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SPOTLIGHT PODCAST LIBRARY
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 | 2009 January | | DBS (Deep Brain Stimulation) vs. Best Medical Practice for Parkinson's Disease January 30, 2009 In this podcast, Dr. David Bachman discusses a recent head-to-head trial of DBS vs. best medical care for the treatment of Parkinson's disease. 
Necrotizing Myopathy Following Statin Use January 23, 2009 Dr. David Bachman reports on a rare but serious adverse effect of statin use: necrotizing myopathy.
Insulin Resistance and Stroke January 18, 2009 Dr. Jonathan Edwards reports a recent study indicating that insulin resistance in non-diabetic patients may predict vulnerability to stroke.
Spinal Cord Compression in Metastatic Cancer January 9, 2009 A recent study examines the association of spinal cord compression in patients with metastatic cancer.
Are Migraines Associated with Stroke? January 7, 2009 A new study suggests that migraines may be associated with cerebellar and cerebral strokes later in life.
Smoking and Neuropathic Pain January 5, 2009 A recent study investigates the association of smoking and the development of neuropathic pain. |
| | 2008 December | | Methadone for Pain Control December 28, 2008 Dr. Jonathan Edwards presents a review of the use of methadone for analgesia.
Tenecteplase for Acute Ischemic Stroke December 19, 2008 Tenecteplase for Acute Ischemic Stroke
Special: New Basic Research on Alzheimer's Disease; Transplantation Therapy for MS; DBS for Refractory Temoral Lobe Epilepsy December 12, 2008 Today's show starts with a Russian study showing positive results for transplantation therapy for MS. Next, DBS may be effective for some cases of refractory temporal lobe epilepsy. The second half of the show is devoted to a special on clinical and basic science studies of Alzheimer's disease.
Lead Levels in Children; Amyloid Plaques in Alzheimer's; Misdiagnosis of Stroke in the ED December 5, 2008 Researchers examine the effects of even low levels of lead exposure in children. New diagnostic techniques identify amyloid plaques -- but what do they signify? Stroke presenting as dizziness is often misdiagnosed in the ED. |
| | 2008 November | | Rett Syndrome; Carotid Stenting and Stroke; AERS and the FDA; Methylprednisolone and MS November 28, 2008 New research on Rett Syndrome explores the genetic basis of this developmental disorder. Carotid stenting is associated with a high rate of microemboli, but surgical technique can reduce this occurence. The FDA has launched a new system for publishing when it is investigating possible adverse drug events. Methylprednisolone is effective as an add-on in the treatment of multiple sclerosis.
Early Treatment Improves MS Outcome; MRS and MRI to Diagnose Brain Tumors; Retinal Thinning in PD; Insulin and Alzheimer's Disease November 21, 2008 Beginning treatment for MS at time of first symptoms improves outcome at two and five years. MRS and MRI used in combination to diagnose brain tumors improve accuracy. Retinal thinning is found in patients with Parkinson's Disease; Insulin treatment is associated with fewer plaques found at autopsy in patients with Alzheimer's Disease.
Advertisements for Stimulant Drugs; Veterans of Iraq War and TBI; Chronic Inflammatory Demyelinating Polyneuropathy; Chronic Retinal Inflammation in MS Patients November 14, 2008 The FDA has warned pharmaceutical companies about misleading information on advertisements for stimulant drugs. Veterans returning from the Iraq war have high rates of TBI and epilepsy. A new treatment has been approved for Chronic Inflammatory Demyelinating Polyneuropathy. Examination of retinas collected at autopsy of MS patients reveals progressive inflammation.
Pardupronox for PD; Mortality and Affluence; Pregabalin for Alcohol Withdrawal November 7, 2008 Pardupronox shows modest benefit and potentially advantageous side effect profile in the treatment of Parkinson's Disease. WHO statistics reflect decreased infectious disease but increased lifestyle-associated causes of mortality worldwide. The anticonvulsant pregabalin shows efficacy in reducing alcohol craving. |
| | 2008 October | | Veterans with ALS; Hemangiomas and PHACES; Alteplase for Stroke; OCD and Brain Abnormalities October 31, 2008 VA offers services to veterans with ALS. The location of hemangiomas correlates with anomalies in the neurocutaneous disorder PHACES. Alteplase may limit post-stroke morbidity. OCD patients and their relatives may share specific brain abnormalities.
