Neurology & Neurosurgery

Neurology & Neurosurgery

2017 YEAR IN REVIEW

Advanced 214 # 10

NYU LANGONE HEALTH TECHNOLOGY FOR NEUROLOGY IN U.S. NEWS & NEUROSURGICAL FACULTY WORLD REPORT 550 First Avenue, New York, NY 10016 IMAGING NYULANGONE.ORG Contents

1 MESSAGE FROM THE CHAIRS

2 FACTS & FIGURES

4 2017 IN BRIEF

10 2017 IN DEPTH

11 Epilepsy Advances Target Seizure Activity, Severity

13 Complex Case: Resection of a Deep Thalamic Cavernous Malformation

16 Gamma Knife Radiosurgery—Versatility in Tumor and AVM Treatment

18 Novel Optical Assessments Offer Insight into Neurological Conditions

20 Complex Case: Intramedullary Cavernoma Calls for Intervention

22 Promising Research Fuels the Pursuit of New Alzheimer’s Pathways

24 Novel Neuromodulation Approaches for Movement Disorders

26 ACADEMIC ACTIVITIES

34 FACULTY

35 LEADERSHIP

Produced by: Office of Communications and Marketing, NYU Langone Health Writer: Royce Flippin Design: Ideas On Purpose, www.ideasonpurpose.com Primary Photographer: Karsten Moran On the cover: Nerve fibers Printing: Allied Printing Services, Inc. MESSAGE FROM THE CHAIRS Dear Colleagues and Friends:

STEVEN L. GALETTA, MD JOHN G. GOLFINOS, MD For the departments of Neurology and Neurosurgery at

NYU Langone Health, 2017 was a Philip K. Moskowitz, MD Chair, Department of year of continued advancement. Professor and Chair of Neurosurgery Our record of excellence is Neurology Associate Professor of reflected in our top 10 ranking Professor of Neurology Neurosurgery and and Ophthalmology Otolaryngology among the nation’s most elite programs, a testament to our cross-specialty impact.

Whether refining surgical techniques, sclerosis, and the Division of Neuro- insights revealed by our faculty in the uncovering novel neurodegenerative Ophthalmology is analyzing eye Division of Headache Medicine. disorder treatments, or investigating movements to aid in the diagnosis of a Promising treatments emerging from brain cancer’s biological underpinnings, variety of neurological disorders. At the clinical trials in the Center for Cognitive our faculty have extended our leadership Multiple Sclerosis Comprehensive Care Neurology and our epilepsy, MS, and in every aspect of neurological medicine. Center, clinicians are demonstrating Parkinson’s programs are quickly put Fueling this leadership are cutting- the efficacy of low-voltage transcranial into practice for the benefit of our edge diagnostic imaging techniques direct current stimulation for MS-related patients. Aided by one of the most and applications, identified through fatigue. Collaboration between the extensive and complex tissue banks in interdisciplinary collaboration. Our Brain Tumor Center and NYU Langone the country, we are advancing the Gamma Knife radiosurgery program has pathologists has enabled the first understanding of disease pathology and enabled noninvasive treatment of U.S.-certified use of 450K methylation treatment response that expands our multiple brain tumors, and our Center technology in tissue evaluations. clinical options. Prominent new for Neuromodulation is refining the latest Interdisciplinary collaboration is physician recruits at the growing Marlene generation of deep brain stimulation central to advancing our clinical and and Paolo Fresco Institute for Parkinson’s (DBS) devices for Parkinson’s disease. research progress. Our close partnerships and Movement Disorders bring DBS is also under investigation for with Neuroradiology and other specialties enhanced research and clinical rigor to Tourette’s syndrome, as we explore the have enabled such advances as MRI our programs. benefits of both DBS and Gamma Knife perfusion techniques to monitor brain With our dedicated clinicians’ and radiosurgery for obsessive-compulsive tumor treatment response. At the Eye researchers’ unique blend of focused disorder. The complex cases highlighted Movement Testing Lab, teamwork with collaboration and innovation, we are in this report are a testament to how our our Concussion Center colleagues has ready to produce unprecedented change neurosurgeons use these advances to evolved concussion diagnosis, and our in our field. Together, we will continue achieve previously impossible feats. stroke program—part of the integrated to make promising discoveries that Our faculty continue to pioneer Center for Stroke and Neurovascular transform outcomes—and realize the and advance novel technology for both Diseases—benefits from close work with great promise that neurological diagnosis and treatment. Our neuro- specialists across NYU Langone. Our and neurosurgical advances hold for ophthalmologists are using optical cross-disciplinary expertise helps us our patients. coherence tomography to expand the unravel the most complex clinical diagnostic criteria for multiple puzzles, as demonstrated by recent

Neurology & Neurosurgery 2017 | NYU Langone Health 1 FACTS & FIGURES Neurology and Neurosurgery

RESEARCH FACULTY PATIENT CARE 70 + 27 5,100 + ONGOING CLINICAL TRIALS FULL-TIME NEUROSURGERY NEUROSURGICAL IN NEUROLOGY FACULTY CASES and with more than 30 part-time and affiliated faculty 30 + ONGOING CLINICAL TRIALS IN NEUROSURGERY 214 560 + NEUROLOGY FACULTY GAMMA KNIFE CASES 20 + 20 joined in 2017 YEARS OF CONTINUOUS NIH FUNDING 91 for a single R01 grant in neurosurgery RESIDENCY POSITIONS 1,200+ 75 in neurology SPINAL NEUROSURGERY 16 in neurosurgery CASES 30 + ONGOING RESEARCH STUDIES on the treatment and prevention of ACCOLADES neurocognitive disorders 77,000 + #10 NEUROLOGY $11.75 M IN THE COUNTRY OUTPATIENT VISITS for neurology and neurosurgery NEUROLOGY GRANT FUNDING in U.S. News & World Report’s awarded in 2017 “Best Hospitals” 35 18 #1 in the Nation NEUROLOGY FACULTY AND RESIDENTS RESIDENT PRESENTATIONS FOR LOWEST MORTALITY SCORE IN involved in ongoing quality at the American Academy of and safety projects Neurology 2017 annual meeting CRANIAL NEUROSURGERY as awarded by Vizient, Inc.

2 NYU Langone Health | Neurology & Neurosurgery 2017 NYU Langone Health

View of NYU Langone Health’s main Manhattan campus, including renderings of the new Science Building (left) and the Helen L. and Martin S. Kimmel Pavilion (right), both set to open in 2018. (Image credit: Ennead Architects)

#19 #12 Leader IN THE NATION IN THE NATION IN QUALITY CARE AND and nationally ranked in 12 specialties: BEST MEDICAL SCHOOLS PATIENT SAFETY Rehabilitation, Orthopedics, FOR RESEARCH For the past four years, NYU Langone Rheumatology, Neurology & and a leader in innovation in has received top rankings for overall Neurosurgery, Geriatrics, Urology, medical education, including patient safety and quality of care Cardiology & Heart Surgery, accelerated pathways to from Vizient, Inc., formerly the Gastroenterology & GI Surgery, the MD degree University HealthSystem Consortium. Diabetes & Endocrinology, In 2017, NYU Langone received Pulmonology, Cancer, and Nephrology two significant awards from Vizient— the Bernard A. Birnbaum, MD, Quality Leadership Award and the Ambulatory Care Quality and Accountability Award for demonstrated 5 Star Rating excellence in delivering high-quality, patient-centered outpatient care. FROM CMS HOSPITAL COMPARE NYU Langone Health is the only full-service hospital in New York State and one of 9 percent of hospitals nationwide to receive a five-star rating from the Centers for Medicare and Medicaid Services (CMS). The rating reflects overall safety, quality, and patient experience.

Neurology & Neurosurgery 2017 | NYU Langone Health 3 2017 IN BRIEF Research and Innovation Transform Clinical Outcomes

Adelene E. Jann, MD, and Lawrence C. Newman, MD

Homing In on Cutting-Edge Headache Therapies

In the newly expanded Division of Headache Medicine, specialists are leading clinical trials aimed at delivering new treatment options for chronic or intractable headaches. In one phase III clinical trial, investigators are testing an experimental drug that works by blocking calcitonin gene– related peptide (CGRP), a neurotransmitter thought to trigger migraines. Researchers are exploring whether eptinezumab, administered via injection once every 12 weeks, can prevent chronic and frequent episodic migraines. “The trials have been very promising, with minimal side effects,” says Lawrence C. Newman, MD, professor of neurology and director of the Division of Headache Medicine. “Results tend to be seen within a week or so—much faster than with Advances in Epilepsy Target other medications.” Seizure Activity and Severity

BREAKING THE HEADACHE CYCLE At the Comprehensive Epilepsy Center, recent research and clinical trials are shedding new light on The new drug would add to the range of headache treatments ways to reduce the severity of seizures and provide currently available, including those offered at a new infusion better quality of life for patients with epilepsy and center at NYU Langone, where patients are administered related disorders. Building on the center’s pioneering targeted treatments that often provide relief within the hour. application of the cannabis-derived drug cannabidiol, The division is also teaming with physicians investigators uncovered new signs of efficacy that at NYU Langone’s Concussion Center and vestibular could lead to FDA approval of the drug for seizures rehabilitation program to increase our understanding of the associated with Dravet syndrome and Lennox-Gastaut mechanisms of headache associated with head trauma. “Each syndrome. On another drug front, a phase II trial of member of our collaborative team is interested in sharing inhaled alprazolam is offering encouraging data their expertise to enhance the field,” notes Dr. Newman. demonstrating rapid absorption stems oncoming Recently, headache faculty began offering an elective rotation seizures, supporting use of the drug as a rescue in headache medicine, in which neurology residents are medication. Researchers are also continuing their exposed to the full range of headache disorders. efforts to unravel the mystery of sudden unexpected “Although just a few drugs are currently FDA-approved death in epilepsy (SUDEP). Spurred by newly for migraine prevention, our growing understanding of uncovered estimates of SUDEP prevalence indicating headache mechanisms continues to augment our armamen­ that earlier estimates were understated, the center is tarium of treatments that provide relief,” adds Dr. Newman. pursuing a new technology that would use heightened nervous system activity to warn family members of SUDEP onset—and potentially save lives.

Read more on PAGE 11

4 NYU Langone Health | Neurology & Neurosurgery 2017 Complex Case: Multidisciplinary Expertise and Precision Imaging Enable Resection of a Deep Thalamic Cavernous Malformation

Vascular lesions of the thalamus are rare, and A patient with a deep thalamic cavernous information on their surgical removal is limited to a malformation turned to NYU Langone after being told small series of case reports. Although excellent by multiple surgeons that his lesion was inoperable. outcomes have been reported with a well-planned Leveraging cutting-edge research, advanced surgical approach, complications of surgery include neuroimaging techniques, and cerebrovascular devastating neurological injury. If the lesion is left surgical expertise, the multidisciplinary­ untreated, however, mass effect, secondary neurovascular team at the Center for Stroke and compromise of the microcirculation, and irritation of Neurovascular Diseases planned and executed a the cortical and subcortical tissue by local deposition successful resection of this patient’s thalamic of hemosiderin from microhemorrhages can result in cavernoma and enabled his swift recovery. progressive neurological deficits and seizures. Read more on PAGE 13

Research Targets Triggers and Symptoms of Multiple Sclerosis

secondhand smoke, and childhood trauma. “We’re making significant headway in identifying these environmental triggers,” notes center director Lauren B. Krupp, MD, the Nancy Glickenhaus Pier Professor of Pediatric Neuropsychiatry. “It’s my belief that what we’re finding in pediatric MS is also relevant to adults with MS and likely relevant to other autoimmune diseases as well.” Separately, a randomized controlled study published in September 2017 in the Multiple Sclerosis Journal showed that 20 sessions of portable transcranial direct current stimulation (tDCS), using an NYU Langone–customized device that delivers low-voltage electric current to the scalp, significantly alleviated MS-related fatigue in adults. “This is a major advance, since we have no effective medication to treat the Leigh E. Charvet, PhD, and Lauren B. Krupp, MD fatigue MS patients so commonly experience,” notes Leigh E. Charvet, PhD, associate professor of neurology, who led the research—the first-ever controlled study of tDCS NYU Langone’s Multiple Sclerosis Comprehensive Care benefits for MS patients. In a complementary controlled Center continues to uncover and pioneer novel approaches study, published in PLOS One in 2017, an in-home, computer- to multiple sclerosis (MS) symptom control, disease based cognitive remediation program was found to management, and treatment. significantly improve subjects’ performance on various In a seminal 2018 publication in the Journal of Neurology, neuropsychological tests. Neurosurgery & Psychiatry, center researchers identified an Researchers also continue to analyze and publish data important potential environmental trigger for MS, showing collected through the center’s participation in the MS PATHS that young MS patients with a lower intake of saturated fat project—a multicenter effort in which iPads are used to collect had fewer relapses compared to those with a high intake. detailed data from patients at each clinical visit. “So far, The new findings are part of an ongoing investigation of 5,000 people have been evaluated,” notes Dr. Krupp. “We’ll environmental factors that can exacerbate genetic combine this information with MRI data on new lesions and, predisposition to pediatric MS, with other potential risk eventually, outcome measurements to significantly advance factors including childhood obesity, pesticide exposure, clinical MS research.”

Neurology & Neurosurgery 2017 | NYU Langone Health 5 Commitment to Discovery Yields New Hope for Brain Cancer

At the Brain Tumor Center, recent research breakthroughs because transcription factor SOX2 was silenced. This effect enabled by the center’s unique cross-disciplinary collaboration was traced back to reduced binding of chromatin organizer have brought investigators closer to major therapeutic and CTCF to DNA, which led to the unraveling of the chromatin diagnostic discoveries. structure and the silencing of SOX2 by preventing SOX2’s In one such advance, a research team led by Dimitris G. promoter from interacting with nearby enhancer elements. Placantonakis, MD, PhD, assistant professor of neurosurgery, “We’ve uncovered one of the first examples of chromatin identified GPR133, a protein not normally found in the restructuring acting as a mechanism in tumor formation— brain, on the cell surfaces of glioblastoma tissue—making it which ultimately could apply to many cancer types,” notes a promising target for novel therapies. “It turns out that the Dr. Placantonakis. “In addition, our low-grade glioma model protein is found in all glioblastomas, and we’ve shown can be used to screen drugs and test new therapies.” that when we knock it down, the tumor cells die,” says Dr. Placantonakis. The lab’s discovery, published in COLLABORATION LEADS TO DIAGNOSTIC PROGRESS Oncogenesis in 2016 and Clinical Neurosurgery in September 2017, has led to a patent application and collaboration with The Brain Tumor Center, working closely with molecular a U.K. pharmaceutical firm and NYU Langone’s Office for pathologists and neuropathologists, will become the first Therapeutic Alliances to develop GPR133-inhibiting molecules. U.S. program certified to use genomic DNA methylation In another breakthrough, published in the October 2017 technology in clinical evaluations of brain tumors. The issue of Cell Reports, researchers studied human neural stem technology, developed for research use at NYU Langone by cells engineered to express the IDH gene mutation that is found Matija Snuderl, MD, assistant professor of pathology and in the majority of low-grade gliomas. This mutation caused the director of Molecular Pathology, can determine a brain tumor’s neural progenitors to develop into low-grade astrocytoma-like genetic subtype by means of a single high-throughput, cells. The lab discovered that the cells quickly stopped comprehensive DNA test on a small brain tissue sample. differentiating—an important first step in tumor creation— “Our early adoption of this forward-thinking diagnostic

Dimitris G. Placantonakis, MD, PhD

6 NYU Langone Health | Neurology & Neurosurgery 2017 Gamma Knife Radiosurgery Offers Versatility in Treating Brain Tumors and AVMs

Ongoing research continues to uncover and enhance the efficacy of Gamma Knife radiosurgery for an expanding array of conditions, including cancer and arteriovenous malformations (AVMs). Aided by enhanced surveillance, physicians at NYU Langone are tracking and targeting tumors more precisely and employing Gamma Knife’s versatility to treat conditions previously considered untreatable, improving options and outcomes for the most complex cases. The approach is illustrated by two recent, very different cases in which Gamma Knife radiosurgery’s precision proved invaluable: the Axial T2 and FLAIR MRIs showing the T2-FLAIR mismatch imaging successful treatment of a patient with more than sign for the preoperative diagnosis of IDH mutated and 1p/19q non-codeleted gliomas 25 individual tumors and the highly delicate resolution of an otherwise unresectable AVM.

