Neurology® Podcast

Elan Louis, UT Southwestern neurology chair and movement-disorders researcher, explores essential tremor beyond its motor symptoms. He discusses rates of mild cognitive impairment and dementia, findings from the deeply characterized Cognet cohort, comparisons with Parkinson’s disease, Alzheimer-type pathology, tau biology, and emerging blood-based biomarkers. He also considers when clinicians should assess cognition and what future research may reveal.

Kelsey Smith, a Mayo Clinic neurologist and epileptologist, explores menopause care for women with epilepsy. She discusses individualized therapy, hormone treatment, seizure patterns, sleep disruption, and medication interactions, including lamotrigine. The conversation also covers bone health, osteoporosis risks, recognizing overlapping menopause and seizure symptoms, and the need for stronger research in midlife epilepsy care.

Pascal Geldsetzer, a Stanford physician and epidemiologist, discusses intriguing evidence linking herpes zoster vaccination with lower rates of new dementia diagnoses. He explains how natural experiments help reduce bias, why a randomized trial is needed, and what possible viral or immune mechanisms could be involved. The conversation also explores sex differences and how clinicians should discuss potential cognitive benefits without overselling them.

John McDonough, a Harvard public health policy expert, examines the forces shaping American medicine. He explores the shift toward market-driven health care, industry consolidation, rising prices, drug-cost pressures, and financialization. He also discusses patient rights, workforce protections, antitrust policy, and how neurologists can engage in systemic change.

Daniel Daneshvar, a Harvard Medical School physician-scientist specializing in brain injury and CTE, discusses its prevalence among deceased NFL players and links between severe pathology and dementia. He examines why death certificates miss much dementia, how cumulative head-impact force may matter more than position or concussion history, risks that build from youth football, and whether reducing contact practices could help.

Katharina Schmidbauer, a Munich neurologist and neuro-oncology researcher, discusses the elusive primary CNS T-cell lymphoma. Topics include its mimicry of glioma and inflammation on MRI, low PET uptake, steroid-sensitive biopsy interpretation, multidisciplinary planning, molecular testing, and treatment strategies involving methotrexate and transplantation. She also explores why international collaboration is vital for this rare disease.

Bhaskar Roy, a Yale neuromuscular researcher, compares emerging myasthenia gravis treatments. Harvard neuroimmunologist Michael Levy explores satralizumab for relapsing MOGAD. Amanda L. Piquet, a University of Colorado autoimmune neurologist, discusses CAR-T therapy for stiff person syndrome. NINDS specialist Irene Cortese examines virus-specific T cells and other advances against PML.

Bruce Cohen, a child neurologist at Akron Children’s Hospital and mitochondrial disorder expert, explores the future of child neurology residency training. He discusses how genetics, imaging, and molecular therapies are reshaping education, debates over adult neurology requirements and training length, and the balance between flexibility, certification, patient safety, workforce needs, and access to care.

Tamara Pringsheim, a University of Calgary neurologist and guideline methodologist, explores updated recommendations for preventing migraine in adults. She explains how evidence confidence is assessed, which medications have the strongest support for episodic and chronic migraine, and why newer CGRP therapies are changing care. The discussion also covers quality-of-life measures, limits of drug comparisons, and shared decision-making.

Irene Cortese, a neurologist and NINDS immunotherapy director, discusses the challenges of treating progressive multifocal leukoencephalopathy. Topics include JC virus, immune compromise, checkpoint inhibitors, virus-specific T cells, and their potential role before hematopoietic transplantation. She also explores PML linked to HIV and natalizumab, IRIS risks, clinical trials, and the search for direct antiviral treatments.