing a surprising degree of overlap between cerebrovascular disease and neurodegenerative disease. All of this has led to the coining of a new word: the neurovasculome. Our guest today is Dr. Eric Smith, an author of a recent scientific statement about the neurovasculome in the journal Stroke. Dr. Smith is a Professor of Neurology, Radiology, and Community Health Sciences at the University of Calgary, and the holder of the endowed Katthy Taylor Chair in Vascular Dementia. He was interviewed about the neurovasculome by Dr. Christoph Stretz, a Vascular and Critical Care neurologist at the Warren Alpert Medical School of Brown University. Series 5, Episode 1

Featuring:

• Guest: Eric Edward Smith, MD, MPH, FRCPC, FAHA, University of Calgary
• Interviewer: Christoph Stretz, MD, Brown University
• Disclosures: Dr. Smith disclosed that he receives personal consulting fees from Alnylam Pharmaceuticals and Eli Lilly

As the ANA's 2023 Annual Meeting comes to a close, we wanted to catch up with Frances Jensen Chair of the Department of Neurology at University of Pennsylvania and outgoing President of the ANA, and Rebecca Gottesman, Stroke Branch Chief of the National Institute of Neurological Disorders and Stroke and outgoing Chair of the Annual Meeting Planning Committee. Listen as these two leaders chat about the cutting-edge research, exciting sessions, and broader themes that have defined this year's meeting in Philadelphia.

A growing body of research suggests that people with insomnia are at higher risk of stroke. Listen today as we dive into how sleep health, stroke, and the nervous system all have an affect on each other. Series 4, Episode 11 Featuring:

• Guest: Dr. .Sonja Schuetz, University of Michigan
• Interviewer: Dr. Joseph Carerra, University of Michigan
• Disclosures: Dr. Schuetz reports funding from contracts between University of Michigan and Oura Health Ltd., Huxley Medical Inc., and Apple Inc.

Lysosomal storage diseases are progressive, inherited disorders of metabolism, many with devastating effects on the nervous system. Some of these diseases, like Infantile-Onset Pompe disease, can be treated to some degree in childhood by giving back the missing enzyme - a strategy called enzyme replacement therapy, or ERT. But a recent study reported in the New England Journal of Medicine goes a step farther -- by giving enzyme replacement therapy to a fetus with Pompe disease, for the first time, in an attempt to treat the disease before it does any serious damage. The paper’s first author is Dr. Jennifer Cohen, a Pediatric Medical Genetics Physician-Scientist at Duke University Health System. During this episode, she’ll walk us through the potential benefits of in-utero enzyme replacement therapy and other cutting-edge approaches to treating genetic neurologic conditions. A relatively new field called fetal therapy. Dr. Cohen was interviewed by Dr. Adeline Goss, the host of ANA Investigates. Series 4, Episode 10

Featuring:

• Guest: Dr. Jennifer Cohen, Duke University Health System
• Interviewer: Dr. Adeline Goss, Highland Hospital
• Disclosures: Dr. Cohen is a consultant with Bayer.

A recent study in JAMA Neurology found an association between contaminated water at a military base in the 1970s-80s and the risk of Parkinson’s disease in military service members. What do we know about Parkinson’s and environmental toxins? Series 4, Episode 9

Featuring:

• Guest: Dr. Ray Dorsey, University of Rochester
• Interviewer: Dr. Sara Stern-Nezer, UC Irvine
• Disclosures: This episode does not award CME credit.

There are trillions of bacteria living inside each of our gastrointestinal tracts and there’s growing evidence that those bacteria communicate with the brain. Some researchers are even hopeful that drugs targeted at the gut microbiome could help treat diseases as diverse as Parkinson’s disease, multiple sclerosis, or autism. The nature of this so-called “gut-brain axis” -- the extent to which bacteria might actually shape brain function and disease -- is the topic of our show today. Dr. Sarkis Mazmanian is the Luis and Nelly Sooks Professor of Microbiology in the Division of Biology and Biological Engineering at Caltech. He’s the recipient of many awards, including a MacArthur Genius Grant, for his work on the gut microbiome axis. Series 4, Episode 8

Featuring:

• Guest: Dr. Sarkis Mazmanian, Caltech
• Interviewer: Dr. Adeline Goss, Highland Hospital
• Producer: Dr. Sara Stern-Nezer, UCI Health
• Disclosures: Dr. Mazmanian disclosed the following relationships related to this podcast topic: Axial Therapeutics: Board member and Consultant, Nuanced Health: Board member and Consultant, and Seed Health: Board member. This episode does not award CME credit.