Experts from NYU Langone’s Department of Neurology present their latest clinical findings and research discoveries at the American Academy of Neurology (AAN) 2025 Annual Meeting, April 5 to 9, in San Diego.
Among the topics presented:
- disparities in time to acute treatment in hemorrhagic stroke vs. ischemic stroke
- a review of clinical outcomes following lecanemab therapy for mild cognitive impairment and mild dementia due to Alzheimer’s disease
- an overview on the management of optic neuritis and the need for improved diagnostics
- a presentation on how social determinants of health early in life increase pediatric MS onset
“Our faculty continue to push the boundaries of discovery in neurological science, and the presentations at this year’s AAN annual meeting are another testament to that,” said Steven L. Galetta, MD, the Philip K. Moskowitz, MD, Professor and Chair of Neurology in the Department of Neurology at NYU Grossman School of Medicine. “We are proud to be part of an institution that invests in pushing forward the field of neurology and uncovering new ways to improve the lives of our patients.”
U.S. News & World Report’s “Best Hospitals” ranks NYU Langone the No. 1 hospital in the country for neurology and neurosurgery; its Department of Neurology has 18 divisions and centers.
At this year’s meeting, there are nearly 70 presentations by Department of Neurology faculty. Below are some of the more notable.
Plenary Session: Blood Pressure Targets in ICH: Should We Go Low?
Blood pressure management is a critical part of intracerebral hemorrhage (ICH) stroke management, although the optimal target is still unknown. Kara R. Melmed, MD, clinical associate professor in the Department of Neurology and the Department of Neurosurgery, will debate the optimal target for blood pressure management following acute ICH. The most recent ICH guidelines suggest that acute blood pressure lowering below 150 mm HG is safe, but lowering under 130 mm HG is potentially harmful. Dr. Melmed will present the most recent studies and data to support these guidelines. She will also discuss the benefits of minimizing blood pressure variability and, most important, early intervention.
As neurologists says, “Time is brain,” and this is as true for ICH as it is for acute ischemic stroke (AIS). Dr. Melmed says more attention needs to be given to acute ICH management. In a recent study analyzing over 8,700 stroke patients from 11 major U.S. hospitals, patients with ICH received critical treatments much later than those with AIS, despite ICH having a higher risk of death.
“These delays in ICH treatment are unacceptable given the potential impact on survival,” said lead author Dr. Melmed. “Our findings highlight the urgent need to improve emergency care for hemorrhagic stroke patients.”
Saturday, April 5, 9:55 to 10:35AM PT, San Diego Convention Center | Ballroom 20. PL1 — Controversies in Neurology Plenary Session
Platform: Early Clinical Outcomes Following Lecanemab Therapy for Mild Cognitive Impairment and Mild Dementia Due to Alzheimer’s Disease
A recent study at NYU Langone Health evaluated early patient outcomes following treatment with Leqembi (lecanemab), an FDA-approved drug for mild cognitive impairment and early-stage Alzheimer’s disease. A team of five neurologists carefully reviewed each patient before starting treatment to ensure they met strict criteria, including a confirmed Alzheimer’s diagnosis and a low risk of brain hemorrhage. Patients underwent MRI scans to monitor side effects.
After nine months of treatment, cognitive decline was generally slow and consistent with findings from the CLARITY AD trial. The clinical dementia rating (CDR) score remained stable, with a slight increase from 0.73 at baseline to 0.85 at nine months. However, the Mini-Mental State Exam (MMSE) scores declined more noticeably, dropping from 24.13 at baseline to 21.65 (p=0.003). Some patients experienced side effects, including brain swelling in as many as 4 patients and small brain bleeds in as many as 11 patients, particularly among those with the ApoE4 genetic variant. Eight patients stopped treatment, but no deaths were linked to the drug.
“Our findings suggest that cognitive decline remains relatively slow in the first nine months of Leqembi therapy,” said lead author Philip Kuball, MD, a resident in the Department of Neurology who will present on the work during AAN. “Establishing a review committee helped ensure a standardized approach to patient selection.”
