"The Gold Standard" Humility, Compassion, and Grace - Looking Back on KC, Looking Ahead to 'The Big C'-Chicago 2018 - Child Neurology Society

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"The Gold Standard" Humility, Compassion, and Grace - Looking Back on KC, Looking Ahead to 'The Big C'-Chicago 2018 - Child Neurology Society
Winter 2018 | Volume 26, No. 1

                          Bringing CNS Members Together to Make Children’s Lives Better

 “The Gold Standard”
Humility, Compassion, and Grace

Looking Back on KC, Looking Ahead to ‘The Big C’—Chicago 2018
"The Gold Standard" Humility, Compassion, and Grace - Looking Back on KC, Looking Ahead to 'The Big C'-Chicago 2018 - Child Neurology Society
CHILD NEUROLOGY SOCIETY
            From the President

                               Seizing Opportunities, Setting Priorities

                               I
                                   wish everyone a Happy New Year. May you all        diversity. For any member who is interested in serving
                                   have happiness and success in 2018. It is an       on a committee, please contact me (Jonathan_Mink@
                                   exciting time for the field of child neurology.    urmc.rochester.edu) or Roger Larson (rblarson@
                               Disease-modifying therapeutics for rare and fatal      childneurologysociety.org) to express your interest
                               neurodegenerative disease are now becoming reality     and which committee(s) would be most aligned with
                               with FDA approval in the past year of Brineura         your interests. In addition, we will be launching a new
                               (cerliponase alfa) for CLN2 disease (late-infantile    effort to include junior member participation on the
                               Batten Disease) and Spinraza (nusinersen) for          committees. An announcement regarding nominations
                               spinal muscular atrophy; more are on the horizon.      will be forthcoming in the next couple of months.
                               Despite a tight funding environment, research in
Jonathan Mink, MD, PhD
                               child neurology and developmental neuroscience         Another priority is to increase our alliances with
President, CNS                 continues to provide important advances.               other organizations active in our field. These include
                               The number of clinical child neurologists also         the American Academy of Neurology, the American
                               continues to grow, providing improved access to        Academy of Pediatrics, the International Child Neurology
                               high quality neurological care for children.           Association, The Child Neurology Foundation, and
                                                                                      others. I do believe that there is “safety in numbers”.
                               Plans are already underway for what promises to        We must not relinquish our identity as child neurologists
                               be an exciting 47th Annual Meeting in Chicago          and must not allow the needs of child neurology to
My Top Priorities:             this year. By now, you have probably received a        become secondary priorities to the needs of the larger
                               few notices that the meeting days will be different    fields of pediatrics and neurology. However, to have the
...Increase diversity          from our traditional Wednesday through Saturday.       greatest impact advocating for our profession we must
in CNS leadership              This year’s meeting will start Monday October 15       work with these other organizations. Two years ago, a
                               and run through Thursday October 18. Proposals for     Child Neurology working group was formed that includes
...Strengthen alliances        symposia and breakfast seminars have been received     representatives from CNS, AAN, AAP, PCN, and CNF
                               and will be reviewed by the Scientific Selection and   with a goal of coordinating our efforts to assure that the
with other                     Program Planning Committee over the next month.        professional needs of child neurologists are supported.
organizations in               The abstract submission site will remain open until
                               midnight, April 2.                                     A third priority is to expand programming at the
our field                                                                             Annual Meeting and between meetings for our junior
                               As I assume the role of President, I want to state     members. They are the future of our profession. In my
...Expand programming          some of my priorities for the next two years.          view, the Child Neurology Society has a responsibility
for Junior Members                                                                    to provide career-development support and mentoring
                               The first is to increase the diversity of membership   in a broader context than is available at individual
                               on the CNS committees and ultimately in the            institutions. We will work to implement a “junior
                               leadership of the Society. The membership of the       member track” with activities on each day of the
                               CNS is currently about 50 percent men and 50           Annual Meeting targeted at junior members.
                               percent women, but 70 percent of current residents
                               in child neurology are women. The number of            I am excited about the Child Neurology Society and
                               historically under-represented minorities is also      opportunities to continue and enhance our role as a
                               increasing among our members and trainees.             professional society in advancing education, research,
                               As the path to leadership in professional societies    clinical care, and career satisfaction. I am proud to have
                               usually starts with participation on a committee,      been part of the CNS for over 25 years and look forward
                               this will be one focus of our efforts to increase      to working with all of you over the next two years.

