Neurology Minute

American Academy of Neurology

The Neurology Minute podcast delivers a brief daily summary of what you need to know in the field of neurology, the latest science focused on the brain, and timely topics explored by leading neurologists and neuroscientists. From the American Academy of Neurology and hosted by Stacey Clardy, MD, Ph.D., FAAN, with contributions by experts from the Neurology journals, Neurology Today, Continuum, and more.

  1. 1D AGO

    Overview from the 2026 International Stroke Conference - Part 2

    In part two of the series, Dr. Andy Southerland and Dr. Seemant Chaturvedi break down key takeaways from the OCEANIC‑STROKE trial.  Show citation:  Read more about the OCEANIC-STROKE trial.  Show transcript:  Dr. Andy Southerland:  Hello everyone. This is Andy Southerland from the University of Virginia. For today's Neurology Minute, I've just been speaking with my colleague, Seemant Chaturvedi from the University of Maryland, about exciting trials presented at this year's 2026 International Stroke Conference from the American Heart Association, American Stroke Association. And the one we want to discuss for today's Neurology Minute in brief was the OCEANIC-STROKE trial. This was a very large international trial looking at the use of a novel antithrombotic agent, a Factor XI inhibitor, compared to placebo as an adjunct to our traditional antiplatelet therapies for secondary stroke prevention. And it was received with quite a bit of excitement. So Seemant, tell us in brief, what did we learn from OCEANIC-STROKE? Dr. Seemant Chaturvedi:  One new class of agents, which is being tested are the Factor XIa inhibitors. And this has a unique mechanism of action, and it's believed that it can reduce thrombotic events without causing an increase in bleeding, which would be truly a major breakthrough. And so in OCEANIC-STROKE, over 12,000 patients were enrolled with either stroke or high-risk TIA within 72 hours of the last event. And the trial found that patients who had fairly mild strokes with a median NIH score of two, that when you add the asundexian 50 milligrams per day on top of either dual antiplatelet or single antiplatelet therapy, that there was an improved outcome and reduction in stroke with asundexian. There was a 2.2% absolute reduction in ischemic stroke, 26% in relative terms. Stroke, MI, and vascular death was also reduced with asundexian, as was disabling stroke. An exciting finding was that major bleeding was not increased with asundexian. And so this confirmed the preclinical hypothesis. And so I think this was a significant result in terms of reducing recurrent ischemic stroke without increasing bleeding. And so I think we eagerly await the full publication, and I think it could be applicable to many of the patients that we see in our clinical practice. Dr. Andy Southerland:  So asundexian, folks, you'll hear more about this as the drug hopefully comes on the market and we see the full primary publication of this OCEANIC-STROKE trial, but exciting nonetheless to have a possible new treatment to help us reduce the risk of recurrent stroke for our patients. So Seemant, thanks so much again for joining us for today's Neurology Minute. And I encourage all of our listeners, as always, to listen to the full podcast interview ain The Neurology Podcast. Seemant, thanks for joining us. Dr. Seemant Chaturvedi:  My pleasure.

