USA Health neurologist first in the state to perform new aneurysm procedure – FOX10 News

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USA Health neurologist first in the state to perform new aneurysm procedure - FOX10 News

A to Z List of Neurological Disorders – Disabled World

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Synopsis: Alphabetical list of currently known Human Neurological Conditions including short definitions for each disorder. A neurological disorder is defined as any disorder of the body nervous system. Neurological disorders affect the brain as well as the nerves found throughout the human body and the spinal cord.

A neurological disorder is defined as any disorder of the body nervous system. Structural, biochemical or electrical abnormalities in the brain, spinal cord or other nerves can result in a range of symptoms. Examples of symptoms include paralysis, muscle weakness, poor coordination, loss of sensation, seizures, confusion, pain and altered levels of consciousness. The specific causes of neurological problems vary, but can include genetic disorders, congenital abnormalities or disorders, infections, lifestyle or environmental health problems including malnutrition, and brain injury, spinal cord injury or nerve injury.

There are many recognized neurological disorders, some relatively common, but many rare. They may be assessed by neurological examination, and studied and treated within the specialties of neurology and clinical neuropsychology. Mental disorders, on the other hand, are "psychiatric illnesses" or diseases which appear primarily as abnormalities of thought, feeling or behavior, producing either distress or impairment of function.

Neurological disorders affect the brain as well as the nerves found throughout the human body and the spinal cord. These three parts of the body work together and are referred to as the central nervous system that control everything in the body. Neurology is the medical science that deals with the nervous system and disorders that affect it. Conditions that are classed as mental disorders, or learning disabilities and forms of Intellectual disability, are not themselves usually dealt with as neurological disorders.

Neurological disorders can be categorized according to the primary location affected, the primary type of dysfunction involved, or the primary type of cause. The broadest division is between central nervous system disorders and peripheral nervous system disorders. Neurological disorders can affect an entire neurological pathway or a single neuron. Even a small disturbance to a neuron's structural pathway can result in dysfunction.

According to the University of California, San Francisco, there are more than 600 neurological disorders that strike millions each year. These diseases and disorders inflict great pain and suffering on millions of patients and their families, and cost the U.S. economy billions of dollars annually. Social Security approves disability benefits for serious cases of epilepsy, cerebral palsy, Parkinson's disease, multiple sclerosis, ALS, and other nerve-based diseases.

Diagram of the human brain showing the four lobes - frontal lobe, parietal lobe, occipital lobe, and temporal lobe - of the cerebral cortex. The cerebrum or cortex is the largest part of the human brain, associated with higher brain function such as thought and action.

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Cite:Journal: Disabled World. Language: English. Author: Disabled World. Electronic Publication Date: 2015/04/08. Last Revised Date: 2019/09/23. Reference Title: "A to Z List of Neurological Disorders", Source: A to Z List of Neurological Disorders. Abstract: Alphabetical list of currently known Human Neurological Conditions including short definitions for each disorder. Retrieved 2019-10-19, from https://www.disabled-world.com/health/neurology/disorders-list.php - Reference Category Number: DW#101-11375.

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A to Z List of Neurological Disorders - Disabled World

The Stars in Our Brains – Duke Department of Neurology

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More than 10 million people worldwideabout 1 percent of people over age 60live with Parkinsons disease. There are treatments that can help control symptoms, but there is no cure.

The hallmark of the disease is the death of certain brain cellsneurons that produce dopamine. Most Parkinsons researchers have focused on studying these cells. But what if the disease starts elsewhere? What if it involves not only neurons but other cells that interact with neurons? In particular, what role is played by astrocytes, star-shaped cells that nurture and help form the connections, or synapses, between the neurons?

(This article by Angela Spivey, with photos by Alex Boerner, originally appeared in Duke Medical Alumni News. Read that story here.)

Thats the question a team of Duke researchers led by Cagla Eroglu, PhD, associate professor of cell biology and neurobiology, is exploring, thanks to a $1 million grant from the Chan Zuckerberg Initiative.

Sitting in her office, Eroglu picks up an orange plastic object that resembles a piece of coral, its tentacles branching this way and that. This is a model of a mouse astrocyte, she says. It can interact with 100,000 synapses at the same time. Astrocytes, she explains, infiltrate the brain, touching everything within their reach. They communicate with its synapses, regulating blood flow and metabolism.

Astrocytes from the Greek astron, meaning "star"have traditionally been thought of as support cells. But that thinking is changing. Since astrocytes are in such close contact and continuously communicating with synapses, we are beginning to appreciate that they are also fundamentally involved in regulating brain function, Eroglu says.

Collaborating with Albert La Spada, MD, PhD, Eroglu found that a certain gene known to be important in Parkinsons is more highly expressed in astrocytes than in neurons. And when the researchers mutated that gene in astrocytes, they saw some intriguing changes. This still-unpublished work laid the foundation for their proposal to the Chan Zuckerberg Initiative, which is bringing together experimental scientists from divergent fields to take a fresh look at the causes of neurodegenerative disorders.

There are vanishingly few papers that have delved into how astrocytes are contributing to the Parkinsons disease process, says La Spada, professor of neurology and vice chair of research for the Department of Neurology. This is an area that's been under-studied, and I think that the results that we're generating are suggesting that it deserves more attention.In addition to his long experience studying neurodegenerative diseases, La Spada brings expertise in growing astrocytes from induced pluripotent stem cells (IPSCs). That process starts by growing skin cells from a skin biopsy from a Parkinsons patient. Then we use what's called a reprogramming protocol to basically revert them to stem cells that are pluripotent. Once you create the IPSCs, you could use them to make any cell you wanta muscle cell or a cardiac cell or a neuron or an astrocyte, La Spada says. The beauty of this is, it comes from the patient who has the disease of interest."

His labs expertise will only grow because of the Chan Zuckerberg Initiative, which has formed focus groups for grantees around various areas, such as stem cell modeling, CRISPR gene-editing technology, bioinformatic analysis of data sets, and more. We're meeting other researchers from around the world who are doing really unique things. It's a chance for us all to compare notes, and I think this will accelerate all of our endeavors, La Spada says.

Rounding out the team is Nicole Calakos, MD, PhD, a scientist and clinician who treats patients with movement disorders, including Parkinsons. Calakos says that when she first met Eroglu, she was intrigued by her idea that since astrocytes are involved in sculpting the language of neurons, perhaps they play a role in the events that can lead to disease.

Everybody has been fixated like a magnet on the idea that the problem is the neuron that's dying, Calakos says. Cagla said, Hey, let's think outside of the box of that dead cell. Lets consider whether astrocytes are like the soil around a plant, providing the nutrition, and allowing it to form roots, and maybe that is whats broken. Why aren't we even thinking about this critical piece of the brain?

Eroglu puts it this way: Maybe the problem is loss of connections between neurons, even before they die.

Calakos says that part of the reason she came to Duke was the close intermingling of physicians and bench scientists. Because of how the community is at Duke, Cagla and I had been exchanging ideas and collaborating over the years, she says. The Chan Zuckerberg grant is an opportunity to get together as a formal team. I think it's really forward-thinking of them to have teams of basic scientists and practicing physicians all talking to each other.

The Chan Zuckerberg Initiative was launched in December 2015 by Mark Zuckerberg, founder and CEO of Facebook, and Priscilla Chan, a pediatrician and founder and CEO of The Primary School in East Palo Alto. In addition to her clinical insight, Calakos brings expertise in electrophysiologyreal-time recording and observation of electrical signals coming from brain cells. We can listen to the language of synapses, she says. They speak in electrical currents,which we can measure. Eroglu believes that by learning all they can about how astrocytes support synaptic development and health in the normal brain, they may find ways to stop neurodegenerative diseases like Parkinsons.

We are seeing aging as a part of development, Eroglu says. If your house is built on a strong base, then it might last longer. Whereas, if you build it in another way, it may be there for a while, but gradually start to break down.

This doesn't mean that we are destined to have neurodegeneration and we can't do anything. We may be more predisposed to get the disease, but we may not get it if we have done something else in our lives that helps strengthen our brain. I strongly believe that there will be ways to stop neurodegeneration.We will find a way to strengthen the brain connections. If we can figure out the weakest link, then we could concentrate on solving that.

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The Stars in Our Brains - Duke Department of Neurology

Mount Sinai Roosevelt | Department of Neurology

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The Department of Neurology at Mount Sinai West is a highly-integrated, multidisciplinary department specializing in the evaluation and treatment of people with neurological diseases. Our neurologists are widely respected for their high-quality clinical care and research.

Our physicians make use of the most advanced diagnostics and recent clinical innovations to diagnose and treat very complex and difficult-to-diagnose neurological disorders.

The neurologists at Mount Sinai West provide treatment for people with cancers of the nervous system or with neurologic complications from cancer and its therapies.

We understand the unique nature of many pediatric conditions, including how the tumor and treatment may affect the patients developing brain and neurological development.

We provide treatment for people with cancers of the nervous system or with neurologic complications from cancer and its therapies.

Mount Sinai Wests team of physicians evaluates and treats neurologic and systemic disorders that cause sensory, visual, ocular motor, eyelid, or papillary dysfunctions.

Mount Sinai Wests Neurophysiology department uses the most advanced diagnostic testing in order to evaluate nervous system functioning.

The Stroke Center is a state-of-the-art facility at the forefront of diagnostics and therapies that provides high-quality, compassionate care for life-threatening strokes.

Get answers to the most commonly asked questions about neurological disorders and their treatment.

Meet the highly-trained members of our Neurology department staff.

