Neurology Minute

In part two of this series, Dr. Tesha Monteith and Dr. Andrew Hershey discuss appropriate treatment strategies to prevent migraines in children and adolescents.
Show citation: 
Hershey AD, Szperka CL, Barbanti P, et al. Fremanezumab in Children and Adolescents with Episodic Migraine. N Engl J Med. 2026;394(3):243-252. doi:10.1056/NEJMoa2504546 
Show transcript: 
Dr. Tesha Monteith:
This is Tesha Monteith with the Neurology Minute. I'm back with Andrew Hershey, professor of Pediatrics and Director of the Division of Neurology at Cincinnati Children's and the Children's Headache Center. This is part two of our discussion on his paper published in the New England Journal of Medicine, fremanezumab in Children and Adolescents with Episodic Migraine.
Andrew, now that we have fremanezumab approved for prevention of episodic migraine in children and adolescents, and we have a number of other devices and treatments for patients that can be used as part of FDA-approved treatment or even off-label, can you discuss an appropriate treatment paradigm to prevent migraine?
Dr. Andrew Hershey:
I think the first and foremost part of the paradigm is to identify the disease, so recognition that headaches are a component of the disease migraine, so you have headaches attacks due to migraine is an essential part. Many of the children, adolescents and their families are unaware that that is even what they're having, and clarifying the etiology actually goes a long way. One of my former mentors, Dr. Prensky, always said that 50% of kids get better from just seeing a child neurologist, and I think it's that clarification of the diagnosis.
Second to that, you need to provide a very adequate acute treatment as well as what's probably even more essential than anything else is healthy lifestyle habits. So regular eating, drinking, sleeping, and exercise. And then finally, if the headache is causing severe disability or frequent headaches or interfering with the child's school, home or social life, the prevention medications may need to be added. And this is where the fremanezumab, or if you prefer devices, devices can be used for both the acute and preventive treatment.
Dr. Tesha Monteith:
Well, thank you for the summary, and congratulations again on your paper.
Dr. Andrew Hershey:
Thank you.
Dr. Tesha Monteith:
Do check out the full podcast for more details about the paper and treatment of migraine in children and adolescents. This is Tesha Monteith. Thank you for listening to the Neurology Minute.

Dr. Greg Cooper and Dr. David G. Coughlin discuss the role of αSyn-SAAs in diagnosing DBL and their relationship with Alzheimer's disease biomarkers. 
Show citation:
Coughlin DG, Jain L, Khrestian M, et al. CSF α-Synuclein Seed Amplification Assays and Alzheimer Disease Biomarkers in Dementia With Lewy Bodies: Presentation and Progression. Neurology. 2025;105(12):e214346. doi:10.1212/WNL.0000000000214346

Show transcript: 
Dr. Greg Cooper:
Hi, this is Dr. Greg Cooper. I just finished interviewing Dr. David Coughlin for this week's Neurology Podcast. For today's Neurology Minute, I'm hoping you can tell us the main points of your paper.
Dr. David Coughlin:
The main points of this paper in my mind is that α-Synuclein seed amplification assays from cerebrospinal fluid samples is useful in confirming the presence of synuclein pathology in people with clinically suspected dementia with Lewy bodies. But also that, for people who have synuclein positivity, that the presence of Alzheimer's disease mixed pathology is associated with a worse cognitive progression over time.
Dr. Greg Cooper:
Thank you Dr. Coughlin, for that summary and for all of your work on this topic. Please check out this week's podcast to hear the full interview and read the full article published in Neurology, CSF α-Synuclein Seed Amplification Assays and Alzheimer's Disease Biomarkers in Dementia with Lewy Bodies. Thank you.

In part one of this two-part series, Dr. Tesha Monteith and Dr. Andrew Hershey summarize findings from the SPACE trial evaluating fremanezumab in adolescents and children with migraine.
Show citation:
Hershey AD, Szperka CL, Barbanti P, et al. Fremanezumab in Children and Adolescents with Episodic Migraine. N Engl J Med. 2026;394(3):243-252. doi:10.1056/NEJMoa2504546 
Show transcript: 
Dr. Tesha Monteith:
Hi, this is Tesha Monteith with the Neurology Minute. I'm here with Andrew Hershey, Professor of Pediatrics and Director of the Division of Neurology at Cincinnati Children's and the Children's Headache Center. We're here talking about his new paper published in the New England Journal of Medicine, Fremanezumab in Children and Adolescents with Episodic Migraine. Andrew, thank you for being on our Neurology Minutes.
Dr. Andrew Hershey:
Thank you for inviting me.
Dr. Tesha Monteith:
Can you summarize the findings of the space trial investigating Fremanezumab for adolescents and children with migraine?
Dr. Andrew Hershey:
This is one of the four monoclonal antibodies against CGRP, or it's this receptor that had been proven effective for adults. And it's the first one, the formazepam, that's been able to report its effectiveness in children and adolescents with less than 15 headache days per month. This study looked at over 200 children adolescents that were in a double-blinded randomized placebo controlled study. And reached its primary, as well as its secondary endpoint of a reduction compared to placebo. And the number of attacks of migraine per month, as well as a greater than 50% reduction in the number of headache attacks per month, with minimal to no side effects, the most notable side effect being injection site erythema.
Dr. Tesha Monteith:
Great. Thank you so much for providing that update. Do check out the full podcast for more details about his paper and the treatment of migraine in children and adolescents. This is Tesha Monteith. Thank you for listening to the Neurology Minute.

In this episode, Dr. Andy Southerland reviews the February 9 Capitol Hill Report, highlighting state-level advocacy efforts.
Stay updated with what's happening on the hill by visiting aan.com/chr. 
Learn how you can get involved with AAN advocacy.

In the February episode of the President's Spotlight, Dr. Jason Crowell and Dr. Natalia Rost discuss the AAN's Research Program. 
Stay informed by watching the President's Spotlight video.