Microlearning Topics
Introduction to Neurology
Introduction to Neurology
Diagnosis
Overview: Neurological Evaluation
Summary
Summary: Neurology
Diagnosis
History: Neurological History
Neuroanatomy
Brain Regions
Fabry Disease : Overview
Common Clinical Manifestations: Neurological
Epidemiology and Natural History
Clinical Manifestations: Neurological/CNS Involvement
Neuroanatomy
Anatomical Axes and Planes: Coronal Plane
Neuroanatomy
Anatomical Axes and Planes: Sagittal Plane
Neuroanatomy
Anatomical Axes and Planes: Horizontal Plane
Basic Organization and Function
Central Nervous System (CNS)
Basic Organization and Function
Peripheral Nervous System (PNS)
Neuroanatomy
Anatomical Axes and Planes: Most Commonly Used Terminology
Neuroanatomy
Brain Regions: Cerebellum
Neuroanatomy
Brain Regions: Blood-Brain Barrier
Neuronal Signaling
Chemical Signaling: Major Classes of Neurotransmitters
Details of Selected Neurotransmitters
Details of Selected Neurotransmitters
Neuronal Signaling
Electrical Signaling: Ion Channels
Neuronal Signaling
Chemical Signaling: Electrical Synapses
Neuronal Circuits
Neuropil
Neuronal Circuits
Signal Integration: Interactivity
Neuronal Circuits
Signal Integration: Divergence
Neuroanatomy
Brain Regions: Diencephalon
Neuroanatomy
Brain Regions: Cerebrospinal Fluid (CSF)
Neuronal Signaling
Neuronal Signaling
Neuronal Signaling
Chemical Signaling: Synapse and Neurotransmitters
Neuronal Signaling
Chemical Signaling: SNARE Proteins
Neuronal Signaling
Chemical Signaling: Neurotransmitter Release
Neuronal Signaling
Chemical Signaling: Peptide Neurotransmitters
Details of Selected Neurotransmitters
Histamine
Neuronal Signaling
Chemical Signaling: G-Protein Coupled Receptors
Pathways and Networks
Pathways and Networks
Pathways and Networks
Lobes of the Pituitary
Neuroanatomy
Anatomical Axes and Planes Terminology
Neuronal Signaling
Electrical Signaling
Neuronal Signaling
Electrical Signaling: Sodium-Potassium Pump
Details of Selected Neurotransmitters
Dopamine: Associated Pathologies
Details of Selected Neurotransmitters
Serotonin: Associated Pathologies
Details of Selected Neurotransmitters
Dopamine in Reward Circuitry
Neuronal Circuits
Types of Circuits: Synapse Types
Neuroanatomy
Brain Regions: Cerebrum
Neuroanatomy
Brain Regions: Brain Stem
Neuronal Signaling
Chemical Signaling: Neurotransmitter Clearance
Neuronal Signaling
Chemical Signaling: Small Molecule Neurotransmitters
Details of Selected Neurotransmitters
Acetylcholine (ACh)
Details of Selected Neurotransmitters
Dopamine (DA) and Dopamine Signaling
Details of Selected Neurotransmitters
Norepinephrine
Details of Selected Neurotransmitters
Peptide Neurotransmitters: Cannabinoids
Neuronal Circuits
Types of Circuits: Afferent vs. Efferent
Neuronal Circuits
Types of Circuits: Excitatory vs. Inhibitory
Neuronal Circuits
Measuring Membrane Potential
Neuronal Circuits
Feedback in Neuronal Circuits
Pathways and Networks
Frontoparietal Attention Network
Summary
Summary: Neuronal Circuits and Signaling
Basic Organization and Function
Cell Types: Neurons
Basic Organization and Function
Cell Types: Glial Cells
Details of Selected Neurotransmitters
Acetylcholinesterase (AChE)
Details of Selected Neurotransmitters
Peptide Neurotransmitters: Opioid Peptides
Neuronal Circuits
Signal Integration: Convergence and Divergence
Pathways and Networks
Frontostriatal Network
Pathways and Networks
Mesocorticolimbic Network
Pathways and Networks
Default Mode Network
Patient History
Neurological History
Basic Organization and Function
Central Nervous System: White and Grey Matter
Neuronal Signaling
Electrical Signaling: Threshold Potential and the All-or-None Response
Pathways and Networks
Hypothalamic-Pituitary-Adrenal (HPA) Axis and Functions
Pathways and Networks
Hypothalamic-Pituitary-Adrenal (HPA) Axis and Disorders
Neuronal Circuits
Types of Circuits: Excitatory vs. Inhibitory Synapses
Details of Selected Neurotransmitters
Serotonin (5-hydroxytryptamine, 5-HT)
Details of Selected Neurotransmitters
Glutamate and Gamma Aminobutyric Acid (GABA)
Neurology/Schizophrenia Treatments: Introduction
Overview of Antipsychotics
Introduction: Diagnosis and Prognosis of MS
Neurological Evaluation
Management Guidelines
Treatment of Acute Neurological Complications: Hemorrhagic Transformation of Ischemic Stroke
Management Guidelines
Treatment of Acute Neurological Complications: Management of Cerebral and Cerebellar Infarction with...
Overview of Schizophrenia
Overview of Schizophrenia
Schizophrenia Disease
Schizophrenia
Etiology
Pathogenesis of Schizophrenia
Etiology
Cortical Development
Schizophrenia Treatments
Antipsychotics
Mechanism of Action
Mechanism of Action
Efficacy
Efficacy Measures
Safety
Hyperprolactinemia
Details of Selected Neurotransmitters
Histamine
Glutamate and Gamma Aminobutyric Acid (GABA)
Peptide Neurotransmitters: Opioid P...
Patient History
Neurological History
Presenting Symptoms in MS Patients
Schizophrenia Disease
Epidemiology and Prevalence
Schizophrenia Treatments
Atypical Antipsychotics
Administration
Long-acting Injectable Antipsychotics
Safety
Neuroleptic Malignant Syndrome (NMS)
Pharmacological Treatments
Selective Serotonin Reuptake Inhibitors (SSRIs)
Basic Organization and Function
Basic Organization and Function
Central Nervous System (CNS)
Peripheral Nervous System (PN...
Details of Selected Neurotransmitters
Acetylcholine (ACh)
Acetylcholinesterase (AChE)
Dopamine (DA) and Dopamine Signaling
...
Neuronal Circuits
Neuronal Circuits
Neuropil
Types of Circuits: Afferent vs. Efferent
Types of Circuits...
Pathways and Networks
Pathways and Networks
Frontostriatal Network
Frontoparietal Attention Network
Mesocor...
Schizophrenia Disease
Positive and Negative Symptoms of Schizophrenia
Comorbid Conditions
Comorbid Chronic Medical Conditions
Clinical Trials
Clinical Trials for Conventional Antipsychotics
Safety
Common Adverse Effects of Conventional Antipsychotics
Safety
Common Adverse Effects for Atypical Antipsychotics
Diagnosis
Overview: The Challenge of Diagnosis
Physical Examination: Motor
Physical Examination: Oth...
Neuroanatomy
Neuroanatomy
Anatomical Axes and Planes Terminology
Anatomical Axes and Planes: Most Commo...
Neuronal Signaling
Neuronal Signaling
Electrical Signaling
Electrical Signaling: Sodium-Potassium Pump
E...
Neurology/Major Depressive Disorder Disease: Diagnosis
Diagnosis Criteria
Neurology/Major Depressive Disorder Disease: Diagnosis
Diagnosis Tools
Neurology/Major Depressive Disorder Disease: Introduction
Major Depressive Disorder (MDD)
Neurology/Major Depressive Disorder Disease: Welcome
Overview of Major Depressive Disorder
Neurology/Major Depressive Disorder Disease: Summary
Major Depressive Disorder (MDD)
Neurology/Major Depressive Disorder Disease: Welcome
Overview of Major Depressive Disorder Treatment
Neurology/Major Depressive Disorder Disease: Introduction
Major Depressive Disorder (MDD)
Neurology/Major Depressive Disorder Disease: Summary
Treatment of Major Depressive Disorder (MDD)
Etiology
Influencing Factors
Comorbid Conditions
Medical Conditions
Nonpharmacological Treatment
Psychotherapy
Pharmacological Treatments
Safety of Antidepressants
Pharmacological Treatments
Antidepressant Medication Classes
Pharmacological Treatments
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Pharmacological Treatments
Mixed Serotonergic Medications (Mixed 5-HT)
Pharmacological Treatments
Norepinephrine and Dopamine Reuptake Inhibitor (NDRI)
Pharmacological Treatments
Serotonin and α2-Adrenergic Receptor Antagonists
Pharmacological Treatments
Monoamine Oxidase Inhibitors (MAOIs)
Learning Objectives
Learning Objectives
Basic Organization and Function
Basic Organization and Function
Neuroanatomy
Neuroanatomy
Details of Selected Neurotransmitters
Parkinson's Disease: Introduction and Overview
Parkinson's Disease: Introduction and Overview
Introduction
Introduction
Learning Objectives
Learning Objectives
Neuronal Circuits
Neuronal Circuits
Pathways and Networks
Pathways and Networks
Prognosis
Clinical Scoring Systems: Expanded Disability Scoring Scale (EDSS)
Clinical Scoring Systems and Prognosis
Expanded Disability Scoring Scale (EDSS)
Clinical Scoring Systems and Prognosis
Expanded Disability Scoring Scale (EDSS)
Diagnosis
Physical Examination: Overview
Classification
Severity Outcomes
Classic Pain Pathway
Spinal Nociceptive Transmission
Nociceptive Pain
Diverse Mechanisms
Classic Pain Pathway
Basic Pain Processes
Classic Pain Pathway
Modulation
Primary Afferents
Aδ and C Nociceptors
Modulation
Descending Modulation
Prognosis
Clinical Scoring Systems: Expanded Disability Scoring Scale (EDSS) Background
Physical Exam
Physical Examination: Overview
Diagnosis
History: Patient Descriptions
Prognosis
Clinical Scoring Systems: Other Scoring Systems
Clinical Scoring Systems and Prognosis
Other Scoring Systems
Clinical Manifestations
Symptoms: Non-Motor
Prognosis
Prognostic Factors: First Interattack Interval
Prognostic Factors: Summary of Prognostic Factor...
