Susan Jeffrey

April 23, 2012

April 23, 2012 (New Orleans, Louisiana) — The Big Easy is the backdrop this year to the American Academy of Neurology's 64th Annual Meeting, and along with great food and cool music — the city's legendary jazz festival begins later this week — neurologists will hear about the latest developments and cutting-edge science in their field.

Lisa DeAngelis, MD, chair of the Department of Neurology, co-executive director of the Brain Tumor Center at Memorial Sloan-Kettering Cancer Center, New York, and chair of the Science Committee and Scientific Program Subcommittee for the meeting, discussed some changes in how information is delivered to attendees, and pointed to session highlights she is also anticipating.

Dr. Lisa DeAngelis

"We do have 2 changes in the program this year," Dr. DeAngelis told Medscape Medical News. First, "we've added a new plenary session, which is a controversies session," she noted. Five wide-ranging and current controversial topics in neurology will be debated, from whether biomarkers in Alzheimer's disease are ready for prime time to the merits of stenting vs surgery for stroke prevention in carotid disease.

The other major change is that the session formerly known as "Late Breaking Science" has been rechristened "Emerging Science." Along with a new name, this session has a new format. Rather than a standard podium or poster presentation, Emerging Science will be presented both ways, starting with rapid-fire oral session for the first 45 minutes of the session on Wednesday evening, followed immediately by the same abstracts presented as posters.

"This year we had really a wealth of fantastic science that was submitted in the Emerging Science program, and we have 15 abstracts that we accepted," Dr. DeAngelis notes. "All of them will be presented as a poster, but we're also trying a very brief, 'data blitz' kind of presentation as well. For every abstract, there will be an oral presentation, in which they'll have 3 minutes to present the data, basically 3 slides, to hit the highlights. We're going to go through all 16 abstracts, and people can sit there and in basically an hour or less get the salient features of a lot of the top science that's going to be presented at the meeting."

The "data blitz" approach is new. "We're trying this out to do these very rapid presentations to see how people like that," she noted. If it's well received, this strategy may be used in other parts of the program in future.

Emerging Science — With a "Data Blitz"

According to the meeting site, abstracts qualify as Emerging Science presentations "by having key aspects of research conducted after the October 24th abstract submission deadline, and must be new and of sufficient scientific importance to warrant expedited presentation and publication."

Preliminary results of some but not all of the abstracts have already been released by the AAN in advance of the meeting, and Medscape Medical News coverage of these can be seen here.

  • 001: Long-Term Efficacy and Augmentation Assessment of a Dopamine Agonist (Pramipexole) Compared with an Alpha-2-Delta Ligand (Pregabalin) in Restless Legs Syndrome: Results of a Randomized, Double-Blinded, Placebo-Controlled Trial — Diego Garcia, Borreguero, Madrid, Spain

  • 002: An International Study Investigating Rotigotine Dose Response (2-8 mg/24 h) on 'Off' Time in Advanced Parkinson's Disease — Lawrence Elmer, Toledo, Ohio

  • 003: Randomized, Double-Blind, Double-Dummy Study of Continuous Infusion of Levodopa-Carbidopa Intestinal Gel in Patients with Advanced Parkinson's Disease: Efficacy and Safety — C. Warren Olanow, New York, New York

  • 004: A Phase 2b Placebo-Controlled Study of the Exon-Skipping Drug Eteplirsen in Subjects with Duchenne Muscular Dystrophy — Jerry Mendell, Columbus, Ohio

  • 005: Weekly Assessments of Pain and Sleep During a 17-Week, Double-Blind, Placebo-Controlled Trial of Pregabalin for the Treatment of Chronic Neuropathic Pain After Spinal Cord Injury — Bruce Parsons, New York, New York

  • 006: Brain Autopsy and In-Vivo Cortical Brain Biopsy Trials Show a Strong Concordance Between [18F]flutemetamol PET and Amyloid-β pathology — David Wolk, Philadelphia, Pennsylvania