Read more on technology puts us in a strong position to move it from the lab PAGE 16 to the clinical setting,” says Andrew S. Chi, MD, PhD, assistant professor of medicine, neurology, and neurosurgery, chief of neuro-oncology, and co-director of the Brain Tumor Center at Perlmutter Cancer Center. Novel Optical Assessments Separately, Rajan Jain, MD, associate professor of radiology and neurosurgery, has discovered a novel structural biomarker Provide New Windows into known as a T2-FLAIR mismatch, which is 100 percent indicative Neurological Conditions of a molecular subtype of glioma that carries an IDH gene mutation and lacks codeletion of chromosomes 1p and 19q. As researchers and clinicians pursue new modes of This biomarker, reported in July 2017 in Clinical Cancer Research, treatment for complex neurological diseases, can be easily detected using conventional clinical brain MRI advancements in optical coherence tomography scans, without specialized equipment or invasive protocols. (OCT)—capable of delivering images at 1,000 times “It’s what we’re all looking for—a way to diagnose a tumor’s the resolution of MRI—and the expansion of OCT molecular subtype without having to open the skull,” says Dr. Chi. applications have enhanced clinicians’ capacity to In another project, Dr. Jain is pioneering the clinical use of diagnose and treat these conditions. OCT and other MRI perfusion to better visualize how certain tumors respond vision-based diagnostic tools have enabled the to therapy. visualization of optic nerve lesions associated with “It’s becoming clear that molecular subtyping is necessary multiple sclerosis, adding weight to efforts to for optimal management of brain tumors,” notes Dr. Chi, “since incorporate these markers in diagnostic criteria for each subtype may respond differently to specific therapies.” the disease. In traumatic brain injury, the new Breakthroughs, then, will come not only from developing new visualization techniques are being used to elucidate classes of drugs and immune therapies, but also from identifying the mechanisms behind retinal loss associated with which molecular subtype is sensitive to a given therapy. “That’s concussion and other neurological conditions. why developing rapid, robust molecular subtyping diagnostics that can easily be applied to the clinical setting is so critical,” Read more on adds Dr. Chi. PAGE 18

Neurology & Neurosurgery 2017 | NYU Langone Health 7 Collaboration among Neuroradiologists and Neurosurgeons Enables Neuroimaging Firsts

The partnership between NYU Langone neurosurgeons and neuroradiologists contributes to continued advancements in the field of neurosurgical planning, pushing the limits of imaging technology and fundamentally shifting approaches to surgery. Among recent innovations: reduced field-of-view diffusion MRI; three-dimensional volumetric MRI; and advanced diffusion tractography, applied to spinal neurosurgery for the first time at NYU Langone. These technologies provide real-time maps of spinal cord tumor location and the relative positions of important spinal cord white matter tracts to improve safety and surgical outcomes.

“Imaging science experts have developed newer techniques New MRI sequences for improved preoperative planning and for the conventional diffusion tractography already used real-time intraoperative surgical navigation in cervical spinal cord tumors: a gradient-based sequence for gray-white by our neuroradiologists, giving us unprecedented differentiation (A), a cardiac-gated high-angular resolution visualization of brain and spinal cord structures,” explains diffusion protocol to precisely locate the corticospinal tracts and dorsal columns without tractography (B), and greatly Timothy M. Shepherd, MD, PhD, assistant professor of improved tractography (C) radiology. Dr. Shepherd’s team is working on a novel protocol that will enable surgeons to visualize important eloquent white matter pathways, such as the arcuate fasciculus, even in the presence of edema. “Edema or mass effect from tumors can impair our ability to visualize these pathways with Complex Case: Cutting-Edge conventional tractography for operative planning and is a major imaging challenge in neurosurgery,” says Dr. Shepherd. Neuroimaging Adapted to Safely “By seeing through edema effectively, we can enhance the Resect a Challenging Spinal Tumor accuracy of the brain maps we provide for neurosurgical navigation—and thus reduce patient risk.” The use of newer imaging technologies such as advanced diffusion tensor imaging (DTI) has enabled safe resection of once-inoperable spinal cord PROGRESS IN IMAGING ENABLES PRECISION tumors. Initially pioneered for brain surgery, the Neuroradiologists are also preparing to publish their novel use technology was used in the spine for the first time by of simultaneous multi-slice diffusion and track density Anthony K. Frempong‑Boadu, MD, associate imaging to directly visualize key anatomical targets in the professor of neurosurgery and director of the brain for functional neurosurgery applications. “The Division of Spinal Surgery. This was two years before sequence has been around for a few years, but it’s never been a 29-year-old patient presented with a risky intra­ altered in this way to make it practical for use in patients. medullary cavernoma whose removal carried the risk Our collaboration with colleagues in imaging physics, of permanent morbidity. These rare tumors—only a neurology, and neurosurgery helped us realize its value for small fraction of all the central nervous system functional neurosurgery,” explains Dr. Shepherd. With this lesions that are seen—are so complex that few sequence, the modified images show the structures and centers are equipped to treat them. For this patient, inter­connections in the thalamus, subthalamus, and basal Dr. Frempong-Boadu teamed with neuroradiologists ganglia regions in more detail than was previously possible, to apply the leading-edge DTI approach, creating an advance that will help surgeons to more clearly visualize visual touchpoints for the surgery that enabled where deep brain stimulation electrodes are being placed. resection of the tumor while leaving the patient’s “This is another example of how enhanced imaging is neurological function—and quality of life—intact. moving us away from indirect targeting based on anatomical atlases,” adds Dr. Shepherd. “The methods our work uncovers Read more on could have a profound impact on functional neurosurgery— PAGE 20 ultimately improving outcomes and decreasing risk.”

8 NYU Langone Health | Neurology & Neurosurgery 2017 Novel Drugs and Biological Discoveries Accelerate Hunt for an Alzheimer’s Cure

With 12 ongoing clinical trials, NYU Langone’s Center for Cognitive Neurology is one of the world’s most active centers for research on Alzheimer’s disease and other neurocognitive disorders. The center’s more than 70 researchers are working across a range of disciplines to unravel the root causes of these conditions. Research into immunotherapies for Alzheimer’s and related dementias is one of the Steven J. Frucht, MD, and Andrew S. Feigin, MD pathways offering promise—and the recently published groundbreaking studies are paving the way for human trials. At the same time, investigations into the biological mechanisms behind these conditions— New Leadership Renews Commitment including several studies funded by the National to Translational Research in Movement Institutes of Health—are yielding new insights into Disorder Treatment the proteomic and genetic markers of Alzheimer’s that could eventually lead to a preventive treatment. With newly appointed leadership, the Division of Parkinson’s and Movement Disorders at NYU Langone is increasing its Read more on focus on translational research. Steven J. Frucht, MD, PAGE 22 professor and associate chair of neurology and director of NYU Langone’s Division of Parkinson’s and Movement Disorders, and Andrew S. Feigin, MD, professor and associate chair of neurology and executive director of the Marlene and Innovative Neuromodulation Paolo Fresco Institute for Parkinson’s and Movement Approaches for Movement Disorders Disorders, bring a mix of experience that will help the division cultivate new pathways for transforming its research At the Center for Neuromodulation, new and discoveries into new therapies. expanded applications of deep brain stimulation Both Dr. Frucht and Dr. Feigin have launched clinical trials (DBS) and related innovations are targeting testing novel vaccines and antibody drugs designed to block symptoms and enhancing quality of life for patients toxic brain proteins, including alpha-synuclein and tau with Parkinson’s disease, tremor, and other disorders. proteins, thought to contribute to movement disorders. In The center has been involved in clinical trials of addition, institute researchers will investigate novel methods newer DBS technologies and devices, giving of administering symptom-relieving medications such as clinicians a unique view of their efficacy in delivering subcutaneous infusion of levodopa and dopamine agonists, electrical stimulation to targeted brain regions to and new imaging techniques that may yield movement reduce motor symptoms of Parkinson’s, essential disorder biomarkers. tremor, and dystonia. The DBS technologies provide Clinicians and researchers will also work closely with additional options—and new therapeutic targets—for colleagues across NYU Langone to develop a new biological personalizing treatment of Parkinson’s symptoms understanding of movement disorders and refine leading- while limiting side effects and also offer new hope as edge diagnostic and treatment approaches—including deep an off-label treatment for the debilitating symptoms of brain stimulation for Parkinson’s symptoms and eye severe Tourette’s syndrome. The expanding field of movement tracking technology for diagnosis—to improve neuromodulation also includes MRI-guided focused quality of life for patients with these disorders. ultrasound, which targets areas of the brain linked “We have a unique opportunity to establish the institute as to tremor and other symptoms, eliminating the need a leading center for clinical and translational research for for surgery while potentially mitigating symptoms. movement disorders,” says Dr. Frucht, who has been involved in many Parkinson’s studies as well as pilot studies of Read more on refractory movement disorders. “Together, we will provide PAGE 24 multidisciplinary care while simultaneously advancing clinical research,” adds Dr. Feigin.

Neurology & Neurosurgery 2017 | NYU Langone Health 9 2017 IN DEPTH Pushing Treatment Boundaries through Collaboration and Discovery

John G. Golfinos, MD, and Andrew S. Chi, MD, PhD

10 NYU Langone Health | Neurology & Neurosurgery 2017 EPILEPSY

Epilepsy Studies Uncover New Options for Shortening Seizures—and Extending Lives

A growing body of knowledge, informed by recent investigations and clinical trials at the Comprehensive Epilepsy Center, could equip physicians and family members with new tools for stemming seizures and preventing sudden death in patients with epilepsy and related disorders.

SUCCESSFUL CANNABIDIOL TRIAL found that cannabidiol in liquid form syndromes, according to lead author HERALDS FIRST TREATMENT reduced seizures in children and Orrin Devinsky, MD, professor of FOR DRAVET-RELATED SEIZURES young adults with Dravet syndrome by neurology, neurosurgery, and psychiatry 39 percent on average. Two other soon- and director of the Comprehensive Epileptologists have uncovered a to‑be-published studies found that the Epilepsy Center. “The FDA could approve potential new treatment option in the drug also reduced the frequency of it as soon as mid-2018, which would be a cannabis-derived drug cannabidiol drop seizures in individuals with Lennox- huge milestone,” says Dr. Devinsky. (Epidiolex), shown to significantly reduce Gastaut syndrome, another form of NYU Langone Health has been involved convulsive seizures related to Dravet epilepsy that often resists drug treatment. in cannabidiol’s pharmaceutical syndrome, a rare pediatric-onset disorder On the basis of these studies, development from the very beginning, for which there are currently no U.S.- cannabidiol will soon be formally having hosted the first meeting with the approved medications. submitted for FDA approval as a treatment drug’s manufacturer to discuss these trials The Dravet trial, published in May 2017 for both Dravet and Lennox-Gastaut five years ago. in The New England Journal of Medicine,

Orrin Devinsky, MD

Neurology & Neurosurgery 2017 | NYU Langone Health 11 EPILEPSY

INHALED ALPRAZOLAM SHOWS PROMISE NYU Langone–affiliated nonprofit FACES greater than the number reported by the AS A PRE-SEIZURE RESCUE MEDICATION (Finding a Cure for Epilepsy and Seizures), medical examiner. researchers are now collaborating with a “Combine this new estimate with the Separately, NYU Langone researchers start-up enterprise to support the yearlong number of deaths of people with epileptic are spearheading a phase II clinical efficacy trial. seizures that result in drowning, car trial testing an inhaled form of the accidents, or falls,” says Dr. Devinsky, benzodiazepine alprazolam (Xanax) as a “and it becomes clear that epilepsy-related rescue medication for incipient seizures. UNRAVELING THE MYSTERY OF death is an underestimated and under- “Oral benzodiazepines are already used EPILEPSY-RELATED SUDDEN DEATH addressed public health problem.” to shorten the duration of seizure clusters, Ongoing research continues to unravel the To address this issue, researchers are but they don’t work fast enough to prevalence and biology of SUDEP. One studying a wrist sensor that monitors actually abort a seizure when a person finding, published in August 2017 in sympathetic nervous system activity via feels it coming on,” explains Jacqueline A. Neurology, suggests that the annual the skin. The goal is twofold: to examine French, MD, professor of neurology and number of deaths from SUDEP in the the link between heightened electro­ director of Translational Research and United States could actually be far higher dermal activity and the onset of seizures Clinical Trials at the Comprehensive than the reported and widely accepted and to explore the device’s usefulness in Epilepsy Center. “This approach uses a number of 3,000. The recalculation was warning family members of a potential device that vaporizes the medication so based on an examination of data for all SUDEP-causing seizure. the lungs absorb it at a rapid rate, nearly sudden cardiac deaths in the San “Our continued research has revealed equivalent to an intravenous dose.” Francisco area over a three-year period. one more clue we can pursue to unravel A preliminary study with individuals Researchers reviewed autopsy and the mystery of SUDEP,” notes Dr. Devinsky. susceptible to light-induced seizures medical records of any decedents with a “In time, with further resources devoted to showed that inhaled alprazolam produced history of seizures or epilepsy, and understanding how these deaths occur, an anti-seizure effect within two minutes. concluded that the number of definite or we hope to prevent them.” Through a connection made via the possible SUDEP cases was three times

HUMAN EPILEPSY PROJECT: HUNTING FOR BIOMARKERS TO OVERCOME TREATMENT RESISTANCE

In an effort to find biomarkers enabling early identification of This information is being logged in a data bank, where it can be treatment-resistant epilepsy, the Human Epilepsy Project mined by collaborating scientists. “We know that a third of recently enrolled 500 newly diagnosed focal-seizure epilepsy people with epilepsy won’t respond well to any medication, but patients in a multisite study co-led by NYU Langone. For three currently there’s no way to determine at the onset of treatment years, researchers will follow patients in the United States, who they are,” says Dr. French. “This is an effort to understand Europe, and Australia, gathering biological information including the biological drivers behind that resistance.” DNA and blood samples, urinalyses, EEG readings, and a special Three proposals from scientific groups seeking to examine MRI evaluation while also tracking participants’ response to specific biomarkers have been green-lit, she adds. Two will epilepsy medications. explore autoimmune factors, believed to trigger epilepsy in some cases. A third group is looking at a blood biomarker involved in inflammation, which is hypothesized to exacerbate seizures.

The project has already yielded one unexpected discovery: Many study subjects were found to have experienced subtle seizures for months or years before their epilepsy diagnosis. “People can experience numerous safety issues if their diagnosis is delayed,” notes Dr. French. “This finding indicates that we need to better help the public and the medical community to identify seizures.”

Jacqueline A. French, MD

12 NYU Langone Health | Neurology & Neurosurgery 2017 NEUROVASCULAR

Complex Case: Progressive Symptoms Point to the Resection of a Deep Thalamic Cavernous Malformation

Previously advised against surgery because of the risky location of his thalamic lesion, a patient found new hope in NYU Langone Health’s Center for Stroke and Neurovascular Diseases and an advanced approach carefully coordinated by a multidisciplinary team.

In the 16 years since a right thalamic cavernous malformation was identified on MRI imaging, the patient had had multiple hemorrhages, a relatively common complication of thalamic cavernous malformations. In addition to expansion of the lesion, the patient had also experienced progressive hemisensory loss and dysesthetic pain syndrome, making treatment imperative. “The patient had been told by other surgical teams that the cavernous malformation was inoperable, because there was increasing concern about progressive functional damage,” says Howard A. Riina, MD, professor of neurosurgery, neurology, and radiology. “It was critical to find a surgical approach that could help mitigate potential risks, including left hemiplegia and venous infarction of the thalamus.”

PREOPERATIVE PLANNING AND TARGETED MAPPING SET TRAJECTORY FOR SUCCESS

The optimal resection approach for a thalamic cavernous malformation depends on the location of the malformation in the thalamus. This patient’s malformation was in the lateral posteroinferior region, bordered anteriorly by the medial and lateral thalamus, so that a parieto-occipital transventricular approach through the superior parietal lobe could be used to bypass the optic radiations and the somatosensory region.

“We decided that the best way to access the malformation safely was to perform the procedure through a small tube, a minimally invasive approach typically used for brain tumors,” explains Dr. Riina, who handled the Howard A. Riina, MD

Neurology & Neurosurgery 2017 | NYU Langone Health 13 NEUROVASCULAR

Three-dimensional preoperative imaging was used to The final trajectory—through the superior parietal lobe—was assess the location of the pathology and relevant anatomy. identified as the best approach for a successful resection.

cerebrovascular aspects of the surgery. and otolaryngology and chair of the to the surface, just as we had seen in “Rather than cut into the thalamus, we Department of Neurosurgery, and presurgical imaging,” Dr. Riina recalls. “We found a very simple trajectory through the Jeffrey H. Wisoff, MD, professor of worked in turns to resect the cavernous ventricle, from which I could extend into the neurosurgery and pediatrics. Continuous malformation and evacuate old hemorrhage thalamus to gain access to the lesion.” stereotactic guidance and tractography products so that we could ensure that we supported the procedure’s navigation, reached the borders in all planes.” Advanced imaging was imperative to guide while Surgical Theater and Brainlab the surgeons’ precision approach. Using The thorough excision of the malformation projections oriented the surgeons to the Surgical Theater’s surgical planning was enabled by comprehensive, imaging- limits of the tumor, confirmed the approach software to combine MRI, MR angiography, aided preplanning that allowed the surgical vector, and guided the placement of the and diffusion tensor imaging, the team team to choreograph the removal without tubular retractor. The surgeons worked as selected a target point. The combination of leaving a trace—and set the patient on a a team throughout the procedure, with the data sets into a three-dimensional swift path to recovery. “Two days after the each surgeon rotating in at critical surgical planning model allowed the operation, the patient went home,” reports junctures to lend his specific expertise. surgeons to map multiple trajectories and Dr. Golfinos. “This is a remarkable outcome choose the best one: through the posterior After performing a circular craniotomy, given the lesion’s treacherous location and medial parietal lobe, superior to the optic the dura was opened in cruciate fashion. the precision approach it demanded.” radiations and posterior to the The operating microscope was introduced somatosensory cortex, to the lesion. The through a prominent sulcus selected as borders of the cavernous malformation the entry point. To displace delicate MULTIDISCIPLINARY COLLABORATION were simultaneously drawn in the Brainlab tissues and folds of the brain—and limit AND CONCENTRATED RESOURCES image guidance system to create a lesion intraoperative damage—a tubular retractor ENHANCE NEUROVASCULAR CARE volume around the target. This combined was advanced along the chosen trajectory This achievement, notes Dr. Riina, is a credit approach, using surgical planning software into the atrium of the lateral ventricle, to the collaboration and teamwork fostered and image guidance, provided surgical entering the thalamus at a point identified by experts in the Center for Stroke and access that transversed the least amount of by the microscope and pointer as superior Neurovascular Diseases. “These lesions brain tissue, significantly reducing the risk and lateral to the choroid plexus. Precise would be extraordinarily difficult for of complications and permanent injury. navigation for microdissection was enabled surgeons to treat without the concentration by visual tracking. of advanced neuroimaging, protocols, and neurosurgical expertise available at INTRAOPERATIVE PROJECTIONS Immediately after making a small NYU Langone,” he adds. “Our center is IMPROVE SURGICAL PRECISION corticectomy, the surgeons encountered hemosiderin staining within the tissue. unique in that respect, giving patients with With planning in place, Dr. Riina was joined A large developmental venous anomaly was unique and complex cases options for in the operating room by John G. Golfinos, identified medially and preserved intact. successful surgical treatment that are MD, associate professor of neurosurgery “The lesion was only a few millimeters deep simply unavailable elsewhere.”

