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今年4月12至18日举行的美国神经医学会(AAN)第60届年会，将会有超过12,000名来自世界各地的听众，以及发表2000篇以上的摘要，包括猪肉工人的神经状况研究，将创下出席听众与科学发表的新纪录。
由梅约诊所Daniel Lachance医师所发表之令人期待的重点中，于年会的两个最新科学会议之一分享了有关一群猪肉工人不寻常神经疾病的初步发现。
AAN网路的科学编辑、AAN科学委员会会员、John Henson医师向Medscape神经学&神经外科学表示，本研究提出相当有趣的议题，会引起相当大的注意。
报告中提及的神秘发炎性神经病变，包括疼痛、麻木、四肢刺痛以及虚弱，在2007年12月首度出现。
所有感染工人的工作都包括处理猪脑，包括使用压缩空气枪清理猪颅骨；此时，空气枪会使脑中物质雾化，而工人会吸入，导致免疫反应以及后续的脊索与根部神经发炎。
Lachance博士将在4月16日向与会听众发表这些病患的最新发现。
【临床定义MS的延迟变化？】
在最新科学会议中的另一篇重点，是两篇多发性硬化症(multiple sclerosis，MS)的研究，也有重要的临床影响。
义大利米兰Vita-Salute San Raffaele大学的Giancarlo Comi医师与同事将发表他们有关的glatiramer acetate研究，看此成分是否会让有初步临床个别症状的MS病患延迟转化。
Henson医师表示，本研究相当重要，如果结果显示此药物可以减缓初步病征病患之MS转化率，将对临床实务有重要影响。
另一篇有关MS的报告，是由多伦多大学的Paul O'Connor医师所提出，比较两种剂量的干扰素β (250 μg 与 500 μg)和glatiramer acetate用于治疗复发与缓解MS的效果与安全性。
Henson 医师表示，这是一个重要的比较研究，可以明确比较不同剂量的干扰素β和glatiramer；这些结果对MS病患的治疗有重要影响。
【Statins用于失智症？】
另一篇也会引起关注的是“Lipitor's Effect in Alzheimer's Dementia (LEADE)”研究，这是一篇随机控制试验，着眼于atorvastatin用于轻微到中度阿兹海默症（Alzheimer's disease，AD）病患的认知和全脑功能的效果。
这篇报告由温哥华英属哥伦比亚大学的Howard Feldman医师所发表，也包括在AAN年会4月16日的最新科学会议之中。
Henson医师表示，本研究设计检视是否降低胆固醇可以对轻微AD的病程有影响。
他指出，证明statins对治疗轻微AD有效，这将是个重要发现，可以减缓失智症恶化，且对数以百万计罹患此病的人有重要影响；如果研究证明显示有好处，将会是相当令人振奋的进步。
【新的CADASIL结果？】
会中也报告了“体显性脑动脉血管病变合并皮质下脑梗塞及脑白质病变（cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL)）”这项有关donepezil的随机试验结果，此研究的初步结果最近在纽奥良的美国中风学会国际中风会议中发表。
当时的Medscape神经学&神经外科学报导指出，该研究未能符合其血管AD评估量表-认知次量表（vascular AD assessment scale cognitive subscale，V-ADAS-cog）之初步终点 。
【镜子神经元系统之更新】
其他AAN会议重点包括两场由全世界各领域专家共同出席的全员大会；首先，开场文献是义大利Parma大学的Giacomo Rizzolatti医师所发表之有关镜子神经元系统的报告。
Rizzolatti医师是此一领域的先驱，将发表一篇被Henson医师称为“奇幻现象”的最新研究；Henson医师解释，当一个人看到另一个人进行某种动作时，他们脑中的相对应神经元也会以同样模式启动，仿佛自己就有做那动作一样。
Rizzolatti医师即将发表有关此现象的最新发现，包括人类镜子神经元系统的核磁共振资料(MRI)。
加州大学洛杉矶分校的最新研究显示，泛自闭症障碍的小孩对此系统有所不同— 这项发现认为此状况有潜在机转。
此外，Vanderbilt大学的Robert MacDonald医师将讨论有关r-氨基丁酸(gamma-aminobutyric-acid，GABA)受体突变的最新研究，这会影响许多广泛抽搐异常的病患。
【数位报告】
最后，今年的AAN 将率先推出数位壁报计划，听众可以透过多媒体导览机浏览壁报；Henson 医师表示，这项进步将可让学会发表更多数量的科学发现，克服会场的空间限制。
Henson 医师表示，目前，我们接受的壁报约为申请件数的60%，我们体认到年会中有越来越多好的科学结果提出发表的需求，但是，可能会因为会场空间而有限制，所以数位海报会议提供了创新的解决方案。
What Promises to Be Hot at AAN
By Caroline Cassels
Medscape Medical News
With more than 12,000 international attendees and more than 2000 abstracts, including research into a neurological condition in pork workers, this year's upcoming American Academy of Neurology (AAN) 60th Annual Meeting (April 12 to 18) may set new records for attendance and scientific presentations.
