What Promises to Be Hot at AAN's Annual Meeting?

Initial Findings of a Neurological Condition in Pork Workers Among Conference Highlights

Caroline Cassels

April 11, 2008

April 11, 2008 (Chicago, Illinois) — With more than 12,000 international attendees and more than 2000 abstracts, including research into a neurological condition in pork workers, this year's upcoming American Academy of Neurology (AAN) 60th Annual Meeting (April 12 to 18) may set new records for attendance and scientific presentations.

Among the expected meeting highlights is a presentation by Daniel Lachance, MD, from the Mayo Clinic in Rochester, Minnesota, who will share initial findings on an unusual neurological illness in a cluster of pork workers at 1 of 2 late-breaking science sessions to be held at the meeting.

"This research promises to be very interesting and will likely garner a great deal of attention," John Henson, MD, a member of the AAN Science Committee and science editor of the AAN's Web site, told Medscape Neurology & Neurosurgery.

Reports of the mysterious inflammatory neuropathy, which includes symptoms of pain, numbness, and tingling in the extremities as well as weakness, were first made public in December 2007.

All of the affected workers had jobs processing pig brains, which involved the use of a compressed air gun to clean out the skulls. At this point, it is thought the air gun aerosolized the brain matter, which workers then inhaled, setting up an immune response and subsequent inflammation in the spinal cord and root nerves.

On April 16, Dr. Lachance will update meeting attendees on the latest findings in these patients.

Delaying Conversion to Clinically Definite MS?

Also featured in the late-breaking sessions are 2 multiple sclerosis (MS) studies that may have important clinical implications.

Giancarlo Comi, MD, from Vita-Salute San Raffaele University, in Milan, Italy, and colleagues will present their study results of glatiramer acetate and whether it delays conversion to clinically definite MS in patients with early clinically isolated syndromes.

"This study could be very important. If the results show this drug can lower the conversion rate [to MS] in patients with early signs of the disease, it could have a significant impact on clinical practice," said Dr. Henson.

The second MS paper, by Paul O'Connor, MD, from the University of Toronto, in Ontario, compares the efficacy and safety of 2 doses of interferon beta (250 µg and 500 µg) and glatiramer acetate in the treatment of relapsing and remitting MS.

"This is an important comparison study that could identify how differing doses of interferon beta compare with glatiramer. These results could have significant therapeutic implications for MS patients," said Dr. Henson.

Statins for Dementia?

Another study likely to generate major interest is the Lipitor's Effect in Alzheimer's Dementia (LEADE) study, a randomized, controlled trial looking at the effect of atorvastatin on cognitive and global function in patients with mild to moderate Alzheimer's disease (AD).

Presented by Howard Feldman, MD, from the University of British Columbia, in Vancouver, the study will also be included in a session of AAN's late-breaking science presentations on April 16.

"This study is designed to test whether lowering cholesterol has an effect on the rate of progression in mild AD," said Dr. Henson.

If it turns out statins are effective in treating mild AD, this would be an important finding that could blunt the progress of dementia and have an impact that could extend to millions of people affected by the disease, he said.

"If the study turns out to show a beneficial effect, it would be a very exciting advance," he said.

New CADASIL Results?

Results of a randomized trial examining the use of donepezil in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) will also bereported. Preliminary results of this study were recently presented at the American Stroke Association's International Stroke Meeting in New Orleans.

Reported by Medscape Neurology & Neurosurgery at that time, the study failed to meet its primary end point of change from baseline in the vascular AD assessment scale cognitive subscale (V-ADAS-cog).

Update on Mirror Neuron System

Other AAN conference highlights include 2 plenary sessions led by world experts in their respective fields. The first, which opens the meeting, is the presidential lecture by Giacomo Rizzolatti, MD, from the University of Parma, in Italy, on the mirror neuron system.

A pioneer in this area, Dr. Rizzolatti will present the latest research into what Dr. Henson calls a "fascinating" phenomenon. When individuals observe a person performing a goal-directed action, their mirror neurons fire in the same pattern as if they were performing the action themselves, Dr. Henson explained.

Dr. Rizzolatti, will present the most up-to-date findings on this phenomenon, including magnetic resonance Imaging (MRI) data of the mirror neuron system in humans.

Recent research from investigators at the University of California, Los Angeles has shown that children with autism spectrum disorder have a breakdown in this system — a finding that suggests it is an underlying mechanism for the condition.

In addition, Robert MacDonald, MD, from Vanderbilt University, in Nashville, Tennessee, will discuss the latest research on gamma-aminobutyric-acid (GABA)–receptor mutations, which predispose affected individuals to a broad spectrum of seizure disorders.

Digital Posters

Finally, this year the AAN will pilot a digital poster session program in which attendees can access poster sessions via on-site kiosks. This advance, said Dr. Henson, will allow the academy to present a larger number of scientific presentations and thus overcome space limitations at some meeting sites.

"Right now, we accept somewhere on the order of about 60% of the scientific papers submitted. We recognize the need to present even more good science at the annual meeting. However, we can be limited by the size of the meeting venues, so digitization of the poster sessions offers an innovative solution," said Dr. Henson.


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