  • 007: [18F]Flutemetamol Uptake and Cognitive Performance in Non-Demented Community-Dwelling Elders — Dustin Hammers,  Salt Lake City, Utah

  • 008: Results of a Multicentre Phase 3 trial on Florbetaben for β-Amyloid Brain PET in Alzheimer Disease — Marwan Sabbagh, Scottsdale, Arizona

  • 009: LCO Spectroscopy of Human Brain Reveals APOE-Isotype-Specific Changes in Protein Aggregate Conformation: Possible Basis for Impaired Aggregate Clearance in the Presence of APOE ε4 — Samuel E. Gandy, New York, New York

  • 010: A European Consortium for High-Profile Translational Research on Early-Onset Dementia – A Prevalence Study of the FTLD-ALS Causing C9orf72 Repeat Expansion Mutation in an Extended European Cohort — Julie van der Zee, Antwerp, Belgium

  • 011: The Threshold Effect of Repeated Head Trauma on Brain Structure and Cognition: The Professional Fighters Brain Health Study — Charles Bernick, Las Vegas, Nevada

  • 012: A Novel Method for Generation of Regulatory T Cells in Auto-Reactive T Cell Culture by Bowman-Birk Protease Inhibitor — Mohamad Rostami, Philadelphia, Pennsylvania

  • 013: A Double-Blind, Placebo-Controlled, Phase 2, 26-Week DreaMS trial of a Selective S1P Receptor Agonist ONO-4641 in Patients with Relapsing-Remitting Multiple Sclerosis — Timothy Vollmer, Aurora, Colorado

  • 014: Efficacy of 2 Dosing Frequencies of Subcutaneous Interferon Beta-1a on the Risk of Conversion from a First Demyelinating Event to Multiple Sclerosis and on MRI Measures of Disease: 3-Year Results of Phase 3, Double-Blind, Multicenter Trials (REFLEX and REFLEXION) — Mark Freedman, Ottawa, Canada

  • 015: Efficacy and Safety of Fingolimod in Patients with Relapsing-Remitting Multiple Sclerosis (RRMS): Results From an Additional 24-Month Double-Blind, Placebo-Controlled Study (FREEDOMS II Study) — Peter Calabresi, Baltimore, Maryland

Emerging Science Session will be held Wednesday, April 25, 2012, in the Ernest N. Morial Convention Center, La Nouvelle Ballroom A/B Theatre, from 5:45 pm to 7:00 pm.

Controversies in Neuroscience

For the first time, the Academy is instituting a plenary session given over to debate on some of the major controversies affecting today's neurology practice, Dr. DeAngelis said. "Some are traditional neurologic issues, but some are less traditional."

One of the less traditional questions, for example, is the role of the current requirement for 1 year of adult neurology training for pediatric neurologists. Physicians pursuing specialty training in pediatric neurology have to do 2 years of pediatrics, followed by 1 year of adult neurology, and then 2 years of pediatric neurology, she noted. "So what's the function of that 1 year of adult neurology?"

"This is a big issue for pediatric neurologists, and there's discussion about whether that should change," she said. On the other hand, though, such a change would affect adult neurology training programs as well because pediatric trainees are "in the mix of manpower" in these programs. "That's just one example of what I would say is a non-traditional topic, but one that's really important in the overall picture of neurologic education," Dr. DeAngelis said.

Joseph Jankovic, MD, and Walter Rocca, MD, are slated to moderate the session. Debate topics include the following:

  • Cerebrospinal fluid and Alzheimer's disease biomarkers: Ronald Petersen, MD, PhD, will discuss whether biomarkers for Alzheimer's disease are "ready for prime time." Nicklas Mattsson, MD, PhD, takes the position that β-amyloid biomarkers and amyloid positron emission tomography should be used clinically to diagnose those with mild cognitive impairment at risk for dementia due to Alzheimer's disease and for research purposes in normal persons.

  • Increasing prevalence of autism: Lawrence Brown, MD, and Max Wiznitzer, MD, will debate whether the increase prevalence of autism represents a health crisis.

