What's Hot at AAN 2018?

Deborah Brauser

April 19, 2018

This year's American Academy of Neurology (AAN) Annual Meeting should give welcome relief to neurologists experiencing "cold weather fatigue" from an especially wintry-feeling spring. The conference is scheduled for Saturday, April 21, to Friday, April 27, and will be located in sunny Los Angeles (LA), California.

The location for the AAN meeting, which is expected to attract around 14,000 participants, was chosen for multiple reasons, said chair of the event's science committee, Natalia Rost, MD, MPH, director of the Acute Stroke Service at Massachusetts General Hospital and associate professor of neurology at Harvard Medical School, Boston.

Dr Natalia Rost

"Who doesn't love LA? It's always been a very popular destination with many conferences. And for AAN, it's just a great venue," Rost told Medscape Medical News. "It's a fantastic city in terms of what it can offer to the attendees beyond the science, but also the set-up for the scientific conference there is well established."

She added that the LA convention center can easily house large groups. "Our conferences run on the order of 12,000 to 14,000 people. So we need a really good home base, and LA provides that."

Rost noted that last year's conference location in Boston was especially popular with attendees from the East Coast and from Europe, whereas this year's location should prove popular for international neurologists in Asia, Australia, and South America. "We're looking at record numbers of attendees yet again, and we're looking forward to LA accommodating all of us."

She added that colleagues from Minnesota, where 2 feet of snow was dumped just a few days ago and where the AAN is headquartered, "have been happy" to get away to this location. 

As for the conference, several meeting innovations that were introduced last year will, because of their success, return this year, noted Rost. These include Neuroscience in the Clinic sessions, "Best Of" scientific sessions, and shorter oral presentations to allow more time for questions and lively discussions.

"We're coming to the realization that the way an audience learns, and the way that information is delivered, is changing tremendously," said Rost. "A presentation often sparks a question and an intellectual debate around it. If you don't address that almost right away, you're losing momentum on how people process information and how they store it as something useful."

The "Best Of" platform sessions, which feature some of the highest-ranked abstracts submitted in a disease category, will be presented each morning Sunday through Thursday from 8:00 am to 9:00 am.

Neuroscience in the Clinic Sessions

In 2017, Neuroscience in the Clinic sessions replaced the Integrated Neuroscience Sessions that were presented in years past.

This type of session "is a pretty radical concept that we developed over the past couple of years," said Rost. In response to attendee feedback, a major goal of the scientific program has been to become more interactive.

"According to the feedback, they were looking for something that creates a stage for conversation between neuroscientists and practicing neurologists. We wanted to make sure we were creating a connection between bench scientists and what neurologists can take back with them to their practice," Rost explained.

The seven 2-hour sessions presented this year will focus on topics such as antisense oligonucleotide treatment, opioid use and abuse, and progressive multiple sclerosis (MS). In addition, the first session, scheduled for Sunday afternoon, will focus on "autism myth busters."

"There's a lot of science behind autism, but there's also a lot of lore behind it as well," said Rost.

Speakers for this presentation were chosen "who could start the conversation by presenting a clinical vignette and then talk about the science that underpins the biology behind autism. Then, they can perhaps present again some clinical scenario and how some sort of myth develops around it — and then discuss the science that busts that particular myth or some other misperception in the area," she said.

This type of format "not only engages the clinicians on the stage, but also in the audience as there's an extensive question and answer period that follows."

  • N1 Neuroscience in the Clinic: Autism Myth Busters, Sunday, April 22, 3:30 pm to 5:30 pm

  • N2 Neuroscience in the Clinic: Antisense Oligonucleotide (ASO) Therapy, Monday, April 23, 3:30 pm to 5:30 pm

  • N3 Neuroscience in the Clinic: Challenges in Genetic Diagnosis in Neurology, Tuesday, April 24, 1:00 pm to 3:00 pm

  • N4 Neuroscience in the Clinic: Opioid Use and Abuse: The Overlapping Neurobiology of Pain and Addiction, and the Path Toward Better Treatments, Wednesday, April 25, 3:30 pm to 5:30 pm

  • N5 Neuroscience in the Clinic: Treatment of Progressive Multiple Sclerosis, Thursday, April 26, 1:00 pm to 3:00 pm

  • N6 Neuroscience in the Clinic: Neurologic Complications of Cancer Immunotherapy: A New Frontier in Neuro-Inflammation, Thursday, April 26, 3:30 pm to 5:30 pm

  • N7 Neuroscience in the Clinic: REM Sleep Behavior Disorder: Past, Present, Future, Friday, April 27, 3:30 pm to 5:30 pm.

