Explore every episode of the podcast MedLink Neurology Podcast

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: September 20, 2018

Apomorphine has a more than 20-year history as a therapeutic adjunct in the management of idiopathic Parkinson disease. And yet, no randomized, placebo-controlled clinical trial to show for it. As of July 2018, now there is. In this week's episode of BrainWaves, Dr. Siegler discusses the relevance, strengths, and weaknesses of the TOLEDO trial.

Produced by James E. Siegler. Music by Ondrosik and Rod Hamilton. Sound effects by Mike Koenig, Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Katzenschlager R, Poewe W, Rascol O, et al. Apomorphine subcutaneous infusion in patients with Parkinson's disease with persistent motor fluctuations (TOLEDO): a multicentre, double-blind, randomised, placebo-controlled trial. Lancet Neurol 2018;17(9):749-59. PMID 30055903

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: May 20, 2018

It's the age of thrombectomy. The DAWN of a new era. But should we give up on intravenous thrombolysis for acute ischemic stroke? In this installment of the Quanta series (typically shorter episodes, this one happens to be 19 minutes), we review the latest data on fibrinolytic agents and anticipate the upcoming paradigm shift in the management of patients with cerebral infarction.

Produced by James E Siegler. Music by Hyson and Jon Watts. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Assessment of the Safety and Efficacy of a New Thrombolytic (ASSENT-2) Investigators; Van De Werf F, Adgey J, et al. Single-bolus tenecteplase compared with front-loaded alteplase in acute myocardial infarction: the ASSENT-2 double-blind randomised trial. Lancet 1999;354(9180):716-22. PMID 10475182

Campbell BC, Mitchell PJ, Churilov L, et al. Tenecteplase versus alteplase before thrombectomy for ischemic stroke. N Engl J Med 2018;378(17):1573-82. PMID 29694815

Haley EC Jr, Lyden PD, Johnston KC, Hemmen TM; TNK in Stroke Investigators. A pilot dose-escalation safety study of tenecteplase in acute ischemic stroke. Stroke 2005;36(3):607-12. PMID 15692126

Haley EC Jr, Thompson JL, Grotta JC, et al. Phase IIB/III trial of tenecteplase in acute ischemic stroke: results of a prematurely terminated randomized clinical trial. Stroke 2010;41(4):707-11. PMID 20185783

Huang X, Cheripelli BK, Lloyd SM, et al. Alteplase versus tenecteplase for thrombolysis after ischaemic stroke (ATTEST): a phase 2, randomised, open-label, blinded endpoint study. Lancet Neurol 2015;14(4):368-76. PMID 25726502

Logallo N, Novotny V, Assmus J, et al. Tenecteplase versus alteplase for management of acute ischaemic stroke (NOR-TEST): a phase 3, randomised, open-label, blinded endpoint trial. Lancet Neurol 2017;16(10):781-8. PMID 28780236

Parsons M, Spratt N, Bivard A, et al. A randomized trial of tenecteplase versus alteplase for acute ischemic stroke. N Engl J Med 2012;366(12):1099-107. PMID 22435369

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: August 7, 2017

Progressive weakness can be terrifying for patients. And even more terrifying for clinicians can be the vast number of potential causes to consider. Among them are disorders of muscle inflammation. In this week's episode of the Quanta series, Dr. Megha Dhamne reviews the clinically relevant antibodies and associated phenotypes we see in patients with autoimmune myositis.

Produced by James E Siegler. Music by Coldnoise and Josh Woodward. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Dalakas MC. Inflammatory muscle diseases. N Engl J Med 2015;372(18):1734-47. PMID 25923553

Goyal NA, Cash TM, Alam U, et al. Seropositivity for NT5c1A antibody in sporadic inclusion body myositis predicts more severe motor, bulbar and respiratory involvement. J Neurol Neurosurg Psychiatry 2016;87(4):373-8. PMID 25857661

Gunawardena H, Betteridge ZE, McHugh NJ. Myositis-specific autoantibodies: their clinical and pathogenic significance in disease expression. Rheumatology (Oxford) 2009;48(6):607-12. PMID 19439503

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: September 12, 2019

We just used clinical trial data regarding eculizumab in myasthenia gravis as an example of how to critically appraise the literature, and in this week's program...MORE data on the efficacy of eculizumab in another neurologic condition. This week on BrainWaves, the exciting results of the PREVENT trial, and the future treatment of NMO spectrum disorder! 

Produced by James E Siegler. Special thanks to Dr. Olga Rosenveld Thon. Music courtesy of Unheard Music Concepts, TRG Banks, and Aitua. Sound effects by Mike Koenig and baby Sofia Joan Siegler. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

FDA News Release: FDA approved first treatment for neuromyelitis optica spectrum disorder, a rare autoimmune disease of the central nervous system. 27 June 2019. Available online at https://www.fda.gov/news-events/press.... Accessed 30 Aug 2019.

Pittock SJ, Berthele A, Fujihara K, et al. Eculizumab in aquaporin-4-positive neuromyelitis optica spectrum disorder. N Engl J Med 2019;381(7):614-25. PMID 31050279

Pittock SJ, Lennon VA, McKeon A, et al. Eculizumab in AQP4-IgG-positive relapsing neuromyelitis optica spectrum disorders: an open-label pilot study. Lancet Neurol 2013;12(6):554-62. PMID 23623397

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

All you need to know about CNS Lyme disease in 10 minutes or less. More to come in a few weeks when Dr. Colin Quinn shares his experience with what was "definitely not Lyme disease." Stay tuned.

Produced by James E Siegler. Music by Josh Woodward, Chris Zabriskie, Peter Rudenko, Advent Chamber Orchestra. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Halperin JJ, Shapiro ED, Logigian E, et al. Practice parameter: treatment of nervous system Lyme disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2007;69(1):91-102. Erratum in: Neurology 2008;70(14):1223. PMID 17522387

Marques A. Chronic Lyme disease: a review. Infect Dis Clin North Am 2008;22(2):341-60, vii-viii. PMID 18452806

Marques AR. Lyme neuroborreliosis. Continuum (Minneap Minn) 2015;21(6 Neuroinfectious Disease):1729-44. PMID 26633786

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: December 13, 2018

Want to make a name for yourself? Declare yourself chief of something. Or chief of many things, as Dr. S A Kinnier Wilson did. This week on the podcast, we commemorate his legacy and his commitment to neurology.

Produced by James E Siegler. Music by Chris Zabriskie and Mystery Mammal. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Compston A. Progressive lenticular degeneration: a familial nervous disease associated with cirrhosis of the liver, by S. A. Kinnier Wilson, (From the National Hospital, and the Laboratory of the National Hospital, Queen Square, London) Brain 1912: 34; 295-509. Brain 2009;132(Pt 8):1997-2001. PMID 19634211

S. A. Kinnier Wilson (1878-1937) Lenticular-hepatic degeneration. JAMA 1968;205(12):871-2. PMID 4877350

Trocello JM, Broussolle E, Girardot-Tinant N, et al. Wilson's disease, 100 years later…. Rev Neurol (Paris) 2013;169(12):936-43. PMID 24119853

Walshe JM. History of Wilson disease: a personal account. Handb Clin Neurol 2017;142:1-5. PMID 28433095

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: October 18, 2018

What do gardeners and snow skiers have in common? Well, besides the fact that both tend to enjoy the outdoors, it turns out they are also at an increased risk of peripheral nerve injury. This week on the podcast, we review the anatomy and pathophysiology of several of the most common sites of nerve damage in the lower extremity.

Produced by James E Siegler. Music by Lee Rosevere. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Baima J, Krivickas L. Evaluation and treatment of peroneal neuropathy. Curr Rev Musculoskelet Med 2008;1(2):147-53. PMID 19468889

Marciniak C. Fibular (peroneal) neuropathy: electrodiagnostic features and clinical correlates. Phys Med Rehabil Clin N Am 2013;24(1):121-37. PMID 23177035

Stewart JD. Foot drop: where, why and what to do? Pract Neurol 2008;8(3):158-69. PMID 18502948

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: November 13, 2017

How often do you call the plumber and say, "My faucet is leaking," and then the plumber REMOVES your faucet? Problem solved, right? Ironically, this simplistic approach works extremely well in a variety of epileptic conditions. In this week's show, Dr. Myriam Abdennadher and Danielle Becker comment on the protocol and efficacy for surgery in patients with drug-resistant epilepsy. Produced by James E. Siegler. Music by Little Glass Men, Montplaisir, Three Chain Links, and Squire Tuck. Voiceover by Isa Smrstik. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

DeGiorgio CM, Krahl SE. Neurostimulation for drug-resistant epilepsy. Continuum (Minneap Minn) 2013;19(3 Epilepsy):743-55. PMID 23739108

Engel J Jr, Wiebe S, French J, et al. Practice parameter: temporal lobe and localized neocortical resections for epilepsy: report of the Quality Standards Subcommittee of the American Academy of Neurology, in association with the American Epilepsy Society and the American Association of Neurological Surgeons. Neurology 2003;60(4):538-47. Erratum in: Neurology 2003;60(8):1396. PMID 12601090

Englot DJ, Wang DD, Rolston JD, Shih TT, Chang EF. Rates and predictors of long-term seizure freedom after frontal lobe epilepsy surgery: a systematic review and meta-analysis. J Neurosurg 2012;116(5):1042-8. PMID 22304450

Jobst BC, Cascino GD. Resective epilepsy surgery for drug-resistant focal epilepsy: a review. JAMA 2015;313(3):285-93. PMID 25602999

Schwartz TH, Spencer DD. Strategies for reoperation after comprehensive epilepsy surgery. J Neurosurg 2001;95(4):615-23. PMID 11596956

Spencer S, Huh L. Outcomes of epilepsy surgery in adults and children. Lancet Neurol 2008;7(6):525-37. PMID 18485316

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

Quantum (noun, pl. quanta): The amount of neurotransmitter stored within a single vesicle of a neuron. It is quantitatively the smallest amount of information that can be transmitted between nerves in the human body. We have hijacked this concept to describe the smallest amount of information we can share with you on a neurology podcast. In this series, which we have called Quanta, we'll be discussing the most fundamental neurologic principles so that our main episodes won't have to. Enjoy! BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice.