Among the expected meeting highlights is a presentation by Daniel Lachance, MD, from the Mayo Clinic in Rochester, Minnesota, who will share initial findings on an unusual neurological illness in a cluster of pork workers at 1 of 2 late-breaking science sessions to be held at the meeting.
"This research promises to be very interesting and will likely garner a great deal of attention," John Henson, MD, a member of the AAN Science Committee and science editor of the AAN's Web site, told Medscape Neurology & Neurosurgery.
Reports of the mysterious inflammatory neuropathy, which includes symptoms of pain, numbness, and tingling in the extremities as well as weakness, were first made public in December 2007.
All of the affected workers had jobs processing pig brains, which involved the use of a compressed air gun to clean out the skulls. At this point, it is thought the air gun aerosolized the brain matter, which workers then inhaled, setting up an immune response and subsequent inflammation in the spinal cord and root nerves.
On April 16, Dr. Lachance will update meeting attendees on the latest findings in these patients.
Delaying Conversion to Clinically Definite MS?
Also featured in the late-breaking sessions are 2 multiple sclerosis (MS) studies that may have important clinical implications.
Giancarlo Comi, MD, from Vita-Salute San Raffaele University, in Milan, Italy, and colleagues will present their study results of glatiramer acetate and whether it delays conversion to clinically definite MS in patients with early clinically isolated syndromes.
"This study could be very important. If the results show this drug can lower the conversion rate [to MS] in patients with early signs of the disease, it could have a significant impact on clinical practice," said Dr. Henson.
The second MS paper, by Paul O'Connor, MD, from the University of Toronto, in Ontario, compares the efficacy and safety of 2 doses of interferon beta (250 μg and 500 μg) and glatiramer acetate in the treatment of relapsing and remitting MS.
"This is an important comparison study that could identify how differing doses of interferon beta compare with glatiramer. These results could have significant therapeutic implications for MS patients," said Dr. Henson.
Statins for Dementia?
Another study likely to generate major interest is the Lipitor's Effect in Alzheimer's Dementia (LEADE) study, a randomized, controlled trial looking at the effect of atorvastatin on cognitive and global function in patients with mild to moderate Alzheimer's disease (AD).
Presented by Howard Feldman, MD, from the University of British Columbia, in Vancouver, the study will also be included in a session of AAN's late-breaking science presentations on April 16.
"This study is designed to test whether lowering cholesterol has an effect on the rate of progression in mild AD," said Dr. Henson.
If it turns out statins are effective in treating mild AD, this would be an important finding that could blunt the progress of dementia and have an impact that could extend to millions of people affected by the disease, he said.
"If the study turns out to show a beneficial effect, it would be a very exciting advance," he said.
New CADASIL Results?
Results of a randomized trial examining the use of donepezil in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) will also be reported. Preliminary results of this study were recently presented at the American Stroke Association's International Stroke Meeting in New Orleans.
Reported by Medscape Neurology & Neurosurgery at that time, the study failed to meet its primary end point of change from baseline in the vascular AD assessment scale cognitive subscale (V-ADAS-cog).
Update on Mirror Neuron System
Other AAN conference highlights include 2 plenary sessions led by world experts in their respective fields. The first, which opens the meeting, is the presidential lecture by Giacomo Rizzolatti, MD, from the University of Parma, in Italy, on the mirror neuron system.
A pioneer in this area, Dr. Rizzolatti will present the latest research into what Dr. Henson calls a "fascinating" phenomenon. When individuals observe a person performing a goal-directed action, their mirror neurons fire in the same pattern as if they were performing the action themselves, Dr. Henson explained.
Dr. Rizzolatti, will present the most up-to-date findings on this phenomenon, including magnetic resonance Imaging (MRI) data of the mirror neuron system in humans.
Recent research from investigators at the University of California, Los Angeles has shown that children with autism spectrum disorder have a breakdown in this system — a finding that suggests it is an underlying mechanism for the condition.
In addition, Robert MacDonald, MD, from Vanderbilt University, in Nashville, Tennessee, will discuss the latest research on gamma-aminobutyric-acid (GABA)–receptor mutations, which predispose affected individuals to a broad spectrum of seizure disorders.
Digital Posters
Finally, this year the AAN will pilot a digital poster session program in which attendees can access poster sessions via on-site kiosks. This advance, said Dr. Henson, will allow the academy to present a larger number of scientific presentations and thus overcome space limitations at some meeting sites.
"Right now, we accept somewhere on the order of about 60% of the scientific papers submitted. We recognize the need to present even more good science at the annual meeting. However, we can be limited by the size of the meeting venues, so digitization of the poster sessions offers an innovative solution," said Dr. Henson.