    3 min
  2. 2D AGO

    Overview from the 2026 International Stroke Conference - Part 1

    In part one of this series, Dr. Andy Southerland and Dr. Seemant Chaturvedi discuss two trials highlighted at the 2026 International Stroke Conference.  Show citation:  Read more about the CHOICE-2 trial.  Show transcript:  Dr. Andy Southerland: Hello everyone. This is Andy Southerland. And for this week's Neurology Minute, I have just been speaking once again with my colleague, Seemant Chaturvedi, about his impressions from this year's 2026 American Heart Association, American Stroke Association International Stroke Conference. We've discussed a number of the very exciting pivotal trials presented at this year's meeting that occurred just a couple of weeks ago. But for the minute today, we want to just highlight two that were represented as late breaking trials in the world of acute stroke treatment. And the first was OPTION, which was a trial looking at extended window thrombolysis patients between four and a half and 24 hours. And the second was in the use of thrombolysis as an adjunct local treatment in patients receiving thrombectomy. So Seemant, to the best of your ability in our brief snippet today, what were the main highlights from these studies? Dr. Seemant Chaturvedi: In the OPTION trial, 570 patients were enrolled from China, and these were patients in the four and a half to 24 hour window with no evidence of large vessel occlusion. And they had a mismatch present at baseline imaging, median NIH score was seven. And when the tenecteplase was administered in this select group of patients, there was improvement in the excellent outcome of about 44% with tenecteplase and 34% with placebo. And there was a slight increase in hemorrhage of about 3%, but no increase in mortality. The second trial, CHOICE-2, also looked at thrombolysis, but it looked at local intraarterial thrombolysis following thrombectomy. And they enrolled patients with a median NIH score of 15 and the patients were enrolled from Spain and they gave a local TPA versus placebo following successful thrombectomy. And they also reported improved outcomes with about 57.5 having an excellent outcome with intraarterial TPA compared to 43% with placebo. There was slightly increased mortality in the TPA group, but this didn't seem to be explained by intracerebral hemorrhage. And so I think both of these were very intriguing and they add some complexity to acute stroke treatment. And so primary stroke centers and comprehensive stroke centers need to discuss the results with their teams and see if they want to embrace these treatment options. Dr. Andy Southerland: Fantastic, Seemant. So bottom line is thrombolysis is much more than it used to be in that very narrow time window and that very narrow indication. There are now patients who may benefit in that extended time window, and it's also being shown to have benefit in cases in which we get incomplete reperfusion with our traditional mechanical thrombectomy. So take that and run with it. Hopefully we can apply it to our stroke systems of care and help patients. Thank you again, Seemant for being with us on today's Neurology Minute. Seek out the full interview and also the primary publications as well.

    3 min
  3. 4D AGO

    Consensus Recommendations for Diagnosis and Management of Vanishing White Matter - Part 2

    In part two of this series, Dr. Justin Abbatemarco, Dr. Marjo S. van der Knaap, and Romy J. van Voorst discuss the patient management card and how patients should use it.  Show citation: and Clinical Management of Vanishing White Matter. Neurology. 2025;105(11):e214320. doi:10.1212/WNL.0000000000214320  Show transcript:  Dr. Justin Abbatemarco: Hello and welcome back. This is Justin Abbatemarco here with Romy J. van Voorst and Dr. Marjo S. van der Knaap. After discussing her article, Published Neurology Consensus Base Expert Recommendation for Diagnosis and Clinical Management of Vanishing White Matter Disease. Romy, I really want to talk with you about the patient management card. What inspired you to create that in this publication, and how should patients use that? Romy J. van Voorst:  So what the main motivation was of the study was actually a previous study that we did before. And in this study, we looked at the impact of any short matter on unaffected family members. And we found out that actually many family members encountered clinicians that were unfamiliar with its disease or disease-specific management. And during interviews, we saw that there was an urgent need for moral harmonization of care and also symptom management because families felt like they are left alone with just their child and no guidance on how to go further. And we wrote these recommendations to help families better understand the diagnostic and care process so they can also participate in informed decision-making. So they can understand what kind of preventive measures they can take and whether or not this interferes, for example, with quality of life goals. So there are a lot of different recommendations families can take home with. Dr. Justin Abbatemarco:  Marjo, anything else you want to add there? Dr. Marjo S. van der Knaap:  Yeah, I think the management card also helps because they have a physical card when they go to consultation or to emergency room that they can hand over. It's an official publication. It's developed by the Finishing WebMetter Expert Consortium in combination with other experts in combination with patient advocates and representatives. And so it's really a sort of a guidance that cannot be denied. So it has some authority to it. Dr. Justin Abbatemarco:  But I think it's a theme that applies to many neurological diseases, and addressing that. You do it really practically. And I agree, giving something more tangible for patients to present, especially to non-neurologists to help them give some guidance. It's an idea that we need to think about in clinic all the time on how we're interacting and supporting caregivers and when they're interfacing with the medical community at large. So I love what you guys have done here and to make us think about this more broadly. Thanks again for all your time and your work on this topic. Dr. Marjo S. van der Knaap:  Thank you for having us.