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

Seeing is believing. Or so I'm told. But this isn't a hard and fast rule in neurology. Cognitive neuroscientist and neurologist Dr. Geoffrey Aguirre joins me in this brief episode to discuss the neuroanatomy of higher-order visual processing.

Produced by James E Siegler and Erika Mejia. Music by Ars Sonor and Nuno Adelaida. Voiceover by Erika Mejia & Jennifer Aniston. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES 

Barton JJ. Disorders of higher visual processing. Handb Clin Neurol 2011;102:223-61. PMID 21601069

Meadows JC, Munro SS. Palinopsia. J Neurol Neurosurg Psychiatry 1977;40(1):5-8. PMID 845607

Radoeva PD, Prasad S, Brainard DH, Aguirre GK. Neural activity within area V1 reflects unconscious visual performance in a case of blindsight. J Cogn Neurosci 2008;20(11):1927-39. PMID 18416678

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: January 22, 2018

Did anyone else catch the 2017 update to the diagnostic criteria for multiple sclerosis? Me neither. Hopefully this episode will catch you up on it.

Produced by James E Siegler. Music by Daniel Birch and Chris Zabriskie. The BrainWaves' podcast and online content are intended for medical education and entertainment purposes only.

REFERENCES

Polman CH, Reingold SC, Banwell B, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 2011;69(2):292-302. PMID 21387374

Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol 2018;17(2):162-173. PMID 29275977

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities. Episodes originally aired from 2016 to 2021.

Originally released: September 14, 2017

In 2016, the management of patent foramen ovale was “open” for discussion. Now (2017), consider the case closed. Recent data indicate patent foramen ovales should be closed in certain patients with cryptogenic strokes. But some questions remain unanswered. This week's episode is a follow-up discussion on this frequent topic that troubles stroke units.

Produced by James E Siegler and Chris Favilla. Music by Lee Rosevere and Marcos H. Bolanos. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education purposes only. Jim is not a cardiac surgeon. Just a guy who's trying to bring you all the latest updates on what smarter doctors are doing.

REFERENCES

Kent DM, Dahabreh IJ, Ruthazer R, et al. Device closure of patent foramen ovale after stroke: pooled analysis of completed randomized trials. J Am Coll Cardiol 2016;67(8):907-7. PMID 26916479

Kent DM, Ruthazer R, Weimar C, et al. An index to identify stroke-related vs incidental patent foramen ovale in cryptogenic stroke. Neurology 2013;81(7):619-25. doi: 10.1212/WNL.0b013e3182a08d59. Epub 2013 Jul 17. PMID 23864310

Meier B, Lock JE. Contemporary management of patent foramen ovale. Circulation 2003;107(1):5-9. PMID 12515733

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: December 26, 2019

2019 was a big year. The year of the Mueller report. The American college admissions scandals. Brexit. But it was also the year the US Women's team won the World Cup and lobbied for the equal pay of women and men in sports. It was the year of NMO, in which several pivotal trials showed the benefit of disease-modulating therapy in this condition. The year Will Smith played Genie in Aladdin.

2019 was a great year. And as we wrap up 2019, this week's episode includes some of the highlights. Enjoy!

Produced by James E Siegler with support from Erika Mejia, Rajat Dhar, and the entire Siegler family. Music courtesy of Axletree, Chris Zabriskie, John Paston, Kevin Mcleod, Josh Woodward, Steve Combs, Lee Rosevere, Scott Holmes, Advent Chamber Orchestra, Coldnoise, and Pachyderm. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

[BRAIN FOOD]

Devore EE, Kang JH, Breteler MM, Grodstein F. Dietary intakes of berries and flavonoids in relation to cognitive decline. Ann Neurol 2012;72(1):135-43. PMID 22535616

Kennedy DO, Wightman EL, Reay JL, et al. Effects of resveratrol on cerebral blood flow variables and cognitive performance in humans: a double-blind, placebo-controlled, crossover investigation. Am J Clin Nutr 2010;91(6):1590-7. PMID 20357044

Lefèvre-Arbogast S, Gaudout D, Bensalem J, et al. Pattern of polyphenol intake and the long-term risk of dementia in older persons. Neurology 2018;90(22):e1979-e1988. PMID 29703769

Liu QP, Wu YF, Cheng HY, et al. Habitual coffee consumption and risk of cognitive decline/dementia: A systematic review and meta-analysis of prospective cohort studies. Nutrition 2016;32(6):628-36. PMID 26944757

Miller MG, Hamilton DA, Joseph JA, Shukitt-Hale B. Dietary blueberry improves cognition among older adults in a randomized, double-blind, placebo-controlled trial. Eur J Nutr 2018;57(3):1169-80. PMID 28283823

Morris MC, Tangney CC, Wang Y, et al. MIND diet slows cognitive decline with aging. Alzheimers Dement 2015;11(9):1015-22. PMID 26086182

Newman JC, Covarrubias AJ, Zhao M, et al. Ketogenic diet reduces midlife mortality and improves memory in aging mice. Cell Metab 2017;26(3):547-57.e8. PMID 28877458

Norton S, Matthews FE, Barnes DE, Yaffe K, Brayne C. Potential for primary prevention of Alzheimer's disease: an analysis of population-based data. Lancet Neurol 2014;13(8):788-94. Erratum in: Lancet Neurol 2014;13(11):1070. PMID 25030513

Okkersen K, Jimenez-Moreno C, Wenninger S, et al. Cognitive behavioural therapy with optional graded exercise therapy in patients with severe fatigue with myotonic dystrophy type 1: a multicentre, single-blind, randomised trial. Lancet Neurol 2018;17(8):671-80. PMID 29934199

Radd-Vagenas S, Duffy SL, Naismith SL,

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities. Episodes originally aired from 2016 to 2021.

Originally released: November 14, 2019

The FDA label for ACTEMRA® (tocilizumab)--the first medication approved for use in giant cell arteritis in 2017--is 40 pages long. Of the information provided in this document, which includes important dosing information, dose adjustments based on leukocyte count, clinical trial and epidemiologic data, there is a box of text on the first page of the insert. "WARNING: RISK OF SERIOUS INFECTIONS," it reads.

What do you make of this warning? And with such a clear and broad-sweeping statement stamped on the medication, how do you mitigate the medico-legal risk of using this drug?

This week on the program we launch into a two-part series focused on some of the events that follow major clinical trials. In part 1, we cover the three major classifications of FDA alerts for medical treatments using two examples from the neurologic pharmacopoeia. In part 2, we emphasize the importance of post-publication peer review. And both are equally instrumental in our medical decision-making.

Produced by James E Siegler with the support of Michael Rubenstein (University of Pennsylvania) and Zachary Newcomer (University of Florida). Music courtesy of Coldnoise, Cuicuitte, Doctor Turtle, Jahzzar, and Peter Rudenko under a CC license. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. None of what is discussed here should be misconstrued as medical advice, so don't just go prescribing drugs off-label! (Or willy nilly, as my grandmother might say) Be sure to follow us on Twitter (now X) @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Ballard C, Hanney ML, Theodoulou M, et al. The dementia antipsychotic withdrawal trial (DART-AD): long-term follow-up of a randomised placebo-controlled trial. Lancet Neurol 2009;8(2):151-7. PMID 19138567

Dorsey ER, Beck CA, Darwin K, et al. Natural history of Huntington disease. JAMA Neurol 2013;70(12):1520-30. PMID 24126537

Hubers AA, van Duijn E, Roos RA, et al. Suicidal ideation in a European Huntington's disease population. J Affect Disord 2013;151(1):248-58. PMID 23876196

Moore TJ, Singh S, Furberg CD. The FDA and new safety warnings. Arch Intern Med 2012;172(1):78-80. PMID 22232155

Rose RV, Kass JS. Prescribing antipsychotic medications to patients with dementia: boxed warnings and mitigation of legal liability. Continuum (Minneap Minn) 2019;25(1):254-9. PMID 30707196

Schneider LS, Dagerman KS, Insel P. Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomized placebo-controlled trials. JAMA 2005;294(15):1934-43. PMID 16234500

Schultz JL, Killoran A, Nopoulos PC, Chabal CC, Moser DJ, Kamholz JA. Evaluating depression and suicidality in tetrabenazine users with Huntington disease. Neurology 2018;91(3):e202-7. PMID 29925548

Shen V, Clarence-Smith K, Hunter C, Jankovic J. Safety and efficacy of tetrabenazine and use of concomitant medications during long-term, open-label treatment of chorea associated with Huntington's an

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities. Episodes originally aired from 2016 to 2021.

