American Academy of Neurology, April 12-19, 2008
American Academy of Neurology 60th Annual Meeting
The American Academy of Neurology's 60th Annual Meeting took place April 12-19 in Chicago, attracted about 12,000 attendees from around the world and included presentations of more than 2,000 abstracts. Highlights included updates on research that eventually could lead to better treatments for seizure disorders and a late-breaking science session that addressed topics such as immune polyradiculoneuropathy -- a newly identified neurological disorder -- and new management strategies for multiple sclerosis.
"The meeting represented a broad array of exciting advances in the field of neurological disease," said science committee member John Henson, M.D., of Massachusetts General Hospital in Boston. "Because we met in such a large venue -- McCormick Place -- we were able to accept 85 percent of the submitted abstracts."
This year's Robert Wartenberg Lecture, "Molecular Pathogenesis of Genetic Epilepsies Associated with GABAA Receptor Mutations," was delivered by Robert MacDonald, M.D., of Vanderbilt University in Nashville, Tenn. "For many years, Dr. MacDonald has been working to characterize these mutations that underlie a fairly broad range of seizures," Henson said. "Some of these mutations are passed from parents to children and explain a certain proportion of cases of hereditary seizure disorder. What he described in his talk were molecular studies elucidating how these mutations cause neurons to become abnormally hyperexcitable and how various gene-based therapies might address those abnormal functions. Within five to 10 years, this could lead to new approaches for treating various kinds of seizures."
Another highlight, Henson said, was "Outbreak of Immune Polyradiculoneuropathy in Workers Exposed to Porcine Neural Tissue," a late-breaking study presented by Daniel H. Lachance, M.D., of the Mayo Clinic in Rochester, Minn. In that study, Lachance and colleagues evaluated 15 employees at a Minnesota meat processing plant who used air guns to extract brain tissue from slaughtered pigs and developed symptoms ranging from a transverse myelitis syndrome and inflammation of the spinal cord to mild weakness, fatigue, numbness and tingling in arms and legs. "The current theory is that the aerosolized pig tissue was inhaled by these workers, which triggered an immune reaction that also attacked the workers' own nervous systems," Henson said. "It's possible that the pig brain and the human brain are antigenically similar in ways."
"This appears to be a new syndrome of immune-mediated polyradiculoneuropathy, or more simply, a novel neurological disorder caused by an immune system response to something in the workplace environment shared by these individuals," Lachance said in a statement.
Abstract #LBS.001
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Henson cited two late-breaking studies that could affect the management of patients who either are at high risk of developing multiple sclerosis or have already developed relapsing and remitting multiple sclerosis.
The first study, "Treatment With Glatiramer Acetate Delays Conversion to Clinically Definite Multiple Sclerosis (CDMS) in Patients With Clinically Isolated Syndromes (CIS)," was presented by Giancarlo Comi, M.D., of the Scientific Institute H. San Raffaele in Milan, Italy. "He randomized patients with clinically isolated syndromes to treatment with either glatiramer acetate or placebo and followed them over time," Henson said. "He found that the conversion rate to clinically definite multiple sclerosis was reduced by half compared to placebo. This will be very important in terms of managing patients who have had one clinical demyelinating event -- such as weakness on one side or double vision -- and two demyelinating lesions on an MRI scan."
The second study, "Interferon Beta-1b 500mcg, Interferon Beta-1b 250 mcg and Glatiramer Acetate: Primary Outcomes of the Betaferon/Betaseron Efficacy Yielding Outcomes of a New Dose) Study," was presented by Paul O'Connor, M.D., of St. Michael's Hospital in Toronto. "This study is important, not only because it compared interferon with glatiramer acetate in patients with relapsing and remitting multiple sclerosis but also because it compared two separate doses of interferon, which can be a toxic medication," Henson said. "The researchers found that there were no significant differences in the three study groups in terms of relapse rate and that the number of lesions found on MRI was higher in the glatiramer arm than in either of the interferon arms. So their conclusion was that 250 micrograms is the optimal dose of interferon."