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The terrorist inside my husband’s brain | Neurology

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I am writing to share a story with you, specifically for you. My hope is that it will help you understand your patients along with their spouses and caregivers a little more. And as for the research you do, perhaps this will add a few more faces behind the why you do what you do. I am sure there are already so many.

This is a personal story, sadly tragic and heartbreaking, but by sharing this information with you I know that you can help make a difference in the lives of others.

As you may know, my husband Robin Williams had the little-known but deadly Lewy body disease (LBD). He died from suicide in 2014 at the end of an intense, confusing, and relatively swift persecution at the hand of this disease's symptoms and pathology. He was not alone in his traumatic experience with this neurologic disease. As you may know, almost 1.5 million nationwide are suffering similarly right now.

Although not alone, his case was extreme. Not until the coroner's report, 3 months after his death, would I learn that it was diffuse LBD that took him. All 4 of the doctors I met with afterwards and who had reviewed his records indicated his was one of the worst pathologies they had seen. He had about 40% loss of dopamine neurons and almost no neurons were free of Lewy bodies throughout the entire brain and brainstem.

Robin is and will always be a larger-than-life spirit who was inside the body of a normal man with a human brain. He just happened to be that 1 in 6 who is affected by brain disease.

Not only did I lose my husband to LBD, I lost my best friend. Robin and I had in each other a safe harbor of unconditional love that we had both always longed for. For 7 years together, we got to tell each other our greatest hopes and fears without any judgment, just safety. As we said often to one another, we were each other's anchor and mojo: that magical elixir of feeling grounded and inspired at the same time by each other's presence.

One of my favorite bedrock things we would do together was review how our days went. Often, this was more than just at the end of the day. It did not matter if we were both working at home, traveling together, or if he was on the road. We would discuss our joys and triumphs, our fears and insecurities, and our concerns. Any obstacles life threw at us individually or as a couple were somehow surmountable because we had each other.

When LBD began sending a firestorm of symptoms our way, this foundation of friendship and love was our armor.

The colors were changing and the air was crisp; it was already late October of 2013 and our second wedding anniversary. Robin had been under his doctors' care. He had been struggling with symptoms that seemed unrelated: constipation, urinary difficulty, heartburn, sleeplessness and insomnia, and a poor sense of smelland lots of stress. He also had a slight tremor in his left hand that would come and go. For the time being, that was attributed to a previous shoulder injury.

On this particular weekend, he started having gut discomfort. Having been by my husband's side for many years already, I knew his normal reactions when it came to fear and anxiety. What would follow was markedly out of character for him. His fear and anxiety skyrocketed to a point that was alarming. I wondered privately, Is my husband a hypochondriac? Not until after Robin left us would I discover that a sudden and prolonged spike in fear and anxiety can be an early indication of LBD.

He was tested for diverticulitis and the results were negative. Like the rest of the symptoms that followed, they seemed to come and go at random times. Some symptoms were more prevalent than others, but these increased in frequency and severity over the next 10 months.

By wintertime, problems with paranoia, delusions and looping, insomnia, memory, and high cortisol levelsjust to name a fewwere settling in hard. Psychotherapy and other medical help was becoming a constant in trying to manage and solve these seemingly disparate conditions.

I was getting accustomed to the two of us spending more time in reviewing our days. The subjects though were starting to fall predominantly in the category of fear and anxiety. These concerns that used to have a normal range of tenor were beginning to lodge at a high frequency for him. Once the coroner's report was reviewed, a doctor was able to point out to me that there was a high concentration of Lewy bodies within the amygdala. This likely caused the acute paranoia and out-of-character emotional responses he was having. How I wish he could have known why he was struggling, that it was not a weakness in his heart, spirit, or character.

In early April, Robin had a panic attack. He was in Vancouver, filming Night at the Museum 3. His doctor recommended an antipsychotic medication to help with the anxiety. It seemed to make things better in some ways, but far worse in others. Quickly we searched for something else. Not until after he left us would I discover that antipsychotic medications often make things worse for people with LBD. Also, Robin had a high sensitivity to medications and sometimes his reactions were unpredictable. This is apparently a common theme in people with LBD.

During the filming of the movie, Robin was having trouble remembering even one line for his scenes, while just 3 years prior he had played in a full 5-month season of the Broadway production Bengal Tiger at the Baghdad Zoo, often doing two shows a day with hundreds of linesand not one mistake. This loss of memory and inability to control his anxiety was devastating to him.

While I was on a photo shoot at Phoenix Lake, capturing scenes to paint, he called several times. He was very concerned with insecurities he was having about himself and interactions with others. We went over every detail. The fears were unfounded and I could not convince him otherwise. I was powerless in helping him see his own brilliance.

For the first time, my own reasoning had no effect in helping my husband find the light through the tunnels of his fear. I felt his disbelief in the truths I was saying. My heart and my hope were shattered temporarily. We had reached a place we had never been before. My husband was trapped in the twisted architecture of his neurons and no matter what I did I could not pull him out.

In early May, the movie wrapped and he came home from Vancouverlike a 747 airplane coming in with no landing gear. I have since learned that people with LBD who are highly intelligent may appear to be okay for longer initially, but then, it is as though the dam suddenly breaks and they cannot hold it back anymore. In Robin's case, on top of being a genius, he was a Julliard-trained actor. I will never know the true depth of his suffering, nor just how hard he was fighting. But from where I stood, I saw the bravest man in the world playing the hardest role of his life.

Robin was losing his mind and he was aware of it. Can you imagine the pain he felt as he experienced himself disintegrating? And not from something he would ever know the name of, or understand? Neither he, nor anyone could stop itno amount of intelligence or love could hold it back.

Powerless and frozen, I stood in the darkness of not knowing what was happening to my husband. Was it a single source, a single terrorist, or was this a combo pack of disease raining down on him?

He kept saying, I just want to reboot my brain. Doctor appointments, testing, and psychiatry kept us in perpetual motion. Countless blood tests, urine tests, plus rechecks of cortisol levels and lymph nodes. A brain scan was done, looking for a possible tumor on his pituitary gland, and his cardiologist rechecked his heart. Everything came back negative, except for high cortisol levels. We wanted to be happy about all the negative test results, but Robin and I both had a deep sense that something was terribly wrong.

On May 28th, he was diagnosed with Parkinson disease (PD).

We had an answer. My heart swelled with hope. But somehow I knew Robin was not buying it.

When we were in the neurologist's office learning exactly what this meant, Robin had a chance to ask some burning questions. He asked, Do I have Alzheimer's? Dementia? Am I schizophrenic? The answers were the best we could have gotten: No, no, and no. There were no indications of these other diseases. It is apparent to me now that he was most likely keeping the depth of his symptoms to himself.

Robin continued doing all the right thingstherapy, physical therapy, bike riding, and working out with his trainer. He used all the skills he picked up and had fine-tuned from the Dan Anderson retreat in Minnesota, like deeper 12-step work, meditation, and yoga. We went to see a specialist at Stanford University who taught him self-hypnosis techniques to quell the irrational fears and anxiety. Nothing seemed to alleviate his symptoms for long.

Throughout all of this, Robin was clean and sober, and somehow, we sprinkled those summer months with happiness, joy, and the simple things we loved: meals and birthday celebrations with family and friends, meditating together, massages, and movies, but mostly just holding each other's hand.

Robin was growing weary. The parkinsonian mask was ever present and his voice was weakened. His left hand tremor was continuous now and he had a slow, shuffling gait. He hated that he could not find the words he wanted in conversations. He would thrash at night and still had terrible insomnia. At times, he would find himself stuck in a frozen stance, unable to move, and frustrated when he came out of it. He was beginning to have trouble with visual and spatial abilities in the way of judging distance and depth. His loss of basic reasoning just added to his growing confusion.

It felt like he was drowning in his symptoms, and I was drowning along with him. Typically the plethora of LBD symptoms appear and disappear at random timeseven throughout the course of a day. I experienced my brilliant husband being lucid with clear reasoning 1 minute and then, 5 minutes later, blank, lost in confusion.

Prior history can also complicate a diagnosis. In Robin's case, he had a history of depression that had not been active for 6 years. So when he showed signs of depression just months before he left, it was interpreted as a satellite issue, maybe connected to PD.

Throughout the course of Robin's battle, he had experienced nearly all of the 40-plus symptoms of LBD, except for one. He never said he had hallucinations.

A year after he left, in speaking with one of the doctors who reviewed his records, it became evident that most likely he did have hallucinations, but was keeping that to himself.

It was nearing the end of July and we were told Robin would need to have inpatient neurocognitive testing done in order to evaluate the mood disorder aspect of his condition. In the meantime, his medication was switched from Mirapex to Sinemet in an effort to reduce symptoms. We were assured Robin would be feeling better soon, and that his PD was early and mild. We felt hopeful again. What we did not know was that when these diseases start (are diagnosed) they have actually been going on for a long time.

By now, our combined sleep deficit was becoming a danger to both of us. We were instructed to sleep apart until we could catch up on our sleep. The goal was to have him begin inpatient testing free of the sleep-deprived state he was in.

As the second weekend in August approached, it seemed his delusional looping was calming down. Maybe the switch in medications was working. We did all the things we love on Saturday day and into the evening, it was perfectlike one long date. By the end of Sunday, I was feeling that he was getting better.

When we retired for sleep, in our customary way, my husband said to me, Goodnight, my love, and waited for my familiar reply: Goodnight, my love.

His words still echo through my heart today.

Monday, August 11, Robin was gone.

After Robin left, time has never functioned the same for me. My search for meaning has replicated like an inescapable spring throughout nearly every aspect of my world, including the most mundane.

