Current Topics in Neurology and Neurological Surgery CME Series

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There is a lack of response by movement disorders patients to pharmacological therapies. For such patients, neuromodulation can be a therapeutic mainstay. Clinicians need to better understand the current technologies surrounding neuromodulation and be able to identify targets in the brain to improve the quality of life of patients with a growing number of movement disorder diagnoses. Additionally, there is a need for ongoing evaluation of novel therapeutics and treatments for those with these diagnoses.   

The Department of Neurology Division of Movement Disorders, in partnership with the Department of Neurological Surgery, maintains a Neurology/Neurosurgery Center of Excellence in Neuromodulation offering a wide range of state-of-the-art invasive and noninvasive therapeutic interventions that target the central nervous system in both adults and children with movement disorders.  Every year, we see a significant number of patients with disabling movement disorders who do not respond or no longer respond to pharmacological therapies. For such patients, particularly those with Parkinson’s disease, neuromodulation has become a therapeutic mainstay. 

The field of neuromodulation continues to rapidly advance, with the development of new technologies and the identification of targets in the brain to improve the quality of life of patients with a growing number of movement disorder diagnoses. In this session, we will discuss recent advances in our understanding of these diseases and how this knowledge has led to new neuromodulation treatments targeting specific areas of the brain. We will also highlight ongoing research in neuromodulation for conditions such as cerebral palsy.  

Agenda 

Introduction  
Richard P. Mayeux, MD, MSc & E. Sander Connolly Jr., MD, FACS 

What Neuromodulation Offers to Patients with Parkinson’s Disease and Other Movement Disorders Such as Essential Tremor  
Blair Ford, MD 

Invasive and Non-Invasive Neuromodulation Approaches for Movement Disorders 
Guy M. McKhann, MD, PhD 

Harnessing Cerebellar Rhythm with Neuromodulation for Ataxia and Tremor 
Sheng-Han Kuo, MD 

New Movement Disorders Therapy for Cerebral Palsy 
Jason B. Carmel, MD, PhD & Linn Katus, DO, MSc 

Panel Discussion and Q&A  
Moderators: Richard P. Mayeux, MD, MSc & E. Sander Connolly Jr., MD, FACS 

Speakers 

Jason B. Carmel, MD, PhD, Assistant Professor of Pediatric Neurology (in Orthopaedic Surgery, Columbia University Vagelos College of Physicians and Surgeons  

E. Sander Connolly Jr., MD, FACS, Bennett M. Stein Professor of Neurological Surgery, Columbia University Vagelos College of Physicians and Surgeons 

Blair Ford, MD, Professor of Neurology at CUMC, Columbia University Vagelos College of Physicians and Surgeons 

Linn Katus, DO, MSc, Assistant Professor of Neurology at CUMC, Columbia University Vagelos College of Physicians and Surgeons 

Sheng-Han Kuo, MD, Assistant Professor of Neurology, Columbia University Vagelos College of Physicians and Surgeons 

Richard P. Mayeux, MD, MSc, Gertrude H. Sergievsky Professor of Neurology, Psychiatry and Epidemiology (in the Gertrude H. Sergievsky Center and in the Taub Institute for Research on Alzheimer's Disease and the Aging Brain); Chair, Department of Neurology; Director, Gertrude H. Sergievsky Center; Co-Director, Taub Institute for Research on Alzheimer's Disease and the Aging Brain; Director, Human Genetic Resources Core, Columbia University Vagelos College of Physicians and Surgeons 

Guy M. McKhann, MD, PhD, Florence Irving Associate Professor of Neurological Surgery; Director, Epilepsy and Movement Disorder Surgery; Director, Adult Hydrocephalus Center; Director, Awake Brain Mapping for Tumors and Epilepsy, Columbia University Vagelos College of Physicians and Surgeons 

Recent advances in fluid biomarkers, neuroimaging, and genetics will help the clinician more accurately diagnose patients with Alzheimer’s Disease, Dementia with Lewy Bodies and Frontotemporal Dementia. An understanding of the basic biology of these disorders will provide a foundation for the understanding of new precision treatment strategies. 