Originally released: November 28, 2019

Peer review prior to publication of medical data dates back to the 9th century CE but has only really gained steam in the past 70 or 80 years. Ideally, peer review would serve as an initial filter for data that enter a permanent public scientific record. But peer review is not without flaws. In the second installment of the BrainWaves segment, “It’s not over yet…,” we discuss publication as a potential source of bias and highlight the reasons why it should not be the final step of the peer review process.

Produced by James E Siegler. Music courtesy of Cullah, Lee Rosevere, John Bartmann, Kevin McLeod, and Jon Watts. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter (now X) @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Bingham C, van der Weyden MB. Peer review on the Internet: launching eMJA peer review study 2. Med J Aust 1998;169(5):240-1. PMID 9762058

Godlee F, Gale CR, Martyn CN. Effect on the quality of peer review of blinding reviewers and asking them to sign their reports: a randomized controlled trial. JAMA 1998;280(3):237-40. PMID 9676667

Haffar S, Bazerbachi F, Murad MH. Peer review bias: a critical review. Mayo Clin Proc 2019;94(4):670-6. PMID 30797567

Jefferson T, Alderson P, Wager E, Davidoff F. Effects of editorial peer review: a systematic review. JAMA 2002;287(21):2784-6. PMID 12038911

Jefferson T, Rudin M, Brodney Folse S, Davidoff F. Editorial peer review for improving the quality of reports of biomedical studies. Cochrane Database Syst Rev 2007;2007(2):MR000016. PMID 17443635

Mandavilli A. Peer review: Trial by Twitter. Nature 2011;469(7330):286-7. PMID 21248816

Ware M. Peer review: Benefits, perspectives, and alternatives. Publishing Research Consortium, 2008.

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities. Episodes originally aired from 2016 to 2021.

Originally released: August 22, 2019

This week on the BrainWaves podcast, finally...a REAL show about BRAINWAVES! Dr. Carolina Maciel of the University of Florida schools Jim Siegler on how to read EEG and interpret abnormal patterns across the ictal-interictal continuum.

Produced by James E Siegler and Carolina Maciel. Music courtesy of Chris Zabriskie, Montplaisir, Rafael Archangel, Steve Combs, Unheard Music Concepts, and Siddhartha. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter (now X) @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Benbadis SR, LaFrance WC Jr, Papandonatos GD, et al. Interrater reliability of EEG-video monitoring. Neurology 2009;73(11):843-6. PMID 19752450

Beniczky S, Hirsch LJ, Kaplan PW, et al. Unified EEG terminology and criteria for nonconvulsive status epilepticus. Epilepsia 2013;54 Suppl 6:28-9. PMID 24001066

Chong DJ, Hirsch LJ. Which EEG patterns warrant treatment in the critically ill? Reviewing the evidence for treatment of periodic epileptiform discharges and related patterns. J Clin Neurophysiol 2005;22(2):79-91. PMID 15805807

Claassen J. How I treat patients with EEG patterns on the ictal-interictal continuum in the neuro ICU. Neurocrit Care 2009;11(3):437-44. PMID 19851892

Gaspard N, Hirsch LJ, LaRoche SM, Hahn CD, Westover MB; Critical Care EEG Monitoring Research Consortium. Interrater agreement for Critical Care EEG Terminology. Epilepsia 2014 ;55(9):1366-73. PMID 24888711

Gerber PA, Chapman KE, Chung SS, et al. Interobserver agreement in the interpretation of EEG patterns in critically ill adults. J Clin Neurophysiol 2008;25(5):241-9. PMID 18791475

Hirsch LJ, LaRoche SM, Gaspard N, et al. American Clinical Neurophysiology Society's Standardized Critical Care EEG Terminology: 2012 version. J Clin Neurophysiol 2013;30(1):1-27. PMID 23377439

Newey CR, Sahota P, Hantus S. Electrographic features of lateralized periodic discharges stratify risk in the interictal-ictal continuum. J Clin Neurophysiol 2017;34(4):365-9. PMID 28166083

Rubinos C, Reynolds AS, Claassen J. The ictal-interictal continuum: to treat or not to treat (and how)? Neurocrit Care 2018;29(1):3-8. PMID 29139014

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities. Episodes originally aired from 2016 to 2021.

Originally released: October 17, 2019

College is a tough time for any kid. But it should also be exciting. Then to experience the freedoms of young adulthood, only later to face the horrifying reality of a progressive neurodegenerative condition...it's not something anyone should experience. In this week's continuation of the patient narrative series, Dr. Paul McIntosh (Duke) shares his life-changing story and his optimism about surviving a chronic neurologic illness.

Produced by James E Siegler with the help of Paul McIntosh. For more information about Pompe Disease, check out the resources provided by the United Pompe Foundation at unitedpompe.com. Music for our program this week was courtesy of Ars Sonor, Franz Danzi, Lee Rosevere, and Scott Holmes. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter (now X) @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Beltran Papsdorf TB, Howard JF Jr, Chahin N. Pearls & Oy-sters: clues to the diagnosis of adult-onset acid maltase deficiency. Neurology 2014;82(9):e73-5. PMID 24590251

Cupler EJ, Berger KI, Leshner RT, et al. Consensus treatment recommendations for late-onset Pompe disease. Muscle Nerve 2012;45(3):319-33. PMID 22173792

Gutiérrez-Rivas E, Bautista J, Vílchez JJ, et al. Targeted screening for the detection of Pompe disease in patients with unclassified limb-girdle muscular dystrophy or asymptomatic hyperCKemia using dried blood: a Spanish cohort. Neuromuscul Disord 2015;25(7):548-53. PMID 25998610

Kishnani PS, Howell RR. Pompe disease in infants and children. J Pediatr 2004;144(5 Suppl):S35-43. PMID 15126982

Kishnani PS, Corzo D, Nicolino M, et al. Recombinant human acid [alpha]-glucosidase: major clinical benefits in infantile-onset Pompe disease. Neurology 2007;68(2):99-109. PMID 17151339

Klinge L, Straub V, Neudorf U, et al. Safety and efficacy of recombinant acid alpha-glucosidase (rhGAA) in patients with classical infantile Pompe disease: results of a phase II clinical trial. Neuromuscul Disord 2005;15(1):24-31. PMID 15639117

Lukacs Z, Nieves Cobos P, Wenninger S, et al. Prevalence of Pompe disease in 3,076 patients with hyperCKemia and limb-girdle muscular weakness. Neurology 2016;87(3):295-8. PMID 27170567

Van den Hout JM, Kamphoven JH, Winkel LP, et al. Long-term intravenous treatment of Pompe disease with recombinant human alpha-glucosidase from milk. Pediatrics 2004;113(5):e448-57. PMID 15121988

van der Ploeg AT, Clemens PR, Corzo D, et al. A randomized study of alglucosidase alfa in late-onset Pompe's disease. N Engl J Med 2010;362(15):1396-406. PMID 20393176

Wokke JH, Escolar DM, Pestronk A, et al. Clinical features of late-onset Pompe disease: a prospective cohort study. Muscle Nerve 2008;38(4):1236-45. PMID 18816591

We believe that

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities. Episodes originally aired from 2016 to 2021.

Originally released: May 30, 2019

Since January 1, 2019, there have been nearly 900 confirmed measles cases across 24 states in the United States. This is 10 times greater than the number of cases in the US 3 years ago, and it is the largest outbreak the US has seen since 1994. The month of May also marks the first reported case of measles in the state of Pennsylvania, where BrainWaves is produced. So this week on the program, Jim Siegler speaks with Dr. Erika Mejia (pediatrician) about the medical and sociopolitical triggers for this outbreak, the misconceptions of the measles-mumps-rubella vaccine, and finally, what you can do to keep measles from "going viral."*

Produced by James E Siegler and Erika Mejia. Music courtesy of Advent Chamber Orchestra, Coldnoise, Josh Woodward, Kevin McLeod, and Lee Roosevere. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter (now X) @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Bester JC. Measles and measles vaccination: a review. JAMA Pediatr 2016;170(12):1209-15. PMID 27695849

Bester JC. Not a matter of parental choice but of social justice obligation: children are owed measles vaccination. Bioethics 2018;32(9):611-19. PMID 30229958

Campbell H, Andrews N, Brown KE, Miller E. Review of the effect of measles vaccination on the epidemiology of SSPE. Int J Epidemiol 2007;36(6):1334-48. PMID 18037676

Fournet N, Mollema L, Ruijs WL, et al. Under-vaccinated groups in Europe and their beliefs, attitudes and reasons for non-vaccination; two systematic reviews. BMC Public Health 2018;18(1):196. PMID 29378545

Maglione MA, Das L, Raaen L, et al. Safety of vaccines used for routine immunization of U.S. children: a systematic review. Pediatrics 2014;134(2):325-37. PMID 25086160

Murch SH, Anthony A, Casson DH, et al. Retraction of an interpretation. Lancet 2004;363(9411):750. PMID 15016483

Perry RT, Halsey NA. The clinical significance of measles: a review. J Infect Dis 2004;189 Suppl 1:S4-16. PMID 15106083

Poland GA, Jacobson RM. The age-old struggle against the antivaccinationists. N Engl J Med 2011;364(2):97-9. PMID 21226573

Trump’s tweet:  https://twitter.com/realdonaldtrump/status/449525268529815552?lang=en 

*Truth be told, measles claims the lives of 100,000 people around the globe every year. It has already gone viral. This was just a figure of speech.