Robin and I had begun our unplanned research on the brain through the door of blind experience. During the final months we shared together, our sights were locked fast on identifying and vanquishing the terrorist within his brain. Since then, I have continued our research but on the other side of that experience, in the realm of the science behind it.

Three months after Robin's death, the autopsy report was finally ready for review. When the forensic pathologist and coroner's deputy asked if I was surprised by the diffuse LBD pathology, I said, Absolutely not, even though I had no idea what it meant at the time. The mere fact that something had invaded nearly every region of my husband's brain made perfect sense to me.

In the year that followed, I set out to expand my view and understanding of LBD. I met with medical professionals who had reviewed Robin's last 2 years of medical records, the coroner's report, and brain scans. Their reactions were all the same: that Robin's was one of the worst LBD pathologies they had seen and that there was nothing else anyone could have done. Our entire medical team was on the right track and we would have gotten there eventually. In fact, we were probably close.

But would having a diagnosis while he was alive really have made a difference when there is no cure? We will never know the answer to this. I am not convinced that the knowledge would have done much more than prolong Robin's agony while he would surely become one of the most famous test subjects of new medicines and ongoing medical trials. Even if we experienced some level of comfort in knowing the name, and fleeting hope from temporary comfort with medications, the terrorist was still going to kill him. There is no cure and Robin's steep and rapid decline was assured.

The massive proliferation of Lewy bodies throughout his brain had done so much damage to neurons and neurotransmitters that in effect, you could say he had chemical warfare in his brain.

One professional stated, It was as if he had cancer throughout every organ of his body. The key problem seemed to be that no one could correctly interpret Robin's symptoms in time.

I was driven to learn everything I could about this disease that I finally had the name of. Some of what I learned surprised me.

One neuropathologist described LBD and PD as being at opposite ends of a disease spectrum. That spectrum is based on something they share in common: the presence of Lewy bodiesthe unnatural clumping of the normal protein, -synuclein, within brain neurons. I was also surprised to learn that a person is diagnosed with LBD vs PD depending on which symptoms present first.

After months and months, I was finally able to be specific about Robin's disease. Clinically he had PD, but pathologically he had diffuse LBD. The predominant symptoms Robin had were not physicalthe pathology more than backed that up. However you look at itthe presence of Lewy bodies took his life.

The journey Robin and I were on together has led me to knowing the American Academy of Neurology and other groups and doctors. It has led me to discover the American Brain Foundation, where I now serve on the Board of Directors.

This is where you come into the story.

Hopefully from this sharing of our experience you will be inspired to turn Robin's suffering into something meaningful through your work and wisdom. It is my belief that when healing comes out of Robin's experience, he will not have battled and died in vain. You are uniquely positioned to help with this.

I know you have accomplished much already in the areas of research and discovery toward cures in brain disease. And I am sure at times the progress has felt painfully slow. Do not give up. Trust that a cascade of cures and discovery is imminent in all areas of brain disease and you will be a part of making that happen.

If only Robin could have met you. He would have loved younot just because he was a genius and enjoyed science and discovery, but because he would have found a lot of material within your work to use in entertaining his audiences, including the troops. In fact, the most repeat character role he played throughout his career was a doctor, albeit different forms of practice.

You and your work have ignited a spark within the region of my brain where curiosity and interest lie and within my heart where hope lives. I want to follow you. Not like a crazed fan, but like someone who knows you just might be the one who discovers the cure for LBD and other brain diseases.

Thank you for what you have done, and for what you are about to do.

Susan Schneider Williams serves on the Board of Directors for the American Brain Foundation (americanbrainfoundation.org) but reports no disclosures relevant to the manuscript. Go to Neurology.org for full disclosures.

Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the author, if any, are provided at the end of the editorial.

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The terrorist inside my husband's brain | Neurology

Neurology Services NYC | Mount Sinai – New York

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When it comes to finding care for a neurological condition, you want the best medicine, backed by the newest research, and delivered by highly skilled doctors who take the time to develop a relationship with you and your family.We believe every patient who walks through our door deserves exactly that combination of science and personalized attention whether you are an inpatient seen by one of our neurohospitalists or are seeking outpatient care at one of our many locations.

Our approach starts simply: We listen to you. After hearing about your symptoms and answering your questions, well guide you through the most advanced testing to make a thorough and accurate diagnosis. From there, we offer the newest treatment options, informed by innovative research conducted right here at the Icahn School of Medicine at Mount Sinai.Our physicians specialize in the full range of neurological conditions in children, adolescents, and adults including stroke, epilepsy, headache, Parkinsons disease, multiple sclerosis, brain and spinal tumors, Alzheimers disease, and amyotrophic lateral sclerosis (ALS) and work with a trained team of nurses, social workers, neuropsychologists and others to customize the right treatment plan for you and your family.

The Mount Sinai Health System is an internationally recognized leader in clinical neurology,neurology education, and neurology research.

With high 2017-2018 rankings fromU.S. News & World Report, our Department is committed to combining our scientific expertise with the compassionate, individualized attention you need to enjoy the best possible health.

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Neurology Services NYC | Mount Sinai - New York

Neurologist: Definition, Treatments Areas, and More

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A neurologist is a medical doctor who specializes in treating diseases of the nervous system. The nervous system is made of two parts: the central and peripheral nervous system. It includes the brain and spinal cord.

Illnesses, disorders, and injuries that involve the nervous system often require a neurologists management and treatment.

Before they can practice, neurologists must:

Neurologists manage and treat neurological conditions, or problems with the nervous system. Symptoms that commonly require a neurologist include:

People who are having problems with their senses, such as touch, vision, or smell, may also need to see a neurologist. Problems with senses are sometimes caused by nervous system disorders.

Neurologists also see patients with:

Because the nervous system is complex, a neurologist may specialize in a specific area. They will do a fellowship in that area after residency training. Subspecialties have evolved to narrow a doctors focus.

There are many subspecialties. Some examples of subspecialties include:

During your first appointment with a neurologist, they will likely perform a physical exam and a neurological exam. A neurological exam will test muscle strength, reflexes, and coordination. Since different disorders can have similar symptoms, your neurologist may need more testing to make a diagnosis.

Neurologists may recommend a variety of procedures to help diagnose or treat a condition. These procedures may include:

Your neurologist may use a lumbar puncture to test your spinal fluid. They may recommend the procedure if they believe your symptoms are caused by a problem in your nervous system that can be detected in your spinal fluid. The procedure involves inserting a needle into the spine after numbing it and taking a sample of spinal fluid.

This procedure can help your neurologist diagnose myasthenia gravis. In this test, your doctor injects you with a medicine called Tensilon. Then they observe how it affects your muscle movements.

By applying electrodes to your scalp, this test measures electrical activity in the brain.

Neurologists may use other types of tests, as well. Although they may not perform the test, they may order it, review it, and interpret the results.

To make a diagnosis, a neurologist may use imaging tests such as:

Other diagnostic procedures include sleep studies and angiography. Angiography determines blockages in the blood vessels going to the brain.

Your neurologist may help you manage your symptoms and neurological disorder alone, or with your primary care physician and other specialists.

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Neurologist: Definition, Treatments Areas, and More

Neurology | Michigan Medicine | University of Michigan

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Welcome: A Message from Dr. Fink, Chair

The brain makes us who we are, largely defining our uniqueness as individuals and as a species. For this reason diseases that attack the nervous system - whether suddenly as in stroke, insidiously as in Alzheimer's disease, or with recurrent attacks as may occur in multiple sclerosis - strike at the core of our being. Imagine being unable to speak, being unable to move your limbs at will, or experiencing difficulty recognizing common surroundings or close relatives.

In the Department of Neurology at the University of Michigan, a dedicated team of academic neurologists pursues the three-part academic mission of clinical care, research and education. Highly skilled physicians with subspecialty expertise in each of the domains of adult neurology provide care to patients with diseases of the nervous system in both hospital and outpatient settings. Many of these physicians direct laboratory or clinical research programs to advance our understanding of neurological disease, and to develop and test new therapies for these diseases.

David J. Fink, M.D.Robert Brear Professor and Chair

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Patients Receiving Treatment for MS Have Increased Risk for Any Infection – Neurology Advisor

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WEST PALM BEACH Patients who have been diagnosed with and treated for multiple sclerosis (MS) have an increased risk for any type of infection, and are more frequently hospitalized because of infections compared with their health counterparts, according to research presented at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) 2020 Forum held from February 27 to 29, 2020, in West Palm Beach, Florida. Results further showed that the highest increased risk was associated with renal tract infection.

Previous research has suggested that patients with MS have an increased risk for infection; therefore, the current study was designed to describe infection rates in this patient population using data from the United States Department of Defense database. Patients who were diagnosed with MS >1 year ago and were receiving treatment for this illness between January 2004 and August 2017 (n=8695) were matched with control patients without MS (n=86,934) by sex, age, and geographic region. Infections recorded after MS diagnosis were identified and incidence rates and incidence rate ratios (IRRs) of infection type and first infection were calculated.

During a median 7 years of follow-up, participants with MS had higher infection rates (any infection, diagnoses combined) (IRR, 1.76; 95% CI, 1.72-1.80) and hospitalized infections (IRR, 2.43; 95% CI, 2.23-2.63). Compared with matched controls, patients with MS had a higher incidence rate of first renal tract infection (IRR, 1.88; 95% CI, 1.81-1.95); skin infections (IRR, 1.51; 95% CI, 1.45-1.58); fungal infections (IRR, 1.47; 95% CI, 1.41-1.53); pneumonia and influenza (IRR, 1.48; 95% CI, 1.40-1.56); as well as other types of infection including helminthiases, rickettsioses, spirochetal diseases, nonsyphilitic and nongonococcal venereal diseases, and parasitic infections and infestations (IRR, 1.68; 95% CI, 1.61-1.75).