Aneurysm: Clipping or coiling? TPA Liability; WHole Brain Irradiation for Brain Cancer; DBS for Depression October 23, 2008 Aneurysm: Does clipping or coiling yield better long term results? TPA administration causes physicians liability worries; Whole brain irradiation for brain cancer; DBS for treatment resistant depression
Myelopathy in Pediatric Spine Trauma; Cine MRI and OSA; Imaging Plus Biomarker and Dementia; Continuous IVIG Stabilizes Cognition October 16, 2008 MRI may demonstrate spinal cord injury in children following trauma even without evident radiographic abnormality. Cine MRI may reveal obstructive sleep apnea in children. Low levels of amyloid Beta 42 in the CSF combined with PIB-positivity in the brain may be a marker for future development of Alzheimer's disease. Continuous infusion of intravenous immunoglobulin (IVIG) stabilized cognitive function in a small study of Alzheimer's patients.
Title: Rabies Vaccine Shortage; PML and Natalizumab; Tetrabenazine and Huntington's Chorea; Methylene Blue and Alzheimer's Disease. October 9, 2008
Rasagiline and Parkinson's Disease; Metabolic Syndrome and Neuro-Aging; Dimebon and Alzheimer's Disease; Monoclonal Antibodies for Alzhemier's Disease. October 2, 2008 Rasagiline is an monamine oxidase inhibitor-B that may delay the progression of Parkinson's disease. |
| | 2008 September | | Pregabalin and Refractory Partial Seizures; Lacosamide for Epilepsy; Activity and Cognition September 26, 2008 Pregabalin shows promise as an augmenting agent in refractory partial seizures. Lacosamide is effective as an anti-epilepsy medication. Activity can improve cognition in older adults.
Lamotrigine in Pregnancy and Cleft Lip; CT Scans and Pacemaker Function; Smoking and Alzheimer's Disease in Carriers of ApoE4 Allele September 18, 2008 Lamotrigine in pregnancy is associated with increased occurrence cleft lip. CT scans may be associated with pacemaker malfunction. Smoking is associated with higher prevalence of Alzheimer's Disease in carriers of Apo E4 allele.
Adolecscence and Decreased Cerebral Perfusion;Vitamin D Deficiency and Heart Disease in Migraineurs; Thunderclap Headaches; Methylphenidate in Alzheimer's Disease. September 12, 2008 Researchers document decreased cerebral lood flow at the onset of adolescence. Vitamin D deficiency is associated with a higher risk for cardiovascualr disease in patients with maigraine headaches. Thunderclap headaches are severe headaches with acute onset. Methylphenidate is effective for treating apathy in Alzheimer's patients.
Tarenflurbil and Alzheimer's Disease; Mag Sulfate and Cerebral Palsy; PRoFESS and Recurrent Stroke; PCB's and Cognitive Decline. September 5, 2008 Phase III data for Tarenflurbil for the treatment of Alzheimer's disease has been reported. A new study examines the efficacy of magnesium sulfate to prevent Cerebral Palsy in pre-term infants. PRoFESS data are analyzed for the prevention of secondary stroke. PCB exposure is associated with cognitivie difficulties.
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| | 2008 August | | Suicidality and AED's; DBS for Primary Dystonia; Impulse Control and Anti-Parkinson's Drugs; Telcagepant for Migraines August 29, 2008 FDA advisory committees have ruled on the need for black box warning for suicidal risk for anti-epilepsy medications. A ten year follow-up study examines the efficacy of deep brain stimulation for primary dystonia. Anti-parkinonson's drugs may be associated with impulse control problems. Telcagepant has shown efficacy for the treatment of migraine headaches in Phase III trials.
Sleep and Learning; "Classic" EEG in Absence; Vaccine for Zoster; Genetics of Restless Legs Syndrome August 22, 2008 New research offers insight on how sleep consolidates learning and memory. An analysis of EEG patterns in absence seizures challenges conventional wisdom about so called "classic" patterns. The CDC offers guidelines on vaccines for the elderly to protect against herpes zoster and reduce the risk of shingles. Genetic studies shed light on the etiology of Restless Legs Syndrome.
Investigational Drug for Alzheimer's; Headaches and Thyroid Disease in Kids; Nortriptyline for Parkinson's Patients; Obama's Health Plan August 14, 2008 A new compound, AL 108, is undergoing Phase II trials for the treatment of Alzheimer's Disease. Children with thyroid disease may present with headaches. Nortriptyline may help depression in patients with Parkinson's Disease. Obama's Health proposal is compared with McCain's.