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities. Episodes originally aired from 2016 to 2021.

Originally released: August 8, 2019

Clean up on aisle 4!

Or should it be IL-4? In this week's installment of the BrainWaves Podcast, we immerse ourselves into the microscopic environment of Alzheimer disease pathology. It's interesting, it's messy, and whoever made this mess is also responsible for the clean-up.

Produced by James E Siegler. Music courtesy of Andy Cohen, Brendan Kinsella, Cuicuitte, Damiano Baldoni, Kai Engel, Nctrnm. Sound effects by Mike Koenig, Blastfx.com, Caroline Ford, Robertv, and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter (now X) @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Arranz AM, De Strooper B. The role of astroglia in Alzheimer's disease: pathophysiology and clinical implications. Lancet Neurol 2019;18(4):406-14. PMID 30795987

Breitner JC, Baker LD, Montine TJ, et al. Extended results of the Alzheimer's disease anti-inflammatory prevention trial. Alzheimers Dement 2011;7(4):402-11. PMID 21784351

Chun H, Lee CJ. Reactive astrocytes in Alzheimer's disease: a double-edged sword. Neurosci Res 2018;126:44-52. PMID 29225140

Heneka MT, Carson MJ, El Khoury J, et al. Neuroinflammation in Alzheimer's disease. Lancet Neurol 2015;14(4):388-405. PMID 25792098

Kumar A, Singh A, Ekavali. A review on Alzheimer's disease pathophysiology and its management: an update. Pharmacol Rep 2015;67(2):195-203. PMID 25712639

Maragakis NJ, Rothstein JD. Mechanisms of disease: astrocytes in neurodegenerative disease. Nat Clin Pract Neurol 2006;2(12):679-89. PMID 17117171

Mattsson N, Zetterberg H, Hansson O, et al. CSF biomarkers and incipient Alzheimer disease in patients with mild cognitive impairment. JAMA 2009;302(4):385-93. PMID 19622817

Wisniewski T, Konietzko U. Amyloid-beta immunisation for Alzheimer's disease. Lancet Neurol 2008;7(9):805-11. PMID 18667360

Yan R, Vassar R. Targeting the β secretase BACE1 for Alzheimer's disease therapy. Lancet Neurol 2014;13(3):319-29. PMID 24556009

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities. Episodes originally aired from 2016 to 2021.

Originally released: May 16, 2019

It would be an understatement to say that endovascular thrombectomy has revolutionized acute stroke management. As of 2018, the American Heart Association recommends treatment up to 24 hours after time last seen normal for select patients. This week on the BrainWaves podcast, Dr. Tudor Jovin--PI for the DAWN and REVASCAT clinical trials--summarizes the history of thrombectomy trials and what it is about our current strategies that have breathed new life into a technique that has historically fizzled.

Produced by James E Siegler and Jesse Thon. Music courtesy of Cuicuitte, Coldnoise, Medyn, Jon Watts, Lee Rosevere, and Mystery Mammal. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter (now X) @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Campbell BC, Majoie CB, Albers GW, et al. Penumbral imaging and functional outcome in patients with anterior circulation ischaemic stroke treated with endovascular thrombectomy versus medical therapy: a meta-analysis of individual patient-level data. Lancet Neurol 2019;18(1):46-55. Erratum in: Lancet Neurol 2019 Mar;18(3):e2. PMID 30413385

Goyal M, Menon BK, van Zwam WH, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet 2016;387(10029):1723-31. PMID 26898852

Gross BA, Jadhav AP, Jankowitz BT, Jovin TG. The ongoing revolution in thrombectomy: expanding inclusion criteria to larger cores. World Neurosurg 2018;120:393-94. PMID 30292027

Heit JJ, Wintermark M. Perfusion computed tomography for the evaluation of acute ischemic stroke: strengths and pitfalls. Stroke 2016;47(4):1153-8. PMID 26965849

Jadhav AP, Molyneaux BJ, Hill MD, Jovin TG. Care of the post-thrombectomy patient. Stroke 2018;49(11):2801-07. PMID 30355218

Konstas AA, Goldmakher GV, Lee TY, Lev MH. Theoretic basis and technical implementations of CT perfusion in acute ischemic stroke, part 2: technical implementations. AJNR Am J Neuroradiol 2009;30(5):885-92. PMID 19299489

Nogueira RG, Jadhav AP, Haussen DC, et al. Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct. N Engl J Med 2018;378(1):11-21. PMID 29129157

Román LS, Menon BK, Blasco J, et al. Imaging features and safety and efficacy of endovascular stroke treatment: a meta-analysis of individual patient-level data. Lancet Neurol 2018;17(10):895-904. PMID 30264728

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities. Episodes originally aired from 2016 to 2021.

Originally released: February 13, 2019

In the second half of our two-part series on complications of organ transplantation, Dr. Raj Dhar (Neurocritical Care, Washington University in St. Louis) discusses his experience managing the noninfectious complications of organ transplantation--from drug toxicities to multidisciplinary medical care.

Produced by James E Siegler and Raj Dhar. Music by Steve Combs, Lee Rosevere, and Scott Holmes. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter (now X) @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Dhar R, Young GB, Marotta P. Perioperative neurological complications after liver transplantation are best predicted by pre-transplant hepatic encephalopathy. Neurocrit Care 2008;8(2):253-8. PMID 17928960

Dhar R. Neurologic complications of transplantation. Handb Clin Neurol 2017;141:545-572. PMID 28190435

Mateen FJ, Dierkhising RA, Rabinstein AA, Van De Beek D, Wijdicks EF. Neurological complications following adult lung transplantation. Am J Transplant 2010;10(4):908-14. PMID 20121751

Muñoz P, Valerio M, Palomo J, et al. Infectious and non-infectious neurologic complications in heart transplant recipients. Medicine (Baltimore) 2010;89(3):166-75. PMID 20453603

Senzolo M, Ferronato C, Burra P. Neurologic complications after solid organ transplantation. Transpl Int 2009;22(3):269-78. PMID 19076332

Wu Q, Marescaux C, Wolff V, et al. Tacrolimus-associated posterior reversible encephalopathy syndrome after solid organ transplantation. Eur Neurol 2010;64(3):169-77. PMID 20699617

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: November 22, 2018

Of the "reversible" causes of dementia, normal pressure hydrocephalus may be the most controversial. But there is something to be said about how surgical intervention alters the physiology of patients who present with gait impairment, ventriculomegaly, and normal CSF pressure. This week on the show, we discuss the clinical features and the controversy behind this diagnosis.

Produced by James E Siegler. Music by Ghost, Jon Watts, Julie Maxwell, Komiku, and Kevin McLeod. Sound effects by Mike Koenig, Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Gallia GL, Rigamonti D, Williams MA. The diagnosis and treatment of idiopathic normal pressure hydrocephalus. Nat Clin Pract Neurol 2006;2(7):375-81. PMID 16932588

Kazui H, Miyajima M, Mori E, Ishikawa M; SINPHONI-2 Investigators. Lumboperitoneal shunt surgery for idiopathic normal pressure hydrocephalus (SINPHONI-2): an open-label randomised trial. Lancet Neurol 2015;14(6):585-94. PMID 25934242

Klassen BT, Ahlskog JE. Normal pressure hydrocephalus: how often does the diagnosis hold water? Neurology 2011;77(12):1119-25. PMID 21849644

Relkin N, Marmarou A, Klinge P, Bergsneider M, Black PM. Diagnosing idiopathic normal-pressure hydrocephalus. Neurosurgery 2005;57(3 Suppl):S4-16; discussion ii-v. PMID 16160425

Williams MA, Relkin NR. Diagnosis and management of idiopathic normal-pressure hydrocephalus. Neurol Clin Pract 2013;3(5):375-85. PMID 24175154

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: December 20, 2018

This week, part 2 of our two-part primer on Huntington disease. Treatment. From tried-and-true therapies to the latest-and-greatest compounds being studied in clinical trials. Enjoy!