Primary Afferents
Nociceptors
Primary Afferents
Dorsal Ganglia
Ascending Pathways
Spinomesencephalic Tract (SMT)
Ascending Pathways
Spinoreticular Tract
Supraspinal Systems
Thalamus
Supraspinal Systems
Cerebral Cortex
Supraspinal Systems
Hypothalamus
Modulation
Serotonin and Norepinephrine
Scientific Background of Migraines: Introductions
Scientific Background of Migraines: Overview
Pathophysiology
CGRP in Migraine
Diagnosis
Physical Examination: Other
Current Therapies
Symptomatic Therapies
Physical Exam
Physical Examination: Other
Clinical Scoring Systems and Prognosis
Expanded Disability Scoring Scale (EDSS)
Symptoms: Diagnosis
MS is a Clinical Diagnosis
Complications of RA
Major Organs Affected by RA
Clinical Scoring Systems and Prognosis
Other Scoring Systems
Cognitive Dysfunction Assessment
Clinical Manifestations
Disease Progression
Parkinson's Disease: Introduction and Overview
Parkinson's Disease: Introduction and Overview
Epidemiology
Incidence and Prevalence, Demographics and Risk Factors
Epidemiology
Juvenile-Onset Parkinson's Disease
Primary Afferents
Dorsal Horn
Classic Pain Pathway
Classic Pain Pathway
Nociceptive Pain
Nociceptive Pain
Nociceptive Pain
Inflammation
Nociceptive Pain
Neuropathic Pain
Primary Afferents
Primary Afferents
Primary Afferents
Theories for Signal Transduction Mechanism
Primary Afferents
TRPV1
Primary Afferents
Rexed Laminae
Ascending Pathways
Neospinothalamic Tract, Paleospinothalamic Tract
Supraspinal Systems
Reticular Formation
Modulation
Modulation
Modulation
Segmental Modulation
Modulation
Cerebral Cortex, Thalamus
Modulation
Descending Modulation
Modulation
Brainstem, Opioids
Primary Afferents
Substance P
Criteria for the Diagnosis of Dementia Due to Alzheimer's Disease
The DSM-IV-TR Criteria for Dementia Due to AD
Passive Immunization
Intravenous Immunoglobulin (IVIg) Phase II Results
Triggers and Risk Factors for Migraine
Risk Factors
Current Therapies
Intensive Immune Suppression for Non-Responders
Patient History
Patient Descriptions
Physical Exam
Physical Examination: Overview
Physical Examination: Somatosensory
Clinical Manifestations
Symptoms: Secondary Motor and Other Signs
Epidemiology
Early-Onset Parkinson's Disease
Epidemiology
Demographics and Risk Factors
Pathology
Lewy Pathology
Classic Pain Pathway
Afferent Neurons
Classic Pain Pathway
Basic Pain Processes: First and Second Pain
Primary Afferents
Nociceptors
Ascending Pathways
Spinothalamic Tract: Ascending Pathways
Primary Afferents
Neurotransmitters
Primary Afferents
Glutamate
Criteria for the Diagnosis of Dementia Due to Alzheimer's Disease
NINCDS-ADRDA and DSM-IV-TR
Clinical Presentation and Clinical Diagnosis of Alzheimer's Disease
Diagnosis of Alzheimer's Disease
Disease Overview: Multiple Sclerosis
Multiple Sclerosis: Definition
Diagnostic Criteria
The First Official Criteria for MS Diagnosis
Symptoms: Diagnosis
Timeline of Diagnostic Criteria and Therapy
Diagnostic Criteria
Differential Diagnosis of Migraine
Disease Overview
Patient Descriptions
Conditions Causing Low Back Pain
Arthritis
Pharmacologic Treatments
Anti-Epileptics
Clinical Manifestations
Symptoms: Sleep Disorders
Epidemiology
Burden of Disease
Etiology
Idiopathic Parkinson's Disease and Environmental Factors
Etiology
Genetics
Pathology
Lewy Pathology and Stages of Development
Current Therapies
Symptomatic Therapies - Severe Relapses
Structure of the Spine
Structure of the Vertebrae
Principles of Treatment: Acute vs Chronic
Treatment with Pharmaceuticals: Acute vs Chronic
Atherosclerosis Contribution to Cardiovascular Diseases
Ischemic Stroke
Clinical Manifestations
Symptoms
Pathology
Dopamine Hypothesis of PD
Clinical Scales
Hoehn and Yahr Scale, Unified Parkinson's Disease Rating Scale, and Other Scales
Migraine
Symptoms of Migraine
Migraine
The Evolution of Migraine
Scientific Background of Migraines: Summary
Scientific Background of Migraines: Summary
Disease Overview: Multiple Sclerosis
Clinical Presentation
Multiple Sclerosis: Definition
Summary: Diagnosis and Prognosis of MS
Summary: Diagnosis and Prognosis of MS
Current Therapies
Overview: Current Therapies for MS
Treatment of Acute Relapses: Severe Relapses: Therapeutic P...
Current Therapies
Intensive Immune Suppression For Non-Responders
Introduction to Low Back Pain
Introduction to Low Back Pain
Structure of the Spine
The Spine
Structure of the Spine
Structure of the Vertebrae
Conditions Causing Low Back Pain
Causes of Low Back Pain
Conditions Causing Low Back Pain
Skeletal Irregularities
Conditions Causing Low Back Pain
Metabolic Disorders
Principles of Treatment: Acute vs Chronic
Surgery
Clinical Progression
Hypercalcemia
Management Guidelines
Early Diagnosis: Brain and Vascular Imaging
Disease Overview
Prognosis
Current Therapies
Goals of Disease Modifying Therapy (DMT)
Symptomatic Therapies - Symptom Reduction
Hormona...
Classification
Types of MS: Progressive-Relapsing MS (PRMS)
Severity Outcomes
Interactive Exercises
...
Currently Approved Therapies: Novantrone
Novantrone, Mitoxantrone
Ascending Pathways
Spinothalamic Tract: Ascending Pathways
Neospinothalamic Tract, Paleospinothalamic Tract
S...
Nociceptive Pain
Nociceptive Pain
Inflammation
Neuropathic Pain
Diverse Mechanisms
Supraspinal Systems
Thalamus
Cerebral Cortex
Reticular Formation
Hypothalamus
Self Check: Supraspina...
Modulation
Serotonin and Norepinephrine
Descending Modulation
Cerebral Cortex, Thalamus
Brainst...
Migraine
Types of Migraine
Diagnostic Criteria
Diagnosis of Migraine
Pathophysiology
Pathophysiology of Migraine
Triggers and Risk Factors for Migraine
Burden and Triggers
Introduction to Low Back Pain
Introduction to Low Back Pain
Principles of Treatment: Acute vs Chronic
Pain Relief & Restoration of Functionality
Structure of the Spine
Intervertebral Discs
Conditions Causing Low Back Pain
Trauma
Conditions Causing Low Back Pain
Arthritis
Conditions Causing Low Back Pain
Arthritis
Conditions Causing Low Back Pain
Infections
Conditions Causing Low Back Pain
Tumors
Conditions Causing Low Back Pain
Other Conditions
Principles of Treatment: Acute vs Chronic
Overview of Treatment Methods
Clinical Progression
Hypercalcemia
Hypercalcemia: Symptoms
Traditional Immunosuppressive Therapies
Corticosteroids: Gene Expression (Therapeutic Uses of Corticosteroids)
SLE Treatments: Immunosuppressants
IVIg: Side Effects
Etanercept
Safety
Cost-Effectiveness Studies: Harrington et al., 2013
Harrington Study: Conclusions
Management Guidelines
Intravenous Fibrinolysis
Classic Pain Pathway
Classic Pain Pathway
Basic Pain Processes
Afferent Neurons
Basic Pain Processes: Firs...
Primary Afferents
Neurotransmitters
Substance P
Glutamate
Self Check: Neurotransmitter
Classification
Classification of MS
Complications of Atrial Fibrillation (AF)
Thromboembolic Complications: Transient Ischemic Attacks and Stroke
Principles of Treatment: Acute vs Chronic
Appropriate Medications; Risk of Dependence
Introduction to Low Back Pain
Acute vs Chronic
Structure of the Spine
Structure of the Vertebrae
Conditions Causing Low Back Pain
Herniated Disc
Principles of Treatment: Acute vs Chronic
Diagnosis and Targeting Treatments
Aspirin and Primary Stroke Prevention
Types of Stroke
Thromboembolic Complications
Transient Ischemic Attacks and Stroke and Impact of Stroke in Atrial Fibrillation
Pathology of Cerebrovascular Disease
Stroke Types and Definitions
Primary Afferents
Dorsal Horn
Primary Afferents
Nociceptors
Theories for Signal Transduction Mechanism
Modulation
Modulation
Serotonin and Norepinephrine
Descending Modulation
Cerebral Cortex, Thala...
Currently Approved Therapies: Novantrone
Pivotal Trials
Disease Overview
Definition of Multiple Sclerosis
Prognosis
Clinical Presentation
Patient Descriptions...
Introduction to Low Back Pain
Introduction to Low Back Pain
Introduction to Low Back Pain
Nociceptive vs Neuropathic
Introduction to Low Back Pain
Local vs Referred
Structure of the Spine
Vertebrae
Conditions Causing Low Back Pain
Arthritis
Epidemiology and Natural History
Clinical Presentation and Course of Disease
Management Guidelines
Interventions
Structure of the Spine
Structure of the Vertebrae
Principles of Treatment: Acute vs Chronic
Surgery
Typical Clinical Course
Clinical Features/Presentation
Diagnosis of SLE
1997 ACR Diagnostic Criteria
Diagnosis of SLE
Standard Measures of Disease Activity Used in Clinical Trials: BILAG, SLAM, ECLAM
Microvascular Complications
Diabetic Neuropathy: Treatment, Diabetic Foot
Mechanisms of Select Autoimmune Disorders
Multiple Sclerosis: Molecular Mimicry
Cost-Effectiveness Studies: Harrington et al., 2013
Study Overview: Harrington et al.
Complications of Atrial Fibrillation (AF)
Thromboembolic Complications: Impact of Stroke in Atrial Fibrillation
Sanfilippo Syndrome: Introduction and Overview
Clinical Features
Gaucher Disease: Overview
Clinical Manifestations
Principles of Treatment: Acute vs Chronic
Surgery
Traditional Immunosuppressive Therapies
Corticosteroids: Gene Expression
Corticosteroids: Gene Expression (The Anti-Inflammatory Effect...
SLE Treatments: Immunosuppressants
Immunosuppressants: IVIg
IVIg: Case Reports
IVIg: Side Effects
Metachromatic Leukodystrophy: Introduction and Overview
Common Clinical Manifestations
Overview of Diagnosis
Clinical Stroke Classification Schemes: Overview and Outcomes
Introduction to Low Back Pain
Introduction to Low Back Pain
Acute vs Chronic
Nociceptive vs Neuropathic
Local vs Re...
Structure of the Spine
The Spine
Vertebrae
Structure of the Vertebrae
Intervertebral Discs
Clinical Manifestations
Complications of Chronic Cholestasis
Management Guidelines
General Supportive Care and Treatment of Acute Complications: Airway Support, Temperature, and Cardi...
Management
Goals of Treatment
Prognosis
Other Factors
Conditions Causing Low Back Pain
Causes of Low Back Pain
Trauma
Herniated Disc
Arthritis
Infections
Tumors
Principles of Treatment: Acute vs Chronic
Appropriate Medications; Risk of Dependence
Pain Relief & Restoration of Functionality
Ove...