Heart and Brain Anomalies in Premies, Occipital Nerve Stimulation for Migraines, Cancer Stem Cells and Prognosis, and Guidelines for Febrile Seizure Management August 8, 2008 Imaging studies reveal a high rate of brain anomalies in premature infants with heart abnormalities. Median survival for patients with glioblastoma multiforme can be predicted based on tissue culture of tumors generating stem cells. Occipital nerve stimulation may help some patients with migraine headaches. New guidelines should reassure parents of infants with febrile seizures that long term treatment is not necessary.
Lumbar Spinal Stenosis, Sleep Meds for Fibromyalgia, Deep Brain Stimulation for Parkinson's Disease, and Simplifying Medications August 1, 2008 A recent study demonstrated that weight-supported walking exercise resulted in improved function compared to flexion for patients with lumbar spinal stenosis. A clinical trial of sodium oxybate showed efficacy as a hypnotic for patients with fibromyalgia. Deep Brain Stimulation resulted in a greater symptom reduction than best medical therapy for Parkinson's Disease. We close with a clinical discussion of a practical strategy to simplify complex regimens of medications. |
| | 2008 July | | Tanezumab and Pain Control; Migraines, Stroke, and Lupus; Hypopituitarism and Traumatic Brain Injury; Biparietal Diameter in Newborns and Mental Development July 25, 2008 Tanezumab is a novel medication for pain control effective in osteoarthritis, acting by inhibiting nerve growth factor. Preterm infants with reduced biparietal diameter show delayed Bayley Developmental Scores at age two years. Migraine headaches predict increased riskof stroke inpatients with SLE. A significant number of patients with traumatic brain injury and subarachnoid hemorrhage develop hypopituitarism.
Statins and Myopathy; Paresthesia and Small Nerve Fiber Density; Strokes and Diabetes; Elderly and Optimal Exercise July 18, 2008 Statin use has been found in rare cases to cause severe necrotizing myopathy. Paresthesia may be associated with reduced density of small nerve fiber documented by skin biopsy. Strokes are more common in patients with diabetes who have elevated fasting blood sugar levels. Elderly patients may benefit most by exercise that targets motor learning as opposed to muscle strength and flexibility.
Daibetes and ALS, Funding for Alzheimer's Disease, Gender Differences in Dementia, and More July 11, 2008
Diabetes and ALS, Modafinil and Chemotherapy Fatigue, Research Dollars for Alzheimers, Gender and Dementia July 11, 2008 New research examines the association of diabetes and ALS. An important study examines whether modafinil (Provigil) is a useful treatment for fatigue due to chemotherapy. Newt Gingrich calls for increased research spending for Alzheimer's disease. Dementia may have a different time course for men and women.
Lead and Peripheral Neuropathy, Computerized Dementia Screening,Buccal Fentanyl, FDA Electronic Surveillance for Side Effects July 4, 2008 Exposure to even low levels of lead may be associated with increased risk for peripheral neuropathy. A new computerized test for dementia may be useful for office screening. The FDA recommended against approving the buccal formulation of fentanyl for pain other than that associated with cancer. The FDA has also developed a new electronic surveillance system to identify adverse drug reactions. |
| | 2008 Jun | | Intrauterine Toxins & ADHD, Herbal Supplements and Lead Toxicity, Cognitive Decline & Gender, Teratogenic Drug Relabelling Jun 27, 2008 More than 800,000 cases of ADHD in the US may be attributable to intrauterine exposure to lead and tobacco smoke. A wide variety of herbal supplements contain lead contaminants and may contribute to elevated lead levels in people of both genders and all ages. A Mayo Clinic study shows that rates of decline in cognition may be different for elderly men and women. Finally, a new system for labelling teratogenic risk of drugs may soon be in place.
Depression and Astrocytoma, Early Deep Brain Stimulation in Parkinson's, Recombinant Factor VIIa and Stroke, and WHO Mortality Data Jun 19, 2008 Depressed patients with astrocytoma have a worse prognosis than non-depressed patients with this type of cancer. Deep brain stimulation has been shown in a recent study to be effective in controlling symptoms of Parkinson's early in the course of the disease. Recombinant Factor VIIa has mixed results in the treatment of intracerebral stroke. WHO data show changes in causes of mortality in third world countries.
NSAIDS and Alzheimer's Disease, Giant Cell Arteritis, Chemobrain, and Decompression after Spinal Cord Injury Jun 13, 2008 Data from the Alzheimer's Disease Anti-Inflammatory Prevention Trial (ADAPT) has been analyzed to examine whether NSAIDs may have a positive or negative impact on the development of dementia. Recognition and treatment of giant cell arteritis is essential to prevent blindness. Investigators examine whether chemobrain following cancer chemotherapy is a true clinical phenomenon. We wrap up with a study exploring whether decompression following spinal cord injury improves outcomes.