Produced by James E Siegler and Steven Aradi. Music by Mike Durek, Jesse Spillane, Lee Rosevere, Jason Shaw, and Dr. Turtle. Sound effects by Mike Koenig, Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Bates GP, Dorsey R, Gusella JF, et al. Huntington disease. Nat Rev Dis Primers 2015;1:15005. PMID 27188817

Claassen DO, Carroll B, De Boer LM, et al. Indirect tolerability comparison of Deutetrabenazine and Tetrabenazine for Huntington disease. J Clin Mov Disord 2017;4:3. PMID 28265459

Paulsen JS, Nehl C, Hoth KF, et al. Depression and stages of Huntington's disease. J Neuropsychiatry Clin Neurosci 2005;17(4):496-502. PMID 16387989

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: December 6, 2018

You may be able to recognize chorea. But what does it make you think of besides Huntington disease? In this two-part series, we'll cover the clinical manifestations, differential diagnosis, and management of Huntington disease. In part 1, Dr. Travis Lewis (University of Pennsylvania) creates a framework for hyperkinetic movement disorders and Huntington disease. Part 2 will focus on the current and future therapeutics of this neurodegenerative condition.

Produced by Travis Lewis and James E Siegler. Music by Azevedo Silva, Chris Zabriskie, Cullah, John Bartmann, and Nuno Adelaida. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Bates GP, Dorsey R, Gusella JF, et al. Huntington disease. Nat Rev Dis Primers 2015;1:15005. PMID 27188817

Ghosh R, Tabrizi SJ. Huntington disease. Handb Clin Neurol 2018;147:255-78. PMID 29325616

Reilmann R, Leavitt BR, Ross CA. Diagnostic criteria for Huntington's disease based on natural history. Mov Disord 2014;29(11):1335-41. PMID 25164527

Walker RH. Chorea. Continuum (Minneap Minn) 2013;19(5 Movement Disorders):1242-63. PMID 24092289

Wild EJ, Tabrizi SJ. The differential diagnosis of chorea. Pract Neurol 2007;7(6):360-73. PMID 18024776

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: October 25, 2018

Every time you order an MRI with contrast, you should think to yourself, "Why do I need contrast?"

Then, "If I need contrast, what are the risks?" This week’s show is all about the risks of routine neuroimaging.

Produced by James E Siegler. Music by Little Glass Men, Loyalty Freak Music, and Kevin McLeod. Sound effects by Mike Koenig, Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

McDonald RJ, McDonald JS, Kallmes DF, et al. Intracranial gadolinium deposition after contrast-enhanced MR imaging. Radiology 2015;275(3):772-82. PMID 25742194

Pullicino R, Radon M, Biswas S, Bhojak M, Das K. A review of the current evidence on gadolinium deposition in the brain. Clin Neuroradiol 2018;28(2):159-69. PMID 29523896

Rogosnitzky M, Branch S. Gadolinium-based contrast agent toxicity: a review of known and proposed mechanisms. Biometals 2016;29(3):365-76. PMID 27053146

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

It is April 1st, 2017. Otherwise known as April Fools Day. But it doesn't have to be April 1st for you to be tricked by your neurology patient. In this week's episode of BrainWaves, we go over some of the ways to avoid being fooled the next time around. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice.

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: November 8, 2018

A patient comes into the emergency department. They've got a headache. You get some basic labs, a chest x-ray, and a CT scan. And then you get a drug screen. But does this information even help you? And could it hurt the patient?

This week on the BrainWaves podcast, Dr. Emily Rosenthal shares her experience with Dr. Kelley Humbert on the ethics of toxicology "screening" and how she manages patients with a substance use disorder.

Produced by Emily Rosenthal, Kelley Humbert, and Jim Siegler. Music by Montplaisir, Lee Rosevere, and Kevin McLeod. Sound effects by Mike Koenig, Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

Bates GP, Dorsey R, Gusella JF, et al. Huntington disease. Nat Rev Dis Primers 2015;1:15005. PMID 27188817

Eisen JS, Sivilotti ML, Boyd KU, Barton DG, Fortier CJ, Collier CP. Screening urine for drugs of abuse in the emergency department: do test results affect physicians' patient care decisions? CJEM 2004;6(2):104-11. PMID 17433159

Jones HE, Kaltenbach K, Heil SH, et al. Neonatal abstinence syndrome after methadone or buprenorphine exposure. N Engl J Med 2010;363(24):2320-31. PMID 21142534

Lager PS, Attema-de Jonge ME, Gorzeman MP, Kerkvliet LE, Franssen EJ. Clinical value of drugs of abuse point of care testing in an emergency department setting. Toxicol Rep 2017;5:12-17. PMID 29270362

Silver B, Miller D, Jankowski M, et al. Urine toxicology screening in an urban stroke and TIA population. Neurology 2013;80(18):1702-9. PMID 23596074

Smith PC, Schmidt SM, Allensworth-Davies D, Saitz R. A single-question screening test for drug use in primary care. Arch Intern Med 2010;170(13):1155-60. PMID 20625025

Tenenbein M. Do you really need that emergency drug screen? Clin Toxicol (Phila) 2009;47(4):286-91. PMID 19514875

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: October 11, 2018

As the name suggests, "evidence-based medicine" is dependent on published evidence to support our clinical practice and medical decision-making. Implicit in this is the notion that all published evidence reflects the truth that underlies the biology, pathophysiology, and pharmacology of our health.

This is not the case.

Clinical research and published findings can be extremely limited, and what you read in Lancet and NEJM should be interpreted with caution. In this week's episode of the "I wonder" series, where Jim Siegler speaks with Ali Hamedani on various topics in medicine and neurology, the speakers review the major biases inherent to the practice and interpretation of clinical research.

Produced by James E Siegler. Music by Jahzzar, Kai Engel, and Lee Rosevere. Sound effects by Mike Koenig, Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Anonymous. Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. Lancet 1988;2(8607):349-60. PMID 2899772

Kazui H, Miyajima M, Mori E, Ishikawa M; SINPHONI-2 Investigators. Lumboperitoneal shunt surgery for idiopathic normal pressure hydrocephalus (SINPHONI-2): an open-label randomised trial. Lancet Neurol 2015;14(6):585-94. PMID 25934242

Montalban X, Hauser SL, Kappos L, et al. Ocrelizumab versus placebo in primary progressive multiple sclerosis. N Engl J Med 2017;376(3):209-20. PMID 28002688

Smith GC, Pell JP. Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials. BMJ 2003;327(7429):1459-61. PMID 14684649

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: August 2, 2018

How visual information transforms from pixels into people is more complex than dots becoming lines, lines becoming shapes, and shapes becoming faces. Your brain makes assumptions about all kinds of sensory information--even without you knowing it. Dr. Geoffrey Aguirre, a neuroscientist who specializes in vision processing, explains how we know what we can't really explain.

Produced by James E Siegler and Geoff Aguirre. Music by Cullah, Jon Watts, Lovira, Loyalty Freak Music, and Scott Holmes. Sound effects by Mike Koenig, Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Psalta L, Young AW, Thompson P, Andrews TJ. The Thatcher illusion reveals orientation dependence in brain regions involved in processing facial expressions. Psychol Sci 2014;25(1):128-36. PMID 24264941

Thompson P. Margaret Thatcher: a new illusion. Perception 1980;9(4):483-4. PMID 6999452

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: September 27, 2018

When is eye pain an ophthalmological issue, and when is it a neurologic issue? This week, neuro-ophthalmologist and glaucoma specialist Dr. Ahmara Ross simplifies ocular pain for the day-to-day neurologist.

Produced by James E Siegler and Ahmara Ross. Music by Yan Terrien, Unheard Music Concepts, Steve Combs, and Scott Holmes. Sound effects by Mike Koenig, Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @BrainWave saudio for the latest updates to the podcast.

REFERENCES

Fiore DC, Pasternak AV, Radwan RM. Pain in the quiet (not red) eye. Am Fam Physician 2010;82(1):69-73. PMID 20590074

Friedman DI. The eye and headache. Continuum (Minneap Minn) 2015;21(4 Headache):1109-17. PMID 26252594

Lee AG, Al-Zubidi N, Beaver HA, Brazis PW. An update on eye pain for the neurologist. Neurol Clin 2014;32(2):489-505. PMID 24703541

Waldman CW, Waldman SD, Waldman RA. A practical approach to ocular pain for the non-ophthalmologist. Pain Manag 2014;4(6):413-26. PMID 25494693

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 19, 2018

Some have estimated the annual cost of chronic back or neck pain in the US to exceed $200 billion per year. And the economic burden is almost as unbearable as the pain faced by patients. This week on the program, we discuss the clinical and radiographic aspects of structural spine disease--or spondylosis--and expert recommendations on how to manage it.

Produced by James E Siegler. Music by Steve Combs and Scott Holmes. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making, especially not for back surgery.

REFERENCES

Baron EM, Young WF. Cervical spondylotic myelopathy: a brief review of its pathophysiology, clinical course, and diagnosis. Neurosurgery 2007;60(1 Supp1 1):S35-41. PMID 17204884

Farrokhi MR, Ghaffarpasand F, Khani M, Gholami M. An evidence-based stepwise surgical approach to cervical spondylotic myelopathy: a narrative review of the current literature. World Neurosurg 2016;94:97-110. PMID 27389939

Rindler RS, Chokshi FH, Malcolm JG, et al. Spinal diffusion tensor imaging in evaluation of preoperative and postoperative severity of cervical spondylotic myelopathy: systematic review of literature. World Neurosurg 2017;99:150-8. PMID 27939797

Stino AM, LoRusso SJ. Myelopathies due to structural cervical and thoracic disease. Continuum (Minneap Minn) 2018;24(2, Spinal Cord Disorders):567-583. PMID 29613900

Witiw CD, Tetreault LA, Smieliauskas F, Kopjar B, Massicotte EM, Fehlings MG. Surgery for degenerative cervical myelopathy: a patient-centered quality of life and health economic evaluation. Spine J 2017;17(1):15-25. PMID 27793760

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 5, 2018

In 2017, neuroimmunology experts revised the criteria with which we diagnose multiple sclerosis. They encouraged more aggressive treatment, and now they have introduced novel therapeutic agents into our pharmacologic armamentarium. Dr. Christopher Perrone explains how these newer agents work and how effective they are in patients with demyelinating disease.