Incidence rate ratios of eye, ear, respiratory, throat, and viral infections were only marginally elevated. Results also demonstrated that rates of renal tract infections were more than 4-fold higher among women compared with men in both groups, but the IRR was higher in men (IRR, 2.47; 95% CI, 2.22-2.75) than women (IRR, 1.90; 95% CI, 1.83-1.98).

The investigators concluded, Treated MS patients have an increased risk of any infections. Hospitalized infections were also increased in MS patients. Most infection types were increased in MS patients with the highest risk associated with renal tract infections.

Visit Neurology Advisors conference section for continuous coverage from the ACTRIMS 2020 Forum.

Reference

Jick S, Persson R, Ulcickas M, et al. Increased risk of infections in patients diagnosed with and treated for multiple sclerosis: A study using the US Department of Defense Database. Presented at: ACTRIMS Forum 2020; February 27-29, 2020; West Palm Beach, FL. Abstract P086.

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Interventional Neurologists Converting to Transradial Access – Medscape

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LOS ANGELES The safety advantage that has already coaxed U.S. interventional cardiologists to switch many of their routine catheterizations from femoral-artery entry in the groin to a radial-artery approach through a patient's wrist is now prompting a similar shift among U.S. interventional neurologists, who are increasingly pivoting to transradial access when performing many neurovascular procedures.

"It's growing dramatically in U.S. practice. It may be hype, but there is big excitement. We are still in an assessment mode, but the adoption rate has been high,"Raul G. Nogueira, MD, said in an interview during the International Stroke Conference sponsored by the American Heart Association.

"The big advantage [of transradial catheterization entry] is elimination of groin complications, some of which can be pretty bad. Is it safe for the brain? It's probably okay, but that needs more study," said Dr. Nogueira, professor of neurology at Emory University and director of the Neurovascular Service at the Grady Marcus Stroke and Neuroscience Center in Atlanta.

His uncertainty stems from the more difficult route taken to advance a catheter from the wrist into brain vessels, a maneuver that requires significant manipulation of the catheter tip, unlike the path from the right radial artery into the heart's arteries, a "straight shot," he explained.

To reach the brain's vasculature, the tip must execute a spin "that may scrape small emboli from the arch or arteries, so we need to look at this a little more carefully," ideally in a prospective, randomized study, he said. "We need to see whether the burden of [magnetic resonance] lesions is any higher when you go through the radial [artery]."

Some of the first-reported, large-scale U.S. experiences using a radial-artery approach for various neurovascular procedures, including a few thrombectomy cases, came in a series of 1,272 patients treated at any of four U.S. centers during July 2018 to June 2019, a period when the neurovascular staffs at all four centers transitioned from primarily using femoral-artery access to using radial access as their default mode.

During the 12-month transition period, overall use of radial access at all four centers rose from roughly a quarter of all neurovascular interventions during July to September 2018 to closer to 80% by April to June 2019,Eyad Almallouhi, MD, reported at the conference.

During the entire 12 months, the operators ran up a 94% rate of successfully completed procedures using radial access, a rate that rose from about 88% during the first quarter to roughly 95% success during the fourth quarter tracked, said Dr. Almallouhi, a neurologist at the Medical University of South Carolina in Charleston.

The rate of crossover from what began as a transradial procedure but switched to transfemoral was just under 6% overall, with a nearly 14% crossover rate during the first quarter that then dropped to around 5% for the rest of the transition year. Crossovers for interventional procedures throughout the study year occurred at a 12% rate, while crossovers for diagnostic procedures occurred at a 5% clip throughout the entire year.

None of the transradial patients had a major access-site complication, and minor complications occurred in less than 2% of the patients, including 11 with a forearm hematoma, 6 with forearm pain, and 5 with oozing at their access site. The absence of any major access-site complications among the transradial-access patients in this series contrasts with a recent report of a 1.7% rate of major complications secondary to femoral-artery access for mechanical thrombectomy in a combined analysis of data from seven published studies that included 660 thrombectomy procedures (Am J Neuroradiol. 2019 Feb.doi: 10.3174/ajnr.A6423).

The other three centers that participated in the study Dr. Almallouhi presented were the University of Miami, Thomas Jefferson University in Philadelphia, and the University of Pittsburgh.

Of the 1,272 total procedures studied, 83% were diagnostic procedures, which had an overall 95% success rate, and 17% were interventional procedures, which had a success rate of 89%. The interventional transradial procedures included 62 primary coilings of aneurysms, 44 stent-assisted aneurysm coilings, 40 patients who underwent a flow diversion, 21 balloon-assisted aneurysm coilings, and 24 patients who underwent stroke thrombectomy.

The size of the devices commonly used for thrombectomy are often too large to allow for radial-artery access, noted Dr. Nogueira. For urgent interventions like thrombectomy "we use balloon-guided catheters that are large-bore and don't fit well in the radial," he said, although thrombectomy via the radial artery without a balloon-guided catheter is possible for clots located in the basilar artery. Last year, researchers in Germany reported using a balloon-guided catheter to perform mechanical thrombectomy via the radial artery (Interv Neuroradiol. 2019 Oct 1;25[5]:508-10).

But it's a different story for elective, diagnostic procedures. "I have moved most of these to transradial," Dr. Nogueira said. He and his coauthors summarized the case for transradial access for cerebral angiography in a recent review; in addition to enhanced safety they cited other advantages including improved patient satisfaction and reduced cost because of a shorter length of stay (Interv Cardiol Clin. 2020 Jan;9[1]:75-86).

Despite his enthusiasm and the enthusiasm of other neurointerventionalists for the transradial approach, other stroke neurologists have been more cautious and slower to shift away from the femoral approach.

"Our experience has been that for most cases it's a bit more challenging to access the cervical vessels from the radial artery than from the traditional femoral approach. For arches with complex anatomy, however, the transradial approach can be of benefit in some cases, depending on the angles that need to be traversed," commentedJeremy Payne, MD, director of the Banner Center for Neurovascular Medicine and medical director of the BannerUniversity Medical Center Phoenix Comprehensive Stroke Program. Dr. Payne highlighted that, while he is not an interventionalist himself, he and his interventional staff have regularly discussed the transradial option.

"In the cardiology literature the radial approach has been very successful, with better overall safety than the traditional femoral approach. Largely this seems to do with the anatomy of the aortic arch. It's simply a more direct approach to the coronaries via the right radial artery; getting the wire into the correct vessel is significantly more difficult the more acute the angle it has to traverse," such as when the target is an intracerebral vessel, Dr. Payne said in an interview.

"Our experience in the past 6 months has been about 25% transradial for some of our procedures, mainly diagnostic angiograms. We don't find any difference in safety, however, as our transfemoral procedures are already very safe. One of the benefits of a transradial approach has been that a closure device may not be needed, with fewer vascular complications at the access site, such as fistula formation. We use ultrasound for access, and have not seen a difference in those approaches at all so far. One might argue that using ultrasound to establish access would slow us down, but so far our fastest case start-to-recanalization time in an acute stroke this year was 6 minutes, so speed does not appear to be a limiting issue.

"Another concern overall for transradial access is the potential limitation in the tools we may be able to deploy, given the smaller size of the vessel. It is reassuring [in the report from Dr. Almallouhi] that a variety of cases were successfully completed via this approach. However, fewer than 2% of their cases [24 patients] were apparently emergent, acute strokes, lending no specific support to that context. I do not expect that to change based on this paper," Dr. Payne concluded.

"It is not clear to me that transradial neurointervention will change much. We have excellent safety data for the femoral approach, a proven track record of efficacy, and for most patients it seems to afford a somewhat wider range of tools that can be deployed, with simpler anatomy for accessing the cervical vessels in most arches. It is reassuring that the results reported by Dr. Almallouhi did not suggest negative outcomes, and as such I suspect the transradial approach at least gives us an additional option in a minority of patients. We have seen in the past 5-10 years an explosion of tools for the endovascular treatment of stroke; transradial access represents another potential strategy that appears so far to be safe," Dr. Payne said.

Drs. Nogueira, Almallouhi, and Payne had no relevant disclosures.

International Stroke Conference (ISC) 2020: Abstract 64. Presented February 19, 2020.

This article originally appeared on MDedge.com.

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Crowdsourcing the Next Big Neurology Study Novel Approaches to Cull ‘Big Data’ – LWW Journals

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ARTICLE IN BRIEF

From basic research using a mouse cortex to the search for detecting early signs of seizures, investigators are using crowdsourcing techniques to elicit more data and answers to basic and clinical neurology questions. Here, they discuss the challenges and opportunities of next-generation research techniques.

Increasingly, researchers are using crowdsourcing techniques to cull data from a broader array of sources, using everything from smart watches that track respiration to holding contests to develop better algorithms for predicting seizures.

The investigators say that crowdsourcing for data enables easier access to huge datasets, faster development, and larger outreach to other researchers. But it's not as simple as launching an app and putting the data online.

Data collection is tricky, and everyone does it a little differently even on the same subject, several investigators told Neurology Today. Holding contests to find algorithmic answers to neurologic problems might seem novel now, but what happens when interests die out? And focusing on specific goal-oriented research requires a dramatic change in how the government and academic institutions reward progress.

Problems can emerge when people input and extract the data in inconsistent ways, for example. There's data in and there's data out, and there are issues on both ends, said Joshua T. Vogelstein, PhD, an assistant professor of biomedical engineering at Johns Hopkins University and its Institute for Computational Medicine. Dr. Vogelstein is a co-founder with his brother, computer scientist Randal Burns, of the Open Connectome Project, which stores large-scale neurologic data in the cloud, to allow scientists to generate and test theories of brain function and dysfunction.