AAN: Medications Linked to Cognitive Decline
FRIDAY, April 18 (HealthDay News) -- Older adults who start taking medications with anticholinergic activity may have an increased risk of cognitive impairment, according to research presented this week at the annual meeting of the American Academy of Neurology in Chicago.
AAN: Maternal Seizure Drug Use Not Harmful to Infants
THURSDAY, April 17 (HealthDay News) -- Breast-feeding infants whose mothers are on anti-epileptic drug monotherapy do not appear to have an increased risk of cognitive impairment at age 2, according to research presented this week at the annual meeting of the American Academy of Neurology in Chicago.
AAN: Migraine Linked to Cardiovascular Disease
THURSDAY, April 17 (HealthDay News) -- Women who experience migraine headaches at least once weekly may have a significantly increased risk of cardiovascular disease and ischemic stroke, according to research presented this week at the annual meeting of the American Academy of Neurology in Chicago.
AAN: Warfarin Users May Be at Risk for Hemorrhage
THURSDAY, April 17 (HealthDay News) -- Warfarin-treated patients who are eligible for intravenous tissue plasminogen activator (tPA) after an acute ischemic stroke may be at increased risk of symptomatic intracranial hemorrhage following thrombolysis, according to research presented this week at the annual meeting of the American Academy of Neurology in Chicago.
AAN: Mediterranean Diet May Help Preserve Cognition
THURSDAY, April 17 (HealthDay News) -- Patients who adhere to the Mediterranean diet -- which is rich in fruits, vegetables and whole grains and low in animal protein -- may have a reduced risk of either developing mild cognitive impairment or progressing from mild cognitive impairment to Alzheimer's disease, according to research presented this week at the annual meeting of the American Academy of Neurology in Chicago.
AAN: Formaldehyde Linked to Amyotrophic Lateral Sclerosis
THURSDAY, April 17 (HealthDay News) -- Exposure to formaldehyde -- but not to pesticides and herbicides -- may increase the risk of amyotrophic lateral sclerosis, according to research presented this week at the annual meeting of the American Academy of Neurology in Chicago.
AAN: Hypertension Linked to Mild Cognitive Impairment
WEDNESDAY, April 16 (HealthDay News) -- Patients with a history of high blood pressure may be at increased risk of developing mild cognitive impairment, according to research presented this week at the annual meeting of the American Academy of Neurology in Chicago.
AAN: Cholesterol, Lifestyle Linked to Alzheimer's Disease
WEDNESDAY, April 16 (HealthDay News) -- Patients with elevated cholesterol levels in midlife are at increased risk of developing Alzheimer's disease, and patients with a history of consuming more than two alcoholic beverages per day or smoking more than one pack of cigarettes per day are at increased risk of developing earlier Alzheimer's disease, according to two studies presented this week at the annual meeting of the American Academy of Neurology in Chicago.
Abstract - Solomon
Abstract - Harwood
AAN: Vitamin E May Improve Survival in Alzheimer's
WEDNESDAY, April 16 (HealthDay News) -- In patients with Alzheimer's disease, treatment regimens that include high doses of vitamin E are associated with significantly improved survival, according to research presented this week at the annual meeting of the American Academy of Neurology in Chicago.
AAN: Oral FTY720 Effective in Multiple Sclerosis
WEDNESDAY, April 16 (HealthDay News) -- In patients with relapsing multiple sclerosis, three years of treatment with oral FTY720 significantly reduces relapse rates and inflammatory activity, according to research presented this week at the annual meeting of the American Academy of Neurology in Chicago.
AAN: Causes of Young-Onset Dementia Identified
TUESDAY, April 15 (HealthDay News) -- Dementia onset is not uncommon among patients under age 45, and its most frequent causes are neurodegenerative and autoimmune/inflammatory conditions. Only rarely is Alzheimer's disease responsible for young-onset dementia, according to research presented this week at the annual meeting of the American Academy of Neurology in Chicago.
AAN: Autism Linked to Mitochondrial Disease
MONDAY, April 14 (HealthDay News) -- Autism may be associated with significant defects in oxidative phosphorylation function, according to research presented this week at the annual meeting of the American Academy of Neurology in Chicago.
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