Neurology Minute

In part one of this series, Dr. Justin Abbatemarco and Dr. Ruth Dobson discuss current evidence on monoclonal antibodies in pregnancy and breastfeeding and prior understanding of CD20 therapies. 
Read more about this abstract on the AAN website.

Dr. Justin Abbatemarco and Dr. Kait Nevel discuss tips and tricks for managing radiation necrosis in hospitals and outpatient settings. 
Show transcript: 
Dr. Justin Abbatemarco:
Hello, and welcome. This is Justin Abbatemarco, and I just finished interviewing Kate Neville about radiation necrosis following radiosurgery. Kait is a neuro-oncologist at Indiana University.
Kait, maybe we could just start with what this entity looks like and some tips and tricks on how we can manage in that hospital or in the outpatient setting when we were picking this up.
Dr. Kait Nevel: 
Yeah. Radiation necrosis can present in a variety of ways. People with radiation necrosis can be completely asymptomatic. In fact, most patients with radiation necrosis are asymptomatic. But symptoms can include things like headaches, seizures, and then focal neurologic deficits related to where the radiation necrosis is located. Imaging-wise, radiation necrosis typically looks like necrotic enhancing lesion as the name implies. Typically, we look at certain anatomical characteristics on standard MRI like vague enhancement along the edges, et cetera, but perfusion can be very helpful including cerebral blood volume, which is typically low in cases of radiation necrosis and high in cases of tumor progression. But this is a really big challenge in neuro-oncology, and differentiating radiographically between tumor and radiation injury.
Dr. Justin Abbatemarco:
I would encourage people to listen to podcast. We talked a little bit about medications, how to dose dexamethasone and others, and how we think through that. So please jump on and take a listen, and then join us back for the next Neurology Minute. We're going to talk about some evidence for supplement use in this disease. So Kait, thank you. 
Dr. Kait Nevel:
Great. Thank you.

Dr. Alex Menze and Dr. Kathryn C. Fitzgerald discuss using accelerometry to detect subtle, longitudinal changes in disability in people with multiple sclerosis and how these changes relate to brain atrophy and disability progression. 
Show citation: 
Fitzgerald KC, Sanjayan M, Dewey BE, et al. Association of Changes in Activity Patterns With Brain Atrophy and Disability Progression in People With Multiple Sclerosis. Neurology. 2026;106(7):e214678. doi:10.1212/WNL.0000000000214678 
Show transcript: 
Dr. Alexander Menze:
Hi, this is Alexander Menze. I just finished interviewing Kate Fitzgerald for the Neurology Podcast. For today's Neurology Minute, Kate, I'm hoping you can tell us the main points of your paper.
Dr. Kathryn C. Fitzgerald: 
So we followed 238 people with MS who are 40 or older for over three years and they wore risk-worn accelerometers roughly every three months and had regular clinical assessments and brain MRI. And what we found was that changes in activity patterns over time at the individual level were associated with subsequent changes in disability worsening and brain volume loss, particularly in the deep gray matter and thalamus.
Dr. Alexander Menze:
Thank you very much. Be sure to download this week's podcast to hear our full interview.

In the second part of this series, Dr. Katie Krulisky and Dr. Cristina Domínguez-González explore the most effective approach to evaluating suspected mitochondrial disease.
Show citation:
Bermejo-Guerrero L, Restrepo-Vera JL, Martin-Jimenez P, et al. Clinical Heterogeneity and Candidate Biomarkers in POLG-Related Mitochondrial Disease. Neurol Genet. 2026;12(2):e200365. Published 2026 Mar 10. doi:10.1212/NXG.0000000000200365 
Show transcript: 
Dr. Katie Krulisky:
This is The Neurology Minute. This is the second part of our series. I'm Katie Krulisky from the University of Utah and I'm here with Cristina Domínguez-González from the 12th of October University Hospital and its affiliated health research institute in Madrid, Spain. We've just recorded a full podcast on our paper, Clinical Heterogeneity and Candidate Biomarkers in POLG-related Mitochondrial Disease, which has been published in Neurology Genetics.
Cristina, for The Minute, what's the most practical way to work up suspected mitochondrial disease today?
Dr. Cristina Domínguez-González: 
In practice, everything starts with the clinical picture. Recognizing the pattern, whether it's a combination of features or a more subtle isolated presentation, is what should first raise suspicion. From there, you decide the next step. Targeted genetic testing if the phenotype is well-defined, grow their sequencing if it is less clear or more complex.
Biomarkers can also be very helpful. GDF15, Growth Differentiation Factor 15, is markedly elevated in many mitochondrial diseases and can support the suspicion. In myopathies in particular, it is especially useful because of its high negative predictive value helping to rule out a mitochondrial cause when levels are not elevated.
And finally, muscle biopsy still has a role. It can provide important information in selected cases, particularly in adults or when genetic results are inconclusive, both for diagnosis and also to guide further studies.
Dr. Katie Krulisky:
Thank you. That's super helpful. And for more on mitochondrial diseases and POLG-related disorders, have a listen to the full neurology podcast.
Again, I'm Katie Krulisky from the University of Utah with Cristina Domínguez-González  from the 12th of October University Hospital and its affiliated health research institute in Madrid, Spain.

In the last episode of the series, Dr. Stacey Clardy and Drs. Deborah Hall and Deborah Setter discuss some practical changes that can immediately improve lactation support in neurology workplaces. 
Show transcript:
Dr. Stacey Clardy:
This is the Neurology Minute. I'm Stacey Clardy from the Salt Lake City VA and the University of Utah. I've just had a fantastic in depth podcast discussion with Deborah Hall from Rush University and Deborah Setter from Olmsted Medical Center on their paper titled Workplace Lactation in Neurology: Barriers and Opportunities. You can find that in Neurology Clinical Practice.
Deborah Hall, what are some practical changes that can immediately improve lactation support in neurology workplaces?
Dr. Deborah Hall:
One practical change that could be considered is to plan immediately when you know a provider will be going out on maternity leave. Prior to departure, you can plan what that schedule's going to look like when that provider returns. Ensure that they have those 30 minute breaks every two to three hours in their inpatient or outpatient schedule. Make sure that there's a space for them and have them go look at it that would be appropriate for their lactation breaks. You want to make sure they have that dedicated refrigerator for breast milk storage. And finally, make a plan for compensation. It's really important that they understand how their productivity targets and how compensation will be affected by the breaks that they will be taking.
Dr. Stacey Clardy:
Easy to make changes, right? And as we discuss in the full-length podcast, please everyone take a listen to this. This is something we can all improve on to support all of our colleagues in neurology. Please have a listen to the full-length podcast. We give you everything that you need to know to be a better support to your colleagues. Thanks so much, Deborah.