The project, which includes 10 terabytes images from a mouse cortex dataset, is all online and open for free, and so is the code that everyone is writing to do the analysis. The cloud-based data enables users to view and analyze the images to identify neurons and synapses using special image-processing tools, and then help annotate them.

In creating the project, Dr. Vogelstein said the developers learned that they needed to create a template, so that all the data would fit the same standards. Now when someone sends data for the project, Dr. Vogelstein's team writes a customized script so that it will inject into the database.

Doctors should never have to learn how to code, like I shouldn't have to learn how to do surgery, said Dr. Vogelstein. But we have to work together to find an appropriate middle ground.

David S. Liebeskind, MD, FAAN, FAHA, FANA, professor of neurology and director of the Neurovascular Imaging Research Core at the University of California, Los Angeles department of neurology, views crowdsourcing as a vehicle for changing the focus of research from the traditional clinical approach.

The focus is not just on the hospital, but going to where the patients are, going to the individual level, he said. The focus is on longitudinal outcomes and not as much on the acute inpatient admission to an academic medical center where the individual has a specific complaint.

With so many people wearing activity monitors and carrying smart phones, a lot of the data are worthwhile and helpful at an individual level, he said. But he acknowledged that with open sharing and access to data, there are concerns about the validity and quality of the data, as well as protecting the confidentiality of information from participants. It's not enough to pull in the data, a framework or context is important to interpret the data, he said

In a 2016 paper in Frontiers in Neuroscience, Dr. Liebeskind proposed A Million Brains Initiative, aimed at collecting imaging data on the brain and vessels to advance stroke research and vascular substrates of dementia. The project requires that individuals upload their brain imaging data to a secure cloud, which could then be developed into a searchable and scalable platform.

Despite such variability in the type of data available and other limitations, the data hierarchy logically starts with imaging and can be enriched with almost endless types and amounts of other clinical and biological data, he wrote. Crowdsourcing allows an individual to contribute to aggregated data on a population, while preserving their right to specific information about their own brain health.

But he said many patients may be unaware of their right to access and obtain their medical images.

Benjamin H. Brinkmann, PhD, assistant professor of neurology biomedical engineering at the Mayo Clinic in Rochester, MN, already had the data, but wanted a better way to use it. Dr. Brinkmann, along with Brian Litt, MD, director of the Center for Neuroengineering and Therapeutics at the University of Pennsylvania, hosted an online competition to develop computer algorithms to detect, predict, and ultimately prevent epileptic seizures.

Hosted by the online platform Kaggle, more than 500 teams worked with shared datasets from a collaborative project with a startup company NeuroVista, and from research epilepsy recordings taken at Mayo Clinic. The contest made the recordings available on the International Epilepsy Electrophysiology Portal, http://www.ieeg.org, a National Institute for Neurological Disorders and Stroke-funded data-sharing platform for collaborative neuroscience research hosted by the University of Pennsylvania. The results of the contest were reported at last year's annual meeting of the American Epilepsy Society.

About $40 million had been spent over 15 years to find a program to predict seizures, with the best results reaching 65 percent, said Dr. Litt. The best result from the crowdsourcing contest reached 84 percent in three months. The top prize was $15,000.

There were pros and cons [to this approach], but overall it was a big success, and it helped us explore so many algorithms and figure out what features we needed to pull out of the data it helped us see past the noise, Dr. Brinkmann said.

The challenge with contests, said Dr. Vogelstein of Johns Hopkins, is that the situation is usually so specific that the algorithm often can't be used in other, similar scenarios and datasets. But Dr. Litt said contests require participants to design the work, specifically the data and the framework, so that it can be used much more widely.

Dr. Brinkmann said one of the winning entries in the algorithm contest for seizure detection was from a man in Israel who had his own company that predicts colon cancer. Although the contest stipulated that the winning algorithm would be released publicly, the man decided to patent his answer instead, and he was disqualified.

The team is adapting the winning answer as part of their current grant project, and, Dr. Vogelstein said, the project will require a fair bit of rewriting.

Although the results may need fine-tuning, Dr. Litt said the crowdsourcing contests drastically changed his thoughts on research objectives and academic success. Where the incentive has been focusing on obtaining large grants or being named first or last on an authored publication, the focus should be on obtaining actual solutions and sharing the information, he said.

If you want to find a way to track epileptic seizures, you want people to solve the problem, not focus on the progress of one individual, said Dr. Litt, who is helping to build an Open Data Ecosystem for Neuroscience, a project that is enlisting multiple centers to share data, collaborate, and crowdsource on the best methods for surgery to treat epileptic seizures.

All the data should be posted and be completely transparent, so other people can validate it, he said. People could use the data, and credit you, like a publication, and you would be promoted and given funding based on your record of sharing, collaborating, and how many people use and quote your data.

Our goal is nothing short of changing the fabric of science, and changing the way research is funded, Dr. Litt said.

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One of longest tenured nonprofit CEOs retiring on a strong note – Minneapolis Star Tribune

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Catherine Rydell, CEO of the American Academy of Neurology (AAN), said she never felt qualified for any of her jobs but believes in raising your hand and saying yes to opportunities. Yet when she retires in May, her 21-year tenure will be one of the longest among Minnesota nonprofit leaders.

Before joining the AAN, she was a volunteer leader as a stay-at-home mom who then became a state legislator in North Dakota. She believes that empowering her staff and giving them opportunities of their own is how the AAN has become the largest association for neurologists, with 36,000 members.

Mary Post, executive director of the American Board of Anesthesiology, will take over for Rydell.

Q: How is the AAN of 2020 different from the organization you were chosen to lead in 1999?

A: In 1999, I became the third executive director and the first woman to hold the position. When I arrived, the board had just approved its first strategic plan but was focused more on operations. With the help of some key board members, we were able to evolve the governing body to be much more strategically focused. As programs and services for members grew, we expanded staff, led by a competent and innovative executive team. Continual strategic planning has become the norm, backed by data, member input and environmental scans, which tip us off to new trends and concerns. This enables us to be more proactive, rather than reactive, which is critical in the rapidly shifting health care environment.

Q: How has the field of neurology changed in 20 years and what demands has that placed on AAN?

A: The AAN was founded in 1948 by Dr. A.B. Baker, who chaired the neurology department at the University of Minnesota. He started it to provide support and continuing medical education to young neurologists who were going into practice.

That need for support, not only for practicing neurologists but for those in academic institutions and in research, has significantly grown as the health care environment has become more complicated and challenging.

Today, the AAN has more than 36,000 members with 28,000 of those in the U.S. and serves as the worlds largest association of neurologists to help the one in six people worldwide affected by neurologic disease, such as stroke, Alzheimers disease, migraine, Parkinsons disease, concussion, MS, and epilepsy.

Our education and science programs at our annual meetings attract as many as 15,000 attendees. We advocate in Washington, D.C., to reduce the administrative burdens that regulations place on our practicing neurologists. We also advocate for increases in funding for the National Institutes of Health and the BRAIN Initiative so we can speed up the cures and treatments needed for more than 600 brain diseases. And we also help our academic neurologists find greater efficiencies and improvements in care for their patients.

Q: How has membership changed in the last 20 years?

A: One of the most significant aspects is that we have very strong retention rates among our U.S. members, currently at 95%. Our members feel they are getting their moneys worth from the AAN, and 83 cents of every dollar in dues goes back to our members in the form of benefits, programs and services. We represent 93% of all neurologists in the U.S. And we have more than 8,000 members from 141 countries.

We have also taken a more holistic approach to recognizing that the neurologist is a member of a care team. Its becoming more the norm that when you see a neurologist, you first see an advanced practice provider who has training in neurology fundamentals and can provide more of the basic services before the neurologist comes to the exam room. We now have more than 1,400 advanced practice providers as members, and we have tailored education programs for them. We also have 300 neurology business administrators as members; they fill the crucial role of keeping our members practices running efficiently, and we have programs and services to help them in their clinics and institutions.

We have seen more women come into neurology, from 29% of our membership in 2008 to 40% in 2019. Women and minority neurologists still face obstacles in the workplace because of gender and race. AAN has developed training programs to address those challenges, and we have created leadership programs to ensure that the leadership of the AAN and neurology in general is broad-based and representative.

Q: How have the publication and convention businesses contributed to the growth of the organization. How have they grown and why are they important to the membership and organization?

A: Members receive our eight publications, including the Neurology medical journal and Brain & Life magazine for patients (its free for the public) as either a membership benefit or a deeply discounted subscription rate. The revenue from our publications is a significant portion of our total revenue, which helps us keep member dues low and provide neurologists the services they need.

Our signature event of the AAN since 1949 has been our annual meeting, which has grown to become the worlds largest gathering of neurology professionals, with over 15,000 attendees. The last time we held our annual meeting in Minneapolis was in 1998, for our 50th anniversary. Since then, we have grown too large for the number of hotel rooms the downtown area can provide. However, this summer we will be holding our Sports Concussion Conference here and expect as many as 500 attendees.

Our meetings not only bring together the best and brightest experts to teach, inform and inspire attendees, they also offer networking opportunities and camaraderie.

Q: Tell us about your successor and the challenges she and the organization will likely face in the next 20 years.

A: Mary Post was selected based on her extensive experience as a CEO of the American Board of Anesthesiology (ABA), as well as her broad experience at the American Academy of Neurology, where she served for 16 years (19922008) in many leadership roles, including a deputy executive director. We are happy to have Mary come home.

Q: What are next steps for you: traditional retirement or an encore career?