    3 min
  4. FEB 27

    2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke

    Dr. Andy Southerland and Dr. Shyam Prabhakaran explain the significance of these guidelines and why they are important.  Show citation:  Prabhakaran S, Gonzalez NR, Zachrison KS, et al. 2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association. Stroke. Published online January 26, 2026. doi:10.1161/STR.0000000000000513  Show transcript:  Dr. Andy Southerland: Hello everyone. This is Andy Southerland from the University of Virginia. And for this week's Neurology Minute, I've just been speaking with my colleague, Shyam Prabhakaran, from the University of Chicago, who was the Chair of the 2026 AHA/ASA guidelines for the early management of patients with Acute Ischemic stroke published in the January 2026 online version of the journal, Stroke. So Shyam, in our brief Neurology Minute today, why don't you just give a plea about why these guidelines are so important? Dr. Shyam Prabhakaran: Thanks, Andy. These guidelines are the first guidelines since 2019, so a lot has happened. So when you look at these guidelines, you'll see a lot of new recommendations. In fact, I think the majority have been revised in some way or another. And I'd point to the actual guideline document, which is in the journal Stroke online January '26, and the print version will be for the March edition of the journal Stroke. In addition to that, I'd say because you want to have interpretability and ease of practice, there are a bunch of derivatives on the AHA website that are very useful. They include case studies, they include figures and workflows that could be really useful for you to have these conversations. And there's even a slide deck that was prepared by our AHA ambassadors. There are these young whippersnappers that did a great job putting together a slide deck for anyone to use. They can use that to have conversations locally or anywhere they want. I encourage people, read the guidelines, but then also use the derivative products that people spent a lot of time on developing. Dr. Andy Southerland: Thank you, Shyam. I think that's a great message from the Chair of the writing group, that when you look at these guidelines, they can seem daunting. But the way you all have provided all these additional resources and analogs for people to interpret it and apply it in their own stroke centers and practice, I think folks definitely will be running out to do that, just to seek out the full guideline, and let's apply all this great new evidence to better care for our patients. So Shyam, thanks again for joining us for this week's Neurology Minute.

    2 min
  5. FEB 26

    Consensus Recommendations for Diagnosis and Management of Vanishing White Matter - Part 1

    In part one of this two-part series, Dr. Justin Abbatemarco, Dr. Marjo S. van der Knaap, and Romy J. van Voorst discuss vanishing white matter disease, focusing on the clinical and MRI findings that would prompt the consideration of genetic testing.  Show citation: van Voorst RJ, Schoenmakers DH, Bonkowsky JL, et al. Consensus-Based Expert Recommendations for Diagnosis and Clinical Management of Vanishing White Matter. Neurology. 2025;105(11):e214320. doi:10.1212/WNL.0000000000214320  Show transcript:  Justin Abbatemarco: Hello and welcome. This is Justin Abbatemarco here with Romy J. van Voorst and Marjo S. van der Knaap. After discussing their article published in Neurology, Consensus-Based Expert Recommendation for Diagnosis and Clinical Management of Vanishing White Matter. They both work for Amsterdam University Medical Center in the Netherlands. And we're going to have a two-part episode dissecting maybe two elements of this paper. Marjo, maybe we could start here and just talking about what vanishing white matter disease is and what in the clinic and MRI findings would make us go towards a genetic testing. Dr. Marjo S. van der Knaap:  There are two things about vanishing white matter that matter most to families, and one is the stress sensitivity. So any type of physical stress, like fever, viral infection, anything may cause a rapid decline and you never know when it comes. And that brings me to the second item that's very difficult and painful for families. And that's the unpredictability. You never know when a disease is going to hit and then your child is going to go down. So you really need the support of neurologists who know about this disease and help you go through this situation. Dr. Justin Abbatemarco: Right. And this paper serves as a great resource for folks that if they have a patient in clinic like this, medications to avoid, how to manage those stress responses. And so it's a really helpful publication to have there. And then I think another message we talked a lot about on the podcast was the importance of genetic testing when patients aren't fitting a typical bucket and this specific disease has unique characteristics. I think the cystic appearance of the MRI, which you do a great job highlighting, would really lead us down that road. So I think it's all really helpful and it gives us some ways to start in clinic with patients and our caregivers. So thank you. Come back and join us for the second part of The Neurology Minute episode where we're going to talk about the patient management.