Produced by James E Siegler. Music by Steve Combs, Pachyderm, and Lee Rosevere. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Hauser SL, Bar-Or A, Comi G, et al. Ocrelizumab versus Interferon Beta-1a in Relapsing Multiple Sclerosis. N Engl J Med 2017;376(3):221-34. PMID 28002679

Hauser SL, Waubant E, Arnold DL, et al. B-cell depletion with rituximab in relapsing-remitting multiple sclerosis. N Engl J Med 2008;358(7):676-88. PMID 18272891

Hemmer B, Nessler S, Zhou D, Kieseier B, Hartung HP. Immunopathogenesis and immunotherapy of multiple sclerosis. Nat Clin Pract Neurol 2006;2(4):201-11. PMID 16932551

Maloney DG, Grillo-López AJ, White CA, et al. IDEC-C2B8 (Rituximab) anti-CD20 monoclonal antibody therapy in patients with relapsed low-grade non-Hodgkin's lymphoma. Blood 1997;90(6):2188-95. PMID 9310469

Montalban X, Hauser SL, Kappos L, et al. Ocrelizumab versus placebo in primary progressive multiple sclerosis. N Engl J Med 2017;376(3):209-20. PMID 28002688

Selter RC, Hemmer B. Update on immunopathogenesis and immunotherapy in multiple sclerosis. Immunotargets Ther 2013;2:21-30. PMID 27471685

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: June 14, 2018

As a pupil of neurology and medicine, I feel like it is my responsibility to cover this topic at least once on the podcast. This topic came to me in a vision. But not one of phosphenes or impaired stereopsis--both of which we'll cover today. This week, we're discussing inflammation of the optic nerve, from the historical aspects to current concepts. And while you're listening, there's no need to lash out at my puns. You can stop rolling your eyes now.

Produced by James E Siegler. Music by Lee Rosevere, Kevin McLeod, Steve Combs, and Unheard Music Concepts. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Balcer LJ. Clinical practice. Optic neuritis. N Engl J Med 2006;354(12):1273-80. PMID 16554529

Beck RW, Cleary PA, Anderson MM Jr, et al. A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis. The Optic Neuritis Study Group. N Engl J Med 1992;326(9):581-8. PMID 1734247

Hickman SJ, Dalton CM, Miller DH, Plant GT. Management of acute optic neuritis. Lancet 2002;360(9349):1953-62. PMID 12493277

Liu GT, Volpe NJ, Galetta SL. Neuro-Ophthalmology: Diagnosis and Management. 2nd Ed. Elsevier, 2010.

O'Doherty M, Flitcroft DI. An unusual presentation of optic neuritis and the Pulfrich phenomenon. J Neurol Neurosurg Psychiatry 2007;78(8):906-7. PMID 17635984

Toosy AT, Mason DF, Miller DH. Optic neuritis. Lancet Neurol 2014;13(1):83-99. PMID 24331795

Volpe NJ. Optic neuritis: historical aspects. J Neuroophthalmol 2001;21(4):302-9. PMID 11756864

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: June 7, 2018

Depression and dementia are, unfortunately, two very common disorders in mental health. But the fact that they occur together is not explained by their overall prevalence. The relationship is a bit more complicated. Joan Dietz joins Jim Siegler in a discussion on how she counters these common conditions.

Produced by James E Siegler. Music by Lee Rosevere, Jason Shaw, Chris Zabriskie, Kai Engel, and Scott Holmes. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Alexopoulos GS, Murphy CF, Gunning-Dixon FM, et al. Microstructural white matter abnormalities and remission of geriatric depression. Am J Psychiatry 2008;165(2):238-44. PMID 18172016

Byers AL, Yaffe K. Depression and risk of developing dementia. Nat Rev Neurol 2011;7(6):323-31. PMID 21537355

Dotson VM, Beydoun MA, Zonderman AB. Recurrent depressive symptoms and the incidence of dementia and mild cognitive impairment. Neurology 2010;75(1):27-34. PMID 20603482

Korczyn AD, Halperin I. Depression and dementia. J Neurol Sci 2009;283(1-2):139-42. PMID 19345960

Lee CW, Lin CL, Sung FC, Liang JA, Kao CH. Antidepressant treatment and risk of dementia: a population-based, retrospective case-control study. J Clin Psychiatry 2016;77(1):117-22; quiz 122. PMID 26845268

Sachdev PS, Smith JS, Angus-Lepan H, Rodriguez P. Pseudodementia twelve years on. J Neurol Neurosurg Psychiatry 1990;53(3):254-9. PMID 2324757

Saczynski JS, Beiser A, Seshadri S, Auerbach S, Wolf PA, Au R. Depressive symptoms and risk of dementia: the Framingham Heart Study. Neurology 2010;75(1):35-41. PMID 20603483

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: May 10, 2018

There is a nationwide epidemic happening right now. And it's not some terrible virus, it's not because of anything we've had to eat or drink. It is an occupational hazard of the hospital environment: Physician suicide. Dr. Pamela Wible, Founder of the Ideal Medical Care Movement, shares her unique approach to this preventable plague.

Produced by James E Siegler. Music by Andrew Sacco, Damiano Baldoni, Kevin McLeod, Jason Shaw, and Rafael Archangel. Voiceover by Patrick Green. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Goldman ML, Shah RN, Bernstein CA. Depression and suicide among physician trainees: recommendations for a national response. JAMA Psychiatry. 2015 May;72(5):411-2. doi: 10.1001/jamapsychiatry.2014.3050. PMID 25738529

Kesselheim AS, Austad KE. Residents: workers or students in the eyes of the law? N Engl J Med 2011;364(8):697-9. PMID 21226569

Schernhammer E. Taking their own lives -- the high rate of physician suicide. N Engl J Med 2005;352(24):2473-6. PMID 15958803

Schernhammer ES, Colditz GA. Suicide rates among physicians: a quantitative and gender assessment (meta-analysis). Am J Psychiatry 2004;161(12):2295-302. PMID 15569903

Sen S, Kranzler HR, Krystal JH, et al. A prospective cohort study investigating factors associated with depression during medical internship. Arch Gen Psychiatry 2010;67(6):557-65. PMID 20368500

Witte TK, Fitzpatrick KK, Joiner TE Jr, Schmidt NB. Variability in suicidal ideation: a better predictor of suicide attempts than intensity or duration of ideation? J Affect Disord 2005;88(2):131-6. PMID 16054227

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: April 26, 2018

Forget what you did 5 minutes ago? What if this happened every 5 minutes...for an entire day? In this week's program, Dr. Laura Mainardi shares her family's experience with a day that will never be forgotten. But never remembered.

Produced by James E Siegler and Laura Mainardi-Villarino. Music by Pablo Pavan, Azevedo Silva, Montplaisir, and Kevin McLeod. BrainWaves' podcasts and online content are intended for medical education only and should not be used for routine clinical decision-making.

REFERENCES

Arena JE, Rabinstein AA. Transient global amnesia. Mayo Clin Proc 2015;90(2):264-72. PMID 25659242

Hainselin M, Quinette P, Juskenaite A, et al. Just do it! How performing an action enhances remembering in transient global amnesia. Cortex 2014;50:192-9. PMID 24268322

Noël A, Quinette P, Hainselin M, et al. The still enigmatic syndrome of transient global amnesia: interactions between neurological and psychopathological factors. Neuropsychol Rev 2015;25(2):125-33. PMID 25868986

Quinette P, Guillery-Girard B, Dayan J, et al. What does transient global amnesia really mean? Review of the literature and thorough study of 142 cases. Brain 2006;129(Pt 7):1640-58. PMID 16670178

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: April 19, 2018

What do Shel Silverstein, Bruce Willis, and French philosophy have in common? At least one thing. This week on the BrainWaves podcast we discuss the Cotard delusion and the legacy of the neurologist who described it. Produced by James E Siegler. Music by Andrew Sacco, Damiano Baldoni, Squire Tuck, Montplaisir, and Rafael Archangel. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Pearn J, Gardner-Thorpe C. Jules Cotard (1840-1889): his life and the unique syndrome which bears his name. Neurology 2002;58(9):1400-3. PMID 12011289

Sahoo A, Josephs KA. A Neuropsychiatric analysis of the cotard delusion. J Neuropsychiatry Clin Neurosci 2018 Winter;30(1):58-65. PMID 28641497

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: March 29, 2018

What does a brain look like in a patient with a functional movement disorder? Pretty normal, it turns out. But beneath the normal anatomy is a storm of aberrant signaling. Dr. Mark Hallett, Chief of the Human Motor Control Section of the NIH, describes the underlying neurophysiology in this spectrum of disorders.