A: Im truly looking forward to spending more time with family, friends, and enjoying lake life. But I also know that I am intrigued by a challenge. As they say, never say never.

Patrick Kennedy 612-673-7926

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One of longest tenured nonprofit CEOs retiring on a strong note - Minneapolis Star Tribune

Russia Neurology Procedures Outlook Over the Period, 2015-2025 – ResearchAndMarkets.com – Yahoo Finance

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The "Russia Neurology Procedures Outlook to 2025 - Hydrocephalus Shunting Procedures, Neurovascular Thrombectomy Procedures, ICP Procedures and Others." report has been added to ResearchAndMarkets.com's offering.

Russia Neurology Procedures Outlook to 2025 - Hydrocephalus Shunting Procedures, Neurovascular Thrombectomy Procedures, ICP Procedures and Others.

Summary

The publisher's new report, Russia Neurology Procedures Outlook to 2025, provides key procedures data on the Russia Neurology Procedures. The report provides procedure volumes within market segments - Hydrocephalus Shunting Procedures, Neurovascular Thrombectomy Procedures, Neurovascular Embolization Procedures, Neurovascular Coiling Assist Procedures, Neurovascular Accessory Procedures, Intracranial Stenting Procedures, ICP Procedures, Dura Substitute Procedures, Neuromodulation Procedures and Minimally Invasive Neurosurgery Procedures.

The data in the report is derived from dynamic market forecast models. The publisher uses epidemiology based models to estimate and forecast the procedure volumes. The objective is to provide information that represents the most up-to-date data of the industry possible.

The epidemiology-based forecasting model makes use of epidemiology data gathered from research publications and primary interviews with physicians to establish the target patient population and treatment flow patterns for individual diseases and therapies. Using prevalence and incidence data and diagnosed and treated population, the epidemiology-based forecasting model arrives at the final numbers.

Extensive interviews are conducted with key opinion leaders (KOLs), physicians and industry experts to validate the procedure volumes.

Scope

Reasons to buy

Key Topics Covered:

1 Table of Contents

1.1 List of Tables

1.2 List of Figures

2 Introduction

2.1 What Is This Report About?

2.2 Neurology Procedures Segmentation

2.3 Definitions of Procedures Covered in the Report

3 Neurology Procedures, Russia

3.1 Neurology Procedures, Russia, 2015-2025

3.2 Neurology Procedures, Russia, 2015-2025

4 Dura Substitute Procedures, Russia

4.1 Dura Substitute Procedures, Russia, 2015-2025

5 Hydrocephalus Shunting Procedures, Russia

5.1 Hydrocephalus Shunting Procedures, Russia, 2015-2025

5.1.1 Revision Hydrocephalus Shunts Procedures, Russia, 2015-2025

6 ICP Procedures, Russia

6.1 ICP Procedures, Russia, 2015-2025

7 Intracranial Stenting Procedures, Russia

7.1 Intracranial Stenting Procedures, Russia, 2015-2025

8 Minimally Invasive Neurosurgery Procedures, Russia

8.1 Minimally Invasive Neurosurgery Procedures, Russia, 2015-2025

8.1.1 Minimally Invasive Neurosurgical Devices Procedures, Russia, 2015-2025

9 Neuromodulation Procedures, Russia

9.1 Neuromodulation Procedures, Russia, 2015-2025

10 Neurovascular Accessory Procedures, Russia

10.1 Neurovascular Accessory Procedures, Russia, 2015-2025

11 Neurovascular Coiling Assist Procedures, Russia

11.1 Neurovascular Coiling Assist Procedures, Russia, 2015-2025

12 Neurovascular Embolization Procedures, Russia

12.1 Neurovascular Embolization Procedures, Russia, 2015-2025

12.1.1 Flow Diversion Stent Procedures, Russia, 2015-2025

13 Neurovascular Thrombectomy Procedures, Russia

13.1 Neurovascular Thrombectomy Procedures, Russia, 2015-2025

14 Appendix

For more information about this report visit https://www.researchandmarkets.com/r/7b7fs5

View source version on businesswire.com: https://www.businesswire.com/news/home/20200217005276/en/

Contacts

ResearchAndMarkets.comLaura Wood, Senior Press Managerpress@researchandmarkets.com For E.S.T Office Hours Call 1-917-300-0470For U.S./CAN Toll Free Call 1-800-526-8630For GMT Office Hours Call +353-1-416-8900

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Parkinson’s: Innovative method stops toxic protein buildup – Medical News Today

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Instead of targeting the tricky protein behind Parkinsons, a new compound attacks the RNA that produces it.

Parkinsons disease is a neurodegenerative disorder characterized by tremor, slowness of movement, limb rigidity, and walking and balance issues.

In Parkinsons, a misfolded protein named -synuclein causes the degeneration and destruction of brain cells. The more -synuclein builds up, the more neurons die.

Now, scientists from Rutgers University in New Brunswick, NJ, and Scripps Research in Jupiter, Florida, have developed a way to decrease the amount of -synuclein the body produces.

New technology allowed scientists to identify a compound that shuts down the messenger RNA (mRNA) coding for the destructive protein, preventing the production of -synuclein and the progression of Parkinsons.

The researchers NIH-funded study appears in the Proceedings of the National Academy of Sciences.

According to the Parkinsons Foundation, over 10 million people worldwide are living with Parkinsons disease, with 1 million of those being in the United States.

Each year, about 60,000 U.S. adults receive a diagnosis of the disease.

The incidence of Parkinsons increases with age, although about 4% of people who receive a diagnosis are less than 50 years old. Men are 1.5 times more likely to develop Parkinsons than women.

Currently, there is no cure for Parkinsons disease, and it is truly a devastating disease, says neurology professor M. Maral Mouradian of Rutgers Robert Wood Johnson Medical School Institute for Neurological Therapeutics, and a co-author of the study.

Numerous other approaches have attempted to address the production and buildup of -synuclein, but since the protein has no regular structure and continually changes shape, it has proven difficult to hit with medication.

Several other experimental drugs, says Mouradian, currently being tested for Parkinsons disease are antibodies that target a very late stage of -synuclein protein aggregates.

We want to prevent these protein clumps from forming in the first place before they do damage and lead to advancing disease.

The new research began when Mouradian reached out to chemistry professor Matthew D. Disney of Scripps to explore the potential for a new technology that Disney had invented for matching RNA structures with small-molecules or drug-like compounds.

The scientists had a hunch that they might find a match for the mRNA that coded for -synuclein and that the mRNA might offer a more stable, predictable target than -synuclein itself. The hunch paid off.

For the first time, we discovered a drug-like compound that has the potential to slow down the disease before it advances through an entirely new approach, says Mouradian.

They named their compound Synucleozid, and Mouradian describes it as highly promising.

While Synucleozid may be most effective in people with minimal symptoms and who are in the early stages of Parkinsons, Mouradian says, This new compound has the potential to [] change the course of life for people with this devastating disease.

Synucleozid may be of value beyond Parkinsons since -synuclein has implications in dementia with Lewy Bodies, another progressive condition that affects 1 million people in the U.S. alone.

The study also makes clear the promise of Disneys RNA/protein-matching technology. As Mouradian says, The reach of our study could go beyond people with Parkinsons disease to many other neurodegenerative diseases.

It is a classic example of how interdisciplinary research leads to significant change.

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Botox used as alternative solution for chronic migraines – The Denver Channel

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COLORADO SPRINGS, Colo. -- Every 12 weeks, Shannon Stone goes to her neurologist to get Botox injected in and around her head. Not for cosmetic reasons, but for chronic migraines.

Ive been working with Stone for chronic migraines, said Dr. Andrea Manhart, a neurologist at UCHealth Colorado Springs. Shes gone from approximately daily migraines to three per month.

The whole process takes no more than five minutes and only needs to be done every few months.

It has really changed the world of neurology, Dr. Manhart said of Botox, a product normally associated with cosmetics and reducing wrinkles.

Stone gets Botox injected into 31 injection sites.

To be a candidate for Botox, you have to have more than 15 migraine headache days for a month and you have to fail three of the oral preventative therapies, Dr. Manhart said.

Stone fit that criteria.

Every migraine medication that they would give me was failing, or the side effects would be too bad to where I couldnt continue the medication any longer, Stone said.

To even begin to understand Stones pain, you have to know her story. She started getting migraines in 2002 and found Botox as a solution two years ago. Stone and her doctors believed the migraines stemmed from a car accident in 2002.

I fractured three vertebrae in my neck and the windshield went through the right side of my face, Stone explained. So, the healing of all of that just caused a lot of neurological and muscle and tissue damage.

It was a bad accident, we barely survived, said Robert McCall, Stones 17-year-old son.

Stone was nine months pregnant with McCall during the accident and as he grew up, he took on more of a role in the family to help when Stone was in pain.

I had to cook dinner a lot of the time and make sure my sisters got whatever they had to do for the night, homework and take a bath and stuff, McCall said.

There would be times where they would last for like three or four days at a time with minimal breaks, Stone said.

When Botox was presented to her as an option, her first fear was that her eyes would get droopy one of the side effects Dr. Manhart explained.

I never wanted to let any of my friends or people that I knew know that I was receiving Botox because I didnt want them to judge me or feel like I was doing it for a beauty type of thing, Stone said.

The FDA approved Botox as a treatment for chronic migraines back in 2010.

Botox is for a specific person, it is for a specific chronic migraine patient, Dr. Manhart said.

A study done by the American Society of Plastic Surgeons showed that three months after injection, patients treated with Botox had an average of 1.6 fewer migraine attacks per month.

How Botox works is relatively unknown but the theory is that it de-activates pain receptors in the brain to reduce neurotransmitters that send pain signals to the brain, Dr. Manhart said.