14 NYU Langone Health | Neurology & Neurosurgery 2017 NEW CENTER PROVIDES AN INTEGRATED FRAMEWORK FOR STROKE AND OTHER NEUROVASCULAR CARE

Launched in 2017, the NYU Langone Center for Stroke and In addition, the new center will support ongoing training and Neurovascular Diseases has established a multidisciplinary education initiatives in neurovascular medicine, with fellowships clinical and research hub for its preeminent stroke and planned in stroke neurology, interventional neuroradiology, and neurovascular capabilities. vascular interventional neurosurgery.

“We seized the opportunity to create a highly specialized center that integrates the latest research, educational, and clinical advances for patients with stroke and neurovascular disease,” says the center’s director, Howard A. Riina, MD, professor of neurosurgery, neurology, and radiology. Over 1,100 The center comprises the institution’s renowned Comprehensive Stroke Center and its cerebrovascular VASCULAR PROCEDURES neurosurgery program, as well as its neurocritical care, stroke PERFORMED IN THE PAST YEAR neuroradiology, and interventional neuroradiology divisions. By providing a shared framework, the center will ensure that the latest advances in neurovascular diagnoses, treatments, and patient care are readily shared across these programs, while facilitating collaboration among clinical and basic science investigators in these areas.

CERTIFICATION RECOGNIZES COMPREHENSIVE STROKE CENTER, REAFFIRMS ONGOING NEUROVASCULAR RESEARCH

In September 2017, the high-volume stroke units at “These approaches represent the new standards of post-stroke NYU Langone’s Tisch Hospital in Manhattan and NYU Langone care at work in our center,” notes Koto Ishida, MD, assistant Hospital–Brooklyn were, for the first time, certified as a single professor of neurology and director of NYU Langone’s Stroke Comprehensive Stroke Center by the Joint Commission. In its Service. “Our certification was a chance to look back at our assessment, the commission praised the rapid, seamless growth and accomplishments over the last few years and integration of the two campuses, and the center’s emphasis on redouble our research efforts—with our newly integrated team— the entire stroke care continuum, enabled by the center’s to offer new hope for stroke patients.” excellent rehabilitation facilities and innovative research initiatives. The joint certification underscores NYU Langone’s commitment to providing cutting-edge neurovascular care for a large—and expanding—patient population. 55 % Reduction In one avenue of research at the center, investigators are pursuing strategies to help restore function after a stroke, such IN MEDIAN TIME TO tPA as improving hand and arm function by promoting connections IN THE PAST 7 YEARS between the two sides of the brain. Additional center protocols showing promise for stroke patients include the use of music to create enriched environments, tailored treatment to facilitate movement and reduce muscle stiffness, and the creation of personalized rehabilitation protocols based on data feedback from interactive devices.

Neurology & Neurosurgery 2017 | NYU Langone Health 15 GAMMA KNIFE

Gamma Knife Radiosurgery Delivers Precision Treatment for Brain Tumors and AVMs

Two recent, very different, very complex cases highlight the utility and efficacy of Gamma Knife radiosurgery for brain tumors and arteriovenous malformations.

PRECISION RADIOSURGERY COMBINES A recent patient provides a case in WITH GENETICALLY TAILORED DRUGS point. Referred to Dr. Kondziolka for GAMMA KNIFE REGISTRY TO CONTROL CANCER consultation, the patient had been ENABLES RESEARCH, previously diagnosed with, and treated For cancer patients with brain metastases, ENHANCES CARE for, lung cancer, which involved a conventional whole-brain radiation mutation that made it susceptible to a treatment can result in a host of side targeted drug treatment. In addition to effects, including memory impairment, Having registered several the lung cancer, the patient was found to fatigue, hair loss, and reduced thousand patients, NYU Langone have 15 small tumors in his brain. “We independence. With the use of Gamma physicians are the leading used precisely targeted Gamma Knife Knife radio­surgery, a more targeted contributors to the American radiosurgery to destroy all 15 tumors, and effective alternative, notes Douglas S. Association of Neurological the patient responded beautifully,” notes Kondziolka, MD, the Gray Family Surgeons/ASTRO national Dr. Kondziolka. Professor of Neurosurgery, professor of radiosurgery registry, which During the next year, the patient’s lung radiation oncology, vice chair of maintains detailed information on cancer improved with drug treatment, and Clinical Research in the Department patient conditions, histories, and quarterly brain scans showed he was clear of Neurosurgery, and director of outcomes. The information is of brain tumors. A year after the initial NYU Langone’s Gamma Knife program, available on demand to Gamma Knife treatment, however, 13 new patients can be spared these side effects. NYU Langone physicians, and to brain tumors appeared. “With quarterly Paradoxically, as systemic treatments physicians across the country, to surveillance, we spotted them early, when improve for various cancers, the inform care and improve patient they were still small,” says Dr. Kondziolka, incidence of metastases in the brain—less diagnosis and treatment. “and at that size, we expected these new affected by systemic therapies—is tumors to respond very well again.” The greatest value of the registry increasing, making their targeted As before, Dr. Kondziolka’s team is that the outcome data are treatment more important than ever. In treated the 13 tumors with the Gamma always available; a physician 2017, Dr. Kondziolka and colleagues at Knife and the patient continued on drug studying the effectiveness of NYU Langone published a study in the therapy. A year later—two years after the radiosurgery for a specific Journal of Neurosurgery demonstrating patient’s first brain cancer diagnosis—he condition can retrieve those cases tumor control rates near 100 percent remains active and without symptoms, quickly. “Keeping the registry for brain tumors less than a centimeter which Dr. Kondziolka attributes in part to current involves significant time in diameter that had been targeted early. the effective genetically targeted lung and effort, with information “As the evidence continues to mount cancer treatment and in part to the early required prospectively on each and prove the Gamma Knife’s efficacy, detection and successful radiosurgery patient, every day—with the payoff more oncologists are surveilling patients of the brain tumors that did occur. being complete data access,” and finding brain tumors earlier— Although tumors could recur, notes notes Dr. Kondziolka. As the enabling us to be more proactive and to Dr. Kondziolka, that has not happened, registry continues to evolve, its avoid neurological symptoms,” and the patient maintains perfect applications are expected to says Dr. Kondziolka. neurological function. “Patients like these expand, guiding surgeons toward are breaking the ‘rules’ of cancer,” he adds. enhanced outcomes as part of a data-driven approach to patient care.

16 NYU Langone Health | Neurology & Neurosurgery 2017 GAMMA KNIFE SURGERY FOR AN “UNRESECTABLE” AVM

Treatment of arteriovenous malformations (AVMs) in the brain­- Several years later, that plan became untenable, when the AVM stem always presents a clinical challenge because of the region’s hemorrhaged and caused a stroke. “At this point, we had to do many critical neurologic functions, but in many cases the something,” continues Dr. Kondziolka. “I talked to colleagues Gamma Knife has proved to be a critical tool in their treatment. around the country, and we decided to attempt a very careful In 2017, the NYU Langone radiosurgery team co-authored a treatment approach using the Gamma Knife.” series of publications—two that appeared in the journal In collaboration with NYU Langone’s neuroradiologists, the team Neurosurgery and a third in World Neurosurgery—highlighting employed diffusion tensor imaging during the procedure to multicenter studies of Gamma Knife surgery outcomes for AVMs visualize the brainstem nerve fiber tracts. Then, to avoid injuring in the brain, all affirming the surgery’s efficacy for patients less the nerve fibers, they used a small amount of Gamma Knife suitable for resection or curative embolization. energy to target the AVM. “It was a very precise use of the For some patients with highly complex AVMs, the Gamma Knife technology,” notes Dr. Kondziolka. provides a surgical option when traditional resection is ruled out. A year later, the patient is doing well. “The AVM looks like it’s One such patient presented to Dr. Kondziolka more than five closing off, the patient’s motor tracts are fine, and he is an active years ago with a congenital brainstem AVM so complex, it was young man,” says Dr. Kondziolka. “This patient experienced an thought to be untreatable. The whole brainstem looked like a excellent outcome for what was thought to be an unresectable massive collection of blood vessels, requiring a very thoughtful condition,” he says. “We’re seeing more and more cases where treatment approach. “At that time, nobody knew what to do—you Gamma Knife changes the trajectory of treatment, ultimately could never have cut it out,” notes Dr. Kondziolka. “Because of delivering a positive outcome.” its complexity, we decided not to touch this AVM.”

Presurgical diffusion tractography of the left corticospinal tract in the brainstem, showing a large AVM centered in the mid and rostral pons.

Six months after treatment, the vascular mass has reduced in size and the tract remains intact and in stable position within the central pons.

Neurology & Neurosurgery 2017 | NYU Langone Health 17 NEURO-OPHTHALMOLOGY

Vision-Based Diagnostics Expand Clinicians’ Vantage into Neurological Conditions

Expanded applications of optical coherence tomography (OCT)—delivering 1,000 times the resolution of MRI—and other vision-based diagnostic tools are elucidating the markers and mechanisms behind complex neurological conditions.

OCT SCANS OF RETINAL NERVE FIBER LAYER SHOW PROMISE FOR EARLY DIAGNOSIS OF MS-RELATED EYE DAMAGE Although the optic nerve is involved in the manifestation of multiple sclerosis (MS) for most patients—in a quarter of them, acute optic neuritis is its initial manifestation—the optic nerve remains absent from the condition’s diagnostic criteria. Bolstered by new NYU Langone Health–led research with an international reach, clinicians can now turn to OCT scans of the retinal nerve fiber layer to identify how the optic nerve can add to MS diagnostic criteria. A high-resolution, noninvasive ocular imaging method, OCT allows clinicians to spot microscopic changes in nerve fiber layer thickness that MRIs can’t detect. “With OCT scans, we have an effective structural measure for this important dimension of MS,” notes Laura J. Balcer, MD, professor of neurology, ophthalmology, and population health and vice chair of the Steven L. Galetta, MD, and Laura J. Balcer, MD Department of Neurology. Furthermore, Dr. Balcer notes, OCT can identify even very subtle optic nerve damage that occurs before there is any subjective International Multiple Sclerosis Visual the inclusion of the optic nerve in the change in vision. This can be useful for System Consortium (IMSVISUAL), international MS diagnosis criteria. early diagnosis for the large cohort of researchers are now using these results, OCT imaging technology affects the MS patients whose condition begins with published in late 2017, to lead the effort to MS field beyond its use in measuring acute acute optic neuritis. expand studies of OCT-visualized optic optic nerve damage from MS, adds Dr. Balcer and a team of investigators nerve lesions as a potential diagnostic Dr. Balcer. Since optic nerve thinning has conducted an extensive analysis of OCT marker for MS. Dr. Balcer, a co-director been found to reflect the overall impact of scan data from MS patients and from of IMSVISUAL, and Steven L. Galetta, MD, MS on the central nervous system, she individuals without MS and determined the Philip K. Moskowitz, MD Professor speculates that OCT retinal scans could that a five-micron reduction in the and Chair of Neurology and professor of one day be used as one of several measures thickness of the retinal nerve fiber layer neurology and ophthalmology, co-wrote to track overall progression of the disease, is enough to indicate MS-related nerve an editorial published in 2017 in including therapeutic response. damage. In conjunction with the Multiple Sclerosis Journal, advocating for

18 NYU Langone Health | Neurology & Neurosurgery 2017 ASSESSING CONCUSSION-RELATED traumatic encephalopathy among retired again showing the greatest disparity. BRAIN DAMAGE WITH VISUAL SCREENS football players and individuals with little Further investigations are under way to or no contact sport exposure. better determine the relationship between Researchers are also investigating the In a separate study, published in 2017 retinal nerve fiber loss and traumatic use of OCT and other vision-based in the Journal of Neuro-Ophthalmology, brain injury. testing to measure function in the setting division researchers and colleagues from “We were fortunate to be early adopters of concussion and related neurological the Illinois College of Optometry found of OCT and low-contrast visual tests in damage. The Division of Neuro- that average retinal nerve thickness MS, over a decade ago,” says Dr. Galetta. Ophthalmology plays a leadership role in among collision-sport athletes was “Now we’re taking the paradigms we NYU Langone’s Concussion Center, reduced relative to controls. The difference learned in MS and applying them to where research on the use of a rapid was especially pronounced among the traumatic brain injury, studying visual number-naming test and laboratory-based study’s subgroup of boxers, who had an tests and OCT as outcome measures in eye tracking is aiding in the sideline average nerve thickness reduction of other neurological conditions.” diagnosis and assessment of sports-related almost 11 microns compared with the concussion. control group. “This study suggests that The division is spearheading a study OCT may identify athletes who have of OCT in active and retired contact-sport had significant repetitive traumatic brain athletes. At the same time, NYU Langone injury,” notes Dr. Galetta. A test of the is an enrolling site for a Boston University– same subjects’ low-contrast letter acuity led, National Institutes of Health–funded also found significant differences between study of potential markers for chronic the athletes and controls, with boxers

EXPANDING THE USE OF RAPID EYE MOVEMENTS AS A CLUE TO NEUROLOGICAL ILLNESS

With the help of the EyeLink high-speed camera, investigators in medicine and neurology, and Todd E. Hudson, PhD, research the Eye Movement Testing Lab are seeking a new understanding assistant professor of rehabilitation medicine. Together, these of the eye movement abnormalities associated with a variety of investigators are evaluating how attention and cognition affect neurological disorders—insights that could lead to enhanced the scores of concussed patients. “Once we understand diagnostic and treatment approaches. concussion’s activity in the brain, we hope to find ways to predict recovery and develop therapies,” Dr. Rucker says. NYU Langone researchers have made important connections between eye movements and concussion over the past several Separately, investigators are working on EyeLink applications years, finding that concussion produces an increased to enhance diagnosis and therapeutic intervention in multiple intersaccadic interval—the time it takes the eye to prepare for sclerosis (MS) and Parkinson’s disease. The information rapid jumps from one focal point to another—explaining slower gained from detailed analysis of nystagmus and internuclear performance on rapid number-reading tests. “Two factors that ophthalmo­plegia may help investigators to advance therapeutic may play a role in this increased intersaccadic interval in options for MS, and rapid number-reading and picture-naming concussion are prolongation of the latency period—the time that tests are being studied as quick screening tools for vision the brain needs to prepare to make fine eye movements—and problems in MS. In Parkinson’s, eye movement analysis is being neurocognitive dysfunction,” says Janet C. Rucker, MD, the used to confirm diagnosis of atypical Parkinson’s disorders such Bernard A. and Charlotte Marden Professor of Neurology, as progressive supranuclear palsy and multiple system atrophy. professor of ophthalmology, and Chief of the Division of “It’s hard to name a neurological disease that doesn’t have Neuro‑Ophthalmology. the capacity to affect eye movements in some way,” notes Dr. Rucker leads the Eye Movement Testing Lab in partnership Dr. Rucker. “Eye movement recording technology can help us with two physicians at NYU Langone’s Rusk Rehabilitation: establish a more accurate diagnosis and evaluate potentially John‑Ross Rizzo, MD, assistant professor of rehabilitation more efficacious treatments.”

Neurology & Neurosurgery 2017 | NYU Langone Health 19 SPINE

Complex Case: Intramedullary Cavernoma Calls for Intervention—but Carries Risks

For a 29-year-old patient presenting with a rare and risky intramedullary cavernoma, the use of advanced diffusion tensor imaging (DTI), pioneered at NYU Langone for spinal surgery, proved essential to a successful resection—and restored quality of life.

When Anthony K. Frempong‑Boadu, MD, was first diagnosed, and they would only at the midline—to achieve access, a surgery associate professor of neurosurgery and worsen as the tumor grew. “It was clear that with a high risk of permanent morbidity, director of the Division of Spinal Surgery, this tumor needed to be managed damage to paraspinal structures, evaluated the patient’s symptoms and surgically,” says Dr. Frempong-Boadu. cerebrospinal fluid leak, central nervous progressing condition, he quickly saw the system infection, and significant However, such a resection carried dilemma: Resection of such a complex neurological injury, including paraplegia. formidable risks. Intramedullary tumors, tumor required the use of a leading-edge, The tumor was densely adhered to which account for just 2 to 4 percent of all highly precise imaging technique that had surrounding nerve tissue, increasing the intrinsic central nervous system tumors, only a limited track record—but postponing likelihood of surgical complications. often permeate the surrounding tissues the surgery was not an option. The Other leading tertiary centers had been after arising from the cells of the spinal debilitating effects of the intradural reluctant to perform the operation. cord. Resection of this tumor would require intramedullary cavernoma had become a myelotomy—dissection of the spinal cord increasingly apparent in the year since it ADVANCED NEURAL IMAGES PROVIDE A ROAD MAP FOR RESECTION

With Dr. Frempong-Boadu’s successful Anthony K. Frempong-Boadu, MD DTI application two years earlier, NYU Langone had become the nation’s only center to use real-time intraoperative functional data during spinal surgery. In this case, use of this approach—which employs multiple high-information MRI scans of the water diffusion rates across nerve membranes to map the exact location of a patient’s nerve tracts—was critical to keeping the patient neurologically intact as the tumor was resected.