Clinical Progression
Myeloma Cell Growth
Myeloma Disease Progression
Bone Pain
Hypercalcemia
Hypercal...
Traditional Immunosuppressive Therapies
Corticosteroids: Immediate Effect (Anti-Inflammatory)
Corticosteroids: Gene Expression
Cor...
Diagnosis of SLE
Standard Measures of Disease Activity Used in Clinical Trials: SLAM
Standard Measures of Diseas...
Traditional Immunosuppressive Therapies
Traditional Immunosuppressive Therapies
Traditional Immunosuppressive Agents
Corticosteroi...
Epidemiology
Longitudinal Studies: Age-Associated Diseases
Physical Exam
Physical Examination: Motor
Currently Approved Therapies: Interferon Beta
Betaseron/Extavia
Currently Approved Therapies: Gilenya
FREEDOMS II
Currently Approved Therapies: Tysabri
Tysabri
Approved Parenteral Treatments for Multiple Sclerosis
Mitoxantrone (Novantrone)
Currently Approved Therapies: Interferon Beta
Rebif
Currently Approved Therapies: Tecfidera
Tecfidera
Emerging Hypotheses on Treatment
Neurodegeneration: Myelination-Targeted Antibodies
Emerging Hypotheses on Treatment
Neurodegeneration: Direct Neuroprotection
Passive Immunization
Bapineuzumab Phase II
Currently Approved Therapies: Interferon Beta
Avonex
Criteria for the Diagnosis of Dementia Due to Alzheimer's Disease
NINCDS-ADRDA Update
Current Therapies
Complementary and Alternative Therapies: Complementary and Alternative Medicine (CAM)
Passive Immunization
Bapineuzumab Phase III
Timeline: Multiple Sclerosis
Timeline: Multiple Sclerosis
Currently Approved Therapies: Gilenya
Pivotal Trials: Gilenya
Current Therapies
Disease Modifying Therapy (DMT): Approved Treatments for Multiple Sclerosis
Emerging Hypotheses on Treatment
Emerging Hypotheses on Treatment: Myelination-Targeted Antibodies
Cell Therapy
Human Stem ...
Mitochondrial Mutations
Mitochondrial Mutations
Ticlopidine
Ticlopidine: Warnings
Standard Agents: Therapeutic Challenges
Fondaparinux: Warnings and Precautions
Typical Clinical Course
Organ Systems Involved
Autoimmune Disease Processes
Consequences of Autoimmune Diseases: Common Autoimmune Diseases
Autoimmune Disease Processes
The Etiology of Autoimmune Disease
The Etiology of Autoimmune Disease: Genetic Factors (Risk)
Autoimmune Disease Processes
Consequences of Autoimmune Diseases: Progression and Destruction in Autoimmune Disorders (Mechanisms...
Biochemistry
Non-Amyloidogenic Pathway
NMDA Receptor Antagonist - Memantine
Introduction: Glutamate
Amyloid Hypothesis
Non-Amyloidogenic Pathway
Neuropathology
Synaptic Loss
Neuropathology
Neurotransmitter Deficits
Acetylcholinesterase Inhibitors
Receptor Deficits
Amyloid Hypothesis
Neurotoxicity: Aβ Oligomers and Aβ Plaques
Biochemistry
Non-Amyloidogenic Pathway
APP Processing and Aβ Production
Aβ Aggregation and Ne...
Biochemistry
Amyloidogenic Pathway
Neuropathology
Receptor Deficits
Neuropathology
Neuritic Plaques
Clinical Course of Alzheimer's Disease
AD Progression, Biomarkers and Pharmacological Therapy
Aβ Immunotherapy
Biologics
Disease Mechanism
Clearance of Aβ
Disease Mechanism
Mitochondrial Dysfunction
Biochemistry
Tau and Neurofibrillary Tangles
Disease Mechanism
Neuronal Impairment
Acetylcholinesterase Inhibitors
Neurotransmitter Deficits
Disease Mechanism
Inflammation
Acetylcholinesterase Inhibitors
Acetylcholinesterase (ChE)
Disease Mechanism
Axonal Transport Mechanisms
γ-Secretase Inhibition
Change in the Equilibrium of Aβ
Acetylcholinesterase Inhibitors
Nerve Cell Loss
NMDA Receptor Antagonist - Memantine
Introduction: Glutamate
Glutaminergic Dysfunction in AD
NMDA Receptor Signaling
NMDA Receptor Antagonist - Memantine
Glutaminergic Dysfunction in AD
Clinical Course of Alzheimer's Disease
ADNI Biomarker Initiative Hypothetical Model
Clinical Course of Alzheimer's Disease
Temporal Ordering of Biomarkers and AD Progression
Amyloid Hypothesis
Amyloid Precursor Protein (APP)
Amyloid Hypothesis
Non-Amyloidogenic Pathway
Amyloid Hypothesis
γ-Secretase
Aβ Immunotherapy
Active Immunization - Vaccination
Aβ Immunotherapy
Passive Immunization
Aβ Immunotherapy
Potential Mechanisms for Aβ Clearance
Biochemistry
APP Processing and Aβ Production
Biochemistry
Aβ Aggregation and Neurotoxicity
NMDA Receptor Antagonist - Memantine
NMDA Receptor Signaling
Amyloid Hypothesis
Amyloidogenic Pathway
Pathophysiology
Cancer Pain
Descending Modulation Animation
Modulation: Neuronal Circuitry and Neurotransmitters
Treatment of Insomnia
Mechanism of Action: Introduction
Benzodiazepines
Non-Benzodiazepines
Treatment of Insomnia
Mechanism of Action: Introduction
Treatment of Insomnia
Benzodiazepines
Non-Benzodiazepines
Overview of Pain: The Nociceptor
Nociceptors
A-δ and C Nociceptors
Transient Receptor Potential Cation Channel (TRPV1)...
Overview of Pain: The Nociceptor
Nociceptors
A-δ and C Nociceptors
Transient Receptor Potential Cation Channel (TRPV1)...
Overview of Pain: The Nociceptor
Nociceptors
Overview of Pain: The Nociceptor
A-δ and C Nociceptors
Overview of Pain: The Nociceptor
Transient Receptor Potential Cation Channel (TRPV1)
Descending Modulation Animation
Modulation: Neuronal Circuitry and Neurotransmitters
Modulation: Cerebral Cortex and Thalamus
Descending Modulation Animation
Modulation
Overview of Pain: The Nociceptor
Theories for Signal Transduction Mechanism
Overview of Pain: Peripheral Sensitization
Peripheral Sensitization
Nociceptor Activators and Sensitizers
Production of Prostaglandin...
Overview of Pain: Peripheral Sensitization
Peripheral Sensitization
Nociceptor Activators and Sensitizers
Production of Prostaglandin...
Overview of Pain: Peripheral Sensitization
Peripheral Sensitization
Overview of Pain: Peripheral Sensitization
Nociceptor Activators and Sensitizers
Overview of Pain: Peripheral Sensitization
Production of Prostaglandin E2
Overview of Pain: Central Sensitization
Central Sensitization
Acute Phase
Late Phase
COX-2 and Central Sensitization
Overview of Pain: Central Sensitization
Central Sensitization
Acute Phase
Late Phase
COX-2 and Central Sensitization
Overview of Pain: Central Sensitization
Central Sensitization
Overview of Pain: Central Sensitization
Acute Phase
Overview of Pain: Central Sensitization
Late Phase
Overview of Pain: Central Sensitization
COX-2 and Central Sensitization
Pathophysiology
Cancer Pain
Visceral Nociceptive Pain
Neuropathic Pain
Somatic Nociceptive Pain
Pathophysiology
Cancer Pain
Visceral Nociceptive Pain
Neuropathic Pain
Somatic Nociceptive Pain
Pathophysiology
Visceral Nociceptive Pain
Pathophysiology
Neuropathic Pain
Pathophysiology
Somatic Nociceptive Pain
Descending Modulation Animation
Modulation: Neuronal Circuitry and Neurotransmitters
Modulation: Cerebral Cortex and Thalamus
Descending Modulation Animation
Modulation: Cerebral Cortex and Thalamus
Descending Modulation Animation
Modulation: Brainstem and Opioids
Descending Modulation Animation
Modulation: Serotonin (5-HT) and Norepinephrine (NE)
Visualization
Acute Ischemic Stroke: Thrombolysis
Background
Tissue Plasminogen Activator (tPA)
Visualization: The NINDS Study
NINDS Study
Stroke: NIHSS Criteria
Cohort Studies: Background
Modified Rankin Score
NIHSS Criteria
Stroke: NIHSS Criteria
Cohort Studies: Background
Stroke: NIHSS Criteria
Modified Rankin Score
Stroke: NIHSS Criteria
NIHSS Criteria
Background
Clinical Trials
Background
Thrombolytic Therapy
Stroke Outcome Measures
Barthel Index
Modified Rankin Score
Glasgow Outcome Scale
NIHSS Criteria
Stroke Outcome Measures
Barthel Index
Stroke Outcome Measures
Modified Rankin Score
Stroke Outcome Measures
Glasgow Outcome Scale
Stroke Outcome Measures
NIHSS Criteria
Background
Penumbra
Introduction: Alzheimer's Disease
What is Alzheimer's disease?