For Stone, its helped her spend more time with her kids.

You can really see an improvement in her and just her overall appearance, McCall said. She doesn't look down all the time, shes not always sleeping.

I can still move my eyebrows, I can still move my face, I just cant make an angry face, Stone said.

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Botox used as alternative solution for chronic migraines - The Denver Channel

Vagus nerve stimulation for treatment of headaches, other neurological conditions – Delray Newspaper

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By: Dr. John Conde DC, DACNB Special to the Boca and Delray newspapers

The vagus nerve is a cranial nerve which is housed in the skull and is often referred to as the wandering nerve because it is the longest nerve in the human body. It travels from the brain stem to the outer ears and all the way down to the lower intestines. The vagus nerve is considered to be a part of the parasympathetic nervous system family, which is responsible for putting the body at rest, slowing the heart rate, enhancing digestion, sexual arousal, lacrimation (tearing), urination, normalizing blood vessel diameter, and defecation to name a few functions. These processes are the exact opposite of the sympathetic nervous system which is considered to be responsible for Fight or Flight dynamics.

Ideally, the predominance of activity should involve the parasympathetic nervous system with activation of the sympathetic nervous system only when appropriate, however this has not been the case for quite some time. Due to our lifestyle and the egregious demands our society places on us daily, this ratio of activation is completely thrown off. We develop a much greater sympathetic tone which is highly contributory to many neurological and psychological conditions. This is one of the reasons why there is such a high level of interest and research in vagus nerve stimulation and the recalibration of the ratio of parasympathetic versus sympathetic activity.

Invasive or surgical vagus nerve stimulation (VNS) involves the surgical implantation of a vagus nerve stimulator (pacemaker) for the treatment of seizures. This was FDA approved in 1997 for the treatment of seizures and then in 2005 for depression and 2015 for weight loss. However, due to the impracticality and danger associated with implantation of this stimulator researchers have been working tirelessly to ascertain a treatment modality that was non-surgical and non-invasive. They have finally succeeded. They have taken advantage of a small patch of tissue in the outer ear termed the cymba concha which is innervated by the auricular branch of the vagus nerve and found that stimulating this area with electrical current can have significant modulatory effects on the parasympathetic nervous system. Because the stimulation is occurring externally it is called transcutaneous vagus nerve stimulation (tVNS).

tVNS is garnering significant traction in several different medical specialties due to the wide-reaching effects this treatment can have. Headaches, specifically migraines are now being treated in many clinics with a combination of modalities that includes tVNS. The understanding is that in patients with chronic migraines there lies an irregularity in blood vessel diameter control such that vasodilation is prominent. Also an area in the brain stem that mediates head and face pain termed the trigeminal cervical complex (TCC) becomes irritated. Normalizing blood vessel diameter and activation of the TCC in the brainstem along with other targeted rehabilitation techniques can reduce migraine frequency and intensity. Other conditions being looked at for treatment include depression, tinnitus, epilepsy, pain, psychological conditions, dysautonomia, mood disorders, autism, and the global effects of aging. These are all mostly off-label but promising.

Dr. John Conde is a Board Certified Chiropractic Neurologist, one of only one thousand in the country. He holds diplomate status through the American Chiropractic Neurology Board. He provides specialized care for difficult cases of back neck pain, numbness-tingling, vertigo-dizziness balance disorders, fibromyalgia, migraines, AD/HD, autism, and dyslexia. His office is located at the Atlantic Grove in Delray Beach and can be reached at 561-330-6096, drconde@thecondecenter.com, http://www.thecondecenter.com

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Vagus nerve stimulation for treatment of headaches, other neurological conditions - Delray Newspaper

Sanofi investigated over epilepsy drug linked to birth defects – Physician’s Weekly

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PARIS (Reuters) French drugmaker Sanofi said on Tuesday it was being investigated over Depakine, an epilepsy drug which caused birth malfunctions and slow neurological development when taken during pregnancy.

The Paris prosecutor had already launched a preliminary investigation into the authorization and marketing of Depakine in 2016, after Frances social affairs inspection agency IGAS criticized the slow response of health authorities and Sanofi to the risks related to the drug and its derivatives.

Sanofi said in a statement that the indictment, which may or may not lead to a trial, will allow it to defend itself and to prove it has always complied with its to duty to inform and been transparent.

Sanofi, which has repeatedly said it had no intention to compensate or take part in a state-backed compensation mechanism for Depakine, added it would continue to fully cooperate with judicial authorities, and was confident over the outcome.

Such legal cases can take years and do not necessarily result in significant amounts of compensation in France compared to other jurisdictions such as the United States.

In one of Frances biggest pharmaceutical scandals, privately-owned Servier has so far paid out 152.5 million euros ($169 million) to patients.

Sodium valproate, the active molecule in Depakine, has been on the market since 1967 to treat epilepsy and bipolar disorder. It features on the World Health Organizations (WHO) list of essential medicines.

Depakine, which lost its patent in 1998, is prescribed in more than 100 countries. It is also sold under the names Depakote and Epilim.

IGAS estimated that between 2006 and 2014, 425 to 450 babies suffered congenital birth defects or were stillborn following exposure to Depakine.

Marine Martin, president of victims association APESAC, said on Twitter she was extremely satisfied to see the criminal proceedings she launched in 2016 reach an important threshold.

Sanofi will have to deal with the tens of thousands of poisoned victims, out of which more than a hundred died.

The French firm become aware of the risk of fetus malformation in the 1980s and then, around 2003, of the drugs impact on the neurological development of the fetus, with a risk of autism or learning difficulties.

The U.S. Food and Drug Administration warned in 2013 that valproate should not be taken during pregnancy.

(Reporting by Benoit Van Overstraeten, Matthias Blamont; Editing by Christian Schmollinger and Alexander Smith)

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Sanofi investigated over epilepsy drug linked to birth defects - Physician's Weekly

Review Highlights the Importance of Smoking Cessation in Patients With Multiple Sclerosis – Neurology Advisor

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Cigarette smoking represents an important modifiable environmental risk factor for multiple sclerosis (MS), and a new review article suggests that smoking increases the risk for developing MS through increased inflammation and exposure to free radicals, cyanates, and carbon monoxide. This review was published in JAMA Neurology.

In this narrative review, Harvard researchers explored the relationship between cigarette smoking and MS risk and progression by examining reports in English-language studies. According to the literature, the prevalence of both MS and cigarette smoking jointly and substantially increased in the 20th century, particularly in women. Studies consistently report dose-response associations between smoking and MS, suggesting causality between smoking and increased MS risk.

The association between the pathogenesis of MS and cigarette smoking appears to be modulated by the immune system, in addition to smokings neurotoxic effects. A proinflammatory cascade is induced by cigarette smoke and continues throughout the respiratory system, subsequently culminating in the lungs. Ultimately, macrophages release cytokines and free radicals that damage the surrounding alveolar epithelium. Inflammation and immune cells within the lungs also contribute to autoimmunity, driving the risk for MS in people who smoke.

Free radicals and cyanide present in cigarette smoke lead to damage to the mitochondria, which may result in severe damage to myelin. Smokes neurotoxic effects may also contribute to worsening disease prognosis in patients with MS who smoke. Additionally, studies have linked cigarette smoking with greater lesion loads on MRI scans in patients with MS as well as clinically isolated syndrome. Concerning findings in other studies suggest that cigarette smoke may adversely affect the efficacy of disease-modifying therapies, such as natalizumab.

While electronic cigarettes have not been extensively studied in regard to their effects on MS risk, researchers have alluded that heated vapor in these devices may be just as harmful as tobacco combustion and may also contribute to the pathogenesis of the autoimmune disorder.

The authors of the review added that the pathways involved in smoking may be implicated in other environmental exposures (eg, organic solvents) and health habits (eg, waterpipe smoking), in addition to tobacco smoke.

Researchers note that in terms of MS risk, increased risk persists after smoking cessation. However, smoking cessation decreases future risk of MS progression and accrual of disability burden. As such counseling is key in supporting patients with all patients, especially those with MS, before and during smoking cessation.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors disclosures.

Reference

Rosso M, Chitnis T. Association between cigarette smoking and multiple sclerosis: a review [published online December 16, 2019]. JAMA Neurol. doi: 10.1001/jamaneurol.2019.4271

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Special Journal Issue on Functional Neurological Disorder Brings Attention to a Neglected Field: Investigator Q&A – Psychiatry Advisor

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The latest issue of The Journal of Neuropsychiatry & Clinical Neurosciences (JNCN) focuses on Functional Neurological Disorder (FND), a neuropsychiatric condition with significant physical and mental health features. Psychiatrists commonly refer to this condition as Conversion Disorder, whereas neurologists may be more familiar with terms such as functional movement disorders and dissociative seizures, among other subtypes of FND.

Largely understudied until recently, FND presents a critical challenge to practitioners in neurology and psychiatry. Furthermore, the complex issues faced by patients require evidence-based approaches to both treatment and the medical communitys fundamental understanding of the disorder. In light of these challenges, the 5 guest co-editors of the special issue David L Perez, MD, MMSc, Selma Aybek, MD, Timothy R Nicholson, MD, PhD, Kasia Kozlowska, MBBS, PhD, W Curt LaFrance, Jr, MD, MPH put together a series of articles touching on risk factors, treatment approaches, and outcome measures, among other key topics. Psychiatry Advisor contacted Dr Perez and Dr Nicholson to discuss the special issue of JNCN and the state of the field.

Psychiatry Advisor: In your view, what is the significance of this special issue, the first published on FND in nearly 2 decades?