The Department of Neurology Division of Aging and Dementia and the Taub Institute for Alzheimer’s Disease and the Aging Brain have a strong tradition of offering state of the art clinical care for patients with neurodegenerative diseases paired with access to cutting edge observational studies and clinical trials designed to modify disease progression in symptomatic and at-risk individuals. Clinical Characterization (“Deep phenotyping”) of patients with Alzheimer’s Disease (AD), Dementia with Lewy Bodies (DLB) and Frontotemporal Dementia (FTD) combined with extensive biofluid banking has facilitated discoveries into the underlying biology of these diseases that we hope will translate into new individualized treatments based on genetic and lifestyle factors.  

In this seminar, we will review recent advances in diagnostic biomarkers including imaging, cerebrospinal fluid and new blood-based biomarkers in determining the presence of Alzheimer’s disease as well as new treatments on the immediate horizon for slowing progression of AD.  

We will discuss how genetic variants in multi-ethnic families in early and late onset AD provide clues to the pathogenesis of both genetic and sporadic forms of AD  

There will be a review of transcriptomic, epigenetic, proteomic and metabolomics screens to identify genetic candidates and biological pathways involved in AD. We will also discuss the potential of ‘omics screens’ to understand the role of genetic candidates in the biology of disease. 

We will also review recent advances in the clinical characterization of manifest and prodromal Dementia with Lewy bodies, genetic and imaging biomarkers, and pharmacological and non- pharmacological treatment strategies.  

Recent findings about FTD Spectrum diseases, including FTD ALS, and implications for development of novel treatments will also be discussed. 

Agenda 

Introduction  
Richard P. Mayeux, MD, MSc & E. Sander Connolly Jr., MD, FACS 

Alzheimer Disease-Recent Advances in Diagnostic Biomarkers and Therapies (18 minutes) 
Lawrence S. Honig, MD, PhD 

Advances in the genetics of early and late-onset Alzheimer’s Disease (18 minutes) 
Christiane Reitz, MD, PhD  

A functional Genomic (multi-omics) approach to the understanding of Alzheimer’s Disease (18 minutes) 
Badri N. Vardarajan, PhD, MS 

Lewy Body Disorders:  Diagnosis and Therapeutic Approaches (18 minutes) 
Karen S. Marder, MD, MPH 

Frontotemporal Dementia: Update on Diagnosis and Novel Treatments (18 minutes) 
Edward D. Huey, MD 

Panel Discussion and Q&A (30 minutes) 
Moderators: Richard P. Mayeux, MD, MSc & E. Sander Connolly Jr., MD, FACS 

Speakers 

E. Sander Connolly Jr., MD, FACS, Bennett M. Stein Professor of Neurological Surgery, Columbia University Vagelos College of Physicians and Surgeons 

Lawrence S. Honig, MD, PhD, Professor of Neurology (in the Gertrude H. Sergievsky Center and the Taub Institute for Research on Alzheimer's Disease and the Aging Brain) at CUMC, Columbia University Vagelos College of Physicians and Surgeons 

Edward D. Huey, MD, Associate Professor of Psychiatry and Neurology (in the Taub Institute for Research on Alzheimer's Disease and the Aging Brain), Columbia University Vagelos College of Physicians and Surgeons 

Karen S. Marder, MD, MPH, Sally Kerlin Professor of Neurology (in the Gertrude H. Sergievsky Center, in the Taub Institute on Alzheimer's Disease and the Aging Brain, and in Psychiatry) at CUMC, Columbia University Vagelos College of Physicians and Surgeons 

Richard P. Mayeux, MD, MSc, Gertrude H. Sergievsky Professor of Neurology, Psychiatry and Epidemiology (in the Gertrude H. Sergievsky Center and in the Taub Institute for Research on Alzheimer's Disease and the Aging Brain); Chair, Department of Neurology; Director, Gertrude H. Sergievsky Center; Co-Director, Taub Institute for Research on Alzheimer's Disease and the Aging Brain; Director, Human Genetic Resources Core, Columbia University Vagelos College of Physicians and Surgeons 

Christiane Reitz, MD, PhD, Assistant Professor of Neurology and Epidemiology (in the Gertrude H. Sergievsky Center and the Taub Institute for Research on Alzheimer's Disease and the Aging Brain), Columbia University Vagelos College of Physicians and Surgeons 

Badri N. Vardarajan, PhD, MS, Assistant Professor of Neurological Science (in Neurology, the Gertrude H. Sergievsky Center, and the Taub Institute, Columbia University Vagelos College of Physicians and Surgeons 

The Department of Neurology Division of NeuroOncology, in partnership with the Department of Neurological Surgery, maintains a Neurology/Neurosurgery Center of Excellence in NeuroOncology offering a wide range of expertise and clinical trials for adults with brain tumors and related diseases.   