Evolving Poster Experiences

Although the idea of "Poster Neighborhoods" will be back, Rost noted that they will be a little easier to navigate during the 2018 meeting.

Last year, posters in the same disease category were grouped into community gathering places that included seating and a more relaxed atmosphere. "These were a big hit. Even though we were in Boston, people were saying, 'This looks like New Orleans' or even Parisian streets because we had things like street lamps that created a nostalgic feel," said Rost.

Although the idea was popular, "it was also a little bit confusing for people," Rost added. "So this year you'll see a lot of markings for different neighborhoods so it'll be really clear where, for example, a movement disorders neighborhood is, et cetera. Those will be clearly delineated."

Electronic-format posters (e-posters) will also be a little different this year. "Feedback said the e-posters were a little harder to use than intended. So we'll have 12 semi-private viewing areas where you can be a little more interactive with the poster content," said Rost.

She added that attendees will also be able to send direct messages to the posters' presenting authors.

In addition, there will be a "town square" in the middle of the poster session for daily presentations on various topics, including the oral portion of the always popular Emerging Science Session.

"After the presentations, everyone can then spread out into the Emerging Science poster neighborhood," explained Rost.

Emerging Science Sessions

The Emerging Science Session is scheduled for 5:45 pm to 7:15 pm on Tuesday, April 24. Rost noted that the Scientific Committee didn't just want so-called late breakers that were just news that didn't make the original submission deadline.

"Instead, we wanted the hottest off-the-press science. We prescreened all submissions to detect whether it's truly the latest emerging concept that's coming out," she said. "It's very competitive to be included, and we are very excited about the quality of the abstracts that will be presented in this session. These are the ones we want to get the most attention."

Rost added that she thinks some of these studies are potentially practice changing. "That's the impact of the Emerging Science in general. If not a direct medication, there may be a key mechanistic relationship that has been described in a particular spectrum of disorder. And that creates a foundation for the next step in discovery."

She noted that the theme for this session could be "a new era of treatment has arrived. We're basically seeing breakthroughs in novel therapeutics in neurology."

As before, at least one of these Emerging Science studies will be presented during the Clinical Trials Plenary Session earlier that morning. The rest will be presented in the oral presentation.

A full list of the Emerging Science presentations is as follows:

  • 001 INTREPID: A Prospective, Double Blinded, Multicenter Randomized Controlled Trial Evaluating Deep Brain Stimulation with a New Multiple Source, Constant Current Rechargable System in Parkinson's Disease, presented by Jerrold L. Vitek, MD, PhD

  • 002 ABX-1431, A First-in-Class Endocannabinoid Modulator, Improves Tics in Adult Patients with Tourette Syndrome, presented by Kirsten Mueller-Vahl, MD

  • 003 Longer-term Assessment of the Safety and Efficacy of Nusinersen for the Treatment of Infantile-onset Spinal Muscular Atrophy (SMA): An Interim Analysis of the SHINE Study, presented by Diana Castro, MD

  • 004 RG7916 Significantly Increases SMN Protein in SMA Type 1 Babies, presented by Giovanni Baranello, MD, PhD

  • 005 Effect of fingolimod in Pediatric MS: further insights from sensitivity, supportive, and post-hoc analyses from PARADIGMS, presented by Kumaran Deiva, MD, PhD

  • 006 MRI and Relapse Results for ALKS 8700 in Patients with Relapsing Remitting Multiple Sclerosis: 1-year Interim Results from the Phase 3 EVOLVE-MS-1 Study, presented by Richard Leigh-Pemberton, MD

  • 007 Ezutromid significantly reduced muscle damage whilst maintaining utrophin in patients with Duchenne muscular dystrophy (DMD) after 24-weeks of treatment, presented by Francesco Muntoni, MD

  • 008 Efficacy, Safety, and Tolerability of Ubrogepant for the Acute Treatment of Migraine: Results from a Single Attack Phase II Study, ACHIEVE I, presented by Joel Trugman

  • 009 Efficacy and safety of erenumab in episodic migraine patients with 2–4 prior preventive treatment failures: Results from the Phase 3b LIBERTY study, presented by Uwe Reuter, MD

Clinical Trials Plenary

Presentations at this session will include results from DEFUSE 3, on expanding the time window for thrombectomy, and results from a phase 3 trial on solriamfetol (JSP-110) for treating sleepiness in patients with narcolepsy.

The latter study is especially interesting, said Rost, who will be co-moderating the session. "We did not have a breakthrough medication for narcolepsy in many years. We're excited to feature a therapy in the sleep medicine domain. I think it's going to make a difference in patients with narcolepsy and it's going to change their lives."

