Which trial is most likely to change your practice?

What do you want to know more about before you do?

8) Asundexian for Secondary Stroke Prevention (phase 3 OCEANIC-STROKE trial) - asundexian at a daily dose of 50 mg resulted in lower risks of ischemic stroke and major cardiovascular events than placebo, without a higher risk of major bleeding

7) ICECAP: In comatose survivors of out-of-hospital cardiac arrest, longer cooling duration did not improve outcomes, arguing against simply extending hypothermia time and toward better patient selection instead. Very interesting adaptive design!

6) METEOROID: Satralizumab cut relapse risk by 68% in relapsing MOGAD versus placebo, with benefit emerging by week 8, significant gains on key secondary endpoints, and a safety profile comparable to placebo.

5) ACUITY: In acute optic neuritis, privosegtor improved low-contrast visual acuity, preserved retinal structure, lowered neurofilament light, and was well tolerated, suggesting a neuroprotective effect beyond symptom recovery.

4) Ecopipam: In pediatric Tourette syndrome, ecopipam reduced relapse risk by 50% versus placebo in this withdrawal trial, supporting more durable maintenance of benefit.

3) Zilganersen: In Alexander disease, the first potential disease-modifying therapy showed statistically significant and clinically meaningful stabilization of gait speed, with secondary endpoints and broader symptom measures also generally favoring treatment.

2) NIMBLE: Cemdisiran given subcutaneously every 3 months met the primary and key secondary endpoints in generalized myasthenia gravis, with rapid, sustained, clinically meaningful improvement, no waning through the dosing interval, and no added benefit from combination therapy.

1) Essential3: Ulixacaltamide became the first positive phase 3 program in essential tremor, showing clinically meaningful, durable benefit across studies and subgroups, was generally well tolerated, and now has FDA Breakthrough Therapy designation.

Big news from the AAN 2026 Clinical Trials Plenary: breakthrough treatments & several other major trial readouts that could shape neurology practice 👇

It’s been 2 months since Peter Steinberger joined, maybe that’s enough time to launch an inspired agent product

You've never seen human anatomy like this before.

Using a particle accelerator, the Human Organ Atlas is producing 3D scans of our organs in unprecedented detail! You can look through different layers of tissue and even zoom in on the cells for the heart, lungs, eyes, kidneys, and more.

Personally, I am hopeful. Especially for stroke prevention.

LAMP is a trial that deserves a confirmatory follow-up.

Ultimately, the evidence is promising but still not definitive, and most human data so far are observational or early-stage rather than practice-changing.

Another late-2025 AAN report described a possible lower epilepsy risk among people with type 2 diabetes taking GLP-1 drugs, especially semaglutide, but the authors emphasized that this does not prove causality

The AAN highlights a study on GLP-1s on migraine.

It's an observational study, but the results are promising to reduce migraine attacks and visits to the emergency room.

GLP-1 receptor agonists like semaglutide and liraglutide are being studied for neurological conditions, especially Alzheimer’s disease, Parkinson’s disease, stroke recovery, and possibly epilepsy.

I'm at the first plenary session of #AANAM - Controversies in Neurology.

Question 3 - Are GLP1s More Hype Than Hope?

Also worth flagging: APOE ε4 carriers may represent a particularly responsive subgroup

The best answer is it depends on when you start.

The "critical window" hypothesis: HRT initiated near menopause may be neuroprotective; started years later, it may actually increase risk.

Same therapy, opposite effect depending on timing. This is why the audience was split.

The audience poll was split, slightly leaning yes.

The AAN has highlighted a trial that shows a positive link, but that does not prove that hormone therapy causes changes in memory

I'm at the first plenary session of #AANAM - Controversies in Neurology.

Question 2 - Is Hormone Replacement Therapy Neuroprotective?

And what about MeVOs and IV Thrombolysis?

- <4.5 hours: strong evidence
- 4.5-9 hours: probably treat, depending on perfusion and other factors
- >9 hours? limited data, more trials needed

And what really counts as a "Medium Vessel" anyway?

Is a proximal/dominant M2 really "medium"? Or should we consider it "large"?

Despite disappointing results from the MeVO trials, the majority of the audience voted yes. To be fair, the answers yes/no don't capture the nuance, and the better answer is closer to "it depends..."

I'm at the first plenary session of #AANAM - Controversies in Neurology.

Question 1 - Is Retrieval of Medium Vessel Occlusions Worth It?

RUSH - Cygnus X-1: Book I & II (A Farewell to Kings ,1977 & Hemispheres, 1978) YouTube video by IAN GMK

Great reference youtu.be/dsgnX5PnWA0?...

How We Know Cygnus X1 is a Black Hole YouTube video by Jason Kendall

That's it! That's the thread. To learn more, check out this YouTube video www.youtube.com/watch?v=AeH2...

NASA's "Galaxy of Horrors" poster for Cygnus X-1

Cygnus X-1, the first discovered black hole, is now cemented into popular culture.

Rush wrote a two-part prog rock epic about it in 1977. A season 7 Futurama episode opens with a tagline about it. And NASA published this awesome fake movie poster!

X-ray image of Cygnus X-1 taken by a balloon-borne telescope, the High-Energy Replicated Optics (HERO) project

The supergiant loses about one solar mass every 400,000 years to stellar wind. The black hole warps that wind, pulling material into an accretion disk heated to millions of degrees.

That's where the X-rays come from.