Learning Objectives
Learning Objectives
Introduction: Alzheimer's Disease
NINCDS-ADRDA Definition of Alzheimer's Disease
Introduction: Alzheimer's Disease
Progressive Neuronal Dysfunction
Histological/Biological Changes
Brain Areas and Characteristic Features
Histological/Biological Changes
Proteinaceous Deposits
Gross Pathology
Cerebral Cortex Atrophy and Brain Weight
Gross Pathology
Regional Differences in Brain Deposits
Neuropathology
Overview: Neuropathology of Alzheimer's Disease
Biochemistry
Aβ Peptides
Disease Mechanisms
Synaptic Failure and Synaptic Loss
Disease Mechanisms
Insulin Signaling and AD
Disease Mechanisms
Vascular Effects
Disease Mechanisms
Calcium Regulation
Genetics
APOE and Cholesterol Metabolism
Genetics
High Serum Cholesterol Levels and AD
Learning Objectives
Learning Objectives
Introduction: Incidence and Prevalence of Dementia
Introduction: Incidence and Prevalence of Dementia
Epidemiology
Epidemiology of Dementia
Epidemiology
Longitudinal Studies: Observational Cohort and Case-Control
Prevalence of Dementia Worldwide
Prevalence of Dementia Worldwide: DAD
Prevalence of Dementia Worldwide
Prevalence of Dementia Worldwide: DAD, Vascular, or Other Dementia
Incidence of Dementia
Incidence of Dementia
Risk Factors for AD
Risk Factors for AD
Non-modifiable Risk Factors
Non-modifiable Risk Factors: Age, Gender and Family History
Non-modifiable Risk Factors
Ethnicity
Non-modifiable Risk Factors
Genetics: Familial DAD
Non-modifiable Risk Factors
Genetics: Sporadic DAD - Isoform ApoE4
Non-modifiable Risk Factors
Genetics: Sporadic DAD - Newly Discovered Genes and Down Syndrome
Potentially Modifiable Risk Factors
Hypertension
Potentially Modifiable Risk Factors
Metabolic Syndrome, Oxidative Stress and Inflammation
Potentially Modifiable Risk Factors
Obesity and Hyperlipidemia
Potentially Modifiable Risk Factors
Hyperlipidemia and Diet
Potentially Modifiable Risk Factors
Exercise, Smoking, and Depression
Potentially Modifiable Risk Factors
Low Education Level Increases Risk for Dementia
Potentially Modifiable Risk Factors
Marriage and Supplement Use (NSAIDs, Nutraceuticals)
Potentially Modifiable Risk Factors
Environmental Exposures
Summary: Epidemiological Research
Summary: Epidemiological Research
Disease Mechanism
Aberrant Cell-Cycle Re-entry
Introduction: Alzheimer's disease
Introduction: Alzheimer's Disease
Learning Objectives
Clinical Course of Alzheimer's Disease
Alzheimer's Disease versus Normal Aging
Clinical Course of Alzheimer's Disease
Stages of Alzheimer's Disease
Clinical Course of Alzheimer's Disease
Stages 1 and 2: No Impairment and Mild Cognitive Decline
Clinical Course of Alzheimer's Disease
Stage 3: Mild Cognitive Decline (Some Early-Stage Alzheimer's Diagnosed)
Clinical Course of Alzheimer's Disease
Stage 4: Moderate Cognitive Decline
Clinical Course of Alzheimer's Disease
Stage 5: Moderately Severe Cognitive Decline
Clinical Course of Alzheimer's Disease
Stage 6: Severe Cognitive Decline
Clinical Course of Alzheimer's Disease
Stage 7: Very Severe Cognitive Decline
Role of Psychiatric Symptoms in Alzheimer's Disease
Role of Psychiatric Symptoms in Alzheimer's Disease
Criteria for the Diagnosis of Dementia Due to Alzheimer's Disease
The Initial NINCDS-ADRDA Criteria for Dementia Due to AD - Supportive and Consistent Features
Criteria for the Diagnosis of Dementia Due to Alzheimer's Disease
The Initial NINCDS-ADRDA Criteria for Dementia Due to AD - Possible and Definite AD
Criteria for the Diagnosis of Dementia Due to Alzheimer's Disease
The Need for an NINCDS-ADRDA Update
Criteria for the Diagnosis of Dementia Due to Alzheimer's Disease
Differential Diagnosis
Criteria for the Diagnosis of Dementia Due to Alzheimer's Disease
Clinical Cognitive Assessments: Mini-Mental State Examination (MMSE)
Criteria for the Diagnosis of Dementia Due to Alzheimer's Disease
Mini-Mental State Examination (MMSE)
Criteria for the Diagnosis of Dementia Due to Alzheimer's Disease
Clinical Cognitive Assessments: Alzheimer's Disease Assessment Scale-Cognitive (ADAS-cog)
Criteria for the Diagnosis of Dementia Due to Alzheimer's Disease
Clinical Functional Assessments: Alzheimer's Disease Cooperative Study Group-Activities of Daily...
Criteria for the Diagnosis of Dementia Due to Alzheimer's Disease
Magnetic Resonance Imaging (MRI) Biomarkers
Criteria for the Diagnosis of Dementia Due to Alzheimer's Disease
Cerebrospinal Fluid (CSF) Biomarkers
Criteria for the Diagnosis of Dementia Due to Alzheimer's Disease
Positron Emission Tomography (PET) Biomarker
Criteria for the Diagnosis of Dementia Due to Alzheimer's Disease
Positron Emission Tomography (PET)
Criteria for the Diagnosis of Dementia Due to Alzheimer's Disease
Familial Genetic Mutations
Clinical Presentation and Clinical Diagnosis of Alzheimer's Disease
Symptoms of Alzheimer's Disease
Clinical Presentation and Clinical Diagnosis of Alzheimer's Disease
Clinical Presentation of Dementia
Learning Objectives
Learning Objectives
Introduction
Introduction: Alzheimer's Disease
Lifestyle Modifications and Prevention
Development of Dementia and Disease Progression
Lifestyle Modifications and Prevention
Risk Factor Modification: Social, Mental, and Physical Activity
Lifestyle Modifications and Prevention
Risk Factor Modification: Exercise and Healthy Diet
Pharmacotherapy
Disease Modification versus Symptom Control
Pharmacotherapy
Cognitive Function Over Time with Disease Modification versus Symptom Control
Pharmacotherapy
Statistical Significance versus Clinical Significance
Pharmacotherapy
Currently Approved Agents
Cholinesterase Inhibitors
Historical Overview of Agents
Acetylcholinesterase Inhibitors
Cholinergic Side Effects: Gradual Low-Dose
Acetylcholinesterase Inhibitors
Cholinergic Side Effects: Common and Uncommon
Acetylcholinesterase Inhibitors
Anticholinergic Drugs
Acetylcholinesterase Inhibitors: Donepezil
Mechanism of Action and Indication - Donepezil
Acetylcholinesterase Inhibitors: Donepezil
Acetylcholinesterase Inhibitors - Donepezil
Acetylcholinesterase Inhibitors: Galantamine
Mechanism of Action and Indication - Galantamine
Acetylcholinesterase Inhibitors: Galantamine
Dosage and Administration - Galantamine
Cholinesterase Inhibitors: Galantamine
Clinical Studies - Overview
Acetylcholinesterase Inhibitors: Galantamine
Clinical Studies in Patients with Probable AD
Acetylcholinesterase Inhibitors: Rivastigmine
Mechanism of Action and Indication - Rivastigmine
Acetylcholinesterase Inhibitors: Rivastigmine
Dosage and Administration - Rivastigmine Oral Dosage
Cholinesterase Inhibitors: Rivastigmine
Clinical Studies: Overview
NMDA Receptor Antagonist - Memantine
Mechanism of Action - NMDA Receptor Antagonist - Memantine
NMDA Receptor Antagonist - Memantine
Memantine Precautions
NMDA Receptor Antagonist - Memantine
Memantine Clinical Studies: Overview
NMDA Receptor Antagonist - Memantine
Indication, Dosage and Administration
Future Research Directions
Search for Disease Modifying Therapies
Future Research Directions
New Alzheimer's Disease Treatment Strategies
Learning Objectives
Learning Objectives
Introduction
Introduction: Pharmaco-economic Impact of Alzheimer's Disease
Variation in Direct and Indirect Costs
Geographic and Cultural Differences
Variation in Direct and Indirect Costs
Disease Severity
Direct Costs
Direct Costs of DAD
Direct Costs
Cost of AD Therapy
Indirect Costs
Informal Care
Direct Costs
Cost-Effectiveness of DAD Treatment
Direct Costs
Hospital Stays and Institutionalization
Indirect Costs
Types of Informal Care
Indirect Costs
Social Impact of Informal Care
Summary
Summary: Pharmaco-economic Impact of Alzheimer's Disease
Learning Objectives
Learning Objectives
Introduction
New Pharmacological Therapy for AD Disease Modification
AD Progression
Overview: AD Progression - Characteristics and Goals
Amyloid Hypothesis
Overview: AD Progression - Aβ Peptide Accumulation
Amyloid Hypothesis
The Cascade
Amyloid Hypothesis
Why Does A beta Accumulate?
Amyloid Hypothesis
APP Processing
γ-Secretase Inhibition
Effects on Notch Signaling
γ-Secretase Inhibition
Development of Inhibitors
γ-Secretase Inhibition
GSI-953 and GSI-953: Effects in Transgenic Mice and Aβ Levels
γ-Secretase Inhibition
GSI-953: Single Oral Dose in Humans
γ-Secretase Inhibition
MK-0752: Phase I Trials
γ-Secretase Inhibition
BMS-708163 Preclinical Data: Rapid and Sustained Reduction
γ-Secretase Inhibition
BMS-708163 Preclinical Data: Aβ40 Reduction
β-Secretase Inhibition
β-Secretase Inhibition
β-Secretase Inhibition
CTS-21166: Small-Molecule β-secretase Inhibitor
Aβ Immunotherapy
Overview: Aβ Immunotherapy
Active Immunization
Animal Studies: First Immunization Evidence
Active Immunization
Animal Studies: Immunization and Disease Severity
Active Immunization
AN1792 Phase I Safety Trial
Active Immunization
AN1792 Phase IIa Trial
Active Immunization
AN1792 Immune Response
Active Immunization
AN1792 Autopsy Findings
Active Immunization
AN1792 Cognitive Findings
Active Immunization
AN1792 CSF Findings
Active Immunization
AN1792 MRI Measures
Active Immunization
Lessons Learned from AN1792
Active Immunization
CAD106: Preclinical Results
Active Immunization
CAD106: Phase I
Active Immunization
CAD106: Phase II
Active Immunization
V950: Active Anti-Aβ Vaccine
Passive Immunization
Overview: Passive Immunization
Passive Immunization
Animal Studies
Passive Immunization
Bapineuzumab Phase II: Cognitive Measures
Passive Immunization
Ponezumab
Passive Immunization
Intravenous Immunoglobulin (IVIg) Pilot Studies
Learning Objectives
Learning Objectives
Introduction
Search for Biomarkers in Alzheimer's Disease
Introduction
Characteristics of an Ideal Biomarker
Introduction
Biomarkers and Development of Clinical Therapeutics
Introduction
Biomarkers and Development of Clinical Therapeutics: ADNI
Introduction
Candidate Biomarkers in AD Based on Neuropathology
Introduction
Candidate Biomarkers in AD Based on Genetic Profile
Clinical Course of Alzheimer?s Disease
Alzheimer's Disease vs. MCI vs. Normal Aging
Clinical Course of Alzheimer's Disease
Models of AD Initiation and Progression
Biomarkers for the Diagnosis of AD
Cerebrospinal Fluid (CSF) Biomarkers
Biomarkers for the Diagnosis of AD
CSF Biomarkers: Aβ42
Biomarkers for the Diagnosis of AD
CSF Biomarkers: T-tau and P-tau
Biomarkers for the Diagnosis of AD
CSF Biomarkers Signature
Biomarkers for the Diagnosis of AD
Plasma Biomarkers
Biomarkers for the Prediction of MCI Conversion to AD
MRI
Biomarkers for the Diagnosis of AD
MRI and Ventricular Expansion
Biomarkers for the Diagnosis of AD
PET, Biomarkers and Cognition
Biomarkers for the Prediction of MCI Conversion to AD
CSF Biomarkers
Biomarkers for the Prediction of MCI Conversion to AD
CSF Biomarkers Study
CSF Biomarkers Predict AD in Elderly with No Symptoms
Presymptomatic Diagnosis of AD Pathology
Biomarkers to Predict the Rate of Cognitive Decline in AD
CSF Biomarkers
Biomarkers to Predict the Rate of Cognitive Decline in AD
PET
Biomarkers to Predict the Rate of Cognitive Decline in AD
FDG-PET by Prespecified Regions of Interest (ROIs)
Biomarkers to Predict the Rate of Cognitive Decline in AD
FDG-PET by Voxel-Based Approaches
Biomarkers to Predict the Rate of Cognitive Decline in AD
SD-SSP PET Approaches
Biomarkers to Predict the Rate of Cognitive Decline in AD
Amyloid Imaging with [11C]PIB PET: PIB-PET
Biomarkers to Predict the Rate of Cognitive Decline in AD
Amyloid Imaging with [11C]PIB PET: PIB Positivity
Biomarkers to Predict the Rate of Cognitive Decline in AD
Amyloid Imaging with AV-45
Drug Development
Value of Biochemical Markers in Drug Development
Drug Development
Biomarkers May Bridge the Gap between Animal Studies and Large Clinical Trials
Drug Development
Biomarkers to Monitor and Track Biochemical Drug Effects
Drug Development
Biomarkers and Biochemical Drug Effects
Surrogate Markers as Clinical Endpoints
Biomarkers as Surrogate Markers
Surrogate Markers as Clinical Endpoints
Surrogate Marker Use at This Point
Passive Immunization
Solanezumab: Preclinical Studies and Rationale
Passive Immunization
Solanezumab: First Human Clinical Study
Passive Immunization
Solanezumab: Phase II Trial - Examination
Passive Immunization
Solanezumab: Phase II Trial - Conclusion
Passive Immunization
Solanezumab Phase III
Neuropathology
Neurofibrillary Tangles
Future Research Directions
Update to Theory of AD Pathophysiology and Potential Drug Failures
Neuropathology
Neuroinflammation
Neuropathology
Cerebral Amyloid Angiopathy (CAA)
Neuropathology
Granulovacuolar Degeneration and Neuropil Threads
Treatment for Neuropsychiatric Symptoms in AD
Overview of Neuropsychiatric Symptoms in AD
Treatment for Neuropsychiatric Symptoms in AD
Treatment of Psychosis and Agitation
Treatment for Neuropsychiatric Symptoms in AD
Clinical Antipsychotic Trials of Intervention Effectiveness - Alzheimers Disease (CATIE-AD)
Treatment for Neuropsychiatric Symptoms in AD
Risks versus Benefits of Antipsychotics in AD
Treatment for Neuropsychiatric Symptoms in AD
Treatment of Depression
Treatment for Neuropsychiatric Symptoms in AD
Treatment of Sleep Disturbances
Introduction
Disease Overview: Mortality
MS Timeline
Etiology
Environmental Factors
Infectiou...