Tuesday, April 8, 1:12 to 1:24PM, San Diego Convention Center | 3. S23 — Innovations in Dementia Treatment
Seminar: Management of Optic Neuritis
Neuro-ophthalmologist Steven L. Galetta, MD, provides an in-depth look at optic neuritis, a condition that causes sudden vision loss due to inflammation of the optic nerve. Affecting individuals between ages 20 and 50, optic neuritis is often associated with multiple sclerosis (MS) and other neurological conditions. Key symptoms include eye pain, blurred vision, and color vision impairment. Most patients (95 percent) recover to 20/40 acuity, but at least half experience some lasting deficits in contrast sensitivity, color vision, or visual field. MRI is essential for diagnosis, particularly to assess the risk of developing MS. Patients with brain lesions on MRI have a significantly higher likelihood of progressing to MS.
New MS diagnostic criteria will add the optic nerve as a fifth topographical site to the more traditional MS sites involving the spinal cord and the periventricular, cortical/juxtacortical, and infratentorial areas. Furthermore, optic nerve involvement may be determined by clinical criteria, intereye differences on optical coherence tomography (e.g., at least 4 microns in the ganglion cell/inner plexiform layer, or GCIPL), intereye differences when evaluating the visual system from the retina to the primary visual cortex, or optic nerve changes on MRI.
Current treatment of MS-associated optic neuritis includes intravenous steroids, which can speed up recovery by a few weeks but do not change long-term vision outcomes. But newer therapies are needed. As Dr. Galetta noted, “While most patients regain relatively good high-contrast letter acuity, we still need better treatments to prevent long-term complications, including low-contrast letter-acuity impairment. We also should separate optic neuritis associated with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) and neuromyelitis optica (NMO) because these patients may require different regimens, including a prolonged taper of oral corticosteroids, typically over months.” Further research is needed to determine whether treatment within the first several days of symptom onset of MOGAD- and NMO-related optic neuritis can improve visual outcomes for these patients.
Tuesday, April 8, 1:10 to 1:30PM, San Diego Convention Center | 30C-E. C146 - Neuro-ophthalmology 2: Optic Neuritis, Visual Fields, and Anisocoria
Seminar: Treatment of Pediatric Multiple Sclerosis in the Current Era
Lauren B. Krupp, MD, the Nancy Glickenhaus Pier Professor of Pediatric Neuropsychiatry in the Department of Neurology and director of NYU Langone’s Multiple Sclerosis Comprehensive Care Center, provides an overview of pediatric MS from an ecological and psychosocial perspective. She notes that environmental factors increase both the risk of developing MS and the likelihood of having MRI indicators of more severe MS. Factors associated with an increased risk include crowding with early exposure to the Epstein-Barr virus, residence in neighborhoods high in pollution and poor air quality, exposure to secondhand smoking, neglect and abuse, mothers with increased mental healthcare utilization rates, and socioeconomic hardship. Dr. Krupp and colleagues noted that among 138 individuals for whom MS began before age 18, poverty indicators and growing up in low-resourced neighborhoods were associated with more severe MRI findings of MS that were not explained by delays in accessing treatment.
“Nearly 90 percent of our brain’s development happens before age 5, so environmental and socioeconomic adversities early in life can have lasting effects related to how the nervous system responds to the inflammatory processes associated with MS,” said Dr. Krupp.
These findings underscore the importance of early diagnosis and optimal treatment approaches in improving long-term outcomes for pediatric MS patients, including not only medications but also healthy diet, regular exercise, and the vigilance of providers to monitor clinical outcomes with digital screening to prevent new MS lesions that could lead to slower cognitive processing speed.
Tuesday, April 8, 7:50 to 8:35AM, San Diego Convention Center | 6A. C135 — Treatment of Pediatric Multiple Sclerosis in the Current Era
About NYU Langone Health
NYU Langone Health is a fully integrated health system that consistently achieves the best patient outcomes through a rigorous focus on quality that has resulted in some of the lowest mortality rates in the nation. Vizient Inc. has ranked NYU Langone No. 1 out of 115 comprehensive academic medical centers across the nation for three years in a row, and U.S. News & World Report recently placed nine of its clinical specialties among the top five in the nation. NYU Langone offers a comprehensive range of medical services with one high standard of care across 7 inpatient locations, its Perlmutter Cancer Center, and more than 320 outpatient locations in the New York area and Florida. With $14.2 billion in revenue this year, the system also includes two tuition-free medical schools, in Manhattan and on Long Island, and a vast research enterprise.
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Colin DeVries
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