“With DTI, combined with Surgical Theater’s three-dimensional virtual imagery of the surgical site, we could visualize exactly where the motor tracts of the patient’s spinal cord and all other relevant structures were at all times, so we could go in and confidently remove the tumor,” says Dr. Frempong-Boadu.

20 NYU Langone Health | Neurology & Neurosurgery 2017 A MULTIDISCIPLINARY TEAM EFFORT imagery of the site. The dura was opened the dura was closed and the vertebrae AUGMENTS ADVANCED IMAGING and retracted, the arachnoid layer was were reconstructed. dissected free and opened, and the dorsal With the full array of spinal imaging “The imaging precisely outlined the tumor root entry zone was identified using techniques at work in the operating room, in three dimensions, so I knew when I intraoperative navigation. The surgeons the surgical team began with a needed to back off and when I could press performed a myelotomy and isolated the decompressive osteoplastic laminectomy ahead right to its margin,” explains tumor, carefully dissecting it free from of the third and fourth thoracic vertebrae. Dr. Frempong-Boadu. “In these procedures, the underlying neural tissue, utilizing both They then located the tumor via ultrasound our goal is to get the greatest amount of microscope-integrated stereotactic and confirmed the location using an resection possible with the least amount of navigation and three-dimensional intraoperative CT scan, intraoperative functional decline.” visualization. After removal of the tumor, navigation, and Surgical Theater’s virtual

BEYOND TUMORS: EXTENDING THE NEURAL MAPS’ REACH

 Three-dimensional imaging of the intradural intramedullary cavernoma Although neurophysiological monitoring indicated some reduction in left leg sensory and motor signals during this patient’s operation, says Dr. Frempong-Boadu, the procedure concluded with the intra­ medullary cavernoma completely resected and no motor impairment beyond a very slight limp. “A half year later, the patient is doing really well—an incredible outcome given the complexity of his tumor,” he adds.

Since assembly of the neural maps is itself a highly complex process, use of the maps is currently limited to the most complex, high-acuity spine tumor cases. The neurosurgery and neuroradiology groups are working on new automation processes to streamline image acquisition and nerve map construction, to potentially extend the technology’s application to cervical spondylosis, myelopathy, and other spinal conditions. “The applicability of this mapping to spinal disease extends well beyond its current use,” says Dr. Frempong- Boadu. “If we can accomplish that, it will be another huge step forward.”

Neurology & Neurosurgery 2017 | NYU Langone Health 21 COGNITIVE NEUROLOGY

The Pursuit of New Alzheimer’s Pathways, Fueled by Promising Research

The Center for Cognitive Neurology is working to unravel the mechanisms behind Alzheimer’s disease and other neurocognitive disorders, while forging new pathways toward transformative treatment and prevention modalities.

PROMISING IMMUNOTHERAPIES MOVE Professor of Neurology, professor of Scientific Reports in 2017, NYU Langone CLOSER TO HUMAN TESTING pathology and psychiatry, and director of Health investigators described how a the center. “As our understanding of protein fragment derived from the rare In 2017, the Center for Cognitive Alzheimer’s improves, we’re testing many disease British amyloidosis can be used to Neurology conducted several promising therapeutic interventions.” prime antibodies to attack the beta-sheet groundbreaking studies that could give One such intervention involves structure common across various rise to novel Alzheimer’s disease conformational monoclonal antibodies, oligomers. In the near future, center immunotherapies. “We now know that the only agents known to target neurotoxic researchers hope to move this unified Alzheimer’s is driven by many pathways, oligomers—clusters of misfolded proteins treatment approach, successful in animal which can vary from patient to patient,” associated with both amyloid-beta and studies, to human trials. notes Thomas M. Wisniewski, MD, the tau, and with neurodegenerative diseases In another 2017 animal study, Gerald J. and Dorothy R. Friedman including Parkinson’s. In an article in published in The Journal of Neuroscience,

Allal Boutajangout, PhD, and Thomas M. Wisniewski, MD

22 NYU Langone Health | Neurology & Neurosurgery 2017 center investigators demonstrated the another possible dementia-prevention efficacy of the NYU Langone–developed approach. Meanwhile, the center NEW INSIGHTS REVEAL immunotherapy drug Class B CpG ODN in continues its phase III clinical trials of TRAUMATIC BRAIN INJURY reducing cerebral amyloid angiopathy, the monoclonal antibody aducanumab, PATHOLOGY another key element of Alzheimer’s which appears to clear amyloid plaque pathology, with accompanying short-term from the brains of individuals with memory improvements. This drug, early Alzheimer’s. A milestone discovery by Center for previously found to enhance clearance of Cognitive Neurology researchers amyloid-beta and tau in animals, boosts UNRAVELING THE BIOLOGY OF could open a new avenue to potential activity of microglia—the primary ALZHEIMER’S DISEASE therapies to mitigate traumatic brain immune cells in the brain—by stimulating injury (TBI) and prevent chronic As new therapies are pursued, the center Toll-like receptor 9. The center hopes to traumatic encephalopathy. The continues to probe the biology underlying commence phase I human trials within research, led by Dr. Wisniewski and Alzheimer’s. In a seminal 2017 study the next two years. published in Acta Neuropathologica published in Acta Neuropathologica, Another 2017 study published in Communications in 2017, revealed researchers applied proteomics to analyze Scientific Reports extended NYU Langone’s that normal prion proteins are a amyloid plaques associated with rapidly groundbreaking investigations of mediator of TBI, serving as receptors progressive Alzheimer’s disease. The interaction between amyloid-beta and for the tau oligomers that form in the researchers found that the plaques apolipoprotein E (apoE)—the brain’s main injury’s aftermath. “We already have contained significantly higher levels of lipid-carrying protein, which can preexisting antibodies that target the neuronal proteins and lower levels of accelerate accumulation of amyloid-beta prion protein,” notes Dr. Wisniewski. astrocytic proteins compared with in the brain. In the study, a novel peptoid “Now, our lab can begin testing these standard Alzheimer’s, opening a new developed by NYU Langone researchers drugs, in hopes of reducing trauma- research pathway. The center will pursue was highly effective at preventing related brain damage.” amyloid-beta from binding with apoE, the pathway with support from a five-year, including apoE4, the most neurotoxic $3.9 million R01 grant awarded by the apoE variant. National Institutes of Health (NIH) in 2017. In a fourth study, published in early “This study was critically dependent 2017 in Current Alzheimer Research, center on the proteomic core that we have here at researchers showed that human umbilical NYU Langone, one of the best in the pharmacology, adds a key piece to the cord stem cells injected into the carotid world,” says Dr. Wisniewski. apoE puzzle. The 2017 study, published in arteries of transgenic mice can cross the Another animal study, led by Molecular Degeneration, found that blood–brain barrier and reduce Martin Sadowski, MD, PhD, associate transgenic mice with the apoE4 gene Alzheimer’s-related pathology, offering professor of neurology, psychiatry, variant—the greatest genetic risk factor and biochemistry and molecular for late-onset Alzheimer’s—showed the most robust stimulation of microglia and the greatest reduction in amyloid plaques when injected with the experimental anti-amyloid-beta antibody 10D5. “This offers hope that Alzheimer’s vaccines may work better in human apoE4 carriers, even $27.9 M though they tend to get Alzheimer’s at a younger age and have more amyloid IN NIH GRANT RESEARCH FUNDING buildup than people without the variant,” AWARDED SINCE 2015 says Dr. Sadowski. He and his team are with engaged in further study of this phenomenon through two NIH grants. $8.3 M

AWARDED IN 2017

Neurology & Neurosurgery 2017 | NYU Langone Health 23 NEUROMODULATION

Patients with Movement Disorder Symptoms Find New Relief in Neuromodulation

Clinical trials under way at NYU Langone Health’s Center for Neuromodulation are expanding the availability and applications of deep brain stimulation (DBS) techniques, MRI-guided ultrasound approaches, and other innovations—bringing benefits to a broad range of patients.

Alon Y. Mogilner, MD, PhD, and Michael H. Pourfar, MD

NYU LANGONE CHARTS NEW TERRITORY All three technologies have their ADDING TO THE NEUROMODULATION WITH SECOND-GENERATION DBS DEVICES strengths, says the center’s other co- ARSENAL: FOCUSED ULTRASOUND director, Alon Y. Mogilner, MD, PhD, Medtronic’s DBS device has been the The center is investigating other associate professor of neurosurgery and only FDA-approved DBS technology for neuromodulation treatment modalities, anesthesiology. “At the moment, the more than 20 years, but the field is now including MRI-guided focused Medtronic device is the only MRI- expanding with the recent approval of ultrasound, which noninvasively targets compatible system, which can benefit Abbott’s DBS system, as well as an ongoing precise areas of brain tissue to alleviate certain patients,” he notes. “In other clinical trial utilizing a DBS system tremor. Under MRI guidance, the instances, the alternate approaches manufactured by Boston Scientific. ultrasound device first heats mapped broaden the therapeutic window by letting Both new devices offer more nuanced tissue, producing a temporary effect so us more effectively troubleshoot side distribution of electrical stimulation, clinicians can confirm that ablating the effects, such as impaired speech which may prove advantageous in some targeted area will improve symptoms or balance.” cases, says Michael H. Pourfar, MD, without problematic side effects. Then the Clinicians used to grapple with simply assistant professor of neurosurgery and ultrasound beam is intensified to destroy whether someone was a candidate for neurology and co-director of NYU the selected brain cells associated with DBS. Now, observes Dr. Mogilner, Langone’s Center for Neuromodulation— the tremor. “we’re having increasingly sophisticated the only facility in New York with conversations about which DBS system to extensive experience with all use and which targets to select within three devices. that system.”

24 NYU Langone Health | Neurology & Neurosurgery 2017 “Since this nonsurgical approach groundbreaking research, including a parameters used to treat the condition. requires little or no anesthesia, it can recent study of 13 NYU Langone Clinicians have also been refining their benefit patients who are too elderly or ill patients who underwent thalamic DBS use of rescue leads—additional electrode for DBS,” notes Dr. Pourfar. “Unlike for severe Tourette’s, the largest such clusters implanted in Parkinson’s patients with DBS, there’s no implanted hardware series in the United States. Led by who continue to experience significant and no need for repeated visits to adjust Dr. Mogilner and Dr. Pourfar and tremors or dyskinesia after initial bilateral the programming.” Although focused published in April 2017 in the Journal of DBS lead implantation. “We’ve found ultrasound is currently used only for Neurosurgery, the study found that after that adding the third electrode provides tremors, the center’s clinicians are working the DBS procedure, the patients’ tic benefit to a number of patients,” says with NYU Langone neuroradiologists to severity decreased by 50 percent, on Dr. Mogilner, who is leading the identify possible ablation targets for average, by the time of their last preparation of an article on the center’s symptoms such as stiffness or slowed postsurgery follow-up. rescue lead patient series. “This is an area movement. The system will be fully “While results can vary, DBS has where the field will continue to improve,” operational in early 2018, and clinicians been life-changing for some Tourette’s he notes. are hoping to begin clinical trials patients,” says Dr. Mogilner. “We’re all soon after. working to gain a better understanding of this therapeutic approach, leading, we NEW FRONTIERS IN DBS FOR hope, to FDA approval of DBS as a TOURETTE’S AND REFRACTORY Tourette’s treatment.” 175 + PARKINSON’S Center researchers continue to mine their own data in combination with the DBS PROCEDURES DBS can also offer hope for those with national Tourette’s database at the treatment-resistant Tourette’s syndrome. University of Florida in order to refine the performed in 2017 The center’s clinicians continue to target brain regions and stimulation pioneer this off-label application with

PIONEERING GAMMA KNIFE SURGERY AS TREATMENT FOR OBSESSIVE-COMPULSIVE DISORDER

Gamma Knife radiosurgery has emerged alongside FDA- “Following treatment, patients score better on measures of approved DBS as a novel treatment for obsessive-compulsive thought resistance and behavior avoidance; the goal is to disorder (OCD). The approach uses radiation to create a reduce the intrusive thoughts and compulsive rituals that so pinpoint lesion in well-identified bilateral targets in the anterior dominate their lives,” Dr. Kondziolka adds. limb of the internal capsule of the brain, between the thalamus and the frontal lobe, known to be involved in OCD.

“We are one of the few institutions in the world offering Gamma Knife radiosurgery as an OCD treatment modality,” says Douglas S. Kondziolka, MD, the Gray Family Professor of Neurosurgery, professor of radiation oncology, vice chair for Clinical Research in the Department of Neurosurgery, and director of NYU Langone’s Gamma Knife program.

Dr. Kondziolka’s team is conducting a national study on Gamma Knife OCD outcomes; though investigators are seeing positive anecdotal results, the brain requires time to rewire itself, so it can take years to produce the full treatment benefit. “This approach can moderate symptoms for the most debilitated OCD patients,” notes Dr. Kondziolka. Joshua S. Silverman, MD, PhD, and Douglas S. Kondziolka, MD