Introduction
Disease Overview: Mortality
Introduction
History: MS Timeline
Introduction
Etiology
Introduction
Etiology: Environmental Factors
Introduction
Etiology: Infectious Factors
Introduction
Etiology: Genetic Factors
Introduction
Etiology: Genetic Factors
Introduction
Etiology: Genetic Factors
Introduction
Etiology: Genetic Factors
Introduction
Etiology: Role of the Immune System
Introduction
Disease Overview: Definition
Introduction
Disease Overview: Clinical Presentation
Introduction
Disease Overview: Progression
Introduction
Disease Overview: Quality of Life (QOL)
Introduction
Epidemiology
Introduction
Epidemiology: Age of Onset
Introduction
Epidemiology: Sex Distribution
Introduction
Epidemiology: Geographical and Racial Distribution
Classification
Types of MS: Progressive-Relapsing MS (PRMS)
Classification
Classification Summary: Summary
Classification
Classification Overview: Relapses
Classification
Classification Overview: Symptom Worsening
Classification
Classification Overview: Relapses Vary
Classification
Types of MS: Classification of MS
Classification
Types of MS: Clinical Isolated Syndrome (CIS)
Classification
Types of MS: Relapsing-Remitting MS (RRMS)
Classification
Types of MS: Primary-Progressive MS (PPMS)
Classification
Types of MS: Secondary-Progressive MS (SPMS)
Signs and Symptoms
Signs and Symptoms Overview: Impact on the Patient
Signs and Symptoms
Damage to Specific CNS Regions
Signs and Symptoms
Interactive Exercises: Patient Reports
Signs and Symptoms
Signs and Symptoms Summary: Summary
Diagnosis
Overview: The Challenge of Diagnosis
Diagnosis
Physical Examination: Motor
Diagnosis
Diagnostic Testing: Magnetic Resonance Imaging (MRI)
Diagnosis
Diagnostic Testing: MRI Parameters
Diagnosis
Diagnostic Testing: Gadolinium (Gd) Contrast Agents
Diagnosis
Diagnostic Testing: Positive MRI
Diagnosis
Diagnostic Testing: Cerebrospinal Fluid (CSF)
Diagnosis
Diagnostic Testing: CSF Findings in MS
Diagnosis
Diagnostic Testing: Evoked Potentials (EPs)
Diagnosis
Diagnostic Testing Summary and Sensitivity
Diagnosis
Approaches to Diagnosis: Red Flag Positives/Negatives
Diagnosis
Approaches to Diagnosis: McDonald Diagnostic Criteria for MS
Diagnosis
Approaches to Diagnosis: Summary
Diagnosis
Overview: Diagnostic Testing
Diagnosis
History: Presenting Symptoms in MS Patients
Diagnosis
Physical Examination: Somatosensory
Diagnosis
Physical Examination: Visual
Prognosis
Prognostic Factors: First Interattack Interval
Prognosis
Prognostic Factors: Summary of Prognostic Factors
Prognosis
Mortality and MS
Prognosis
Emerging Prognostic Indicators: MRI
Prognosis
Emerging Prognostic Indicators: Biomarkers
Prognosis
Overview: The Prognosis is Variable
Prognosis
Clinical Course
Prognosis
Clinical Scoring Systems: EDSS Limitations
Prognosis
Prognostic Factors: Initial Disease Course
Prognosis
Prognostic Factors: Symptoms at Onset
Pathophysiology
Immunopathophysiology: Myelin-Reactive T Cells
Pathophysiology
Immunopathophysiology: T Cell Initiation of MS - Blood Brain Barrier
Pathophysiology
Immunopathophysiology: B Cells and Autoantibodies in Disease Progression
Pathophysiology
Immunopathophysiology: Epstein-Barr Virus (EBV)
Pathophysiology
Epitope Spreading
Pathophysiology
Immunopathophysiology: Microglia
Pathophysiology
Processes
Pathophysiology
Overview: Pathogenesis
Pathophysiology
Anatomical Pathophysiology: Plaques - Pathology
Pathophysiology
Anatomical Pathophysiology: Plaques Histology
Pathophysiology
Anatomical Pathophysiology: Histological Patterns
Pathophysiology
Anatomical Pathophysiology: Axon Damage and Neurodegeneration
Pathophysiology
Anatomical Pathophysiology: Cortical Demyelination
Pathophysiology
Immunopathophysiology: Autoimmune Disease
Pathophysiology
Immunopathophysiology: T Cell Initiation of MS
Current Therapies
Overview: Current Therapies for MS
Current Therapies
Treatment of Acute Relapses: Severe Relapses: Therapeutic Plasma Exchange (TPE)
Current Therapies
Hormonal Therapies
Current Therapies
Anti-Infective Agents
Current Therapies
Disease Modifying Therapy (DMT): Goals of Disease Modifying Therapy (DMT)
Current Therapies
Disease Modifying Therapy (DMT): Rationale for Early Treatment
Current Therapies
Disease Modifying Therapy (DMT): Disease Modifying Therapies (DMTs) Summary
Current Therapies
Intensive Immune Suppression: Chemotherapeutic Agents
Current Therapies
Intensive Immune Suppression: Cell Therapy
Current Therapies
Treatment of Acute Relapses
Emerging Hypotheses on Treatment
Neurodegeneration: Cell Therapy
Emerging Hypotheses on Treatment
Neurodegeneration: Human Stem Cells
Emerging Hypotheses on Treatment
Neurodegeneration Concepts: Summary
Emerging Hypotheses on Treatment
Genetic Concepts: MS Genomics
Emerging Hypotheses on Treatment
Genetic Concepts: Interleukin Receptors
Emerging Hypotheses on Treatment
Genetic Concepts: Other Genes Potentially Involved in MS
Emerging Hypotheses on Treatment
Genetic Concepts: Chances for Success
Emerging Hypotheses on Treatment
Immunological Concepts: Emerging Hypotheses on Treatment
Emerging Hypotheses on Treatment
Immunological Concepts: Vaccines
Emerging Hypotheses on Treatment
Immunological Concepts: Oral Immune-Modulating Drugs
Emerging Hypotheses on Treatment
Immunological Concepts: Monoclonal Antibodies
Emerging Hypotheses on Treatment
Immunological Concepts: Summary
Emerging Hypotheses on Treatment
Neurodegeneration
Emerging Hypotheses on Treatment
Neurodegeneration: Indirect Neuroprotection
Advancing Technologies
Biomarkers: Disease Process-Specific Biomarkers
Advancing Technologies
Biomarkers: Inflammation Biomarkers
Advancing Technologies
Biomarkers: Neurodegenerative Biomarkers
Advancing Technologies
Biomarkers: Treatment Related Biomarkers
Advancing Technologies
Biomarkers: Conclusion
Advancing Technologies
Advanced Imaging Techniques Used in MS
Advancing Technologies
Advanced Imaging Techniques: Magnetization Transfer Imaging (MTI)
Advancing Technologies
Advanced Imaging Techniques: Diffusion-Weighted Imaging (DWI)
Advancing Technologies
Advanced Imaging Techniques: Magnetic Resonance Spectroscopy (MRS)
Advancing Technologies
Advanced Imaging Techniques: Functional MRI (fMRI)
Advancing Technologies
Advanced Imaging Techniques: Ultra-High Field MRI
Advancing Technologies
Biomarkers Overview
Signs and Symptoms
Signs and Symptoms Overview: Impact on the Patient
Damage to Specific CNS Regions
Damage t...
Pathophysiology
Immunopathophysiology: Myelin-Reactive T Cells
Immunopathophysiology: T Cell Initiation of MS -...
Advancing Technologies
Biomarkers: Disease Process-Specific Biomarkers
Biomarkers: Inflammation Biomarkers
Biomar...