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"The Gold Standard" Humility, Compassion, and Grace - Looking Back on KC, Looking Ahead to 'The Big C'-Chicago 2018 - Child Neurology Society
CONTENTS                      WINTER 2018

                                                                                                          Photos by Suzanne Shaff
Connecting with Colleagues
4    In Memoriam: Arnold P. Gold, MD                                  DEPARTMENT
6    Q&A with Erika Augustine, MD, PhD
                                                                        2 FROM THE
21   2018 Abstract Submission Guidelines                                  PRESIDENT
22   CNS and Foundation Awards and Grants Guidelines
                                                                      36 PERSONNEL
26   Focus On Young Researchers
                                                                         REGISTRY
28   Strategic Goals of the CNS: 2018 Committees and Charges

Connecting with the Past
8    Looking Back on the 45th CNS Annual Meeting in Kansas City
10   Thank You CNS Annual Meeting Presenters
11   Thank You to Our Sponsors
14   Legacy Reception
15   Child Neurology Society Awards
16   Scientific Sessions
17   Exhibits & Poster Review
18   Networking

Connecting to the Future                                          Child Neurology Society
12 Child Neurology Career Development Program (CNCDP-K12)         1000 West Cty Rd. E, Suite 290
                                                                  St. Paul, MN 55126
13 2nd Annual CNS John M. “Jack” Pellock
                                                                  Tel: 651/486-9447
   Resident Seminar on Epilsepsy                                  Fax: 651/486-9436
                                                                  Email: nationaloffice@
Connecting with Colleagues Globally                               childneurologysociety.org
                                                                  www.childneurologysociety.org
23 2018 Bernard D’Souza International Fellowship
   Award Guidelines                                               Editor: Daniel Bonthius, MD, PhD
24 ICNC 2018 in Mumbai                                            Managing Editor: Roger Larson, CAE

Connecting with Partners                                          Published Quarterly

33 Professors of Child Neurology                                  Cover photo: René Perez
34 Association of Child Neurology Nurses                          All CNS Annual Meeting photos
                                                                  in this issue by Suzanne Shaff.

                                                                  Child Neurology Society | Winter 2018                             3
"The Gold Standard" Humility, Compassion, and Grace - Looking Back on KC, Looking Ahead to 'The Big C'-Chicago 2018 - Child Neurology Society
CONNECTING WITH COLLEAGUES

    In Memoriam:
    Arnold P. Gold, MD (1925-2018)
    By Nigel S. Bamford, MD and Darryl C. De Vivo, MD

    Education and Training:
    • University of Texas, (1943-1947) B.A.
    • University of Florida, (1947-1949) M.S.
    • University of Lausanne, (1950-1954) M.D.
    • Charity Hospital of Louisiana, New Orleans,
      (1954-1955) Rotating Internship
    • Children’s Hospital, Cincinnati, Ohio, (1955-1958)

                                                                                                                                      Debra Classen
      Residency in Pediatrics
    • Columbia-Presbyterian Medical Center, (1958-1961)
      Fellow in Pediatric Neurology