Neurology & Neurosurgery 2017 | NYU Langone Health 25 Academic Activities

Al-Louzi O, Sotirchos ES, Vidal-Jordana A, Beh SC, Button J, Boutajangout A, Noorwali A, Atta H, Wisniewski T. Human SELECT PUBLICATIONS: Ying HS, Balcer LJ, Frohman EM, Saidha S, Calabresi PA, umbilical cord stem cell xenografts improve cognitive Newsome SD. Characteristics of morphologic macular decline and reduce the amyloid burden in a mouse model of NEUROLOGY abnormalities in neuroimmunology practice. Multiple Alzheimer’s disease. Current Alzheimer Research. 2017; Sclerosis. November 1, 2017; 1352458517741206. 14(1): 104–111. Andronesi OC, Esmaeili M, Borra RJH, Emblem K, Gerstner Brastianos PK, Nayyar N, Rosebrock D, Leshchiner I, Abou-Khalil B, Afawi Z, Allen AS, Bautista JF, Bellows ST, ER, Pinho MC, Plotkin SR, Chi AS, Eicher AF, Dietrich J, Ivy Gill CM, Livitz D, Bertalan MS, D’Andrea M, Hoang K, Berkovic SF, Bluvstein J, Burgess R, Cascino G, Cops EJ, SP, Wen PY, Duda DG, Jain R, Rosen BR, Sorensen GA, Aquilanti E, Chukwueke UN, Kaneb A, Chi A, Plotkin S, Cossette P, Cristofaro S, Crompton DE, Delanty N, Batchelor TT. Early changes in glioblastoma metabolism Gerstner ER, Forsch MP, Suva ML, Cahill DP, Getz G, Devinsky O, Dlugos D, Epstein MP, Fountain NB, Freyer C, measured by MR spectroscopic imaging during Batchelor TT. Resolving the phylogenetic origin of Garry SI, Geller EB, Glauser T, Glynn S, Goldberg-Stern H, combination of anti-angiogenic cediranib and glioblastoma via multifocal genomic analysis of Goldstein DB, Gravel M, Haas K, Haut S, Heinzen EL, chemoradiation therapy are associated with survival. NPJ pre-treatment and treatment-resistant autopsy specimens. Kirsch HE, Kivity S, Knowlton R, Korczyn AD, Kossoff E, Precision Oncology. June 12, 2017; 1: 20. NPJ Precision Oncology. September 18, 2017; 1: 33. Kuzniecky R, Loeb R, Lowenstein DH, Marson AG, McCormack M, McKenna K, Mefford HC, Motika P, Arrillaga-Romany I, Chi AS, Allen JE, Oster W, Wen PY, Burke EA, Frucht SJ, Thompson K, Wolfe LA, Yokoyama T, Mullen SA, O’Brien TJ, Ottman R, Paolicchi J, Parent JM, Batchelor TT. A phase 2 study of the first imipridone Bertoni M, Huang Y, Sincan M, Adams DR, Taylor RW, Paterson S, Petrovski S, Pickrell WO, Poduri A, Rees MI, ONC201, a selective DRD2 antagonist for oncology, Gahl WA, Toro C, Malicdan MCV. Biallelic mutations in Sadleir LG, Scheffer IE, Shih J, Singh R, Sirven J, Smith M, administered every three weeks in recurrent glioblastoma. mitochondrial tryptophanyl-tRNA synthetase cause Smith PEM, Thio LL, Thomas RH, Venkat A, Vining E, Oncotarget. May 12, 2017; 8(45): 79298–79304. levodopa-responsive infantile-onset Parkinsonism. Clinical Genetics. November 9, 2017. epub ahead of print. Von Allmen G, Weisenberg J, Widdess-Walsh P, Ashina H, Newman L, Ashina S. Calcitonin gene-related Winawer MR, Epi4K Consortium. Phenotypic analysis of peptide antagonism and cluster headache: an emerging new Button J, Al-Louzi O, Lang A, Bhargava P, Newsome SD, 303 multiplex families with common epilepsies. Brain: treatment. Neurological Sciences. December 2017; Frohman T, Balcer LJ, Frohman EM, Prince J, Calabresi PA, A Journal of Neurology. August 2017; 140(8): 2144–2156. 38(12): 2089–2093. Saidha S. Disease-modifying therapies modulate retinal Adams J, Alipio-Jocson V, Inoyama K, Bartlett V, Sandhu S, atrophy in multiple sclerosis: a retrospective study. Atherton DS, Davis GG, Wright C, Devinsky O, Hesdorffer D. Neurology. February 7, 2017; 88(6): 525–532. Oso J, Barry JJ, Loring DW, Meador KJ. Methylphenidate, A survey of medical examiner death certification of cognition, and epilepsy: a 1-month open-label trial. vignettes on death in epilepsy: gaps in identifying SUDEP. Cadavid D, Balcer L, Galetta S, Aktas O, Ziemssen T, Epilepsia. December 2017; 58(12): 2124–2132. Epilepsy Research. July 2017; 133: 71–75. Vanopdenbosch L, Frederiksen J, Skeen M, Jaffe GJ, Allen AS, Bellows ST, Berkovic SF, Bridgers J, Burgess R, Butzkueven H, Ziemssen F, Massacesi L, Chai Y, Xu L, Bajaj S, Krismer F, Palma J-A, Wenning GK, Kaufmann H, Freeman S. Safety and efficacy of opicinumab in acute optic Cavalleri G, Chung S-K, Cossette P, Delanty N, Dlugos D, Poewe W, Seppi K. Diffusion-weighted MRI distinguishes Epstein MP, Freyer C, Goldstein DB, Heinzen EL, neuritis (RENEW): a randomised placebo-controlled, phase Parkinson disease from the parkinsonian variant of 2 trial. The Lancet Neurology. March 2017; 16(3): 189–199. Hildebrand MS, Johnson MR, Kuzniecky R, Lowenstein DH, multiple system atrophy: a systematic review and Marson AG, Mayeux R, Mebane C, Mefford HC, O’Brien TJ, meta-analysis. PLoS One. December 29, 2017; 12(12): Chang FCF, Frucht SJ. ICU intensive care unit movement Ottman R, Petrou S, Petrovski S, Pickrell WO, Poduri A, e0189897. disorder emergencies. In: Hall DA and Barton BR (Eds.) Radtke RA, Rees MI, Regan BM, Ren Z, Scheffer IE, Sills GJ, Non-Parkinsonian Movement Disorders. December 27, 2016. Thomas RH, Wang Q, Abou-Khalil B, Alldredge BK, Balcer LJ, Raynowska J, Nolan R, Galetta SL, Kapoor R, John Wiley & Sons, Ltd. Amrom D, Andermann E, Andermann F, Bautista JF, Benedict R, Phillips G, LaRocca N, Hudson L, Rudick R. Berkovic SF, Bluvstein J, Boro A, Cascino GD, Consalvo D, Validity of low-contrast letter acuity as a visual performance Charvet LE, Dobbs B, Shaw MT, Bikson M, Datta A, Crumrine P, Devinsky O, Dlugos D, Epstein MP, Fiol M, outcome measure for multiple sclerosis. Multiple Sclerosis Krupp LB. Remotely supervised transcranial direct current Fountain NB, French J, Freyer C, Friedman D, Geller EB, Journal. April 2017; 23(5): 704–710. stimulation for the treatment of fatigue in multiple sclerosis: Results from a randomized, sham-controlled trial. Multiple Glauser T, Glynn S, Haas K, Haut SR, Hayward J, Helmers SL, Bar-Aluma B-E, Efrati O, Kaufmann H, Palma J-A, Joshi S, Kanner A, Kirsch HE, Knowlton RC, Kossoff EH, Sclerosis Journal. September 1, 2017; 1352458517732842. Norcliffe-Kaufmann L. A controlled trial of inhaled epub ahead of print. Kuperman R, Kuzniecky R, Lowenstein DH, Motika PV, bronchodilators in familial dysautonomia. Lung. December Novotny EJ, Ottman R, Paolicchi JM, Parent JM, Park K, 12, 2017; 1–9. epub ahead of print. Charvet L, Shaw M, Dobbs B, Frontario A, Sherman K, Poduri A, Sadleir LG, Scheffer IE, Shellhaas RA, Sherr EH, Bikson M, Datta A, Krupp L, Zeinapour E, Kasschau M. Shih JJ, Shinnar S, Singh RK, Sirven J, Smith MC, Sullivan J, Becker DA, Schiff ND, Becker LB, Holmes MG, Fins JJ, Remotely supervised transcranial direct current Thio LL, Venkat A, Vining EPG, Von Allmen GK, Horowitz JM, Devinsky O. A major miss in prognostication stimulation increases the benefit of at-home cognitive Weisenberg JL, Widdess-Walsh P, Winawer MR, Epi4k after cardiac arrest: burst suppression and brain healing. training in multiple sclerosis. Neuromodulation. February Consortium, Epilepsy Phenome-Genome Project. Ultra-rare Epilepsy & Behavior Case Reports. 2017; 7: 1–5. 22, 2017. epub ahead of print. genetic variation in common epilepsies: a case-control sequencing study. The Lancet Neurology. February 2017; Begasse de Dhaem O, Barr WB, Balcer LJ, Galetta SL, Minen Charvet LE, Shaw M, Frontario A, Langdon D, Krupp LB. 16(2): 135–143. MT. Post-traumatic headache: the use of the sport Cognitive impairment in pediatric-onset multiple sclerosis concussion assessment tool (SCAT-3) as a predictor of is detected by the Brief International Cognitive Assessment Allen AS, Berkovic SF, Bridgers J, Cossette P, Dlugos D, post-concussion recovery. Journal of Headache and Pain. for Multiple Sclerosis and computerized cognitive testing. Epstein MP, Glauser T, Goldstein DB, Heinzen EL, Jiang Y, December 2017; 18(1): 60. Multiple Sclerosis Journal. March 1, 2017; 1352458517701588. Johnson MR, Kuzniecky R, Lowenstein DH, Marson AG, epub ahead of print. Mefford HC, O’Brien TJ, Ottman R, Petrou S, Petrovski S, Berg AT, Altalib HH, Devinsky O. Psychiatric and behavioral Poduri A, Ren Z, Scheffer IE, Sherr E, Wang Q, Balling R, comorbidities in epilepsy: a critical reappraisal. Epilepsia. Charvet LE, Yang J, Shaw MT, Sherman K, Haider L, Xu J, Barisic N, Baulac S, Caglayan H, Craiu D, De Jonghe P, July 2017; 58(7): 1123–1130. Krupp LB. Cognitive function in multiple sclerosis improves Depienne C, Guerrini R, Helbig I, Hjalgrim H, Berger KI, Burton BK, Lewis GD, Tarnopolsky M, Harmatz with telerehabilitation: results from a randomized Hoffman-Zacharska D, Jahn J, Klein KM, Koeleman B, PR, Mitchell JJ, Muschol N, Jones SA, Sutton VR, Pastores controlled trial. PloS One. May 11, 2017; 12(5): e0177177. Komarek V, Krause R, Leguern E, Lehesjoki A-E, Lemke JR, GM, Lau H, Sparkes R, Shaywitz AJ. Cardiopulmonary Chen H, Dugan P, Chong DJ, Liu A, Doyle W, Friedman D. Lerche H, Linnankivi T, Marini C, May P, Moller RS, exercise testing reflects improved exercise capacity in Muhle H, Pal D, Palotie A, Rosenow F, Selmer K, Application of RNS in refractory epilepsy: targeting insula. response to treatment in Morquio A patients: results of a Epilepsia Open. September 2017; 2(3): 345–349. Serratosa JM, Sisodiya S, Stephani U, Sterbova K, Striano P, 52-week pilot study of two different doses of Elosulfase Alfa. Suls A, Talvik T, Von Spiczak S, Weber Y, Weckhuysen S, JIMD Reports. November 21, 2017. epub ahead of print. Cheng JY, French JA. Intelligent use of antiepileptic drugs is Zara F, Abou-Khalil B, Alldredge BK, Amrom D, beneficial to patients. Current Opinion in Neurology. Andermann E, Andermann F, Bautista JF, Bluvstein J, Biaggioni I, Hewitt LA, Rowse GJ, Kaufmann H. Integrated December 22, 2017. epub ahead of print. Cascino GD, Consalvo D, Crumrine P, Devinsky O, Fiol ME, analysis of droxidopa trials for neurogenic orthostatic Fountain NB, French J, Friedman D, Haas K, Haut SR, hypotension. BMC Neurology. May 12, 2017; 17(1): 90. Chi AS. Identification of more potent imipridones, a new Hayward J, Joshi S, Kanner A, Kirsch HE, Kossoff EH, class of anti-cancer agents. Cell Cycle. August 10, 2017; Bianchi S, Battistella G, Huddleston H, Scharf R, Fleysher L, 16(17): 1566–1567. Kuperman R, McGuire SM, Motika PV, Novotny EJ, Rumbach AF, Frucht SJ, Blitzer A, Ozelius LJ, Simonyan K. Paolicchi JM, Parent J, Park K, Shellhaas RA, Sirven J, Phenotype- and genotype-specific structural alterations in Chin JH. Xpert MTB/RIF ultra: the long-awaited game Smith MC, Sullivan J, Thio LL, Venkat A, Vining EPG, spasmodic dysphonia. Movement Disorders. April 2017; changer for tuberculous meningitis? European Respiratory Von Allmen GK, Weisenberg JL, Widdess-Walsh P, 32(4): 560–568. Journal. October 19, 2017; 50(4): 1701201. Winawer MR. Application of rare variant transmission disequilibrium tests to epileptic encephalopathy trio Blackmon K, Thesen T, Green S, Ben-Avi E, Wang X, Fuchs B, Chin JH, Bhatt JM, Lloyd-Smith AJ. Hypertension—a global sequence data. European Journal of Human Genetics. Kuzniecky R, Devinsky O. Focal cortical anomalies and neurological problem. Journal of the American Medical June 2017; 25(7): 894–899. language impairment in 16p11.2 deletion and duplication Association—Neurology. April 1, 2017; 74(4): 381–382. syndrome. Cerebral Cortex. June 7, 2017; 1–9. epub ahead of print.

26 NYU Langone Health | Neurology & Neurosurgery 2017 SELECT CONFERENCE HIGHLIGHTS: NEUROLOGY & NEUROSURGERY

Allal Boutajangout, PhD, was a selected Horacio Kaufmann, MD, was a selected Chandranath Sen, MD, served as a program keynote speaker at the 15th European keynote speaker at the 28th International moderator at the 27th Annual Meeting of the Neurology Congress in London, England. Symposium on the Autonomic Nervous System North American Skull Base Society in New in Clearwater, Florida. Orleans, Louisiana, and at the annual Leigh E. Charvet, PhD, was a selected keynote Association of Neurological Surgeons meeting speaker at the 2017 NYC Neuromodulation John G. Golfinos, MD, was an honored guest in Los Angeles, California. Conference in New York, New York. speaker at “The Reality in Virtual Reality: A Conversation with Practitioners,” an Enterprise Forum in New York, New York.

AWARDS & RECOGNITION: NEUROLOGY & NEUROSURGERY

Erich G. Anderer, MD, was recognized by the Douglas S. Kondziolka, MD, was appointed James L. Stone, MD, was chosen as a Medical Society of the County of Kings with the treasurer of the American Academy of consultant for the National Aeronautics and 2017 Award of Excellence. Neurological Surgery. Space Administration.

Orrin Devinsky, MD, received the J. Kiffin Lauren B. Krupp, MD, was appointed chair of Blanca Vazquez, MD, was appointed chair of Penry Excellence in Epilepsy Care Award from the International Multiple Sclerosis Cognition the Professional Advisory Board of the Epilepsy the American Epilepsy Society. Society steering committee. Foundation of Metropolitan New York.

David H. Harter, MD, was appointed president Mia T. Minen, MD, MPH, was appointed chair Thomas M. Wisniewski, MD, was appointed elect of the New York State Neurosurgical of the Emergency Medicine, Inpatient and to the board of directors of the New York City Society. Refractory Section of the American Headache chapter of the Alzheimer’s Association. Society.

Chin JH, Twinobuhungiro A, Sandhu A, Hootsmans N, Cohen JM, Dodick DW, Yang R, Newman LC, Li T, Aycardi E, da Silva IRF, Frontera JA. Resumption of anticoagulation Kayima J, Kalyesubula R. Determinants of raised blood Bigal ME. Fremanezumab as add-on treatment for patients after intracranial hemorrhage. Current Treatment Options in pressure in urban Uganda: a community-based case-control treated with other migraine preventive medicines. Neurology. November 2017; 19(11): 39. study. Ethnicity & Disease. January 19, 2017; 27(1): 15–20. Headache: The Journal of Head and Face Pain. October 2017; 57(9): 1375–1384. da Silva IRF, Frontera JA, Bispo de Filippis AM, Chiu AH, De Vries J, O’Kelly CJ, Riina H, McDougall I, do Nascimento OJM. Neurologic complications associated Tippett J, Wan M, de Oliveira Manoel AL, Marotta TR. Cordova C, Chi AS, Chachoua A, Kondziolka D, with the Zika virus in Brazilian adults. Journal of the The second-generation eCLIPs Endovascular Clip System: Silverman JS, Shepherd TM, Jain R, Snuderl M. Osimertinib American Medical Association—Neurology. October 1, 2017; initial experience. Journal of Neurosurgery. March 17, 2017; dose escalation induces regression of progressive EGFR 74(10): 1190–1198. 1–8. epub ahead of print. T790M-mutant leptomeningeal lung adenocarcinoma. Journal of Thoracic Oncology. November 2017; Del Bene VA, Arce Renteria M, Maiman M, Slugh M, Cho S-M, MacDonald S, Frontera JA. Coxsackie B3/ 12(11): e188–e190. Gazzola DM, Nadkarni SS, Barr WB. Increased odds and B4-related acute flaccid myelitis. Neurocritical Care. predictive rates of MMPI-2-RF scale elevations in patients October 2017; 27(2): 259–260. Crandall L, Devinsky O. Sudden unexplained death in with psychogenic non-epileptic seizures and observed sex children. The Lancet Child & Adolescent Health. differences.Epilepsy & Behavior. July 2017; 72: 43–50. Cho SM, Moazami N, Frontera JA. Stroke and intracranial September 2017; 1(1): 8–9. hemorrhage in HeartMate II and HeartWare left ventricular Delva A, Thakore N, Pioro E, Poesen K, Saunders-Pullman R, assist devices: a systematic review. Neurocritical Care. Czeisler BM, Claassen J. A novel clinical score to assess Meijer IA, Rucker JC, Kissel JT, Van Damme P. August 2017; 27(1): 17–25. seizure risk. Journal of the American Medical Association— FEWDON-MND syndrome (finger extension weakness and Neurology. December 1, 2017; 74(12): 1395–1396. downbeat nystagmus): a novel motor neuron disorder? Choi J-H, Wallach AI, Rosales D, Margiewicz SE, Belmont Muscle & Nerve. December 2017; 56(6): 1164–1168. HM, Lucchinetti CF, Minen MT. Clinical reasoning: a Dai M, Cohen B, Cho C, Shin S, Yakushin SB. Treatment of 50-year-old woman with SLE and a tumefactive lesion. the Mal de Debarquement syndrome: a 1-year follow-up. Desnick RJ, Barton NW, Furbish S, Grabowski GA, Neurology. September 19, 2017; 89(12): e140–e145. Frontiers in Neurology. May 5, 2017; 8: 175. Karlsson S, Kolodny EH, Medin JA, Murray GJ, Mistry PK, Patterson MC, Schiffmann R, Weinreb NJ. Roscoe Owen Chopra AM, Mehta M, Bismuth J, Shapiro M, Fishbein MC, Dai W, Selesnick I, Rizzo J-R, Rucker J, Hudson T. Brady, MD: remembrances of co-investigators and Bridges AG, Vinters HV. Polymer coating embolism from A nonlinear generalization of the Savitzky-Golay filter and colleagues. Molecular Genetics and Metabolism. intravascular medical devices—a clinical literature review. the quantitative analysis of saccades. Journal of Vision. January–February 2017; 120(1–2): 1–7. Cardiovascular Pathology. September–October 2017; August 1, 2017; 17(9): 10. 30: 45–54. Devinsky O, Cross JH, Wright S. Trial of cannabidiol for da Silva IRF, Frontera JA. Neurologic complications of acute drug-resistant seizures in the Dravet syndrome. New environmental injuries. Handbook of Clinical Neurology. England Journal of Medicine. May 25, 2017; 376(21): 699. 2017; 141: 685–704.