BED Disease State
Metabolic Syndrome and Metabolic Risk Factors
Introduction: MRI Basics
MRI Imaging
Physical Principles of MRI
Nuclear Magnetic Resonance (NMR)
Conventional MRI
Overview
Conventional MRI Techniques
T2-Weighted MR Image
Conventional MRI Techniques
Gadolinium-Enhanced T1 MR Image
Conventional MRI Techniques
Fluid-Attenuated Inversion Recovery (FLAIR)
Non-Conventional MRI: Diffusion-Weighted Imaging (DWI)
Diffusion-Weighted MRI (DWI)
Non-Conventional MRI: Magnetic Transfer Image/Ratio (MTI/MTR)
Magnetic Transfer (MT) Technique
Non-Conventional MRI: Magnetic Resonance Spectroscopy (MRS)
Magnetic Resonance Spectroscopy (MRS)
Non-Conventional MRI: Magnetic Resonance Spectroscopy (MRS)
MRS and Lesion Type
Summary
Summary: MRI Imaging
Physical Principles of MRI
Nuclear Magnetic Resonance (NMR)
Physical Principles of MRI
Signal Intensity Determines MR Image
Normal ARC Function
Control of Energy Homeostasis
The Weight Control Circuit
Monoamines
Obesity
Normal ARC Function
Control of Energy Homeostasis
Normal ARC Function
The Weight Control Circuit
Normal ARC Function
Monoamines
Normal ARC Function
Obesity
Introduction: Diagnosis and Prognosis of MS
The Diagnosis of MS
Physical Exam
Physical Examination: Visual
Welcome: MRI Basics
Welcome: Brain Imaging
Introduction to MRI Basics
Nuclear Magnetic Resonance (NMR): Relaxation
Nuclear Magnetic Resonance (NMR): Longitudinal Rel...
Introduction to MRI Basics
Nuclear Magnetic Resonance (NMR): Relaxation
Disease Overview: Multiple Sclerosis
Clinical Presentation
Etiology of Multiple Sclerosis
Infectious Factors
Disease Overview: Multiple Sclerosis
Progression
Quality of Life (QOL)
Disease Overview: Multiple Sclerosis
Progression
Disease Overview: Multiple Sclerosis
Quality of Life (QOL)
Epidemiology
Multiple Sclerosis: Important Points
Etiology of Multiple Sclerosis
Cause of Multiple Sclerosis
Environmental Factors
Etiology of Multiple Sclerosis
Genetic Factors: MS Concordance
Genetic Factors: Major Histocompatibility Complex II (MHCII)
Etiology of Multiple Sclerosis
Genetic Factors: MS Concordance
Genetic Factors: Major Histocompatibility Complex II (MHCII)
Etiology of Multiple Sclerosis
Genetic Factors: MS Concordance
Etiology of Multiple Sclerosis
Genetic Factors: Major Histocompatibility Complex II (MHCII)
Etiology of Multiple Sclerosis
Genetic Factors: Complex Interactions
Etiology of Multiple Sclerosis
Role of the Immune System
Epidemiology
Multiple Sclerosis: Important Points
Age of Onset
Sex Distribution
Geographical and R...
Etiology of Multiple Sclerosis
Cause of Multiple Sclerosis
Etiology of Multiple Sclerosis
Environmental Factors
Epidemiology
Age of Onset
Epidemiology
Sex Distribution
Epidemiology
Geographical and Racial Distribution
Epidemiology
Mortality
Summary: History of Multiple Sclerosis
Multiple Sclerosis: Summary
Introduction: The Nervous System
Welcome to the Nervous System
The Nervous System
The Central Nervous System (CNS)
The CNS: Brain
The Nervous System
The Central Nervous System (CNS)
The Nervous System
The CNS: Brain
The Nervous System
The Peripheral Nervous System (PNS)
Neurons: Structure
What is the difference between a neuron and a nerve?
Neurons: Action Potential
Action Potential
Action Potential: Role of Calcium Ions and Neurotransmitters
Neurons: Action Potential
Action Potential
Neurons: Action Potential
Action Potential: Role of Calcium Ions and Neurotransmitters
Myelin
Myelin
Myelinated Neurons
Tracts
Axonal Transection
Myelinated Neurons
Tracts
Myelinated Neurons
Axonal Transection
Myelination
What is Myelination?
Microglia
Glial Cells
Myelination
What is Myelination?
Myelination
Microglia
Myelination
Glial Cells
Myelination
Astrocytes
Oligodendrocytes
Myelin in the Peripheral Nervous System
Neurotrophins
Myelination
Astrocytes
Myelination
Oligodendrocytes
Myelination
Myelin in the Peripheral Nervous System
Myelination
Neurotrophins
Myelination
Beneficial Effects of Inflammation
Remission and Restoration of Nerve Impulses
Myelination
Beneficial Effects of Inflammation
Myelination
Remission and Restoration of Nerve Impulses
The Blood-Brain Barrier
MS Disease Process
Summary: The Nervous System
The Nervous System: Summary
Introduction: MRI Basics
MRI Imaging
Pathogenesis and Clinical Symptomology MS: Introduction
Pathology of MS
Introduction: MRI Basics
MRI System Components
Pathogenesis and Clinical Symptomology MS: Introduction
Pathology-Anatomic
Pathogenesis and Clinical Symptomology MS: Introduction
Plaques - Histology
Pathogenesis and Clinical Symptomology MS: Introduction
Axon Damage and Neurodegeneration
Pathogenesis and Clinical Symptomology MS: Introduction
Summary of Pathophysiology of MS
Animal Models of MS
Animal Models of MS
Animal Models of MS
TMEV Infection Model
Animal Models of MS
Cuprizone Mouse Model
Signs and Symptoms
Impact on the Patient
Signs and Symptoms
Damage to Specific CNS Regions
Signs and Symptoms
Patient Reports
Classification
Relapses
Classification
Symptom Worsening
Classification of MS
Classification: Summary
Summary: Pathogenesis and Clinical Symptomology MS
Pathophysiology of MS
Patient History
Presenting Symptoms in MS Patients
Physical Exam
Physical Examination: Somatosensory
Diagnostic Testing: MRI
Magnetic Resonance Imaging (MRI)
Diagnostic Testing: MRI
MRI Parameters
Diagnostic Testing: MRI
Gadolinium (Gd) Contrast Agents
Positive MRI
Diagnostic Testing: MRI
Gadolinium (Gd) Contrast Agents
Diagnostic Testing: MRI
Positive MRI
Diagnostic Testing: Cerebrospinal Fluid (CSF)
Cerebrospinal Fluid (CSF)
CSF Findings in MS
Diagnostic Testing: Cerebrospinal Fluid (CSF)
Cerebrospinal Fluid (CSF)
Diagnostic Testing: Cerebrospinal Fluid (CSF)
CSF Findings in MS
Diagnostic Testing: Evoked Potentials
Evoked Potentials (EPs)
Diagnostic Criteria
The Poster Criteria for MS Diagnosis
Diagnostic Criteria
McDonald Diagnostic Criteria for MS
Diagnostic Criteria
2010 Update to McDonald Diagnostic Criteria
Diagnostic Criteria
Different Classification Criteria
Clinical Scoring Systems and Prognosis
The Prognosis Is Variable
Clinical Course
Differential Diagnosis
Differential Diagnosis
Differential Diagnosis
Differential Diagnosis: Other Diseases that Share Some MS Features
Clinical Scoring Systems and Prognosis
The Prognosis Is Variable
Clinical Scoring Systems and Prognosis
Clinical Course
Clinical Scoring Systems and Prognosis
EDSS Limitations
Clinical Scoring Systems and Prognosis
Cognitive Dysfunction Assessment
Prognostic Factors
Initial Disease Course
Prognostic Factors
Symptoms at Onset
Recovery from First Attack
First Interattack Interval
Summary of Pr...
Prognostic Factors
Symptoms at Onset
Prognostic Factors
Recovery from First Attack
Prognostic Factors
First Interattack Interval
Prognostic Factors
Summary of Prognostic Factors
Prognostic Factors
Predicting the Course of MS
Infections
Stress
Elevated Body Temperature
Mortalit...
Prognostic Factors
Predicting the Course of MS
Prognostic Factors
Infections
Prognostic Factors
Stress
Prognostic Factors
Elevated Body Temperature
Prognostic Factors
Mortality and MS
Prognostic Factors
Pregnancy
Biomarkers
The Need for Biomarkers
Characteristics of an Ideal Biomarker
Biomarkers
The Need for Biomarkers
Biomarkers
Characteristics of an Ideal Biomarker
Biomarkers
Definition of a Biomarker
Biomarkers
Examples of Current Biomarkers
Candidate Biomarkers
Biomarkers
Examples of Current Biomarkers
Biomarkers
Candidate Biomarkers
Biomarkers
Candidate Biomarkers by Disease Stage
Introduction to MRI Basics
Nuclear Magnetic Resonance (NMR): Longitudinal Relaxation
Introduction to MRI Basics
MRI Imaging Goals and Requirements
Image in Any Plane
Introduction to MRI Basics
MRI Imaging Goals and Requirements
Introduction to MRI Basics
MRI Imaging
Introduction to MRI Basics
Image in Any Plane
Introduction to MRI Basics
Nuclear Magnetic Resonance (NMR): Introduction
Nuclear Magnetic Resonance (NMR): Nuclear Magnet...
Introduction to MRI Basics
Nuclear Magnetic Resonance (NMR): Introduction
Introduction to MRI Basics
Nuclear Magnetic Resonance (NMR): Nuclear Magnetism and Magnetic Field
Introduction to MRI Basics
Nuclear Magnetic Resonance (NMR): Nuclear Spin
Introduction to MRI Basics
Nuclear Magnetic Resonance (NMR): Protons and Energy States
Introduction to MRI Basics
Nuclear Magnetic Resonance (NMR): Magnetization
Introduction to MRI Basics
Nuclear Magnetic Resonance (NMR): Transverse Relaxation
Physical Principles of MRI
MRI System Components
MRI Magnetic Field Strength
Physical Principles of MRI
MRI System Components
Physical Principles of MRI
MRI Magnetic Field Strength
Conventional MRI: Basic T1 and T2 MR Images
Conventional MRI: Overview
Conventional MRI: Basic T1 and T2 MR Images
Conventional MRI: Overview
Signal Intensity Determines MR Image
Contrast on the MR Image
Conventional MRI: Basic T1 and T2 MR Images
Signal Intensity Determines MR Image
Conventional MRI: Basic T1 and T2 MR Images
Contrast on the MR Image
Conventional MRI: Basic T1 and T2 MR Images
T1-Weighted MR Image: Image Acquisition
Conventional MRI: Basic T1 and T2 MR Images
T1-Weighted MR Image: Image Characteristics
Natural History of a New Lesion
Natural Histor...
Conventional MRI: Basic T1 and T2 MR Images
T1-Weighted MR Image: Image Characteristics
Conventional MRI: Basic T1 and T2 MR Images
Natural History of a New Lesion
Conventional MRI: Basic T1 and T2 MR Images
Natural History of Lesions
Conventional MRI: Basic T1 and T2 MR Images
T1-Weighted MR Image: Image Characteristics (Acute vs. Chronic Black Holes)
Conventional MRI: Basic T1 and T2 MR Images
Gadolinium-Enhanced MR Image
Conventional MRI: Basic T1 and T2 MR Images
T2-Weighted MR Image: Image Acquisition
Conventional MRI: Basic T1 and T2 MR Images
T2 Weighted MR Image: Image Characteristics
Conventional MRI: Basic T1 and T2 MR Images
Fluid Attenuated Inversion Recovery (FLAIR)
Fluid Attenuated Inversion Recovery (FLAIR): Disadv...