Produced by James E Siegler. Music by Damiano Baldoni, Kevin MacLeod, Ondrosik, and the Philadelphia String Quartet. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Maurer CW, LaFaver K, Ameli R, Epstein SA, Hallett M, Horovitz SG. Impaired self-agency in functional movement disorders: a resting-state fMRI study. Neurology 2016;87(6):564-70. PMID 27385746

Nahab FB, Kundu P, Gallea C, et al. The neural processes underlying self-agency. Cereb Cortex 2011;21(1):48-55. PMID 20378581

Vuilleumier P, Chicherio C, Assal F, Schwartz S, Slosman D, Landis T. Functional neuroanatomical correlates of hysterical sensorimotor loss. Brain 2001;124(Pt 6):1077-90. Erratum in: Brain 2016;139(Pt 5):e29. PMID 11353724

DISCLOSURES

Dr. Hallett receives funding from the Intramural program of the National Institute of Neurological Disorders and Stroke. No relevant conflicts of interest are present. He serves as Chair of the Medical Advisory Board for and receives honoraria and funding for travel from the Neurotoxin Institute. He may accrue revenue on US Patent: Immunotoxin (MAB-Ricin) for the treatment of focal movement disorders, and US Patent: Coil for Magnetic Stimulation and methods for using the same (H-coil); in relation to the latter, he has received license fee payments from the NIH (from Brainsway) for licensing of this patent. Supplemental research funds have been granted by BCN Peptides, S.A., for treatment studies of blepharospasm; Medtronics, Inc., for studies of deep brain stimulation; UniQure for a clinical trial of AAV2-GDNF for Parkinson Disease; Merz for treatment studies of focal hand dystonia; and Allergan for studies of methods to inject botulinum toxins. Jim is lucky enough to have no relevant competing financial interests.

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: March 8, 2018

Cigarettes can offset Parkinson disease. Alcohol can reduce the risk of heart attack. Can the case be made that marijuana has health benefits too?

Produced by James E Siegler. Music by Montplaisir and Kevin McLeod. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Or, if you're a patient with seizures, this doesn't mean you should start smoking pot now. Be smart.

REFERENCES

Brodie MJ, Ben-Menachem E. Cannabinoids for epilepsy: What do we know and where do we go? Epilepsia 2018;59(2):291-6. PMID 29214639

Cunha JM, Carlini EA, Pereira AE, et al. Chronic administration of cannabidiol to healthy volunteers and epileptic patients. Pharmacology 1980;21(3):175-85. PMID 7413719

Devinsky O, Cross JH, Laux L, et al. Trial of cannabidiol for drug-resistant seizures in the Dravet syndrome. N Engl J Med 2017;376(21):2011-20. PMID 28538134

Maa E, Figi P. The case for medical marijuana in epilepsy. Epilepsia 2014;55(6):783-6. PMID 24854149

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: February 22, 2018

Risk factors for amyotrophic lateral sclerosis: family history, male sex, and serving in the US military? Dr. Colin Quinn shares his experience working with American veterans and summarizes the evidence for this unusual relationship.

Produced by James E Siegler. Music by Jon Watts, Josh Woodward, Lee Rosevere, Unheard Music Concepts, and The United States Army Old Guard Fife and Drum Corps. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education and entertainment purposes only.

REFERENCES

Al-Chalabi A, Hardiman O. The epidemiology of ALS: a conspiracy of genes, environment and time. Nat Rev Neurol 2013;9(11):617-28. PMID 24126629

Haley RW. Excess incidence of ALS in young Gulf War veterans. Neurology 2003;61(6):750-6. PMID 14504316

Horner RD, Kamins KG, Feussner JR, et al. Occurrence of amyotrophic lateral sclerosis among Gulf War veterans. Neurology 2003;61(6):742-9. Erratum in: Neurology 2003;61(9):1320. PMID 14504315

Kasarskis EJ, Lindquist JH, Coffman CJ, et al. Clinical aspects of ALS in Gulf War veterans. Amyotroph Lateral Scler 2009;10(1):35-41. PMID 18792848

Weisskopf MG, O'Reilly EJ, McCullough ML, et al. Prospective study of military service and mortality from ALS. Neurology 2005;64(1):32-7. PMID 15642900

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: March 1, 2018

Dystonia refers to a complex spectrum of disturbances in movement, and the differential diagnosis is even more complicated, but Drs. Andres Deik and David Coughlin make it simple. In this week's episode of the BrainWaves podcast, we'll run through the basics of a dystonia differential and approach to managing patients with these complex symptoms.

Produced by James E Siegler and David Coughlin. Music by Lee Rosevere, Rui, and the Freeharmonic Orchestra. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Albanese A, Barnes MP, Bhatia KP, et al. A systematic review on the diagnosis and treatment of primary (idiopathic) dystonia and dystonia plus syndromes: report of an EFNS/MDS-ES Task Force. Eur J Neurol 2006;13(5):433-44. PMID 16722965

Albanese A, Bhatia K, Bressman SB, et al. Phenomenology and classification of dystonia: a consensus update. Mov Disord 2013;28(7):863-73. PMID 23649720

Skogseid IM. Dystonia--new advances in classification, genetics, pathophysiology and treatment. Acta Neurol Scand Suppl 2014;(198):13-9. PMID 24588501

DISCLOSURES

Andres Deik eceived consulting royalties from Adamas therapeutics, Teva pharmaceuticals, ITF Pharma, and Cynapsus Therapeutics. His research has been funded in part by Cynapsus therapeutics and The Dystonia Coalition. David Coughlin, like Jim Siegler, has no competing financial interests to disclose.

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: January 25, 2018

We expose our soft spot this week on the show. Lindsay Raab and John Best join Jim Siegler in the studio to discuss their own personal struggles with residency and patient care and how they've battled hard to overcome them.

Produced by John Best and Lindsay Raab. Senior producer, Jim Siegler. Music by Daniel Birch, Little Glass Men, The New Valleys, Rod Hamilton, Chris Zabriskie, and Jon Watts. Voiceovers by David Manly, Erika Mejia, and Pat Green. BrainWaves' podcasts and online content are intended for medical education only. If you're in healthcare and feeling burnt out, maybe this episode will be insightful. But please do not misconstrue this as advice.

REFERENCES

Thomas NK. Resident burnout. JAMA 2004;292(23):2880-9. PMID 15598920

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: Jan 18, 2018

When it comes to stroke, treatment is dependent on the stroke mechanism. But most patients wind up on aspirin anyway. Or Plavix (clopidogrel). And sometimes both. The question this week is, Why? I hope you're hungry for some fruit because we're comparing a bunch of apples to oranges in this episode of the BrainWaves podcast.

Produced by James E Siegler. Music by William Ross Chernoff's Nomads, Steve Combs, Rui, Little Glass Men, and Peter Rudenko. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for routine clinical decision-making. Even if this episode is all about choosing aspirin or clopidogrel when you're treating stroke patients. Always talk with your doctor, and if you are a doctor, you should rely on institutional policies and your own clinical judgment when treating patients.

REFERENCES

Antithrombotic Trialists' Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002;324(7329):71-86. Erratum in: BMJ 2002;324(7330):141. PMID 11786451

Bhatt DL, Fox KA, Hacke W, et al. Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. N Engl J Med 2006;354(16):1706-17. PMID 16531616

CAST: randomised placebo-controlled trial of early aspirin use in 20,000 patients with acute ischaemic stroke. CAST (Chinese Acute Stroke Trial) Collaborative Group. Lancet 1997;349(9066):1641-9. PMID 9186381

Collaborative overview of randomised trials of antiplatelet therapy--I: Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. Antiplatelet Trialists' Collaboration. BMJ 1994;308(6921):81-106. Erratum in: BMJ 1994;308(6943):1540. PMID 8298418

CAPRIE Steering Committee. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). CAPRIE Steering Committee. Lancet 1996;348(9038):1329-39. PMID 8918275

Diener HC, Bogousslavsky J, Brass LM, et al. Aspirin and clopidogrel compared with clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients (MATCH): randomised, double-blind, placebo-controlled trial. Lancet 2004;364(9431):331-7. PMID 15276392

Hong KS, Lee SH, Kim EG, et al. Recurrent ischemic lesions after acute atherothrombotic stroke: clopidogrel plus aspirin versus aspirin alone. Stroke 2016;47(9):2323-30. PMID 27418597

Jauch EC, Saver JL, Adams HP Jr, et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2013;44(3):870-947. PMID 23370205

Kennedy J, Hill MD, Ryckborst KJ, et al. Fast assessment of stroke and transient ischaemic attack to prevent early recurrence (FASTER): a randomised controlled pilot trial. Lancet Neurol 2007;6(11):961-9.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: January 4, 2018

You've probably heard of the 10,000-hour rule--or maybe the 10-year rule. The time it takes to master a skill. But what is the evidence for this, and was Malcolm Gladwell's interpretation of it (from his book, Outliers) correct? From mindfulness to memory palaces, this week we explore the neuroscience of expertise.