David Perez, MD, MMSc: This special issue on FND is a landmark event for the field. FND is among the most common conditions encountered by neurologists and neuropsychiatrists, yet because this diagnosis falls at the borderland between neurology and psychiatry, it has not had the clinical, academic, and research attention it deserves.

Over the last few decades, there have been significant breakthroughs in evidence-based diagnostic and treatment approaches, as well as the development of an improved understanding of disease mechanisms, resulting in renewed interest in FND across the clinical neurosciences. This progress is exemplified by the broad range of articles within our special issue on FND.

Psychiatry Advisor: How has our understanding of FND changed since the formative era of modern neuropsychiatry in the early 20th century?

Dr Perez: It is important to highlight that FND, previously termed hysteria and synonymous with Conversion Disorder, was of great interest to early pioneers in psychiatry and neurology, including Charcot, Freud, Janet, Babinski, and others. One of the major hopes of this special issue is that this effort will energize clinicians and researchers across the clinical neurosciences to care for and develop cutting edge research in this underserved population.

Foundational to our modern framing is the notion that FND is a neuropsychiatric disorder at the intersection of the mind and the brain. According to our perspective, this condition is brain-based and neural circuits do not artificially divide into neurological circuits and psychiatric circuits. An integrated, interdisciplinary approach that embraces neurologic, psychiatric, psychological, and rehabilitation perspectives is the present and future of FND clinical and research efforts.

Additionally, it is now recognized that there are a number of predisposing vulnerabilities or risk factors for the development of FND, and adverse life events may have etiological relevance for some but not all patients. This point is nicely exemplified by Professor Jon Stone and colleagues in their study of individuals with functional limb weakness, which notes that only about a third of patients in their sample reported childhood abuse and/or neglect.1

Psychiatry Advisor: In a recent article, an international panel of experts was organized to discuss the complexities of developing outcome measures for FND.2 Why is this an important issue in the field?

Timothy Nicholson, MD, PhD: With the long overdue growth of both clinical service provision for FND and research into its treatments comes a need to optimize outcome measurements to monitor changes in symptoms. Designing and selecting outcome measures is a complex task for any disorder, but there are particular features of FND that make this even more complex. These features, such as the wide variety of symptoms in FND and the potential for subjective rather than objective measures to be of more relevance than in other disorders, are discussed in this perspective article from a panel of 45 experts from 13 countries that aims to drive forward consensus and development of outcome measures in FND.

Psychiatry Advisor: What does FND tell us about the divide between mental and physical health?

Dr Nicholson: FND is the quintessential disorder through which to understand and conceptualize that mental and physical health are inherently intertwined, and any divide is an illusion that hinders both research and clinical care for mental health disorders, neurological disorders, and those in between. Patients with FND present with neurological symptoms that can resemble almost all other neurological disorders, but remain discernable by distinct clinical examination features (so-called positive signs).

The condition also has complex interactions with psychological processes (such as dissociation) and psychological disorders (such as PTSD and panic attacks) that have led to the traditional dominance of psychological models of the disorder. However, such models must of course be rooted in neurological (or brain-based) dysfunction, albeit at a complex multi-network level. There are exciting new theories, such as Bayesian computational models for motor and sensory dysfunction in FND that point the way forward for neuroscientific approaches. These models integrate mental and physical functions, ignoring the mirage of any false divide between them.

Psychiatry Advisor: Your editorial mentions the feasibility of implementing physical therapy for motor FND. Can you highlight other specialties outside of neurology and psychiatry that would benefit patients with FND?

Dr Perez: In addition to neurologists and psychiatrists, optimal care often involves physical therapists, occupational therapists, speech and language pathologists, psychologists, and/or social workers, among other disciplines. This interdisciplinary approach to FND is highlighted by the tree diagram that appears on the cover image for our special issue.

Psychiatry Advisor: The special issue includes an article detailing the establishment of specialized FND clinics in the United Kingdom, Switzerland and Canada. What does quality care for patients with FND currently look like?

Dr Perez: While FND care will certainly require robust engagement with general neurologists and psychiatrists, it is also encouraging that both here in the United States and internationally, such as in the United Kingdom, Switzerland, and Canada, subspecialty FND clinical programs have been developed. The article by Dr. Selma Aybek, one of the guest co-editors for this special issue, highlights the potential role of outpatient subspecialty FND clinics.3 Their roles include providing diagnostic clarification in challenging cases, as well as helping patients connect to evidence-based treatments, such as motor retraining and psychological treatments, particularly cognitive behavioral therapy.

Psychiatry Advisor: Patients with FND present with a wide variety of symptoms and comorbidities. In the context of such heterogeneity, how should clinicians approach treatment strategies?

Dr Perez: From a treatment perspective, the special issue adds to an emerging new outpatient model of care emphasizing roles for diagnostic clarification,3 treatment using cognitive behavioral therapy,4 and motor retraining as part of FND-specific physical therapy.5

Psychiatry Advisor: As you noted in your editorial, FND receives little attention, but when it does, it frequently arises as a medical mystery in stories of mass psychopathology, most recently in the case of the US embassy in Cuba. How can physicians and advocates bring attention to the far more common experiences of the patients you see on a regular basis?

Dr Perez: Indeed, FND is often hiding in plain sight, as illustrated in the article6 by Dr Popkirov and colleagues, which provides evidence that some popular news stories on medical mysteries can be reliably identified as cases of FND on the basis of positive signs of functional movement disorders or dissociative seizures. This phenomenon illustrates the critical importance of training clinicians across disciplines in the diagnosis of FND, including the delivery of the diagnosis in a way that patients can understand and accept, as well as increased awareness and understanding of the disorder among the general public. We hope that public awareness will improve and medical research funding will expand for this underserved population through academic efforts such as this special issue, educational initiatives on FND in medical school and residency training settings, and patient advocacy through organizations such as FND Hope and FND Action. The newly formed FND Society will have its inaugural conference this summer in Boston, which will include a strong training component for all relevant clinicians and scientists who want to learn more about this important, yet poorly understood, disorder.

References

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Special Journal Issue on Functional Neurological Disorder Brings Attention to a Neglected Field: Investigator Q&A - Psychiatry Advisor

Atrius Health announces new board members – The Item – Newton TAB – Newton, MA – Wicked Local Newton

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Atrius Health announced Karen DaSilva, Bonnie Hersh and Kathy Niknejad as new members to its board of trustees and the reelection of Joo Kim to the board.

Atrius Health physicians elect physician trustees to the board, representing Atrius Healths commitment to the strength of provider-patient relationships and providing the right clinical care.

Our incoming board members exemplify the compassionate and coordinated care we strive to deliver each of our patients, said Steve Strongwater, president & CEO of Atrius Health. They also offer impressive clinical leadership in primary and specialty care across our practice. We are pleased to welcome new and existing members to the board, and we look forward to working together to advance our mission to provide high quality, patient-centered and cost effective care to everyone we serve.

DaSilva, a resident of Sudbury, has served as a primary care internist at Atrius Healths Harvard Vanguard Medical Associates Chelmsford practice since 1994. Over the years, she has taken on several leadership roles including vice president of innovation at Atrius Health. In this role, DaSilva helped in developing improved care delivery models to meet the low-cost, high quality care demands of the current healthcare environment. In addition, she served as the organizations specialty director for internal medicine, where she oversaw the delivery of primary care across more than 20 practice sites.

DaSilva also served as deputy chief medical officer of Harvard Vanguard Medical Associates, where she led the development of a new geriatric care model and several disease management programs. She spearheaded the practices early work in the development of a patient-centered medical home program, which ultimately led to Atrius Healths primary care practices receiving Level 3 Patient-Centered Medical Homes from The National Committee for Quality Assurance. She received her medical degree from Albany Medical College and completed her internship and residency at Albany Medical Center Hospital in New York. DaSilva is board-certified in internal medicine and hematology.

As chief of neurology at Atrius Health, Hersh leads Atrius Healths neurology department and has worked at Atrius Health since 2000 when she joined its Harvard Vanguard Medical Associates practice. She is board certified by the American Board of Psychiatry and Neurology.

Hersh attended medical school at McGill University in Montreal and did her internship at Cedars Sinai Medical Center in Los Angeles. She completed her neurology residency at Harvard Medical Schools Harvard-Longwood Neurology Training Program. She then completed fellowship training in movement disorders at Boston Medical Center and neurophysiology/EMG at Massachusetts General Hospital. Prior to joining Atrius Health, Hersh was on the neurology staff at Boston Medical Center.

As chief of urology at Atrius Health, Niknejad leads Atrius Healths urology department and has worked at Atrius Health since 2004 when she joined Harvard Vanguard Medical Associates Chestnut Hill/West Roxbury and Kenmore practices. After joining Harvard Vanguard, she served as its surgical specialties medical director for four years. During that time, she also served as the practices Chief of General Surgery and Urology.

Niknejad is a board-certified urologist. She received her undergraduate degree from San Diego State University and graduated from Harvard Medical School. Niknejad completed her internship and residency at Brigham and Womens Hospital and is an instructor in surgery at Harvard Medical School. Niknejad is a resident of Weston.

Kim, a resident of Belmont, serves as associate chair of Atrius Healths internal medicine service line and has worked as a primary care internist at Atrius Healths Harvard Vanguard Medical Associates practice in Watertown since 2003. She enters her second term as a board clinician trustee.

Kim received her medical degree from The Robert Larner, M.D. College of Medicine at The University of Vermont and completed her undergraduate education at Brown University. She completed her internship and residency at Cambridge Hospital in Massachusetts and is board certified by the American Board of Internal Medicine.

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Atrius Health announces new board members - The Item - Newton TAB - Newton, MA - Wicked Local Newton