The full list of Clinical Trials Plenary Session presentations, scheduled for Tuesday, April 24, 9:15 am to 11:30 am, is as follows:

  • Effects of IONIS-HTTRx in Patients with Early Huntington's Disease, Results of the First HTT-Lowering Drug Trial, presented by Sarah J Tabrizi, PhD

  • Expanding the Time Window for Thrombectomy: Results of the DEFUSE 3 Study, presented by Gregory W Albers, MD

  • A Randomized, Placebo-Controlled Phase 3 Study of the Safety and Efficacy of Solriamfetol (JZP-110) for the Treatment of Excessive Sleepiness (ES)  in Participants with Narcolepsy Types 1 and 2 (NT1/2), presented by Michael J Thorpy, MD

  • A Phase II Trial of Ibudilast in Progressive Multiple Sclerosis, presented by Robert J. Fox, MD

  • Patisiran, a RNAi Therapeutic, to Improve Outcomes in Hereditary Transthyretin-Mediated (hATTR) Amyloidosis with Polyneuropathy, presented by David D Adams, MD

  • Precision Medicine: Intracerebroventricular Enzyme Replacement Therapy with Cerliponase Alfa in Children with CLN2 Disease: Results From an Ongoing Multicenter Study, presented by Emily C De Los Reyes, MD

  • Brain Oxygen Optimization in Severe Traumatic Brain Injury (BOOST) Phase 2 Trial: Towards Evidence-Based in the Neurological Intensive Care Unit, presented by Ramon R Diaz-Arrastia, MD, PhD

Hot Topics and Controversies

During this year's Presidential Plenary Session, scheduled for Sunday, April 22, from 9:15 am to noon, the Presidential Lecture will be given by Francis S Collins, MD, PhD, director of the National Institutes of Health (NIH).

"One of the key pieces of what AAN focuses on, as part of professional development, is support of research and neuroscience," as well as collaborations with major science supporters, including the NIH, said Rost.

Collins will be speaking on the BRAIN Initiative and precision medicine in 2018.

Among other popular Plenaries will be the Hot Topics Plenary Session, scheduled for Saturday, April 21, from 4:15 pm to 5:30 pm. It will include talks on implementing metagenomics for diagnosing meningitis and encephalitis, opioid receptor modulation in treating headache, brain stimulation to improve memory, and monitoring MS using blood neurofilament light protein.

The always-entertaining Controversies in Neurology Plenary is scheduled for Thursday, April 26, from 9:15 am to 11:30 am. Debated topics this year will include whether biomarkers alone should be used for diagnosing Alzheimer's disease and whether neurologists should be primarily responsible for taking care of patients with functional disorders.

A third debate is titled, "Would You Let Your Child Play Contact Sports?"

In addition, Bennet Omalu, MBBS, MPH, will be giving a speech on sports and traumatic brain injuries on Tuesday, April 24, from 1:00 pm to 2:15 pm. Omalu was the subject of the recent movie Concussion, starring Will Smith, about his discovery of the first case of dementia/pugilistica, now known as chronic traumatic encephalopathy, in a US football player, and the resulting backlash from the National Football League. He will be joined in a postpresentation panel by his colleague Steven DeKosky, MD, deputy director of the McKnight Brain Institute, Gainesville, Florida.

"They're going to have a good dialogue and present an overview of what their experience has been in this field. And I think it's going to draw a tremendous crowd," said Rost.

Other plenary sessions include the following:

  • Contemporary Clinical Issues Plenary Session, Monday, April 23, 9:15 am to 11:30 am

  • Frontiers in Neuroscience Plenary Session, Wednesday, April 25, 9:15 am to 11:30 am

  • Neurology Year in Review: Emerging Therapies Plenary Session, Friday, April 27, 9:15 am to 11:30 am

"Watch Out, LA!"

Preliminary results of some studies have already been released by the AAN in advance of the meeting. Medscape Medical News coverage of these data can be found on our AAN online collection page.

Overall, Rost said that AAN 2018 is all about interaction and innovation. "I think those are the two big banners we had in mind when we were developing this. We wanted to be really cutting edge and we wanted people to come back from the Annual Meeting and say, 'We've never been to a meeting like that before.'"

"Neurology is a hopeful profession," added Rost. "There's a lot of work still to be done, but I think we're on a good track. That's the message for future neurologists: Come and join our forces because as the population is aging, a lot more people will care about brain health. And neurologists will be right there supporting that," she said.

"Watch out, Los Angeles, the neurologists are coming!"

A full listing of meeting presentations can be found on the AAN website. Medscape Medical News coverage from onsite journalists will begin Saturday, April 21. For more news, join us on Facebook and Twitter. Also, follow the annual meeting Twitter feed using #AANAM.


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