    D
            r. Arnold P. Gold, one of the true giants in child     growing divisional ranks with Abe Chutorian, Niels Low,
            neurology and American medicine, passed away           Jim Hammill and Richard Koenigsberger. These colleagues
            on Tuesday, January 23, 2018 at the age of 92.         also would make their own marks and become giants in the
    Gold was a founder of modern child neurology and a             nascent field of child neurology. Gold rose from assistant to
    longtime colleague, collaborator and mentor of many            full professor over fifteen years. During this rise in academia,
    who worked and trained at the Columbia University              he would distinguish himself as an outstanding teacher and
    Medical Center and the Neurological Institute of New           able clinician. He enjoyed seeing patients with a broad array
    York. Much has changed in medicine since Dr. Gold began        of neurological diseases and published widely in many diverse
    his career, but his ideals and teachings have not, and now     areas of pediatric neurology. He developed a special interest
    live on in many, if not all, practicing child neurologists.    in the areas of vascular neurology and neurocutaneous
                                                                   diseases which led to chairmanships of the NIH Child Study
    While a resident in pediatrics at Cincinnati, Gold developed   Group for Stroke and the Medical Advisory Board of the
    an interest in endocrinopathies, published a few papers        National Tuberous Sclerosis Association. He served as a
    on the subject and planned a fellowship in endocrinology       member on the American Heart Association Stroke Council
    at Johns Hopkins. These plans changed after spending a         and the Committee on Drugs of the American Academy
    one month rotation with Sidney Carter at the Neurological      of Pediatrics. His diverse interests in child neurology also
    Institute of New York. Carter, a founding father of modern     contributed to our basic understanding of epilepsy, migraine,
    American child neurology, had established one of the           cerebral palsies, collagen vascular diseases, attention/
    country’s first training programs and Gold considered Sid      hyperactivity disorders, movement disorders, infectious
    “a very special person: a friend, mentor and role model;       and inflammatory disorders, developmental neurology,
    the ultimate of what a physician should be.” During his        neuromuscular disease, and learning disabilities. His presence
    fellowship, Gold viewed Carter as an astute diagnostician      was always felt on the wards at Babies Hospital in New York,
    and a compassionate clinician who cared about every            where compassion for the sick children and their families was
    child and their suffering family members and conveyed          constant—a continuing measure of the Carter/Gold legacy.
    these admirable qualities to all of his trainees.              Dr. Gold was indefatigable as he sought out new ways to
                                                                   help the children and their families under his care, and he
    At the end of Gold’s training, Carter offered him a faculty    later explored philanthropy to improve clinical care and the
    position at the Neurological Institute and he joined the       hospital infrastructure.