In this session, we will discuss recent advances in our understanding of primary and metastatic brain tumors and results of recent clinical trials of new treatments.  We will also highlight ongoing research and therapeutic directions.    

Agenda 

Introduction  
Richard P. Mayeux, MD, MSc & E. Sander Connolly Jr., MD, FACS 

Convection Enhanced Delivery 
Jeffrey N. Bruce, MD, FACS 

Immunotherapy for Brain Tumors? 
Fabio M. Iwamoto, MD 

Neurologic Complications of Immunotherapy 
Aya Haggiagi, MD 

The Interface between Epilepsy and Glioma: Intra-operative Translational Science 
Peter Canoll, MD, PhD & Guy M. McKhann, MD, PhD 

Equity in Neuro-oncologic Care: Identifying and Addressing Barriers 
Mary R. Welch, MD 

Panel Discussion and Q&A with speakers
Moderator: Andrew B. Lassman, MD 

Speakers 

Jeffrey N. Bruce, MD, FACS, Edgar M. Housepian Professor of Neurological Surgery; Vice Chairman of Academic Affairs; Director, Bartoli Brain Tumor Research Laboratory; Co-director, Brain Tumor Center, Columbia University Vagelos College of Physicians and Surgeons 

Peter Canoll, MD, PhD, Professor of Pathology & Cell Biology at CUMC, Columbia University Vagelos College of Physicians and Surgeons 

E. Sander Connolly Jr., MD, FACS, Bennett M. Stein Professor of Neurological Surgery, Columbia University Vagelos College of Physicians and Surgeons 

Aya Haggiagi, MD, Assistant Professor of Neurology at CUMC, Columbia University Vagelos College of Physicians and Surgeons 

Fabio M. Iwamoto, MD, Assistant Professor of Neurology, Columbia University Vagelos College of Physicians and Surgeons 

Andrew B. Lassman, MD, John Harris Associate Professor of Neurology, Columbia University Vagelos College of Physicians and Surgeons 

Richard P. Mayeux, MD, MSc, Gertrude H. Sergievsky Professor of Neurology, Psychiatry and Epidemiology (in the Gertrude H. Sergievsky Center and in the Taub Institute for Research on Alzheimer's Disease and the Aging Brain); Chair, Department of Neurology; Director, Gertrude H. Sergievsky Center; Co-Director, Taub Institute for Research on Alzheimer's Disease and the Aging Brain; Director, Human Genetic Resources Core, Columbia University Vagelos College of Physicians and Surgeons 

Guy M. McKhann, MD, PhD, Florence Irving Associate Professor of Neurological Surgery; Director, Epilepsy and Movement Disorder Surgery; Director, Adult Hydrocephalus Center; Director, Awake Brain Mapping for Tumors and Epilepsy, Columbia University Vagelos College of Physicians and Surgeons 

Mary R. Welch, MD, Assistant Professor of Neurology at CUMC, Columbia University Vagelos College of Physicians and Surgeons 

Migraine headache, ADHD, epilepsy are the most common diagnoses among the many other neurological problems affecting children and adolescents. Timely diagnosis and treatment of these conditions are essential to improve the quality of life for children as well as their caregivers.  There are a number of advances in the field of child neurology, including emerging diagnostic modalities and novel treatment options that have the potential to affect outcome on common neurological problems, as well as rare neurogenetic conditions in children.   

The Department of Neurology Division of Child Neurology offers a wide range of state-of-the-art invasive and noninvasive therapeutic interventions that target the central nervous system in children.  

The development of emerging treatment for neurological conditions affecting children and adolescent bring promises to improve the quality of life and favorable outcome in the field of Child Neurology. In this session, we will discuss traditional treatment and recent advances in specific neurological conditions affecting pediatric age groups.   