HgAiC and Dementia, Neurocysticercosis, Psychogenic Movement Disorder, and Neupro Jun 6, 2008 Very high and very low levels of HgA1C may be associated with eventual dementia. The recall of Neupro (patch formulation of rotigine) has caused problems for some patients. Neurocystercosis has emerged as a cause of dementia in some large American cities with immigrant populations. Finally, many children with psychogenic movement disorders are treated with a variety of medications and even surgery instead of psychiatric intervention. |
| | 2008 May | | Restless Legs Syndrome, Vitamin E and Alzheimer's, Ketogenic Diet and Seizures, and ABCD2 May 30, 2008 A new investigational drug, XP13512, has been found effective in a study of 220 patients with Restless Legs Syndrome. A study of Alzheimer's patients taking Vitamin E examines whether the vitamin is associated with shortened life span. The ketogenic diet has been shown to be effective in controlling childhood seizure disorder in many children. Finally, the ABCD2 scoring sytem can predict the likelihood of stroke in patients with TIAs.
Alzheimer's and Cholesterol, Cancer Response Detection, Nursing and Antiseizure Meds, and Insurance for MS Patients May 23, 2008 Dr. David Bachman reports on the association of Alzheimer's disease and elevated cholesterol levels. Dr. Jonathan Edwards reports on new technology that detects the efficacy of cancer chemotherapy very early in treatment. Our next report is on the safety of antiseizure meds for nursing mothers. Dr. Austin closes with a report on the impact of insurance drug tiers on patients with multiple sclerosis.
New Drug for MS, Insulin and Alzheimer's, Dexamethasone and Myopathy,Teen Migraines May 16, 2008 A new investigational drug, FTY720, has demonstrated a 70% reduction in relapse in a study of 3000 patients with multiple sclerosis. Abnormal acute insulin release is linked to an increased risk for Alzheimer's disease. Dexamethasone pulse therapy offers an improved side effect profile compared to prednisone treatment of acute inflammatory myopathy. And divalproex treatment of migraine in teens offers mixed results.
Atherosclerotic Brain Disease, Alzheimers, Smoking and Drinking, Soaring Medical Costs, and Absence Seizures May 9, 2008
Asymptomatic intracranial restenosis in patients treated with stenting or angioplasty for atherosclerosis follows a benign course.
The risk of Alzheimer’s disease increases in smokers those who drink more than two drinks daily.
A study projects that over the next ten years, medical costs will soar to an estimated 4.3 trillion dollars per year.
Absence seizures in children usually disappear by late adolescence, but should be evaluated and treated with specific anticonvulsant medications in the meantime.
Microbubbles for Stroke, Neurofibromatosis, Medicare Cuts, and Insulin Resistance and Stroke May 2, 2008 While the use of microbubble-enhanced TPA treatment of acute ischemic stroke may increase the risk of intracranial hemorrhage, overall the treatment appears to benefit patients. Neurofibromatosis is the most common neurocutaneous disease of children, and we present an update on treatment recommendations. In our Halls of Congress segment, the Bush administration has introduced a bill to reduce Medicare payments by linking reimbursement to physician efficiency and performance. And from the International Stoke Conferenece, a link has been discovered between insulin resistance and stroke. |
| | 2008 April | | Metabolic syndrome and TPA resistance, HIV brain pathology, Retinoblastoma, and Medicare April 25, 2008 Metabolic syndrome predicts a poor response to TPA treatment for ischemic stroke, especially in women. Treating HIV patients with certain types of antiretroviral therapy significantly reduced their risk for HIV brain pathology. Direct intrarterial chemotherapy infusion saves not only eyes but vision of children with retinoblastoma. A newly proposed bill would limit Medicare payments by tying it to physician performance .
Syphilis, Moyamoya Disease, Boarding Stroke Patients in the ED, Medicare Debate April 18, 2008 Syphilis is back again, often forgotten but unfortunately not lost. A new treatment, pial synangiosis, has been shown to be effective for moyamoya disease. As ED wait times get longer, the recovery of stroke patients is compromised. And Congress is debating medicare funding . . . again.
Neurohospitalists, Stroke Prevention, Rabies Vaccine, and TPA Dosing in Obese Patients April 11, 2008 While most hospitalists are internists, neurohospitalists may offer both financial and clinical advantages to hospitals. An update on the prevention of secondary stroke has been presented. A shortage of rabies vaccine means it's important to administer the vaccine judiciously. Finally, the current upper limit of TPA dosage may lead to undertreating obese patients and contribute to stroke.