Conventional MRI: Basic T1 and T2 MR Images
Fluid Attenuated Inversion Recovery (FLAIR)
Conventional MRI: Basic T1 and T2 MR Images
Fluid Attenuated Inversion Recovery (FLAIR): Disadvantages
Non-Conventional MRI - Chronic T1-Weighted MRI
Non-Conventional MRI
Chronic T1-Weighted MRI
Non-Conventional MRI - Chronic T1-Weighted MRI
Non-Conventional MRI
Non-Conventional MRI - Chronic T1-Weighted MRI
Chronic T1-Weighted MRI
Non-Conventional MRI - Diffusion-Weighted Imaging (DWI)
Diffusion-Weighted MRI (DWI)
Diffusion-Weighted MRI (DWI): Image Acquisition
Diffusion-Wei...
Non-Conventional MRI - Diffusion-Weighted Imaging (DWI)
Diffusion-Weighted MRI (DWI)
Non-Conventional MRI - Diffusion-Weighted Imaging (DWI)
Diffusion-Weighted MRI (DWI): Image Acquisition
Non-Conventional MRI - Diffusion-Weighted Imaging (DWI)
Diffusion-Weighted MRI (DWI): Image Characteristics
Non-Conventional MRI - Magnetic Resonance Spectroscopy (MRS)
Magnetic Resonance Spectroscopy (MRS)
Non-Conventional MRI - Magnetic Resonance Spectroscopy (MRS)
Magnetic Resonance Spectroscopy (MRS): Image Characteristics
Magnetic Resonance Spectroscopy (M...
Non-Conventional MRI - Magnetic Resonance Spectroscopy (MRS)
Magnetic Resonance Spectroscopy (MRS): Image Characteristics
Non-Conventional MRI - Magnetic Resonance Spectroscopy (MRS)
Magnetic Resonance Spectroscopy (MRS): Image Acquisition
Non-Conventional MRI - Magnetic Resonance Spectroscopy (MRS)
MRS Limitations
Non-Conventional MRI - Magnetic Transfer Image/Ratio (MTI/MTR)
Magnetic Transfer Technique
Magnetic Transfer Technique: Image Characteristics
Non-Conventional MRI - Magnetic Transfer Image/Ratio (MTI/MTR)
Magnetic Transfer Technique
Non-Conventional MRI - Magnetic Transfer Image/Ratio (MTI/MTR)
Magnetic Transfer Technique: Image Characteristics
Non-Conventional MRI - Brain Volume Assessment (Volumetric MRI)
Brain Volume Assessment
Brain Volume Assessment: Challenges
Brain Volume Assessment: Impro...
Non-Conventional MRI - Brain Volume Assessment (Volumetric MRI)
Brain Volume Assessment
Non-Conventional MRI - Brain Volume Assessment (Volumetric MRI)
Brain Volume Assessment: Challenges
Non-Conventional MRI - Brain Volume Assessment (Volumetric MRI)
Brain Volume Assessment: Improvement in Registration
Summary: MRI Basics
Summary: MRI Basics
Welcome: Oral Therapies
Pharmacokinetics
Introduction to PK
Drug Concentration at Target Site
Different Types of Drug Molecules
Pharmacokinetics vs. P...
Introduction to PK
Drug Concentration at Target Site
Introduction to PK
Different Types of Drug Molecules
Introduction to PK
Pharmacokinetics vs. Pharmacodynamics
Introduction to PK
Pharmacokinetics: Patient Characteristics
Pharmacokinetics: Absorption
ADME
What is Drug Absorption?
Factors that Affect Absorption
Factors that Affect Abso...
Pharmacokinetics: Absorption
ADME
Pharmacokinetics: Absorption
What is Drug Absorption?
Pharmacokinetics: Absorption
Factors that Affect Absorption
Factors that Affect Absorption: Drug Properties
Factors tha...
Pharmacokinetics: Absorption
Factors that Affect Absorption
Pharmacokinetics: Absorption
Factors that Affect Absorption: Drug Properties
Pharmacokinetics: Absorption
Factors that Affect Absorption: Formulation
Pharmacokinetics: Absorption
Factors that Affect Absorption: Route of Administration
Pharmacokinetics: Absorption
Bioavailability
Pharmacokinetics: Absorption
Low Bioavailability
Pharmacokinetics: Absorption
Assessment of Bioavailability
Pharmacokinetics: Distribution
Distribution
Volume of Distribution: Vd Uses
Volume of Distribution: Plasma Protein Bindin...
Pharmacokinetics: Distribution
Distribution
Pharmacokinetics: Distribution
Volume of Distribution: Vd Uses
Volume of Distribution: Plasma Protein Binding
Volume of D...
Pharmacokinetics: Distribution
Volume of Distribution: Vd Uses
Pharmacokinetics: Distribution
Volume of Distribution: Plasma Protein Binding
Pharmacokinetics: Distribution
Volume of Distribution: Blood Brain Barrier Considerations
Pharmacokinetics: Metabolism
Drug Clearance (Elimination)
Plasma Half Life (t¼)
Prodrugs and Active Metabolites
...
Pharmacokinetics: Metabolism
Drug Clearance (Elimination)
Pharmacokinetics: Metabolism
Plasma Half Life (t¼)
Pharmacokinetics: Metabolism
Prodrugs and Active Metabolites
Pharmacokinetics: Metabolism
Phase 1 and 2 Metabolism
Pharmacokinetics: Excretion
Excretion and Clearance
Renal Elimination
Pharmacokinetics: Excretion
Excretion and Clearance
Pharmacokinetics: Excretion
Renal Elimination
Monitoring
Compliance Toxicities
Patient Compliance
Toxicity
Monitoring
Compliance Toxicities
Monitoring
Patient Compliance
Monitoring
Toxicity
Monitoring
Other Laboratory Values: CBC, RBC, WCB, Platelets
Monitoring
Other Laboratory Values: Hepatic Function and Inflammation
Summary: Oral Therapies
Summary: Oral Therapies
Welcome
Welcome to the Patient Experience
Symptoms: Diagnosis
Lesions Visible on MRI
Engagement: Management
Diagnosis: Engagement
Engagement: Management
Mortality
Quality of Life (QOL)
Sources of Information and Assistance: Non-profit Organiza...
Engagement: Management
Mortality
Engagement: Management
Quality of Life (QOL)
Engagement: Management
Sources of Information and Assistance: Non-profit Organizations
Sources of Information and Assi...
Engagement: Management
Sources of Information and Assistance: Non-profit Organizations
Engagement: Management
Sources of Information and Assistance: Pharmaceutical Companies
Engagement: Management
Paying for therapy: Cost
Paying for Therapy: Insurance
Engagement: Management
Paying for therapy: Cost
Engagement: Management
Paying for Therapy: Insurance
Hypothetical Case
Hypothetical Case
Multiple Sclerosis
MS Pathophysiology
Assessment of Bioavailability
AUC, Cmax, Tmax, Plasma Half-Life, Clearance
Hepatic Impairment
Liver Disease
Warnings and Precautions: Bone Marrow Effects
Complete Blood Count (CBC)
Use in Pregnancy
Classification of Drugs
Clinical Studies
Relapsing-Remitting MS (RRMS), Secondary-Progressive MS (SPMS)
Welcome
Welcome
Brain Volume Assessment (Volumetric MRI)
Brain Volume Assessment
Conventional MRI
T1-Weighted MR Image
Conventional MRI Techniques
Gd-Enhanced T1 and the Natural History of a New Lesion
Introduction
Introduction
Treatment Strategies
Disease-Modifying Therapies
Treatment Strategies
Immunosuppression vs. Immunomodulating
Approved Parenteral Treatments for Multiple Sclerosis
Approved Parenteral Therapies for RRMS
Approved Parenteral Treatments for Multiple Sclerosis
Approved Parenteral Therapies for RRMS: Avonex
Approved Parenteral Treatments for Multiple Sclerosis
Approved Parenteral Therapies for RRMS: Betaseron
Approved Parenteral Treatments for Multiple Sclerosis
Approved Parenteral Therapies for RRMS: Extavia
Approved Parenteral Treatments for Multiple Sclerosis
Approved Parenteral Therapies for RRMS: Natalizumab (Tysabri, IV)
Approved Parenteral Treatments for Multiple Sclerosis
Additional Therapeutic Approaches
Approved Oral Treatments for Multiple Sclerosis
Approved Oral Treatments for Multiple Sclerosis
Approved Oral Treatments for Multiple Sclerosis
Approved Oral Treatments for Multiple Sclerosis: Gilenya
Approved Oral Treatments for Multiple Sclerosis
Approved Oral Treatments for Multiple Sclerosis: Aubagio
Approved Oral Treatments for Multiple Sclerosis
Approved Oral Treatments for Multiple Sclerosis: Tecfidera
Intensive Immune Suppression
Intensive Immune Suppression for Non-Responders
Symptomatic Therapies
Treatment of Acute Relapses
Symptomatic Therapies
Severe Relapses
Symptomatic Therapies
Symptomatic Therapies
Summary
Summary: Goals of Disease Modifying Therapy (DMT)
Introduction: Opioids and Pain Management
Introduction: Opioids and Pain Management
Learning Objectives
Learning Objectives
Types of Pain
Types of Pain
Nociceptive versus Neuropathic Pain
Nociceptive versus Neuropathic Pain
Nociceptive versus Neuropathic Pain
Neuropathic Pain
Acute versus Chronic Pain
Acute versus Chronic Pain and Pain Pathways
Opioids and Opioid Receptors
Opioids and Opioid Receptors: Opioid Peptides
Opioids and Opioid Receptors
Opioids and Opioid Receptors: G-Protein Coupled Receptors
Opioids and Opioid Receptors
Opioids and Opioid Receptors Classes and Subtypes
Opioids and Opioid Receptors
Opioids and Opioid Receptors
Mechanism of Action
Mechanism of Action
Effects of Opioids
Effects of Opioids
Clinical Use of Opioids and Pain Classification and Current Guidelines
Clinical Use of Opioids and Pain Classification and Current Guidelines
Clinical Use of Opioids
Clinical Use of Opioids
Specific Compounds
Naturally Occurring Opioids
Clinical Use of Opioids
Specific Compounds: Heroin
Clinical Use of Opioids
Semisynthetic Specific Compounds
Clinical Use of Opioids
Specific Synthetic Compounds
Summary: Opioids and Pain Management
Summary: Opioids and Pain Management
Introduction: Opioid Dependence and Addiction
Opioid Dependence and Addiction
Introduction: Opioid Dependence and Addiction
Learning Objectives: Opioid Dependence and Addiction
Epidemiology
Illicit Drug Use
Epidemiology
Epidemiology
Epidemiology
Opioid-Related Emergency Room Visits
Epidemiology
Risk Factors
Epidemiology
Emotional, Financial, and Social Costs
Epidemiology
Complications
Diagnosis and Primary Prevention
Diagnosis and Primary Prevention
Diagnosis and Primary Prevention
Diagnostic Components and Patient History
Epidemiology