Agenda 

Introduction  
Richard P. Mayeux, MD, MSc & Cigdem I. Akman, MD 

Treatment Update: Migraine Treatment in Children and Adolescents 
Robert H. Fryer, PhD, MD 

Diagnosis and Treatment of ADHD in Children during COVID 
Jay E. Selman, MD  

Epilepsy Syndromes and Genetics
Tristan Sands, MD 

Application of Gene Therapy:  SMA and Glut1 DS 
Umrao Monani, PhD 

Panel Discussion and Q&A  
Moderators: Richard P. Mayeux, MD, MSc & Cigdem I. Akman, MD 

Speakers 

Cigdem I. Akman, MD, Professor of Neurology at CUMC, Columbia University Vagelos College of Physicians and Surgeons 

Robert H. Fryer, PhD, MD, Associate Professor of Neurology at CUMC, Columbia University Vagelos College of Physicians and Surgeons 

Richard P. Mayeux, MD, MSc, Gertrude H. Sergievsky Professor of Neurology, Psychiatry and Epidemiology (in the Gertrude H. Sergievsky Center and in the Taub Institute for Research on Alzheimer's Disease and the Aging Brain); Chair, Department of Neurology; Director, Gertrude H. Sergievsky Center; Co-Director, Taub Institute for Research on Alzheimer's Disease and the Aging Brain; Director, Human Genetic Resources Core, Columbia University Vagelos College of Physicians and Surgeons 

Umrao Monani, PhD, Professor of Neurological Sciences (in Neurology and Pathology & Cell Biology) at CUMC, Columbia University Vagelos College of Physicians and Surgeons 

Tristan T. Sands, MD, PhD, Assistant Professor of Neurology at CUMC, Columbia University Vagelos College of Physicians and Surgeons 

Jay E. Selman, MD, Professor of Clinical Pediatric Neurology, Columbia University Vagelos College of Physicians and Surgeons 

There have been many recent advances in the diagnostic tools, prognostic measures, and therapeutic options for managing neuroinflammatory diseases. In addition, our evaluation of inflammatory measures, adverse immune events, and therapeutic options in traditionally non-inflammatory diseases (cancer, neurodegenerative disease) is increasingly rapidly, requiring general neurologists and specialists to be aware of the latest approached in neuroimmunology. 

The Department of Neurology Division of Neuroimmunology and its affiliated Center for Translational & Computational Neuroimmunology are international leaders in translational studies of immune dysregulation that targets the central nervous system and in the compassionate care of these patients with increasingly more targeted immunomodulatory therapies. 

This clinical area has seen great advances in recent years, with new syndromes such as anti-MOG being recognized and over two dozen therapies being FDA approved for a variety of indications, including pediatric MS and NMO. In this session, we will review recent advances in our understanding of the clinical manifestations of these diseases, in targeted immunotherapy that use new mechanisms, and in managing adverse events of the rapidly growing applications of immunotherapy. We will highlight ongoing research in areas that include cognitive and behavioral maturation of pediatric MS patients, treatment strategies for anti-MOG and NMO syndromes following recent clinical trials, insights from the analysis of cerebrospinal fluid at the single cell level and the management of adverse events from cancer immunotherapy.  

Agenda 

Introduction  
Richard P. Mayeux, MD, MSc & E. Sander Connolly Jr., MD, FACS 

Beyond Neuropsych Testing: Scholastic and Social Network Assessment of Pediatric MS Patients 
Wendy Vargas, MD 

Neuromyelitis Optica Spectrum Disorders: Updates in Diagnosis and Treatment of Anti-NMO and Anti-MOG Mediated Disease 
Rebecca Straus-Farber, MD 

Single Cell Profiling of CSF: Changes in Microglia-like CSF Cells in MS Onset & Immune Reconstitution from Ocrelizumab 
Claire S. Riley, MD 

Cancer Immunotherapy: Managing Adverse Neuroimmune Events & Treating MS Patients with Cancer 
Sarah Wesley, MD 