Neurology & Neurosurgery 2017 | NYU Langone Health 27 Academic Activities

Devinsky O, Friedman D, Cheng JY, Moffatt E, Kim A, Fisher RS, Cross JH, French JA, Higurashi N, Hirsch E, Gutierrez JV, Kaufmann H, Palma J-A, Mendoza- Tseng ZH. Underestimation of sudden deaths among Jansen FE, Lagae L, Moshe SL, Peltola J, Roulet Perez E, Santiesteban C, Macefield VG, Norcliffe-Kaufmann L. patients with seizures and epilepsy. Neurology. August 29, Scheffer IE, Zuberi SM. Operational classification of seizure Founder mutation in IKBKAP gene causes vestibular 2017; 89(9): 878–879. types by the International League Against Epilepsy: position impairment in familial dysautonomia. Clinical paper of the ILAE Commission for Classification and Neurophysiology. November 26, 2017; 129(2): 390–396. Doumlele K, Friedman D, Buchhalter J, Donner EJ, Louik J, Terminology. Epilepsia. April 2017; 58(4): 522–530. Devinsky O. Sudden unexpected death in epilepsy among Gutman JM, Levy M, Galetta S, Kister I. Clinical reasoning: patients with benign childhood epilepsy with French J, Friedman D. The evolving landscape of epilepsy a patient with a history of encephalomyelitis and centrotemporal spikes. Journal of the American Medical neuropathology. The Lancet Neurology. November 29, 2017; recurrent optic neuritis. Neurology. November 7, 2017; Association—Neurology. June 1, 2017; 74(6): 645–649. S1474-4422(17)30429-5. epub ahead of print. 89(19): e231–e234. Drummond E, Nayak S, Faustin A, Pires G, Hickman RA, French JA. Withdrawal of antiepileptic drugs: an Hainline C, Neophytides A, Borja MJ, Galetta SL. Askenazi M, Cohen M, Haldiman T, Kim C, Han X, Shao Y, individualized approach. The Lancet Neurology. July 2017; Progressive ataxia and palatal tremor. Neurology: Clinical Safar JG, Ueberheide B, Wisniewski T. Proteomic differences 16(7): 493–494. Practice. August 2017; 7(4): e37–e38. in amyloid plaques in rapidly progressive and sporadic Alzheimer’s disease. Acta Neuropathologica. June 2017; Frontera JA, Provencio JJ, Sehba FA, McIntyre TM, Hainline C, Rizzo J-R, Hudson TE, Dai W, Birkemeier J, 133(6): 933–954. Nowacki AS, Gordon E, Weimer JM, Aledort L. The role of Raynowska J, Nolan RC, Hasanaj L, Selesnick I, platelet activation and inflammation in early brain injury Frohman TC, Frohman EM, Galetta SL, Balcer LJ, Rucker JC. Drummond E, Nayak S, Ueberheide B, Wisniewski T. following subarachnoid hemorrhage. Neurocritical Care. Capturing saccades in multiple sclerosis with a digitized test Localized proteomics of individual neurons isolated from February 2017; 26(1): 48–57. of rapid number naming. Journal of Neurology. May 2017; formalin-fixed, paraffin-embedded tissue sections using 264(5): 989–998. laser capture microdissection. Current Proteomic Fureman BE, Friedman D, Baulac M, Glauser T, Moreno J, Approaches Applied to Brain Function. June 28, 2017; Dixon-Salazar T, Bagiella E, Connor J, Ferry J, Farrell K, Hainline C, Rucker JC, Zagzag D, Golfinos JG, Lui YW, 289–301. epub ahead of print. Fountain NB, French JA. Reducing placebo exposure in Liechty B, Warren FA, Balcer LJ, Galetta SL. Tumoral trials: considerations from the Research Roundtable in presentation of homonymous hemianopia and Drummond E, Wisniewski T. The use of localized Epilepsy. Neurology. October 2017; 89(14): 1507–1515. prosopagnosia in cerebral amyloid angiopathy-related proteomics to identify the drivers of Alzheimer’s disease inflammation.Journal of Neuro-Ophthalmology. pathogenesis. Neural Regeneration Research. June 2017; Galanopoulou AS, French JA, O’Brien T, Simonato M. March 2017; 37(1): 48–52. 12(6): 912–913. Harmonization in preclinical epilepsy research: a joint AES/ ILAE translational initiative. Epilepsia. November 6, 2017; Halvorsen M, Lin Y, Sampson BA, Wang D, Zhou B, Eng LS, Dugan P, Carlson C, Jette N, Wiebe S, Bunch M, Kuzniecky R, 58(S4): 7–9. Um SY, Devinsky O, Goldstein DB, Tang Y. Whole exome French J. Derivation and initial validation of a surgical sequencing reveals severe thrombophilia in acute grading scale for the preliminary evaluation of adult Galetta KM, Chapman KR, Essis MD, Alosco ML, Gillard D, unprovoked idiopathic fatal pulmonary embolism. patients with drug-resistant focal epilepsy. Epilepsia. Steinberg E, Dixon D, Martin B, Chaisson CE, Kowall NW, EBioMedicine. March 2017; 17: 95–100. May 2017; 58(5): 792–800. Tripodis Y, Balcer LJ, Stern RA. Screening utility of the King-Devick Test in mild cognitive impairment and Harden C, Tomson T, Gloss D, Buchhalter J, Cross JH, Esaki S, Nigim F, Moon E, Luk S, Kiyokawa J, Curry W, Alzheimer disease dementia. Alzheimer Disease & Donner E, French JA, Gil-Nagel A, Hesdorffer DC, Cahill DP, Chi AS, Iafrate AJ, Martuza RL, Rabkin SD, Associated Disorders. April–June 2017; 31(2): 152–158. Smithson WH, Spitz MC, Walczak TS, Sander JW, Ryvlin P. Wakimoto H. Blockade of transforming growth factor-beta Practice guideline summary: sudden unexpected death signaling enhances oncolytic herpes simplex virus efficacy Galetta SL. As the world turns, why do some people adapt in epilepsy incidence rates and risk factors: report of the in patient-derived recurrent glioblastoma models. to vestibular failure and others do not? Neurology. Guideline Development, Dissemination, and International Journal of Cancer. December 1, 2017; 141(11): September 12, 2017; 89(11): 1105–1106. Implementation Subcommittee of the American Academy of 2348–2358. Galetta SL, Balcer LJ. The optic nerve should be included as Neurology and the American Epilepsy Society. Epilepsy Currents. May–June 2017; 17(3): 180–187. Fara MG, Chancellor B, Lord AS, Lewis A. Controversies in one of the typical CNS regions for establishing cardiopulmonary death. Journal of Clinical Ethics. Summer dissemination in space when diagnosing. Multiple Sclerosis. Harden C, Tomson T, Gloss D, Buchhalter J, Cross JH, 2017; 28(2): 97–101. October 1, 2017; 1352458517721054. epub ahead of print. Donner E, French JA, Gil-Nagel A, Hesdorffer DC, Gibbons CH, Schmidt P, Biaggioni I, Frazier-Mills C, Smithson WH, Spitz MC, Walczak TS, Sander JW, Ryvlin P. Fernandez D, Fara MG, Biary R, Hoffman RS, Vassallo S, Practice guideline summary: sudden unexpected death in Balcer L, Torres D. Clinical reasoning: a 27-year-old man Freeman R, Isaacson S, Karabin B, Kuritzky L, Lew M, Low P, Mehdirad A, Raj SR, Vernino S, Kaufmann H. The epilepsy incidence rates and risk factors: report of the with unsteady gait. Neurology. September 5, 2017; 89(10): Guideline Development, Dissemination, and e120–e123. recommendations of a consensus panel for the screening, diagnosis, and treatment of neurogenic orthostatic Implementation Subcommittee of the American Academy of Fiorenzato E, Weis L, Seppi K, Onofrj M, Cortelli P, Zanigni S, hypotension and associated supine hypertension. Journal of Neurology and the American Epilepsy Society. Neurology. Tonon C, Kaufmann H, Shepherd TM, Poewe W, Krismer F, Neurology. August 2017; 264(8): 1567–1582. April 25, 2017; 88(17): 1674–1680. Wenning G, Antonini A, Biundo R. Brain structural profile of Harte-Hargrove LC, French JA, Pitkanen A, Galanopoulou AS, multiple system atrophy patients with cognitive Goni F, Marta-Ariza M, Peyser D, Herline K, Wisniewski T. Production of monoclonal antibodies to pathologic Whittemore V, Scharfman HE. Common data elements for impairment. Journal of Neural Transmission. March 2017; preclinical epilepsy research: standards for data collection 124(3): 293–302. beta-sheet oligomeric conformers in neurodegenerative diseases. Scientific Reports. August 29, 2017; 7(1): 9881. and reporting. A TASK3 report of the AES/ILAE Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Translational Task Force of the ILAE. Epilepsia. November Elger CE, Engel J Jr., Forsgren L, French JA, Hesdorffer DC, Gonzalez Caldito N, Antony B, He Y, Lang A, Nguyen J, 2017; 58(Supplement 4): 78–86. Rothman A, Ogbuokiri E, Avornu A, Balcer L, Frohman E, Lee B-I, Mathern GW, Moshe SL, Perucca E, Scheffer IE, Hasanaj L, Thawani SP, Webb N, Drattell JD, Serrano L, Tomson T, Watanabe M, Wiebe S. How long for epilepsy Frohman TC, Bhargava P, Prince J, Calabresi PA, Saidha S. Analysis of agreement of retinal-layer thickness measures Nolan RC, Raynowska J, Hudson TE, Rizzo J-R, Dai W, remission in the ILAE definition? Epilepsia. August 2017; McComb B, Goldberg JD, Rucker JC, Galetta SL, Balcer LJ. 58(8): 1486–1487. derived from the segmentation of horizontal and vertical spectralis OCT macular scans. Current Eye Research. Rapid number naming and quantitative eye movements Fisher RS, Cross JH, D’Souza C, French JA, Haut S, December 14, 2017; 1–9. epub ahead of print. may reflect contact sport exposure in a collegiate ice hockey Higurashi N, Hirsch E, Jansen FE, Lagae L, Moshe SL, cohort. Journal of Neuro-Ophthalmology. July 25, 2017. epub Korey SR, Purpura DP, Peltola J, Roulet Perez E, Scheffer IE, Green S, Blackmon K, Thesen T, DuBois J, Wang X, ahead of print. Halgren E, Devinsky O. Parieto-frontal gyrification and Schulze-Bonhage A, Somerville E, Sperling M, Yacubian EM, Huang Y, Liu A, Lafon B, Friedman D, Dayan M, Wang X, Zuberi SM. Response to the numbering of seizure types. working memory in healthy adults. Brain Imaging and Behavior. March 13, 2017. epub ahead of print. Bikson M, Devinsky O, Parra LC. Measurements and models Epilepsia. July 5, 2017; 58: 1300–1301. of electric fields in the in vivo human brain during Fisher RS, Cross JH, D’Souza C, French JA, Haut SR, Gupta VP, Garton ALA, Sisti JA, Christophe BR, Lord AS, transcranial electric stimulation. Brain Stimulation: Basic, Higurashi N, Hirsch E, Jansen FE, Lagae L, Moshe SL, Lewis AK, Frey H-P, Claassen J, Connolly ES Jr. Translational, and Clinical Research in Neuromodulation. Peltola J, Roulet Perez E, Scheffer IE, Schulze-Bonhage A, Prognosticating functional outcome following intracerebral July–August 2017; 10(4): e25–e26. Somerville E, Sperling M, Yacubian EM, Zuberi SM. hemorrhage: the ICHOP Score. World Neurosurgery. May 2017; 101: 577–583. Huang Y, Liu AA, Lafon B, Friedman D, Dayan M, Wang X, Instruction manual for the ILAE 2017 operational Bikson M, Doyle WK, Devinsky O, Parra LC. Measurements classification of seizure types. Epilepsia. 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28 NYU Langone Health | Neurology & Neurosurgery 2017 Inglese M, Petracca M, Mormina E, Achiron A, Lafon B, Henin S, Huang Y, Friedman D, Melloni L, Thesen T, Liu DJ, Peloso GM, Yu H, Butterworth AS, Wang X, Straus-Farber R, Miron S, Fabian M, Krieger S, Miller A, Doyle W, Buzsaki G, Devinsky O, Parra LC, Liu AA. Low Mahajan A, Saleheen D, Emdin C, Alam D, Alves AC, Lublin F, Sormani MP. Cerebellar volume as imaging frequency transcranial electrical stimulation does not Amouyel P, Di Angelantonio E, Arveiler D, Assimes TL, outcome in progressive multiple sclerosis. PloS One. April entrain sleep rhythms measured by human intracranial Auer PL, Baber U, Ballantyne CM, Bang LE, Benn M, Bis JC, 24, 2017; 12(4): e0176519. recordings. Nature Communications. October 31, 2017; Boehnke M, Boerwinkle E, Bork-Jensen J, Bottinger EP, 8(1): 1199. 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Neurology & Neurosurgery 2017 | NYU Langone Health 29 Academic Activities

Martin KR, Zhou W, Bowman MJ, Shih J, Au KS, Nascimento OJM, Frontera JA, Amitrano DA, Bispo de Peters MAK, Thesen T, Ko YD, Maniscalco B, Carlson C, Dittenhafer-Reed KE, Sisson KA, Koeman J, Weisenberger DJ, Filippis AM, da Silva IRF. Zika virus infection-associated Davidson M, Doyle W, Kuzniecky R, Devinsky O, Cottingham SL, DeRoos ST, Devinsky O, Winn ME, acute transient polyneuritis. Neurology. June 2017; 88(24): Halgren E, Lau H. Perceptual confidence neglects Cherniack AD, Shen H, Northrup H, Krueger DA, 2330–2332. decision-incongruent evidence in the brain. Nature: Human MacKeigan JP. The genomic landscape of tuberous sclerosis Behaviour. July 10, 2017; 0139. complex. Nature Communications. June 15, 2017; 8: 15816. Nelson AB, Moisello C, Lin J, Panday P, Ricci S, Canessa A, Di Rocco A, Quartarone A, Frazzitta G, Isaias IU, Tononi G, Petzold A, Balcer LJ, Calabresi PA, Costello F, Frohman TC, Meltzer E, Sguigna PV, Subei A, Beh S, Kildebeck E, Cirelli C, Ghilardi MF. Beta oscillatory changes and Frohman EM, Martinez-Lapiscina EH, Green AJ, Kardon R, Conger D, Conger A, Lucero M, Frohman BS, Frohman AN, retention of motor skills during practice in healthy subjects Outteryck O, Paul F, Schippling S, Vermersch P, Villoslada P, Saidha S, Galetta S, Calabresi PA, Rennaker R, Frohman TC, and in patients with Parkinson’s disease. Frontiers in Balk LJ. Retinal layer segmentation in multiple sclerosis: Kardon RH, Balcer LJ, Frohman EM. Retinal architecture Human Neuroscience. March 7, 2017; 11: 104. a systematic review and meta-analysis. The Lancet and melanopsin-mediated pupillary response Neurology. October 2017; 16(10): 797–812. characteristics: a putative pathophysiologic signature for Nelson LD, Furger RE, Gikas P, Lerner EB, Barr WB, the retino-hypothalamic tract in multiple sclerosis. Journal Hammeke TA, Randolph C, Guskiewicz K, McCrea MA. Picard RW, Migliorini M, Caborni C, Onorati F, Regalia G, of the American Medical Association—Neurology. May 1, Prospective, head-to-head study of three computerized Friedman D, Devinsky O. Wrist sensor reveals sympathetic 2017; 74(5): 574–582. neurocognitive assessment tools part 2: utility for hyperactivity and hypoventilation before probable SUDEP. assessment of mild traumatic brain injury in emergency Neurology. August 8, 2017; 89(6): 633–635. Mendoza-Santiesteban CE, Gabilondo I, Palma JA, department patients. Journal of the International Norcliffe-Kaufmann L, Kaufmann H. The retina in multiple Neuropsychological Society. April 2017; 23(4): 293–303. Prabhu VV, Lulla AR, Madhukar NS, Ralff MD, Zhao D, system atrophy: systematic review and meta-analysis. Kline CLB, Van den Heuvel APJ, Lev A, Garnett MJ, Frontiers in Neurology. May 24, 2017; 8: 206. Nelson LD, Furger RE, Ranson J, Tarima S, Hammeke TA, McDermott U, Benes CH, Batchelor TT, Chi AS, Elemento O, Randolph C, Barr WB, Guskiewicz KK, Olsen CM, Lerner EB, Allen JE, El-Deiry WS. Cancer stem cell-related gene Mendoza-Santiesteban CE; Palma J-A, Hedges TR III, McCrea M. Acute clinical predictors of symptom recovery in expression as a potential biomarker of response for Laver NV, Farhat N, Norcliffe-Kaufmann L, Kaufmann H. emergency department patients with uncomplicated mild first-in-class imipridone ONC201 in solid tumors. PloS One. Pathological confirmation of optic neuropathy in familial traumatic brain injury (mTBI) or non-TBI injuries. Journal of August 2, 2017; 12(8): e0180541. dysautonomia. Journal of Neuropathology & Experimental Neurotrauma. November 17, 2017. epub ahead of print. Neurology. March 2017; 76(3): 238–244. Ramdhani RA, Frucht SJ, Kopell BH. Improvement of Norcliffe-Kaufmann L, Galindo-Mendez B, Garcia-Guarniz post-hypoxic myoclonus with bilateral pallidal deep brain Mendoza-Santiesteban CE, Palma J-A, Norcliffe-Kaufmann A-L, Villarreal-Vitorica E, Novak V. Transcranial Doppler in stimulation: a case report and review of the literature. L, Kaufmann H. Familial dysautonomia: a disease with autonomic testing: standards and clinical applications. Tremor and Other Hyperkinetic Movements. May 19, 2017; hidden tears. Journal of Neurology. June 2017; 264(6): Clinical Autonomic Research. August 18, 2017; 1–16. epub 7:461. epub ahead of print. 1290–1291. ahead of print. Rasouli J, Ramdhani R, Panov FE, Dimov A, Zhang Y, Cho C, Mendoza-Santiesteban CE, Palma J-A, Ortuno-Lizaran I, Nwabuobi LA, Pellinen JC, Wisniewski TM. Wang Y, Kopell BH. Utilization of quantitative susceptibility Cuenca N, Kaufmann H. Pathologic confirmation of retinal Thymoma-associated panencephalitis: a newly emerging mapping for direct targeting of the subthalamic nucleus ganglion cell loss in multiple system atrophy. Neurology. paraneoplastic neurologic syndrome. Neuroimmunology during deep brain stimulation surgery. Operative June 6, 2017; 88(23): 2233–2235. and Neuroinflammation. June 6, 2017; 117–123. Neurosurgery. May 21, 2017. epub ahead of print. Miller JB, Barr WB. The technology crisis in Onorati F, Regalia G, Caborni C, Migliorini M, Bender D, Raynowska J, Rizzo J-R, Rucker JC, Dai W, Birkemeier J, neuropsychology. Archives of Clinical Neuropsychology. Poh M-Z, Frazier C, Kovitch Thropp E, Mynatt ED, Bidwell J, Hershowitz J, Selesnick I, Balcer LJ, Galetta SL, Hudson T. August 2017; 32(5): 541–554. Mai R, LaFrance WC Jr., Blum AS, Friedman D, Validity of low-resolution eye-tracking to assess eye Loddenkemper T, Mohammadpour-Touserkani F, movements during a rapid number naming task: Milling TJ Jr., Frontera J. Exploring indications for the use of Reinsberger C, Tognetti S, Picard RW. Multicenter clinical performance of the EyeTribe eye tracker. Brain Injury. direct oral anticoagulants and the associated risks of major assessment of improved wearable multimodal convulsive December 6, 2017; 32(2): 200–208. bleeding. American Journal of Managed Care. April 17, 2017; seizure detectors. Epilepsia. November 2017; 58(11): 23: S67–S80. 1870–1879. Reisberg B, Shao Y, Golomb J, Monteiro I, Torossian C, Boksay I, Shulman M, Heller S, Zhu Z, Atif A, Sidhu J, Miskin N, Patel H, Franceschi AM, Ades-Aron B, Le A, Palma J-A, Kaufmann H. Epidemiology, diagnosis, and Vedvyas A, Kenowsky S. Comprehensive, individualized, Damadian BE, Stanton C, Serulle Y, Golomb J, Gonen O, management of neurogenic orthostatic hypotension. person-centered management of community-residing Rusinek H, George AE. Diagnosis of normal-pressure Movement Disorders Clinical Practice. May–June 2017; 4(3): persons with moderate-to-severe Alzheimer disease: hydrocephalus: use of traditional measures in the era of 298–308. a randomized controlled trial. Dementia and Geriatric volumetric MR imaging. Radiology. October 2017; 285(1): Cognitive Disorders. February 2017; 43(1–2): 100–117. 197–205. Palma J-A, Norcliffe-Kaufmann L, Kaufmann H. Diagnosis of multiple system atrophy. Autonomic Neuroscience: Basic & Reyes A, Thesen T, Kuzniecky R, Devinsky O, McDonald CR, Mistry PK, Batista JL, Andersson HC, Balwani M, Burrow TA, Clinical. October 23, 2017. In press. Jackson GD, Vaughan DN, Blackmon K. Amygdala Charrow J, Kaplan P, Khan A, Kishnani PS, Kolodny EH, enlargement: temporal lobe epilepsy subtype or nonspecific Rosenbloom B, Scott C, Weinreb N. Transformation in Palma J-A, Norcliffe-Kaufmann L, Perez MA, Spalink CL, finding?Epilepsy Research. May 2017; 132: 34–40. pre-treatment manifestations of Gaucher disease type 1 Kaufmann H. Sudden unexpected death during sleep in during two decades of alglucerase/imiglucerase enzyme familial dysautonomia: a case-control study. Sleep. August Reynolds AS, Holmes MG, Agarwal S, Claassen J. replacement therapy in the International Collaborative 1, 2017; 40(8): zsx083. Phenotypes of early myoclonus do not predict outcome. Gaucher Group (ICGG) Registry. American Journal of Annals of Neurology. March 2017; 81(3): 475–476. Hematology. September 2017; 92(9): 929–939. Palma J-A, Spalink C, Barnes EP, Norcliffe-Kaufmann L, Kaufmann H. Neurogenic dysphagia with undigested Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Modrek AS, Golub D, Khan T, Bready D, Prado J, Bowman C, macaroni and megaesophagus in familial dysautonomia. Ferrer R, Kumar A, Sevransky JE, Sprung CL, Nunnally ME, Deng J, Zhang G, Rocha PP, Raviram R, Lazaris C, Clinical Autonomic Research. December 1, 2017. epub ahead Rochwerg B, Rubenfeld GD, Angus DC, Annane D, Beale RJ, Stafford JM, LeRoy G, Kader M, Dhaliwal J, Bayin NS, of print. Bellinghan GJ, Bernard GR, Chiche J-D, Coopersmith C, Frenster JD, Serrano J, Chiriboga L, Baitalmal R, Nanjangud G, De Backer DP, French CJ, Fujishima S, Gerlach H, Chi AS, Golfinos JG, Wang J, Karajannis MA, Bonneau RA, Patel AS, Sulica L, Frucht SJ. Velopharyngeal dystonia: Hidalgo JL, Hollenberg SM, Jones AE, Karnad DR, Reinberg D, Tsirigos A, Zagzag D, Snuderl M, Skok JA, an unusual focal task-specific dystonia? Tremor and Other Kleinpell RM, Koh Y, Lisboa TC, Machado FR, Marini JJ, Neubert TA, Placantonakis DG. Low-grade astrocytoma Hyperkinetic Movements. July 11, 2017; 7: 356. epub ahead of Marshall JC, Mazuski JE, McIntyre LA, McLean AS, Mehta S, mutations in IDH1, P53, and ATRX cooperate to block print. Moreno RP, Myburgh J, Navalesi P, Nishida O, Osborn TM, differentiation of human neural stem cells via repression of Patel SH, Poisson LM, Brat DJ, Zhou Y, Cooper L, Snuderl M, Perner A, Plunkett CM, Ranieri M, Schorr CA, Seckel MA, SOX2. Cell Reports. October 31, 2017; 21(5): 1267–1280. Thomas C, Franceschi AM, Griffith B, Flanders A, Seymour CW, Shieh L, Shukri KA, Simpson SQ, Singer M, Thompson BT, Townsend SR, Van der Poll T, Vincent J-L, Nascimento FA, Tseng ZH, Palmiere C, Maleszewski JJ, Golfinos JG, Chi AS, Jain R. 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30 NYU Langone Health | Neurology & Neurosurgery 2017 Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Schou WS, Ashina S, Amin FM, Goadsby PJ, Ashina M. Thompson AJ, Banwell BL, Barkhof F, Carroll WM, Ferrer R, Kumar A, Sevransky JE, Sprung CL, Nunnally ME, Calcitonin gene-related peptide and pain: a systematic Coetzee T, Comi G, Correale J, Fazekas F, Filippi M, Rochwerg B, Rubenfeld GD, Angus DC, Annane D, Beale RJ, review. Journal of Headache and Pain. December 2017; Freedman MS, Fujihara K, Galetta SL, Hartung HP, Kappos Bellinghan GJ, Bernard GR, Chiche J-D, Coopersmith C, 18(1): 34. L, Lublin FD, Marrie RA, Miller AE, Miller DH, Montalban X, De Backer DP, French CJ, Fujishima S, Gerlach H, Mowry EM, Sorensen PS, Tintoré M, Traboulsee AL, Hidalgo JL, Hollenberg SM, Jones AE, Karnad DR, Kleinpell Shaw MT, Pawlak NO, Frontario A, Sherman K, Krupp LB, Trojano M, Uitdehaag BMJ, Vukusic S, Waubant E, RM, Koh Y, Lisboa TC, Machado FR, Marini JJ, Marshall JC, Charvet LE. 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Neurology & Neurosurgery 2017 | NYU Langone Health 31 Academic Activities