  • Diaphragm pacing for amyotrophic lateral sclerosis (ALS): Raymond Onders, MD, and Catherine Lomen-Hoerth, MD, PhD, will examine implications of the PACER (Diaphragm Pacing in Motor Neuron Disease) study for treatment in ALS.

  • How much adult neurology training do child neurologists need?: Donald Gilbert, MD, will argue the position that the length of required child neurology training should be increased and the adult neurology training reduced, while Douglas Larsen, MD will argue for maintaining the current requirement for adult training for child neurologists.

  • Stenting or surgery for carotid disease: Still a hot potato issue in the wake of CREST (Carotid Revascularization Endarterectomy vs. Stenting Trial), Osama Zaidat, MD, makes the case for stenting, while James Meschia, MD, argues for carotid endarterectomy.

The 2012 Controversies in Neuroscience Session will be held Wednesday, April 25, from 2:00 pm to 5:00 pm.

Integrated Neuroscience Sessions

Others sessions using the new "data-blitz" approach are the Integrated Neuroscience Sessions. The number of these sessions has grown from 2 just about 5 years ago to about 10 on the current program. Each 4-hour session focuses on a particular topic and provides a combination of platform presentations, posters, and invited lecturers, all related to that topic.

"Typically these are among the very best abstracts of the meeting," Dr. DeAngelis noted, presented in a half-hour data blitz. "The data blitz is a way of trying to say, these are real highlights, and we're going to give them to you in take-home nuggets of information; 5-minute presentations of really hot stuff."

Among the topics is the role of biomarkers in neurologic diagnosis and therapeutic monitoring, nonmemory systems in the brain, plasticity in basal ganglia therapy, stem cells, and pediatric movement disorders.

See the Integrated Neuroscience Sessions page here.

Report on Epilepsy

A special session highlighting the Institute of Medicine's recently released report on the public health aspects of epilepsy is planned. Presenters will review the report, speaking to some of the issues that have been outlined in it. "This is something that's new and very timely, to try and get the latest information out to our membership as quickly as possible," Dr. DeAngelis notes.

The Hot Topics in Education Session: Institute of Medicine Report on Epilepsy will be held on Monday, April 23, 2012, from 1:30 to 3:30 pm.

Plenary Sessions

"I think the plenary sessions are going to be spectacular," Dr. DeAngelis said. The major session is the Presidential Plenary Session, with award lectures from Mark Mehler, MD (Presidential Lecture); Ralph Sacco, MD (Robert Wartenburg Lecture); Robert Darnell, MD (George C. Cotzias Lecture); and Rose Mary Boustany, MD (Sidney Carter Award in Child Neurology Lecture).

The Hot Topics Session features a varied group of speakers from all over the world, including some younger researchers rather than the more "sage" neurologists who traditionally speak, she noted. "We're trying to get a little more diversity in that respect."

Another major session is the Contemporary Clinical Issues session that includes both new science presentations (with outside commentary from invited discussants) and didactic talks on areas of interest, such as memory consolidation in sleep and image-guided patient selection for acute stroke therapy.

The Frontiers in Translational Neuroscience session aims to present new research that has an impact at the bedside, Dr. DeAngelis says, focusing on 4 very different areas. "One is brain tumors, which is not a common topic, but one that's close to my heart personally," she said. Other topics include diagnosis of preclinical Alzheimer's disease, exercise in Parkinson's disease, and translational therapeutic development at the National Institutes of Health.

Finally, the scientific program will again conclude with the Scientific Program Highlights Plenary Session on Friday evening starting at 5:15 pm Dr. DeAngelis will moderate a wrap-up of some of the most important presentations from the program. The educational program will end at 5:00 pm to allow all to attend.

Selected abstracts from the meeting have been pre-released, and news coverage of these is already available on Medscape's AAN collection page. Medscape Medical News coverage from onsite reporters will begin Monday, and a slideshow featuring some of the top presentations will follow in the week afterward.

To search the AAN scientific or educational programs, visit the AAN Web site.

American Academy of Neurology (AAN) 64th Annual Meeting, April 21 - 28, 2012, New Orleans, Louisiana.

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