Panel Discussion and Q&A  
Moderator: Philip L. De Jager, MD, PhD 

Speakers 

E. Sander Connolly Jr., MD, FACS, Bennett M. Stein Professor of Neurological Surgery, Columbia University Vagelos College of Physicians and Surgeons 

Philip L. De Jager, MD, PhD, Weil-Granat Professor of Neurology (in the Taub Institute for Research on Alzheimer’s Disease and the aging Brain), Columbia University Vagelos College of Physicians and Surgeons  

Richard P. Mayeux, MD, MSc, Gertrude H. Sergievsky Professor of Neurology, Psychiatry and Epidemiology (in the Gertrude H. Sergievsky Center and in the Taub Institute for Research on Alzheimer's Disease and the Aging Brain); Chair, Department of Neurology; Director, Gertrude H. Sergievsky Center; Co-Director, Taub Institute for Research on Alzheimer's Disease and the Aging Brain; Director, Human Genetic Resources Core, Columbia University Vagelos College of Physicians and Surgeons 

Claire S. Riley, MD, Assistant Professor of Neurology, Columbia University Vagelos College of Physicians and Surgeons 

Rebecca Straus-Farber, MD, Assistant Professor of Neurology at CUMC, Columbia University Vagelos College of Physicians and Surgeons 

Wendy Vargas, MD, Assistant Professor of Neurology, Columbia University Vagelos College of Physicians and Surgeons 

Sarah F. Wesley, MD, MPH, Assistant Professor of Neurology at CUMC, Columbia University Vagelos College of Physicians and Surgeons 

New technologies and new drugs are available or in development for treating acute stroke, but dissemination to the practicing community is not complete. It is necessary to bring knowledge of emerging stroke therapies to health providers who have not yet incorporated them into general practice. 

This seminar, presented by faculty from the Departments of Neurology and Neurological Surgery, will deliver the latest information on acute stroke therapies. Beginning with an illustrative case, the symposium will focus on four main topics: 

1. The time window for acute stroke: How does the science of brain ischemia inform our time limitations for administration of intravenous tPA and mechanical thrombectomy? Are there opportunities to push the windows further? 
2. New drug therapies: What new drugs are on the horizon? How do we use molecular targets and pharmacological principles to find the next new drug?  
3. Update on mechanical thrombectomy: What are the latest approaches? Can we extend the window beyond 24 hours?  
4. Disparities in acute stroke treatment across race-ethnicity populations: Why are there disparities in access to acute stroke therapies and acute stroke outcomes? What can be done about it? Four experts in treatment of acute stroke will address these critical questions in an interactive format.  

Agenda 

Introduction  
Richard P. Mayeux, MD, MSc & E. Sander Connolly Jr., MD, FACS 

Is Time Really Brain? The Pathophysiology of Time Windows for Acute Stroke 
Randolph S. Marshall, MD, MS  

Beyond tPA. Developing New Drug Therapies for Acute Stroke Treatment 
Joshua Z. Willey, MD, MS  

Technological Advances in Mechanical Thrombectomy and What the Future Holds 
Grace K. Mandigo, MD  

Increasing Acute Stroke Treatment Rates Across a Diverse Population 
Olajide A. Williams, MD, MS  

Panel Discussion and Q&A  
Moderators: Richard P. Mayeux, MD, MSc & E. Sander Connolly Jr., MD, FACS 

Speakers 

E. Sander Connolly Jr., MD, FACS, Bennett M. Stein Professor of Neurological Surgery, Columbia University Vagelos College of Physicians and Surgeons 

Grace K. Mandigo, MD, Assistant Professor of Neurological Surgery at CUMC, Columbia University Vagelos College of Physicians and Surgeons 

Randolph S. Marshall, MD, MS, Elisabeth K. Harris Professor of Neurology at Columbia University Medical Center, Columbia University Vagelos College of Physicians and Surgeons 

Richard P. Mayeux, MD, MSc, Gertrude H. Sergievsky Professor of Neurology, Psychiatry and Epidemiology (in the Gertrude H. Sergievsky Center and in the Taub Institute for Research on Alzheimer's Disease and the Aging Brain); Chair, Department of Neurology; Director, Gertrude H. Sergievsky Center; Co-Director, Taub Institute for Research on Alzheimer's Disease and the Aging Brain; Director, Human Genetic Resources Core, Columbia University Vagelos College of Physicians and Surgeons 