Epidemiology
Diagnosis and Primary Prevention
Diagnostic Components and Clinical Examination
Diagnosis and Primary Prevention
Primary Prevention
Diagnosis and Primary Prevention
Primary Prevention and Patients with Chronic Pain
Neurobiology of Addiction and Withdrawal
Neurobiology of Addiction and Withdrawal
Neurobiology of Addiction and Withdrawal
Neurobiology of Reward
Neurobiology of Addiction and Withdrawal
Addiction, Tolerance, and Withdrawal
Neurobiology of Addiction and Withdrawal
RADARS System
Strategies of Abuse-Deterrent Opioids
Strategies of Abuse-Deterrent Opioids
Strategies of Abuse-Deterrent Opioids
Potential for Abuse
Strategies of Abuse - Deterrent Opioids
Strategies of Abuse-Deterrence
Strategies of Abuse-Deterrent Opioids
Strategies of Abuse-Deterrent Opioids
Strategies of Abuse-Deterrent Opioids
Current Status and Challenges
Summary: Opioid Dependence and Addiction
Summary: Opioid Dependence and Addiction
BED Disease State
Diagnostic Criteria, Disease Onset, and Clinical Course
Binge Eating Disorder (BED) Disease State
Binge Eating Disorder (BED) Disease State
Opioid Addiction Treatment
Opioid Addiction Treatment
Opioid Addiction Treatment
Learning Objectives
Problem Recognition
Problem Recognition
Problem Recognition
Transtheoretical Model
Problem Recognition
Assessment Tools
Drug Addiction Treatment Act of 2000
Drug Addiction Treatment Act of 2000
Drug Addiction Treatment Act of 2000
DEA Controlled Substance Schedules
Drug Addiction Treatment Act of 2000
Criteria and Physician Qualification
Drug Addiction Treatment Act of 2000
Waiver Qualification
Drug Addiction Treatment Act of 2000
Patient Limits on Treatment
Treatment Goals and Strategies
Treatment Goals and Strategies
Treatment Goals and Strategies
Abstinence and Medication-Assisted Treatment
Treatment Goals and Strategies
Phases of Treatment
Treaters and Payers
Treaters and Payers
Treaters and Payers
Physician Categories
Treaters and Payers
Patient Categories
Treaters and Payers
Treatment Settings
Treaters and Payers
Distribution of Medication
Treatment Options
Treatment Options
Treatment Options
Psychosocial Interventions
Treatment Options
Non-Pharmaceutical Options
Treatment Options
Pharmaceuticals
Treatment Options
Specific Agents
Treatment Options
Specific Agents: Buprenorphine
Treatment Options
Characteristics of Methadone vs. Buprenorphine/Naloxone
Unmet Need and Discontinuation
Unmet Need and Discontinuation
Unmet Need and Discontinuation
Treatment Challenges and Patient Concerns
Summary: Opioid Addiction Treatment
Summary: Opioid Addiction Treatment
Unmet Needs
Unmet Needs
BED Disease State
Diagnostic Criteria
BED Disease State
Disease Onset and Clinical Course
BED Disease State
Clinical Features and Complications Associated with Eating Disorders
BED Disease State
Metabolic Syndrome Components: Dyslipidemia, Hypertension, and Type 2 Diabetes
BED Disease State
Potential Complications
Epidemiology
Incidence and Prevalence
Epidemiology
Demographics
Diagnosis
Diagnosing BED
Diagnosis
Diagnosing BED: Challenges
Diagnosis
Diagnosing BED: BES, EDE, EDDS
Diagnosis
Differential Diagnosis and Common Comorbidities: Eating Disorders
Diagnosis
Differential Diagnosis and Common Comorbidities: Psychiatric Disorders
Summary: Binge Eating Disorder (BED) Disease State
Summary: Binge Eating Disorder (BED) Disease State
Treatment Goals and Guidelines
American Psychiatric Association (APA) Practice Guidelines
Non-Pharmacologic Treatments
Cognitive Behavioral Therapy (CBT) and Guided Self-Help CBT (CBTgsh)
Biological Basis of Binge Eating Disorder
Biological Basis of Binge Eating Disorder
Biology of Eating Behaviors
Biology of Eating Behaviors
Biology of Eating Behaviors
Hunger and Energy Homeostasis
Biology of Eating Behaviors
Hormonal Control of Energy Homeostasis: Orexigenic and Anorexigenic
Biology of Eating Behaviors
Hormonal Control of Energy Homeostasis: Leptin
Biology of Eating Behaviors
Neuronal Control of Energy Homeostasis
Biology of Eating Behaviors
The Reward Circuit and Appetite Regulation
BED Pathophysiology
BED Pathophysiology
BED Pathophysiology
Impulsivity and Emotional Dysregulation
BED Pathophysiology
Dopamine Dysregulation and the Yale Food Addiction Scale
BED Pathophysiology
Dopamine Dysregulation: Genetic Factors
BED Pathophysiology
Mu-Opioid Signaling Dysfunction
Currently Approved Therapies: Tysabri
Currently Approved Therapies: Tysabri
Biological Basis of Binge Eating Disorder
Summary of Biological Basis of Binge Eating Disorder
Current Treatment of Binge Eating Disorder (BED)
Treatment Goals and Guidelines
Treatment Goals and Guidelines
Treatment Goals
Non-Pharmacologic Treatments
Non-Pharmacologic Treatments
Non-Pharmacologic Treatments
Cognitive Behavioral Therapy (CBT) and Assessment of Body Shape and Weight
Non-Pharmacologic Treatments
Interpersonal Psychotherapy (IPT)
Non-Pharmacologic Treatments
Integrative Response Therapy (IRT)
Non-Pharmacologic Treatments
Dialectical Behavior Therapy (DBT)
Pharmacologic Treatments
Pharmacologic Treatments
Pharmacologic Treatments
Antidepressants
Pharmacologic Treatments
Anti-Obesity Agents
Pharmacologic Treatments
Rapid Response and Treatment Success
Unmet Needs
Disease Burden
Unmet Needs
Areas of Future Research
Competitive Landscape
Products Under Investigation
Competitive Landscape
Stimulants: Lisdexamfetamine/SPD489
Competitive Landscape
Stimulants: Methylphenidate
Competitive Landscape
Baclofen
Competitive Landscape
Zonisamide
Competitive Landscape
Ghrelin Modulation
Current Treatment of Binge Eating Disorder (BED)
Summary: Current Treatment of Binge Eating Disorder (BED)
MS Therapies
MS Therapies
Multiple Sclerosis
Learning Objectives
Currently Approved Therapies: Interferon Beta
Currently Approved Therapies: Interferon Beta (IFN beta)
Currently Approved Therapies: Tysabri
Pivotal Trials
Currently Approved Therapies: Gilenya
Gilenya
Currently Approved Therapies: Novantrone
Aubagio
Currently Approved Therapies: Tecfidera
Pivotal Trials CONFIRM (Study 2 in PI)
Currently Approved Therapies: Tecfidera
Tecfidera Safety (as compiled for PI)
Summary of Approved Therapies
Proposed Mechanism of Action Summary
Summary of Approved Therapies
Efficacy of Approved Multiple Sclerosis Therapies
Emerging Therapies
Emerging Therapies
Emerging Therapies
Emerging Therapies Overview
Emerging Therapies
Emerging Therapies: Alemtuzumab
Emerging Therapies
Emerging Therapies: Ocrelizumab
Emerging Therapies
Emerging Therapies: Peginterferon beta-1a
Emerging Therapies
NU100
Signs and Symptoms
Patient Reports
Screening Instruments
Screening Pregnant Women
Screening Instruments
Selecting a Delivery Method
Screening Instruments
AUDIT and AUDIT-C for General Screening
Screening Instruments
Define Typical Alcoholic Beverage
Screening Instruments
AUDIT Screen Use Guidelines
Screening Instruments
Personnel, Settings and Groups Considered Appropriate for a Screening Programme Using the AUDIT
Screening Instruments
Center for Disease Control Guidelines (CDC)
Risk Factors
Who's at Risk for Having Children with FASD?
Screening Instruments
Screening Pregnant Women
Selecting a Delivery Method
AUDIT and AUDIT-C for General Screeni...
Screening Instruments
Screening Instruments
Risk Factors
Risk Factors Based on Study Population
Overcoming Barriers
Barriers to Identifying Women at Risk
Overcoming Barriers
Barriers to Identifying Women at Risk
Overcoming Barriers to Risk Assessment
Acceptance of...
Overcoming Barriers
Overcoming Barriers to Risk Assessment
Overcoming Barriers
Acceptance of Routine Screening
Risk Factors
Alcohol Use Among Women of Childbearing Age
Risk Factors
Who's at Risk for Having Children with FASD?
Risk Factors Based on Study Population
In...
Risk Factors
Alcoholism
Risk Factors
High Risk Patients
Screening Instruments
Choosing a Screening Instrument
Screening Instruments
Target Drinkers
Screening Instruments
Explain Purpose of AUDIT Screening
Screening Instruments
AUDIT Screening Instrument
Screening Instruments
Scoring and Interpretation
Screening Instruments
Screening Success
Reimbursement
Billing for Preventive Services
Preventive Medicine
Billing for Using a Risk Assessment In...
Reimbursement
Billing for Preventive Services
Reimbursement
Preventive Medicine
Fetal Alcohol Spectrum
Fetal Alcohol Syndrome (FAS) Alcohol Effects
Fetal Alcohol Spectrum
Fetal Alcohol Spectrum Disorders (FASD)
Team Roles
Staff Participation
Reporting
Program Efficacy: Alcohol Screening
Program Efficacy: Prevention of Alcohol Exposed Pregnancies
Reporting
Program Efficacy: Alcohol Screening
Fetal Alcohol Spectrum
Fetal Alcohol Spectrum Disorders are Preventable
Fetal Alcohol Spectrum
Damage Due to Alcohol Exposure
Reporting
Program Efficacy: Prevention of Alcohol Exposed Pregnancies
Legal Issues
Legal Issues
Reimbursement
Billing for Using a Risk Assessment Instrument
Reimbursement
Medicaid Reimbursement for Alcohol Screening and Brief Intervention
Summary: Fetal Alcohol Syndrome
Summary: Fetal Alcohol Syndrome
Fetal Alcohol Spectrum
Fetal Alcohol Syndrome (FAS) Alcohol Effects
Fetal Alcohol Spectrum Disorders (FASD)
Fetal...
Fetal Alcohol Spectrum
Alcohol as Teratogen
Fetal Alcohol Spectrum
Alcohol Consumption During Pregnancy
Fetal Alcohol Spectrum
Economic Costs of FAS
GABA Receptor Drugs
Mechanism of Action
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