American Academy of Neurology, April 21-27

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The 70th Annual Meeting of the American Academy of Neurology

The annual meeting of the American Academy of Neurology was held from April 21 to 27 in Los Angeles and attracted approximately 12,000 participants from around the world, including clinicians, academicians, allied health professionals, and others interested in neurology. The conference highlighted recent advances in neurological disorders, with presentations focusing on the diagnosis, management, and treatment of disorders impacting the brain and nervous system.

In one study, Giancarlo Logroscino, M.D., Ph.D., from the University of Bari Aldo Moro in Italy, and colleagues found that hearing loss may be associated with mild cognitive impairment.

"The data reported were from the Great Age study, a multi-disciplinary population-based study on aging and age-related diseases with a particular focus on neurodegenerative diseases," Logroscino said. "Overall, the prevalence of hearing loss was very high and went up with aging, with one out of four having hearing problems after age 65; at age 85 or older, more than 60 percent experienced hearing problems. There are hearing problems of two types: peripheral and central. We found a strong association between hearing loss of central type and mild cognitive impairment."

According to Logroscino, the loss of hearing can determine the onset and/or the acceleration of cognitive issues. This effect could be due to a concomitant pathologic process.

"The major implication is that, if this data is confirmed, then hearing loss could be a preventable factor to be targeted in dementia prevention," Logroscino added.

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In another study, Annette Langer-Gould, M.D., Ph.D., of Kaiser Permanente Southern California in Pasadena, and colleagues found that consuming fish one to three times per month in combination with taking a fish oil supplement may be tied to a lower risk of multiple sclerosis (MS) development.

"Variation in genes that encode omega-3 biosynthesis enzymes are also associated with a lower risk of MS, independent of fish/seafood intake. These independent protective effects make sense because these genes have nothing to do with fish/seafood intake but are needed to convert plant-based sources of omega-3 precursors to types of omega-3s your body needs," Langer-Gould explained. "Taken together with the existing literature, these findings provide more evidence that a diet rich in fish and omega-3 fatty acids has health benefits. In addition to promoting improved cardiovascular health, a high-fish/seafood diet may also reduce the risk of developing MS."

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Also during the conference, Alexander D. Rae-Grant, M.D., from the Cleveland Clinic, discussed new MS guidelines that advocate beginning MS drug therapy earlier on in the disease course.

"The decision to use disease-modifying therapies in MS should occur early in the condition, often even before a formal diagnosis of MS is made and after a first attack of symptoms when the magnetic resonance imaging (MRI) scan is characteristic of the process of MS. The guideline recommends an ongoing dialogue about treatment between clinicians and people with MS, particularly discussing the reasonable goals of medication, personalized choice in terms of risk tolerance, and an ongoing monitoring strategy to ensure tolerance and use of medications," Rae-Grant said. "The guideline reminds the clinician to focus on other heath conditions which might affect the use of disease-modifying therapy to further personalize therapy."

The guideline suggests switching therapy when there is evidence of ongoing MS activity such as new relapses or new MRI lesions. In addition, according to Rae-Grant, the guideline panel recommends further research in the clinic comparing outcomes with different medications, as well as comparing different strategies such as a high-efficacy medication as the initial treatment as opposed to stepped care starting with lower-efficacy medications.

"I think the thoughtful clinician will find that they are already using many of the recommendations that the guideline lists. The places where practice may change most are in beginning therapy with a first relapse, as long as it is clear that the diagnosis of clinically isolated syndrome, a known precursor to MS, is correct. In addition, we urge clinicians to switch medicines where there is breakthrough disease. This may be a change in practice for some," Rae-Grant said. "Most importantly, listening to the preferences of the patient, particularly where there is limited data to guide therapy, is important for a superior relationship between the health care provider and the patient with MS."

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AAN: New Drug May Help Infants With Spinal Muscular Atrophy

THURSDAY, April 19, 2018 (HealthDay News) -- For infants with type 1 spinal muscular atrophy who have two copies of the survival motor neuron (SMN) 2 gene, RG7916 can increase SMN protein levels in the blood, according to a study presented at the annual meeting of the American Academy of Neurology, held from April 21 to 27 in Los Angeles.

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AAN: Cerliponase Alfa Beneficial for Form of Batten's Disease

THURSDAY, April 26, 2018 (HealthDay News) -- For children with neuronal ceroid lipofuscinosis type 2 (CLN2) disease, intraventricular infusion of cerliponase alfa is associated with reduced decline in motor and language function, according to a study published online April 24 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the American Academy of Neurology, held from April 21 to 27 in Los Angeles.

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AAN: Neuromodulation Therapy Gives Relief From Hand Tremor

FRIDAY, April 20, 2018 (HealthDay News) -- Non-invasive neuromodulation therapy using a custom stimulation pattern provides symptomatic relief from hand tremor in essential tremor, according to a study presented at the annual meeting of the American Academy of Neurology, held from April 21 to 27 in Los Angeles.

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AAN: Erenumab Shows Promise for Hard-to-Treat Migraine

THURSDAY, April 19, 2018 (HealthDay News) -- For patients with episodic migraine who have failed prior preventive migraine treatments (PMTs), erenumab is associated with an increase in the proportion of patients achieving a ≥50 percent reduction in mean monthly migraine days (MMDs), according to a study presented at the annual meeting of the American Academy of Neurology, held from April 21 to 27 in Los Angeles.

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AAN: High Fish Intake Linked to Reduced Risk of Multiple Sclerosis

FRIDAY, March 2, 2018 (HealthDay News) -- High fish intake is associated with reduced risk of multiple sclerosis (MS), according to a study scheduled for presentation at the upcoming annual meeting of the American Academy of Neurology, to be held from April 21 to 27 in Los Angeles.

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AAN: Gluten-Free Diet May Help Cut Pain in Gluten Neuropathy

WEDNESDAY, Feb. 28, 2018 (HealthDay News) -- For patients with gluten neuropathy, following a strict gluten-free diet is associated with significantly reduced odds of peripheral neuropathic pain, according to a study scheduled for presentation at the upcoming annual meeting of the American Academy of Neurology, to be held from April 21 to 27 in Los Angeles.

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AAN: Occupational Exposure to Diesel Exhaust Tied to ALS Risk

WEDNESDAY, Feb. 28, 2018 (HealthDay News) -- There is a correlation for increased risk of amyotrophic lateral sclerosis (ALS) with increased occupational exposures to diesel exhaust (DE), according to a study scheduled for presentation at the upcoming annual meeting of the American Academy of Neurology, to be held from April 21 to 27 in Los Angeles.

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AAN: Adherence to DASH Diet May Reduce Risk of Depression

TUESDAY, Feb. 27, 2018 (HealthDay News) -- Adherence to the Dietary Approaches to Stop Hypertension (DASH) diet is associated with reduced risk of depression among older adults, according to a study scheduled for presentation at the upcoming annual meeting of the American Academy of Neurology, to be held from April 21 to 27 in Los Angeles.

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AAN: Alpha-Synuclein Levels in Tears May Help ID Parkinson's

FRIDAY, Feb. 23, 2018 (HealthDay News) -- Alpha-synuclein levels in tears differ significantly for patients with Parkinson's disease (PD) and healthy controls, according to a study scheduled for presentation at the upcoming annual meeting of the American Academy of Neurology, to be held from April 21 to 27 in Los Angeles.

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