Tenecteplase, TPA Guidelines, Penumbra for Acute Stroke, and Osteopenia in Children with Epilepsy April 4, 2008 First we'll present data about a new drug for acute ischemic stroke -- Tenecteplase. A new study reports that children treated for epilepsy may have progressively reduced bone density beginning in the first year of treatment. A new mechanical clotbusting system, the Penumbra system, appears to be quite safe and effective. Finally, we'll close with a recent study corroborates the importance of adhering to blood pressure guidelines for the administration of TPA in acute stroke patients. |
| | 2008 March | | Methadone, Migraine, Smoking and Neuropathic Pain, Cancer and Spinal Cord Compression March 28, 2008 Today on Spotlight we'll present a review of the use of methadone for pain control. Next, we'll discuss a new study finding an association between migraine headaches in midlife and stroke much later in life. Then, we'll move to a study examining an association between smoking and neuropathic pain. We'll close the show with a story about cancer patients and spinal cord compression.
Teleradiology, Menactra, Stroke, and Autism March 21, 2008 Dr. Stephen Amis has reported on task force findings about teleradiology. New guidelines have been established for administration of the anti-meningococcal vaccine Menactra. A study on the treatment of hypertension in acute post-stroke patients yields intriguing findings. We close with a discussion of whether there really is an epidemic of autism.
Delirium, Angina and Alzheimer's, Tai chi,Desamethason and Meningitis March 14, 2008 From San Francisco, Dr. Jay Luxenberg summarizes the importance of recognizing and treating delirium. From Sweden, a report on the association of angina and
Alzheimer's disease. Dr. Gary Roubin gives recommendations on safe carotid artery stenting. And dexamethasone improves outcome in meningitis.
Satiety, OCD, Rituximab for MS, and Memory Training March 7, 2008 From Amsterdam, deep brain stiumlation is used to treat severe OCD in a pilot study. From UCSF, Rituximab shows promise for the treatment of multiple sclerosis. And from USC, a program in brain training improves memory. |
| | 2008 February | | Gabapentin for Post-Chemo Neuropathy, Pain Meds in the ED, and Tramodol February 29, 2008 Dr. Charles Loprinzi of the Mayo Clinic presents data on the effectiveness of gabapentin for post-chemotherapy neuropathy. In the ED, race matters when pain medications are dispensed. A small but important study examines the efficacy of tramodol to treat opioid dependence. And Lacosamide is a new treatment for epilepsy.
Discontinuing Anti-Seizure Meds, Drugs Samples, Botox, RLS, and Thimersal February 22, 2008 Follow-up of children discontinued from anti-seizure meds . . . Who gets drug samples? . . . Safety concerns for botulinum toxin . . . Genes and Restless Legs Syndrome . . . Thimersal and autism, revisited.
Parkinson's Disease, Autism, and Anti-Seizure Medication Discontinuation February 15, 2008 Episode 5
Exciting breakthroughs using gene therapy in Parkinson's disease, data on head and brain development in autism, new warnings about suicidal risk with antiepileptic medications . . . and more!
Alzheimer's Research, Ecstasy, Carotid Artery Screening, and More February 8, 2008 Episode 4
February 8, 2008
Dr. Weiqian Mi has shown that cystatin C may reduce amyloid plaque formation in transgenic mice. In Amsterdam, studies show that small amounts of Ecstasy may cause cognitive damage. And from New York come new recommendations against carotid artery screening.
Alzheimer's, Epilepsy, and Drug-Abusing Medical Students February 1, 2008 Episode 3
February 1, 2008
Cystain C shows promise as a novel treatment to Alzheimer's disease...an interesting new compound, carisbamate, is being tested for treatment-resistant epilepsy...and from a Midwestern medical school come disturbing findings about drug use among medical students. |
| | 2008 January | | When Does Alzheimer's Brain Pathology Begin? January 25, 2008 Episode 2
January 25, 2008
Our lead story this week: Dr. Richard Caselli discusses PET scan studies of young adult carriers of Apo E4.
Neurologists have increasing concerns about the bioequivalence of generics vs. brand formulations. January 18, 2008
Episode 1
January 18, 2008
Neurologists have increasing concerns about whether generic anti-epileptic medications really have the same efficacy as brand formulations.
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Elsevier/International Medical News Group
Clinical Neurology News Network
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