    2 min
  6. FEB 25

    Neurology on the Hill 2026 - Part 3

    In the final episode of this three-part series, Dr. Stacey Clardy and Max Goldman talk about telehealth.  Stay updated with everything related to Neurology on the Hill. Show transcript:  Dr. Stacey Clardy: Hi, this is Stacey Clardy, and today we're wrapping up our three-part series covering the Top Advocacy Issues for Neurology on the Hill 2026 in Washington, DC. This is the event where many neurologists fly in from all over the country to meet with our elected representatives to discuss the issues of the most importance to our patients, and to allow us to continue to take good quality care of our neurology patients. We have again back with us, Max Goldman. He's the Director of Congressional Affairs from the AAN Legislative Team. Max, we covered Medicare, we covered neuroscience research in the Brain Initiative. The third and final issue is telehealth. What do we need to accomplish on telehealth in Washington, DC this year? Max Goldman: The telehealth flexibilities provided with the COVID-19 public health emergency have been so important to providing neurological care to patients across the country. However, what we saw during the government shutdown at the end of 2025 was a lapse in those flexibilities, which caused a huge amount of panic, of uncertainty for both our members, the AAN, who are providing care, and patients who relied on care through telehealth from their neurologist. That can't happen again. These flexibilities have been extended short-term basis for one year, two year, a couple of months, and what we need now is a permanent extension of these flexibilities so they can't lapse again, and our patients know they can access the care they need. What we're doing at Neurology on the Hill is going to ask our members of Congress to co-sponsor the Connect for Health Act. This bill would permanently extend telehealth flexibilities, including a full extension of protection of audio-only visits, which is important for folks in areas without great broadband or access to internet. This would just be a really good bill. It's got a lot of momentum this year, and we're hopeful that this will finally make telehealth a permanent part of neurological care going forward. Dr. Stacey Clardy: So important. I certainly know out here in Utah where we cover several rural states, this has really been a lifeline to our patients. To learn more about this issue and the other issues being discussed at Neurology on the Hill, you can go to AAN.com and click on advocacy. Thanks for listening, and thank you Max, for representing us in DC.

    3 min
  7. FEB 24

    Neurology on the Hill 2026 - Part 2

    In the second installment of this three-part series, Dr. Stacey Clardy and Max Goldman discuss neuroscience research and the BRAIN Initiative.  Stay updated with everything related to Neurology on the Hill. Show transcript:  Dr. Stacey Clardy:  Hi, this is Stacey Clardy. We are going to continue with our three-part series today about the top advocacy issues covered at Neurology on the Hill 2026 in Washington, DC. Again, as many of you know, this is the AAN's annual advocacy fly-in event. Neurologists come from all over the US to Washington and meet with elected representatives to discuss issues of high importance to allow us to continue providing high-quality care to patients in the US with neurological diseases. In the first minute, we discuss the topic of Medicare, and I have with me again, Max Goldman, director of Congressional Affairs from the AAN legislative team, to talk to us about issue number two, which is neuroscience research, and specifically the BRAIN Initiative. Max, what are we going to discuss about neuroscience research? What do we need to happen in order to continue doing high-quality research? Max Goldman: So, this one is so important, and there's this wonderful program at the NIH called The BRAIN Initiative. This was founded in 2013, really reinforced in 2016 with the 21st Century Cures Act. It's just funding for basic research into how the brain works, right? And the idea behind this is that if we can understand how the brain works, we can find the next generation of treatment or cures for neurological conditions, psychiatric conditions, and issues that go through the brain. This year, we are in a precarious position. Mandatory funding for this program is expiring, and so we're going to lose a lot of money and a lot of opportunities to provide more grants to people to figure out how the brain works. So, what we are doing on Neurology on the Hill is we're asking members of Congress to support $468 million in funding in fiscal year 2027 for the BRAIN Initiative, so we can keep up the good work and keep working towards the next generation of treatments and cures for neurological conditions. Dr. Stacey Clardy: So important. Thank you, Max. To learn more about this issue and the other two issues, you can go to AAN.com. Click on advocacy. And stick with us for the third Neurology Minute, where we will get to the final issue to be discussed, telehealth.

    2 min
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About

The Neurology Minute podcast delivers a brief daily summary of what you need to know in the field of neurology, the latest science focused on the brain, and timely topics explored by leading neurologists and neuroscientists. From the American Academy of Neurology and hosted by Stacey Clardy, MD, Ph.D., FAAN, with contributions by experts from the Neurology journals, Neurology Today, Continuum, and more.

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