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.

In the final episode of this series, Casey Kozak discusses functional sensory loss. 
Show citation:
Sonoo M. Abductor sign: a reliable new sign to detect unilateral non-organic paresis of the lower limb. J Neurol Neurosurg Psychiatry. 2004;75(1):121-125. 
Show transcript:
Welcome back to Neurology Minute. My name is Casey Kozak, and today we're finishing our discussion of functional neurological disorder and physical exam findings. We're going to now turn to functional sensory loss. But first, it's important to acknowledge that the subjective nature of sensory symptoms means that our physical exam tests will be less reliable than those used for functional weakness or movement disorders. Therefore, it's especially important that we as physicians listen carefully to the symptoms our patients are describing and remain aware of the potential for biases such as suggestion, when taking our histories. Nevertheless, there is certainly utility in physical exam tests as positive findings are present in many patients. We're going to discuss a few of these findings. The first is midline splitting, meaning that the patient's sensory loss has a clear edge at the midline of the body. For example, a patient may describe total sensory loss on the right side of their body, including their face, arm, and leg. 
And on testing, their sensory loss resolves in exactly the middle of their trunk. This is an unusual finding for sensory loss caused by central lesions, as the trunk is typically spared. The one exception to this rule, however, are thalamic lesions, which may be caused by stroke or mass effect, for example. While midline splitting is not a sensitive finding, it has a relatively high specificity if present. The second finding is splitting a vibration sense. This time, you will use your tuning fork to measure vibratory sensation across a bone that crosses midline, such as the frontal bone or the sternum. The sensation should be the same across the entire bone as vibration is perceived throughout bone conduction. Splitting a vibration, meaning there is loss of vibratory sensation on the numb side of the body is consistent with functional sensory loss because it defies its principle. Unlike midline splitting, however, splitting a vibration sense has been found to have a much lower specificity in testing.
Finally, sensory deficits may be precisely demarcated by anatomical borders, such as the shoulder or the groin, which is incongruent with peripheral nerve distributions. Beyond these examples, there are many more findings that can suggest FND in patients experiencing motor, sensory, or even visual, gait, or cognitive symptoms. Functional neurological disorder is a challenging disorder, though our understanding of it is improving. If you haven't yet, I highly encourage you to check out the seven-part Neurology Minute series on FND by Jon Stone and Gabriela Gilmour, focusing on recent advances in diagnosis and treatment. With that, thank you for joining us.