DeSousa K, Nossek E, Potts M, Riina HA. Whom I stent. Kano H, Meola A, Yang HC, Guo W, Martinez R, Martinez M, SELECT PUBLICATIONS: In: Veznedaroglu, E (Ed.) Controversies in Vascular Urgosik D, Liscak R, Sheehan J, Lee JY, Abbassy M, Barnett G, Neurosurgery. Springer. 2016: 131–137. Mathieu D, Kondziolka D, Lunsford LD. Stereotactic NEUROSURGERY radiosurgery for jugular foramen schwannomas: an Ding D, Starke R, Kano H, Lee JY, Mathieu D, Pierce J, international multicenter study. Journal of Neurosurgery. Huang P, Feliciano C, Rodriguez-Mercado R, Almodovar L, November 10, 2017; 1–9. epub ahead of print. Grills IS, Silva D, Abbassy M, Missios S, Kondziolka D, Altschul D, Biswas A, Nakhla J, Echt M, Gordon D. Novel Barnett GH, Lunsford LD, Sheehan JP. Stereotactic Katlowitz K, Pourfar MH, Israel Z, Mogilner AY. double catheter technique with detachable microcatheter radiosurgery for Spetzler-Martin grade III arteriovenous Intraparenchymal cysts following deep brain stimulation: for the treatment of arteriovenous malformations: a malformations: an international multicenter study. Journal variable presentations and clinical courses. Operative technical note. Surgical Neurology International. December of Neurosurgery. March 2017; 126(3): 859–871. Neurosurgery. October 1, 2017; 13(5): 576–580. 21, 2016; 7(Supplement 41): S1072–S1074. Ding D, Starke R, Kano H, Lee JYK, Mathieu D, Pierce J, Kolecki R, Dammavalam V, Zahid AB, Hubbard M, Bailes JE, Patel V, Farhat H, Sindelar B, Stone JL. Football Huang P, Missios S, Feliciano C, Rodriguez-Mercado R, Chaudhry O, Reyes M, Han BJ, Wang T, Papas PV, Adem A, fatalities: the first impact syndrome. Journal of Almodovar L, Grills I, Silva D, Abbassy M, Kondziolka D, North E, Gilbertson DT, Kondziolka D, Huang J, Huang P, Neurosurgery: Pediatrics. January 2017; 19(1): 116–121. Barnett G, Lunsford LD, Sheehan JP. Radiosurgery for Samadani U. Elevated intracranial pressure and reversible Bayin NS, Frenster J, Sen R, Si S, Modrek AS, Galifianakis N, unruptured brain arteriovenous malformations: an eye-tracking changes detected while viewing a film clip. Dolgalev I, Ortenzi V, Illa-Bochaca I, Khahera A, Serrano J, international multicenter retrospective cohort study. Journal of Neurosurgery. June 2, 2017; 1–8. Neurosurgery. June 1, 2017; 80(6): 888–898. Chiriboga L, Zagzag D, Golfinos JG, Doyle W, Heguy A, Kondziolka D, Rutka JT. Editorial: A concerted effort to Chesler M, Barcellos-Hoff MH, Snuderl M, Placantonakis Ding D, Starke R, Kano H, Mathieu D, Huang P, Feliciano C, publish the best studies in neurosurgery. Journal of DG. Notch signaling regulates metabolic heterogeneity in Rodriguez-Mercado R, Almodovar R, Grills I, Silva D, Neurosurgery. May 2017; 126(5): 1445–1447. glioblastoma stem cells. Oncotarget. September 12, 2017; Abbassy M, Missios S, Kondziolka D, Barnett G, 8(39): 64932–64953. Lunsford LD, Sheehan JP. International multicenter cohort Lewis A, Lin J, James H, Krok AC, Zeoli N, Healy J, Lewis T, Pacione D. A single-center intervention to discontinue Bayin NS, Ma L, Thomas C, Baitalmal R, Sure A, Fansiwala K, study of pediatric arteriovenous malformations. Part 1: predictors of hemorrhagic presentation. Journal of postoperative antibiotics after spinal fusion. British Journal Bustoros M, Golfinos JG, Pacione D, Snuderl M, Zagzag D, of Neurosurgery. November 2, 2017; 1–5. Barcellos-Hoff MH, Placantonakis DG. Patient-specific Neurosurgery: Pediatrics. February 2017; 19(2): 127–135. screening using high-grade glioma explants to determine Dowd RS, Pourfar M, Mogilner AY. Deep brain stimulation Lewis A, Sen R, Hill TC, James H, Lin J, Bhamra H, potential radiosensitization by a TGF-β small molecule for Tourette syndrome: a single-center series. Journal of Martirosyan N, Pacione D. Antibiotic prophylaxis for inhibitor. Neoplasia. December 2016; 18(12): 795–805. Neurosurgery. April 7, 2017; 1–9. epub ahead of print. subdural and subgaleal drains. Journal of Neurosurgery. March 2017; 126(3): 908–912. Chen H, Judkins J, Thomas C, Wu M, Khoury L, Feng R, Oermann EK, Shrivastava R, Gold A, Collins BT, Benjamin CG, Pacione D, Golfinos J, Kumthekar P, Kondziolka D, Collins SP. Stereotactic radiosurgery for Li P, Fu X, Smith NA, Ziobro J, Curiel J, Tenga MJ, Martin B, Ghamsari F, Chen L, Lein P, Chetovich DM, Snuderl M, melanoma brain metastases: a comprehensive clinical case Freedman S, Cea-Del Rio CA, Oboti L, Tsuchida TN, Horbinksi C. Mutant IDH1 and seizures in patients with series. World Neurosurgery. April 2017; 100: 297–304. Oluigbo C, Yaun A, Magge SN, O’Neill B, Kao A, Zelleke TG, glioma. Neurology. May 19, 2017; 88(19): 1805–1813. Depositario-Cabacar DT, Ghimbovschi S, Knoblach S, Franceschi AM, Wiggins GC, Mogilner AY, Shepherd T, Ho CY, Corbin JG, Goodkin HP, Vicini S, Huntsman MM, Chiu AH, DeVries J, O’Kelly C, Riina HA, McDougal I, Chung S, Lui YW. Optimized, minimal specific absorption Gaillard WD, Valdez G, Liu JS. Loss of CLOCK results in Tippett J, Wan M, Manoel A, Marotta T. The second rate MRI for high-resolution imaging in patients with dysfunction of brain circuits underlying focal epilepsy. generation eClips endovascular clip system: initial implanted deep brain stimulation electrodes. American Neuron. October 11, 2017; 96(2): 387–401.e6. experience. Journal of Neurosurgery. March 17, 2017; 1–8. Journal of Neuroradiology. November 2016; 37(11): epub ahead of print. 1996–2000. Marotta T, Riina HA, McDougal I, Ricci D, Killer-Oberpfalzer M. Physiologic remodeling of bifurcation Cohen-Inbar O, Starke RM, Kano H, Huang P, Frenster JD, Inocencio JF, Xu Z, Dhaliwal J, Alghamdi A, aneurysm: pre-clinical results of the eCLIPs device. Journal Rodriguez-Mercado R, Almodovar L, Grills I, Mathieu D, Zagzag D, Bayin NS, Placantonakis DG. GPR133 promotes of Neurosurgery. March 17, 2017; 1–7. epub ahead of print. Silva D, Abbassy M, Missios S, Lee JYK, Barnett G, glioblastoma growth in hypoxia. Neurosurgery. September 1, Kondziolka D, Lunsford LD, Sheehan JP. Early versus late 2017; 64(CN Supplement 1): 177–181. McClelland S III, Marascalchi BJ, Passias PG, Protopsaltis AVM responders after stereotactic radiosurgery: an TS, Frempong-Boadu AK, Errico TJ. Impact of race and international multicenter study. Journal of Neurosurgery. Golfinos JG. Positioning for cranial surgery. In: Winn HR insurance status on surgical approach for cervical September 2017; 127(3): 503–511. (Ed.) Youmans and Winn Neurological Surgery, Seventh spondylotic myelopathy in the United States: a Edition. November 30, 2016. population-based analysis. Spine. February 2017; Cohen-Inbar O, Starke RM, Lee CC, Kano H, Huang P, 42(3): 186–194. Kondziolka D, Grills IS, Silva D, Abbassy M, Missios S, Golinko MS, Harter DH, Rickert S, Staffenberg DA. Barnett GH, Lunsford LD, Sheehan JP. Stereotactic Cerebrospinal fluid fistula for the craniofacial surgeon: a McClelland S III, Marascalchi BJ, Passias PG, Protopsaltis radiosurgery for brainstem arteriovenous malformations: review and management paradigm. Journal of Craniofacial TS, Frempong-Boadu AK, Errico TJ. Operative fusion of a multicenter study. Neurosurgery. December 1, 2017; Surgery. February 23, 2017. epub ahead of print. multilevel cervical spondylotic myelopathy: impact of 81(6): 910–920. patient demographics. Journal of Clinical Neuroscience. Grady C, Tanweer O, Zagzag D, Jafar JJ, Huang PP, May 2017; 39: 133–136. Cohen-Inbar O, Xu Z, Lee CC, Wu CC, Chytka T, Silva D, Kondziolka D. Delayed hemorrhage from the tissue of an Sharma M, Radwan H, Grills IS, Nguyen B, Siddiqui Z, occluded arteriovenous malformation after stereotactic Mehta GU, Ding D, Patibandla MR, Kano H, Sisterson N, Mathieu D, Iorio-Morin C, Wolf A, Cifarelli CP, Cifarelli DT, radiosurgery: report of 3 cases. Journal of Neurosurgery. Su YH, Krsek M, Nabeel AM, El-Shehaby A, Kareem KA, Lunsford LD, Kondziolka D, Sheehan JP. Prognostic June 2017; 126(6): 1899–1904. Martinez-Moreno N, Mathieu D, McShane B, Blas K, significance of corticotroph staining in radiosurgery for Kondziolka D, Grills I, Lee JY, Martinez-Alvarez R, Reda WA, Hainline C, Golfinos JG, Liu Y, Liechty B, Zagzag D, Liscak R, Lee CC, Lunsford LD, Vance ML, Sheehan JP. non-functioning pituitary adenomas: a multicenter study. Galetta S. Tumoral presentation of homonymous Journal of Neuro-Oncology. October 2017; 135(1): 67–74. Stereotactic radiosurgery for Cushing disease: results of hemianopia and prosopagnosia in cerebral amyloid an international, multicenter study. Journal of Clinical Cordova C, Chi AS, Chachoua A, Kondziolka D, angiopathy-related inflammation. Journal of Endocrinology & Metabolism. November 1, 2017; Silverman JS, Shepherd TM, Jain R, Snuderl M. Osimertinib Neuro-Ophthalmology. March 2017; 37(1): 48–52. 102(11): 4284–4291. dose escalation induces regression of progressive EGFR Hashmonai M, Cameron AEP, Connery CP, Perin N, T790M-mutant leptomeningeal lung adenocarcinoma. Mehta GU, Zenonos G, Patibandla MR, Lin CJ, Wolf A, Licht PB. The etiology of primary hyperhidrosis: a Grills I, Mathieu D, McShane B, Lee JY, Blas K, Kondziolka Journal of Thoracic Oncology. November 2017; systematic review. Clinical Autonomic Research. December 12(11): e188–e190. D, Lee CC, Lunsford LD, Sheehan JS. 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32 NYU Langone Health | Neurology & Neurosurgery 2017 Modrek AS, Golub D, Khan T, Bready D, Prado J, Bowman C, Potts M, Shapiro M, Zumofen D, Raz E, Nossek E, DeSousa K, Starke RM, Ding D, Kano H, Mathieu D, Huang P, Deng J, Zhang G, Rocha PP, Raviram R, Lazaris C, Becske T, Riina HA, Nelson PK. Parent vessel occlusion after Feliciano C, Rodriguez-Mercado R, Almodovar R, Grills I, Stafford JM, LeRoy G, Kader M, Dhaliwal J, Bayin NS, Pipeline embolization of cerebral aneurysms of the anterior Silva D, Abbassy M, Missios S, Kondziolka D, Barnett G, Frenster JD, Serrano J, Chiriboga L, Baitalmal R, Nanjangud circulation. Journal of Neurosurgery. December 2017; Lunsford LD, Sheehan JP. International multicenter cohort G, Chi AS, Golfinos JG, Wang J, Karajannis MA, Bonneau RA, 127(6): 1333–1341. study of pediatric arteriovenous malformations. Part 2: Reinberg D, Tsirigos A, Zagzag D, Snuderl M, Skok JA, outcomes after stereotactic radiosurgery. Journal of Neubert TA, Placantonakis DG. 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Neurology & Neurosurgery 2017 | NYU Langone Health 33 Faculty