Joshua Z. Willey, MD, MS, Associate Professor of Neurology at CUMC, Columbia University Vagelos College of Physicians and Surgeons 

Olajide A. Williams, MD, MS, Professor of Neurology, Columbia University Vagelos College of Physicians and Surgeons 

The Epilepsy Division has a strong tradition of providing state of the art clinical care for pediatric and adult patients with epilepsy focusing on care through the lifespan and treatment of persons with difficult to control epilepsies. Research efforts aim to improve our understanding of the physiology of seizures, genetics of epilepsy, and surgical treatment of refractory epilepsy.

Upon conclusion of this activity, participants will be better able to:

• Discuss the treatment options available for individuals living with epilepsy across all age groups.
• Identify unique concerns for women with epilepsy including contraceptive practices and pregnancy outcomes.
• Recognize potential surgical candidates.
• Explain the etiology and pathophysiology of seizures.
• Discuss the role of epilepsy surgery for treatment of epilepsy and advances in the field.
• Describe the role of genetic testing in epilepsy.
• Discuss the impact of genetic findings on treatment options.

AGENDA
Introduction
Richard P. Mayeux, MD, MSc & E. Sander Connolly Jr., MD, FACS

Epilepsy: Diagnosis, Evaluation, and Treatment
Alison M. Pack, MD, MPH, FAAN, FAES

Pediatric Epilepsy: Unique Issues and Challenges in Children with Seizures
Cigdem I. Akman, MD

Mapping the Physiological Activity of Seizures
Catherine A. Schevon, MD, PhD

Surgical Treatment of Epilepsy
Guy M. McKhann, MD, FAES

Genetics of Epilepsy
Tristan T. Sands, MD, PhD

Panel Discussion and Q&A
Moderators: Richard P. Mayeux, MD, MSc & E. Sander Connolly Jr., MD, FACS

This activity has been approved for AMA PRA Category 1 Credit™

• Demonstrate an awareness of the various therapeutic interventions in neuromodulation.  
• Develop effective processes to detect when treatments for specific areas of the brain can benefit from neuromodulation therapies.  
• Describe the reasons for limitations of an ischemic stroke treatment window. 
• List at least one new acute stroke treatment currently under development. 
• Explain some social determinant barriers to delivering timely stroke treatment to a diverse patient population. 
• Discuss treatment options for acute stroke patients after 6 hours from stroke onset. 
• Identify the traditional and emerging treatment options for children diagnosed with migraine headache.  
• Evaluate children for the diagnosis of ADHD and learn the treatment modalities available at the time of COVID outbreak.  
• List the childhood onset epilepsy syndromes and recognize the clinical implication of genetic testing for treatment and outcome. 
• Demonstrate an awareness of gene therapy in genetic disorders affecting children: Spinal muscular atrophy and Glucose 1 transporter deficiency.  
• Discuss the use of diagnostic biomarkers in dementia, including imaging, spinal fluid, and new blood-based biomarkers. 
• Advance understanding of the current knowledge on the genetics of early and late-onset Alzheimer’s Disease. 
• Evaluate the use of omics technologies in identifying biological mechanisms and potential therapeutic targets in Alzheimer’s Disease. 
• Describe the clinical spectrum, diagnostic approach and treatment strategies for Lewy Body Disorders. 
• Discuss recent development in the diagnosis and treatment of Frontotemporal dementia and related disorders. 
• Describe why currently available standard therapies for gliomas are inadequate. 
• Discuss the potential for and pitfalls with immunotherapy for glioma, and barriers to care. 
• Optimize management of multiple sclerosis for inflammatory disease control and slowing neurodegeneration. 
• Discuss modern approaches to neuromyelitis optica, anti-MOG antibody associated disease, and other causes of myelitis for diagnosis and management. 
• Identify approaches to mitigate immunotoxicity from cancer- or rheumatologic disease immunomodulation and to managment of cancer in a patient with a neuroinflammatory syndrome. 
• Discuss the impact of COVID-19 infection and vaccination on neuroinflammatory disease activity and the impact of disease modifying therapies on responses to infection and vaccination.