Produced by James E Siegler. Music by Mozart, Brendan Kinsella, Jon Watts, Mike Durek, and Lee Rosevere. Voiceover by David Manly. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Ericsson KA, Krampe RT, Teschromer C. The role of deliberate practice in the acquisition of expert performance. Psychol Rev 1993;100:363-406.

Macnamara BN, Hambrick DZ, Oswald FL. Deliberate practice and performance in music, games, sports, education, and professions: a meta-analysis. Psychol Sci 2014;25(8):1608-18. Erratum in: Psychol Sci 2018;29(7):1202-4. PMID 24986855

Raskin E. Comparison of scientific and literary ability: a biographical study of eminent scientists and letters of the nineteenth century. J Abnormal Social Psychol 1936;31:20-35.

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: December 7, 2017

This week on the show, we're discussing the science behind the fiction of George Malley, the protagonist of the 1996 classic, Phenomenon. Specifically, we ask the question, is there a disease out there that incidentally benefits the human organism? Maybe there is...

Produced by James E Siegler. Music by Hyson, Ars Sonor, and Lee Rosevere. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Costanzo JP, Lee RE Jr, Lortz PH. Glucose concentration regulates freeze tolerance in the wood frog Rana sylvatica. J Exp Biol 1993;181:245-55. PMID 8409827

Moalem S, Weinberg ED, Percy ME. Hemochromatosis and the enigma of misplaced iron: implications for infectious disease and survival. Biometals 2004;17(2):135-9. PMID 15088940

Nagasako EM, Oaklander AL, Dworkin RH. Congenital insensitivity to pain: an update. Pain 2003;101(3):213-9.  PMID 12583863

Saloviita T, Ruusila L, Ruusila U. Incidence of Savant syndrome in Finland. Percept Mot Skills 2000;91(1):120-2. PMID 11011882

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released December 21, 2017

Nerve conduction testing should not be as puzzling as it's made out to be. This week, we break it down into individual components and use two case examples to explain how you might interpret this commonly implemented electrodiagnostic assessment.

Produced by James E Siegler. Music by Coldnoise, Jessie Spillane, Loyalty Freak Music, and Yshwa. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for routine clinical decision-making.

REFERENCES

Allen JA. Chronic demyelinating polyneuropathies. Continuum (Minneap Minn) 2017;23(5, Peripheral Nerve and Motor Neuron Disorders):1310-31. PMID 28968364

Kincaid JC. Neurophysiologic studies in the evaluation of polyneuropathy. Continuum (Minneap Minn) 2017;23(5, Peripheral Nerve and Motor Neuron Disorders):1263-75. PMID 28968361

Pareyson D, Scaioli V, Laurà M. Clinical and electrophysiological aspects of Charcot-Marie-Tooth disease. Neuromolecular Med 2006;8(1-2):3-22. PMID 16775364

Preston DC, Shapiro BE. Electromyography and neuromuscular disorders: clinical-electrophysiologic correlations. 3rd ed. London; New York: Elsevier Saunders, 2013.

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: November 30, 2017

Last week was all about how destroying bad brain can help patients with epilepsy. This week, in a stimulating discussion with Dr. Becker, we're reviewing the ways we can activate the nervous system in order to prevent future seizures: the vagus nerve stimulator, deep brain stimulation, and the responsive neurostimulation system.

Produced by James E Siegler. Music by Chris Zabriskie, Josh Woodward, and Kevin McLeod. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

A randomized controlled trial of chronic vagus nerve stimulation for treatment of medically intractable seizures. The Vagus Nerve Stimulation Study Group. Neurology 1995;45(2):224-30. PMID 7854516

Ben-Menachem E. Vagus-nerve stimulation for the treatment of epilepsy. Lancet Neurol 2002;1(8):477-82. PMID 12849332

DeGiorgio CM, Krahl SE. Neurostimulation for drug-resistant epilepsy. Continuum (Minneap Minn) 2013;19(3 Epilepsy):743-55. PMID 23739108

Fisher R, Salanova V, Witt T, et al. Electrical stimulation of the anterior nucleus of thalamus for treatment of refractory epilepsy. Epilepsia 2010;51(5):899-908. PMID 20331461

Handforth A, DeGiorgio CM, Schachter SC, et al. Vagus nerve stimulation therapy for partial-onset seizures: a randomized active-control trial. Neurology 1998;51(1):48-55. PMID 9674777

Lanska DJ. JL Corning and vagal nerve stimulation for seizures in the 1880s. Neurology 2002;58(3):452-9. PMID 11839848

Morrell MJ; RNS System in Epilepsy Study Group. Responsive cortical stimulation for the treatment of medically intractable partial epilepsy. Neurology 2011;77(13):1295-304. PMID 21917777

Morris GL 3rd, Gloss D, Buchhalter J, Mack KJ, Nickels K, Harden C. Evidence-based guideline update: vagus nerve stimulation for the treatment of epilepsy: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology 2013;81(16):1453-9. PMID 23986299

Penry JK, Dean JC. Prevention of intractable partial seizures by intermittent vagal stimulation in humans: preliminary results. Epilepsia 1990;31 Suppl 2:S40-3. PMID 2121469

Yuan H, Silberstein SD. Vagus nerve and vagus nerve stimulation, a comprehensive review: Part II. Headache 2016;56(2):259-66. PMID 26381725

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: November 23, 2017

This week on BrainWaves, we build on concepts introduced in episode 65 regarding the non-pharmacologic management of drug-resistant epilepsy. In the next two episodes, you'll hear from Dr. Danielle Becker (Penn) and Dr. Myriam Abdennadher (NIH) on the minimally invasive procedures that can drastically impact the lives of patients with refractory seizures.

Produced by James E Siegler. Music by Steve Combs, Jason Shaw, and Josh Woodward. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Kwan P, Arzimanoglou A, Berg AT, et al. Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia 2010;51(6):1069-77. Erratum in: Epilepsia 2010;51(9):1922. PMID 19889013

Nilsson L, Farahmand BY, Persson PG, Thiblin I, Tomson T. Risk factors for sudden unexpected death in epilepsy: a case-control study. Lancet 1999;353(9156):888-93. PMID 10093982

Tomson T, Nashef L, Ryvlin P. Sudden unexpected death in epilepsy: current knowledge and future directions. Lancet Neurol 2008;7(11):1021-31. PMID 18805738

Willie JT, Laxpati NG, Drane DL, et al. Real-time magnetic resonance-guided stereotactic laser amygdalohippocampotomy for mesial temporal lobe epilepsy. Neurosurgery 2014;74(6):569-84; discussion 584-5. PMID 24618797

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: September 7, 2017

Reflex testing is an art. And that makes each of us an artist. The nuances of the reflex circuitry and how to interpret reflex testing are the topics of this week's episode, starring medical student Eliana Vasquez from Texas Health Sciences Center.

Produced by Erika Mejia and James E Siegler. Music by Komiku, Jahzzar, and Jason Shaw. BrainWaves podcast and online content are intended for medical education only and should not be used in the routine care of patients. I swear, if someone tries to sue me because their doctor said, "Well, Jim told me I should hit your knee with a hammer," then I'm coming for you.

REFERENCES

Boes CJ. The history of examination of reflexes. J Neurol 2014;261(12):2264-74. PMID 24695995

Walker HK. Deep tendon reflexes. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd ed. Boston, 1990.

Watt D, Lefebvre L. Effects of Altered Gravity on Spinal Cord Excitability. American Institute of Aeronautics and Astronautics, 2001:4939.

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: September 21, 2017

Atrial fibrillation increases your risk of clotting. Anticoagulation increases your risk of bleeding. Surgery increases your risk of both. Dr. Mike Rubenstein speaks with Dr. Jim Siegler this week about how providers weigh the risks and benefits of anticoagulant bridging in the perioperative setting.

Produced by Michael Rubenstein and James E Siegler. Music by Chris Zabriskie, Lee Rosevere, and Jason Shaw. Voiceover by Erika Mejia. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making.

REFERENCES

Garcia DA, Regan S, Henault LE, et al. Risk of thromboembolism with short-term interruption of warfarin therapy. Arch Intern Med 2008;168(1):63-9. PMID 18195197

Raval AN, Cigarroa JE, Chung MK, et al. Management of patients on non-vitamin K antagonist oral anticoagulants in the acute care and periprocedural setting: a scientific statement from the American Heart Association. Circulation 2017;135(10):e604-33. Erratum in: Circulation 2017;135(10 ):e647. Erratum in: Circulation 2017;135(24):e1144. PMID 28167634

Rechenmacher SJ, Fang JC. Bridging anticoagulation: primum non nocere. J Am Coll Cardiol 2015;66(12):1392-403. PMID 26383727

Schulman S, Carrier M, Lee AY, et al. Perioperative management of dabigatran: a prospective cohort study. Circulation 2015;132(3):167-73. PMID 25966905

Steinberg BA, Peterson ED, Kim S, et al. Use and outcomes associated with bridging during anticoagulation interruptions in patients with atrial fibrillation: findings from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). Circulation 2015;131(5):488-94. PMID 25499873

Stroke Prevention in Atrial Fibrillation Study. Final results. Circulation 1991;84(2):527-39. PMID 1860198

We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode’s original release date.