COGNITIVE NEUROLOGY Andreas N. Neophytides NEUROMUSCULAR Howard A. Riina NEUROSURGERY Dora S. Pinkhasova Sara K. Rostanski Sonja Blum MEDICINE Perrin A. Pleninger Heidi Schambra Allal Boutajangout Neil S. Rosenthal Jaydeep M. Bhatt Jose L. Torres Tracy Butler Erich G. Anderer Alexander Schick Myrna I. Cardiel Cen Zhang Mitchell Chesler Eleanor S. Drummond David Schick Mary-Lynn Y. Chu Ting Zhou Werner K. Doyle Silvia Fossati Andre V. Strizhak Farng-Yang A. Foo Anthony K. Frempong-Boadu Elkhonon Goldberg Daniel M. Torres Kiril Kiprovski John G. Golfinos Fernando R. Goni NYC HEALTH + Harold J. Weinberg Arielle M. Kurzweil James B. Golomb Lindsey J. Gurin Patrick Kwon HOSPITALS/BELLEVUE David S. Gordon Ericka Wong Karyn D. Marsh Athena M. Lolis Laura S. Boylan David H. Harter David S. Younger Arjun V. Masurkar Perrin A. Pleninger E. Teresa Hidalgo Xishan Zhang Ludmilla Bronfin Joanna E. Pankiewicz Howard W. Sander Paul P. Huang Regina R. DeCarlo Julia A. Rao David Schick Jafar J. Jafar Audrey Halpern Martin Sadowski GLOBAL HEALTH Douglas S. Kondziolka Sujata P. Thawani Saran Jonas John I. Miller Henrieta Scholtzova Jaydeep M. Bhatt Daniel M. Torres Nancy L. Mueller Alon Y. Mogilner Melanie B. Shulman Jerome H. Chin Janice F. Wiesman Aaron Nelson Donato R. Pacione Thomas M. Wisniewski Ericka Wong Melissa J. Nirenberg Noel I. Perin HEADACHE MEDICINE Robert I. Pfeffer Dimitris G. Placantonakis EPILEPSY NEURO-ONCOLOGY Perrin A. Pleninger Michael H. Pourfar Sait Ashina Anuradha Singh Karen E. Blackmon Jeffrey C. Allen Margaret E. Rice Thomas Berk Janice F. Wiesman Judith Bluvstein Andrew S. Chi Howard A. Riina Adelene E. Jann Ericka Wong Stephen M. Russell Michael Boffa Suja Johnkutty Sylvia C. Eisele Chandranath Sen Lucia A. Melloni Buljevic Valeriya Levitan Claude Macaluso Michael L. Smith Jocelyn Y. Cheng Mia T. Minen Allan E. Rubenstein VETERANS AFFAIRS James Stone Orrin Devinsky Lawrence C. Newman Kaleb H. Yohay NEW YORK HARBOR Lee Tessler Patricia C. Dugan HEALTH CARE SYSTEM Jeffrey H. Wisoff Adeen Flinker NEURO-OPHTHALMOLOGY Zuzana Belisova-Gyure Amanda L. Yaun MULTIPLE SCLEROSIS Jacqueline A. French Alla Feldbarg Joshua H. Bacon Laura J. Balcer Daniel Friedman Jacqueline Friedman Anita L. Belman Mohammad Fouladvand Deana M. Gazzola Richard M. Hanson Robert W. Charlson Steven L. Galetta Jennifer Gelinas Emile M. Hiesiger Leigh E. Charvet Cinthi Pillai NEUROLOGY Eric Halgren Martin Sadowski Jacqueline Friedman Janet C. Rucker Biyu J. He Robert Staudinger Albert Goodgold Floyd A. Warren Scott E. Hirsch Thomas M. Wisniewski AUTONOMIC DISORDERS Manisha G. Holmes Josef M. Gutman Jonathan E. Howard Horacio Kaufmann Amy C. Jongeling NEURO-OTOLOGY Marshall J. Keilson NYU LANGONE Lucy J. Norcliffe-Kaufmann Marshall J. Keilson Ilya Kister Catherine Cho HOSPITAL—BROOKLYN Carlos E. Mendoza- Josiane LaJoie Lauren B. Krupp Santiesteban Karen L. Lee Nada G. Abou-Fayssal Krupa S. Pandey NEUROPSYCHOLOGY Jose-Alberto Palma Beth A. Leeman-Markowski Karthikeyan M. Arcot Anli A. Liu Lana Zhovtis Ryerson William B. Barr Sait Ashina Daniel J. Luciano James L. Salzer Michael Boffa CHILD NEUROLOGY Leigh E. Charvet Michael R. Meager Rachel Ventura Kathleen A. Jantzen Clara D. Boyd Jeffrey C. Allen Lucia A. Melloni-Buljevic Robyn Wolintz Gianna Locascio Alexander B. Chervinsky Judith Bluvstein Daniel K. Miles Chris Morrison Julie DeBacker Mary-Lynn Y. Chu Chris Morrison NEUROCRITICAL CARE Jeffrey Farkas Irving Fish Siddhartha S. Nadkarni Jennifer A. Frontera Barry M. Czeisler PARKINSON’S AND Sandra L. Forem Heath R. Pardoe David S. Gordon Jennifer A. Frontera MOVEMENT DISORDERS Lauren B. Krupp Christina Pressl Katarzyna Jakubowska- Ariane K. Lewis Josiane LaJoie Alcibiades J. Rodriguez Giovanni F. Abbruzzese Sadowska Aaron S. Lord Heather A. Lau Rebecca J. Scott Milton C. Biagioni Amy C. Jongeling Daniel K. Miles Andre V. Strizhak Miroslaw S. Brys David E. Kahn Aaron Nelson Thomas Thesen NEURO-EPIDEMIOLOGY Alessandro Di Rocco Sun Kim Robin E. Smith Blanca Vazquez Laura J. Balcer Arash Fazl Patrick Kwon Hae-Ri Song Bernadette Boden-Albala Andrew S. Feigin Jeremy Liff John T. Wells GENERAL NEUROLOGY Leigh E. Charvet Jori E. Fleisher Gianna Locascio Kaleb H. Yohay Jacqueline A. French Steven J. Frucht Anthony G. Maniscalco Robert S. April Daniel Friedman Maria Felice M. Ghilardi Michelle Molina Lennart Belok Aaron S. Lord Rebecca M. Gilbert Leonard A. Pace CLINICAL Myrna I. Cardiel Arjun V. Masurkar Ioannis Isaias Nikolaos Papamitsakis NEUROPHYSIOLOGY Dominique Cozien Mia T. Minen Amy C. Lemen Matthew D. Sanger Aleksandar Beric Arthur Farkash Heidi Schambra Michael H. Pourfar George P. Tavoulareas Cristina M. Drafta Farng-Yang A. Foo Sujata P. Thawani Angelo Quartarone Ambooj Tiwari Kiril Kiprovski Sun-Hoo Foo Ritesh A. Ramdhani David Turkel-Parrella Athena M. Lolis James B. Golomb David M. Swope NEUROGENETICS Blanca Vazquez Anna Shor Brian W. Hainline Ting Zhou Elvira Kamenetsky Suying L. Song Heather A. Lau VASCULAR NEUROLOGY Ming Xu Marshall J. Keilson Arielle M. Kurzweil Bernadette Boden-Albala David N. Levine Albert S. Favate Mitra Nirmala Koto Ishida

34 NYU Langone Health | Neurology & Neurosurgery 2017 Leadership

James L. Stone, MD Steven J. Frucht, MD NEUROSURGERY Professor of Neurosurgery Professor of Neurology Chief of Service, VA NY Harbor Health Care System Associate Chair of Neurology, Clinical Practices Director, Division of Parkinson’s and John G. Golfnos, MD Lee E. Tessler, MD Movement Disorders Associate Professor of Neurosurgery Associate Professor of Neurosurgery and Otolaryngology Chief of Neurosurgery, NYU Winthrop Hospital Richard M. Hanson, MD Chair of the Department of Neurosurgery Clinical Associate Professor of Neurology Co-Director, Brain Tumor Center Jeffrey H. Wisoff, MD Chief of Service, VA NY Harbor Health Care System Investigator, Neuroscience Institute Professor of Neurosurgery and Pediatrics Director, Division of Pediatric Neurosurgery Horacio Kaufmann, MD Erich G. Anderer, MD Felicia B. Axelrod Professor of Dysautonomia Research Assistant Professor of Neurosurgery Professor of Medicine and Pediatrics Chief of Neurosurgery, NYU Langone Hospital— Director, Division of Autonomic Disorders Brooklyn NEUROLOGY Lauren B. Krupp, MD Mitchell Chesler, MD, PhD Nancy Glickenhaus Pier Professor of Pediatric Professor of Neurosurgery Neuropsychiatry Steven L. Galetta, MD and Neuroscience and Physiology Director, Division of Multiple Sclerosis Vice Chair of Research Philip K. Moskowitz, MD Professor and Associate Director, Medical Science Chair of Neurology Aaron S. Lord, MD Training Program Professor of Neurology and Ophthalmology Assistant Professor of Neurology and Neurosurgery Chair of the Department of Neurology Director, Division of Neurocritical Care Anthony K. Frempong-Boadu, MD Associate Professor of Neurosurgery Laura J. Balcer, MD Lawrence C. Newman, MD and Orthopedic Surgery Professor of Neurology, Ophthalmology, Professor of Neurology Director, Division of Spinal Neurosurgery and Population Health Director, Division of Headache Medicine Co-Director, Spine Center Vice Chair of the Department of Neurology Janet C. Rucker, MD David H. Harter, MD William B. Barr, PhD Bernard A. and Charlotte Marden Professor of Associate Professor of Neurosurgery Associate Professor of Neurology and Psychiatry Neurology Director, Neurosurgery Residency Training Program Director, Neuropsychology Program Professor of Ophthalmology Director, Pediatric Cerebral Endoscopy Chief, Division of Neuro-Ophthalmology Aleksandar Beric, MD Director, Neuro-Ophthalmology Fellowship Program Paul Huang, MD Professor of Neurology, Neurosurgery, Orthopedic Assistant Professor of Neurosurgery Surgery, and Rehabilitation Medicine Howard W. Sander, MD Director, Neurosurgery Service, Director, Division of Clinical Neurophysiology Professor of Neurology, Psychiatry, and Anesthesiology, NYC Health + Hospitals/Bellevue Perioperative Care, and Pain Medicine Jaydeep M. Bhatt, MD Associate Chair, Education Jafar J. Jafar, MD Clinical Associate Professor of Neurology Director, Division of Neuromuscular Medicine Professor of Neurosurgery Director, Division of Global Health Director, Division of Cerebrovascular Surgery Heidi Schambra, MD Andrew S. Chi, MD, PhD Assistant Professor of Neurology and Douglas S. Kondziolka, MD, MSc Assistant Professor of Medicine, Neurology, Rehabilitation Medicine Gray Family Professor of Neurosurgery and Neurosurgery Director, Division of Neuro-Epidemiology Vice Chair of Clinical Research Director, Neuro-Oncology Program Director, Center for Advanced Radiosurgery Co-Director, Brain Tumor Center Anuradha Singh, MD Clinical Professor of Neurology Catherine Cho, MD Alon Mogilner, MD, PhD Director, Neurology Service, NYC Health + Hospitals/ Associate Professor of Neurosurgery Clinical Associate Professor of Neurology and Bellevue and Anesthesiology Otolaryngology Director, Center for Neuromodulation Director, Division of Neuro-Otology Harold J. Weinberg, MD, PhD Clinical Professor of Neurology Orrin Devinsky, MD Noel I. Perin, MD Associate Chair, Clinical Affairs Associate Professor of Neurosurgery Professor of Neurology, Neurosurgery, and Psychiatry Director, Division of General Neurology Director, Minimally Invasive Spinal Surgery Director, Division of Epilepsy Chief, Neurology Service

Howard A. Riina, MD Albert S. Favate, MD John T. Wells, MD Professor of Neurosurgery, Neurology, and Radiology Associate Professor of Neurology Clinical Professor of Neurology Vice Chair of the Department of Neurosurgery Director, Division of Vascular Neurology Director, Division of Child Neurology Director, Endovascular Surgery Associate Director, Neurosurgery Residency Andrew S. Feigin, MD Thomas M. Wisniewski, MD Training Program Professor of Neurology Gerald J. and Dorothy R. Friedman Professor of Director, Advanced Stroke Center Associate Chair of Neurology, Clinical Research Neurology Executive Director, Marlene and Paolo Fresco Institute Professor of Pathology and Psychiatry Chandranath Sen, MD for Parkinson’s and Movement Disorders Associate Chair, Research Professor of Neurosurgery Director, Division of Cognitive Neurology Vice Chair for Education Jennifer A. Frontera, MD Director, Skull Base Surgery Professor of Neurology Chief of Neurology, NYU Langone Hospital—Brooklyn Vice Chair of Neurology, NYU Langone Hospital— Brooklyn

For more information about our physicians, services, and locations, visit nyulangone.org

Neurology & Neurosurgery 2017 | NYU Langone Health 35 Leadership

NEW YORK UNIVERSITY

William R. Berkley Andrew Hamilton, PhD Chair, Board of Trustees President

NYU LANGONE HEALTH

Kenneth G. Langone Michael T. Burke Joseph Lhota Chair, Board of Trustees Senior Vice President and Senior Vice President and Vice Dean, Corporate Chief Financial Officer Vice Dean, Chief of Staff Robert I. Grossman, MD Saul J. Farber Dean and Richard Donoghue Vicki Match Suna, AIA Chief Executive Officer Senior Vice President Senior Vice President and Vice Dean for Strategy, Planning, for Real Estate Development and Facilities Steven B. Abramson, MD and Business Development Senior Vice President and Nader Mherabi Vice Dean for Education, Faculty, Annette Johnson, JD, PhD Senior Vice President and Vice Dean, and Academic Affairs Senior Vice President and Vice Dean, Chief Information Officer General Counsel Dafna Bar-Sagi, PhD Robert A. Press, MD, PhD Senior Vice President and Grace Y. Ko Senior Vice President and Vice Dean, Vice Dean for Science, Chief Scientific Officer Senior Vice President for Chief of Hospital Operations Development and Alumni Affairs Andrew W. Brotman, MD Nancy Sanchez Senior Vice President and Kathy Lewis Senior Vice President and Vice Dean Vice Dean for Clinical Affairs and Strategy, Senior Vice President for for Human Resources and Organizational Chief Clinical Officer Communications and Marketing Development and Learning

NYU LANGONE BY THE NUMBERS*

1,519 98 172,072 68,884 4,500,000 9,654 Beds Operating Emergency Patient Outpatient Births Rooms Room Visits Discharges Faculty Practice Visits

3,633 5,104 516 85 263 418 1,327 Physicians Nurses MD MD/PhD PhD Postdoctoral Residents Candidates Candidates Candidates Fellows and Fellows

5,087 549,707 $359M $364M Original Square Feet NIH Total Grant Research of Research Funding Revenue Papers Space

*Numbers represent FY17 (Sept 2016–Aug 2017) and include NYU Langone Hospital—Brooklyn

36 NYU Langone Health | Neurology & Neurosurgery 2017 Contents

1 MESSAGE FROM THE CHAIRS

2 FACTS & FIGURES

4 2017 IN BRIEF

10 2017 IN DEPTH

11 Epilepsy Advances Target Seizure Activity, Severity

13 Complex Case: Resection of a Deep Thalamic Cavernous Malformation

16 Gamma Knife Radiosurgery—Versatility in Tumor and AVM Treatment

18 Novel Optical Assessments Offer Insight into Neurological Conditions

20 Complex Case: Intramedullary Cavernoma Calls for Intervention

22 Promising Research Fuels the Pursuit of New Alzheimer’s Pathways

24 Novel Neuromodulation Approaches for Movement Disorders

26 ACADEMIC ACTIVITIES

34 FACULTY

35 LEADERSHIP

Produced by: Office of Communications and Marketing, NYU Langone Health Writer: Royce Flippin Design: Ideas On Purpose, www.ideasonpurpose.com Primary Photographer: Karsten Moran On the cover: Nerve fibers Printing: Allied Printing Services, Inc. Neurology & Neurosurgery

2017 YEAR IN REVIEW

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