Miller School Neurologists Make Big Impact at American Academy of Neurology Conference
Summary
- Miller School of Medicine neurologists and trainees showcased cutting-edge science at the recent American Academy of Neurology (AAN) conference.
- Miller School researchers have been investigating how deep brain stimulation can be used to combat gait freezing for Parkinson’s disease patients.
- Dr. Teshamae Monteith participated in multiple sessions, including discussing two studies she co-authored on atogepant, a daily medication that can prevent migraines.
Dozens of University of Miami Miller School of Medicine neurologists and trainees attended the recent American Academy of Neurology (AAN) conference to showcase cutting-edge science and network with colleagues and esteemed alumni.
“UM faculty presented their science during 11 sessions, and our trainees presented in four more, as well as showing 37 posters,” said Jose Romano, M.D., professor of neurology and chief of the Stroke Division at the Miller School. “This is a testament to the science that is being done here and also the participation and recognition of our faculty at the national level.”
Insights into Movement Disorders
Movement disorders, such as Parkinson’s disease, Huntington’s disease, Tourette syndrome and ataxia, are a significant challenge for many people. Miller School physicians care for around 4,000 Parkinson’s patients each year.
Parkinson’s care has improved tremendously over the past decade. Deep brain stimulation (DBS), which uses small, electrical impulses to counteract symptoms, is a particularly important advance. Corneliu Luca, M.D., Ph.D., associate professor of clinical neurology and director of the DBS program at the Miller School, and colleagues have been investigating how the technique can be used more effectively to combat gait freezing, during which Parkinson’s patients lose the ability to walk.
Miller School researchers are also improving on a longstanding diagnostic tool. The Unified Parkinson’s Disease Rating Scale (UPDRS) helps clinicians determine disease progression by assessing how patients walk, move their hands and feet and perform other motions. Miller School scientists are working closely with tech companies to develop a method that automatically assesses patients with iPhone videos.
“A person can shoot a video and the algorithm will score them,” said Ihtsham ul Haq, M.D., chief of the Movement Disorders Division, professor of neurology and associate director of the McKnight Brain Institute at the Miller School. “This simplifies the process and might even do a better job of evaluating patients, who might not have to come into the clinic at all for these assessments. It’s an early-stage prototype, but so far, the results have been quite good.”
Newer Migraine Treatments
Many people believe migraine attacks are just vicious headaches, but that is not the case. They are a distinct, chronic neurological condition and cause tremendous disability, making them an important topic at the conference.
Teshamae Monteith, M.D., a Miller School professor of clinical neurology and chief of the Headache Division, led the Miller School contingent. An acknowledged expert in the field, Dr. Monteith co-edited a textbook on the subject, “Comprehensive Migraine Management,” which was highlighted at the meeting and will be released in June.
Dr. Monteith participated in multiple sessions, including discussing two studies she co-authored on atogepant, a daily medication that can prevent migraines. One study showed the drug was quite effective, reducing the number of moderate/severe migraine days participants experienced by 64%. In the second study, a higher proportion of participants on the drug felt only minimal migraine symptoms, or none at all, compared to a placebo.
“We looked at a number of different measures, including migraine severity, and showed that atogepant is quite effective at preventing the most debilitating attacks,” said Dr. Monteith.
She also led a study that looked at clinician’s attitudes towards short-term migraine prevention (STP). Neurologists implement STP when a patient may be at great risk for a migraine – during their menstrual cycle or if they are going through a period of perceived stress. The study found that practitioners who prescribed STP used triptans and non-steroidal anti-inflammatory agents but preferred the drug rimegepant, which can be used as a preventive measure or to treat acute attacks.
“Rimegepant has dual indications,” said Dr. Monteith. “If a patient takes it every other day, it can prevent migraine. If they take it at the onset of a migraine, it can stop an attack. We found health care providers adopt several strategies for short-term prevention, including situational prevention, to improve quality of life.”
Mentoring Young Neurologists
AAN was also a busy conference for Jason Margolesky, M.D., an associate professor of clinical neurology and director of the neurology residency program at the Miller School.
“There’s an event at the conference for medical students and residents to get to know programs throughout the country,” said Dr. Margolesky. “We talk with a lot of people who may have an interest in our program and who might hopefully apply next year.”
When discussing the program with potential applicants, Dr. Margolesky highlights how much has been learned about the brain in the past few years and how the specialty has changed.
“Treatments have gotten much better, including the surgical options,” he said. “Those improvements allow us to have long-term relationships with our patients, some of whom we work with for decades.”
Neurology Trainee Reunion
One of the highlights of the meeting was the annual Miller School alumni reception.
The program graduates around 20 residents and fellows each year, and many end up practicing at different institutions around the country.
The reception is a unique opportunity for graduates and faculty to see each other again and share experiences.
“The alumni reception is a wonderful event because we get to see how our trainees have done over the years,” said Dr. Margolesky. “It also underscores how important mentorship and networking can be, both at these meetings and just generally. Trainees can meet people from all different areas, connect with them, and learn more about the field.”
Tags: ataxia, Department of Neurology, Dr. Corneliu Luca, Dr. Jason Margolesky, Dr. Jose Romano, Dr. Teshamae Monteith, headache medicine, Huntington's disease, migraine, movement disorders, neurology, Parkinson's disease, stroke, Tourette syndrome