4   Child Neurology Society | Winter 2018
"The Gold Standard" Humility, Compassion, and Grace - Looking Back on KC, Looking Ahead to 'The Big C'-Chicago 2018 - Child Neurology Society
Gold received numerous awards and visiting                  coat is a symbol that emphasizes the ethical, moral and
professorships for his contributions to medicine and        humane imperatives that medical students accept upon
child neurology. He was the recipient of the National       matriculation.
Brennerman Award in Pediatrics, Lifetime Community
Service Award from the Autism Society of America,           In creating the Arnold P. Gold Foundation, the Gold’s
an Honorary Doctorate from the University of                institutionalized their vision of compassionate healthcare
Medicine and Dentistry of New Jersey, an Honorary           through sponsored programs which promote humanism
Doctorate of Humane Letters from Sacred Heart               in medicine, along with student and resident recognitions
University, and awards for Humanitarian Excellence          for individuals who exemplify Gold’s values, including
from various institutions, including the New Jersey         integrity, compassion, empathy, cultural sensitivity,
Council for the Humanities.                                         effective communication, trust and confidence,
                                                                        respect, service and deep appreciation for
Gold was a beloved teacher and mentor                                       the emotional concerns of patients and
for the many pediatricians who trained                                        family members.
at Babies Hospital and the pediatric
                                                      Humility,
neurologists who trained at the                   compassion and                  Gold encouraged programs to evaluate
Neurological Institute. Undoubtedly an          grace characterize                  problems in medicine that resulted
                                                                                     from the de-emphasis of humanity
inborn tendency, Gold elevated the
thoughtful manner of his mentors               “the Gold Standard”                    in medicine. He believed that a
and colleagues to promote care                   in the practice of                    constant awareness of suffering
for the families of his patients;                                                      and the capacity to alleviate it by
one often heard the words “care
                                                  child neurology,                      maintaining competency would
for the family, not just the patient.”               and are the                        prevent physician “burnout”.
                                                                                        The first Arnold P. Gold Foundation
Gold would often extend his clinical
visits with the child to spend quality
                                                essential traits that                  Humanism in Medicine Award was
time with the child’s parents and               Dr. Arnold P. Gold                     presented to Dr. Ruth Nass at the
other family members. The net result                 personified                       Child Neurology Society Annual
often was a comprehensive plan that                                                   Meeting in 2010. Nass was one
would ultimately embrace the family                throughout his                    of Gold’s former trainees who had
and improve each child’s long term                    long and                      promoted humanism in pediatric
quality of life—the true signature of a                                           neurology throughout the New York
caring, compassionate child neurologist.
                                                    distinguished               tri-state area. Since that time, the
                                                        career.               Foundation has supported seven additional
A charter member of the Child Neurology                                    CNS awardees that exemplify the Gold
Society and recipient in 2005 of the Society’                           example, and a biennial Humanism in Medicine
Lifetime Achievement Award, Gold is perhaps best                    Forum at the CNS meeting. By honoring those
known for founding, in 1988 along with his wife,            clinicians who actively promote humanism in medicine, and
Dr. Sandra Gold, the Arnold P. Gold Foundation,             by continuing dialogue about the factors that contribute
dedicated to fostering humanism in medicine. With a         to physician burnout, Dr. Gold felt that the nobility of
grant from the Robert Wood Johnson Foundation,              medicine would be preserved and elevated. Those trainees
he gathered fifty medical school deans together to          who have followed and who did not have the privilege of
discuss ways to offset the diminishing emphasis on the      interacting directly with Dr. Gold will benefit indirectly from
humane aspects of medicine. He proposed mechanisms          the ongoing work of the Foundation and will be viewed
that would inculcate these humanistic behaviors in          as his “grandchildren”. These fundamental principles of
medical students at the beginning of their careers;         humanism will allow the profession to serve our children
behaviors that he regarded as fundamental to the            humanely and to thrive well into the future. Humility,
practice of medicine. One outcome was the White Coat        compassion and grace characterize “the Gold Standard”
Ceremony that medical and dental students participate       in the practice of child neurology, and are the essential
in at the beginning of their training. The first ceremony   traits that Dr. Arnold P. Gold personified throughout his
was in 1993 at the Columbia University College of           long and distinguished career.
Physicians and Surgeons; it has since spread to nearly
every medical and dental school in the United States        Dr. Gold is survived by his wife, Sandra; his children
and more than a dozen countries overseas. The white         and 13 grandchildren.

                                                                                    Child Neurology Society | Winter 2018     5
"The Gold Standard" Humility, Compassion, and Grace - Looking Back on KC, Looking Ahead to 'The Big C'-Chicago 2018 - Child Neurology Society
Q&A
    CONNECTING WITH COLLEAGUES

                                                  Toward Treatments and
                                                  Cures for Rare Diseases:
                                                  Perspective of Dr. Erika Augustine
                                                  By Daniel J. Bonthius, MD, PhD | CNS Connections Editor

                                        QUESTION | Let’s start by talking about          QUESTION | Do clinical trials need to be
                                        the development of therapeutics for rare         organized differently or have different goals
                                        diseases. How did you become interested          when they are addressing a rare disease,
                                        in this topic?                                   in comparison to more common diseases?
                                        One of the great aspects of clinical child       The same principles underlying high quality
                                        neurology is the opportunity to care             scientific research and rigorous evidence
                                        for patients with a broad spectrum of            apply in rare diseases, even with the
                                        disorders, from common to rare. The unique       challenge of small samples. This is critical
                                        expertise of a child neurologist regarding       for generating robust knowledge regarding
                                        the interactions of each organ system with       the safety and efficacy of new treatments.
                                        the brain and the diagnostic challenges of       The infrastructure for trials targeted to rare
                                        complex metabolic and genetic conditions         disorders may necessarily be multi-center
                                        drew me to the field. Even as a medical          or even multi-national, in order to garner
                                        student, it was clear to me that the field       sufficient patient numbers. In addition,
    Erika Augustine, MD, PhD            of Child Neurology would change during           patient partnership in the development and
                                        the course of my career as new scientific        execution of trials is especially important.
                                        knowledge led to novel therapeutics.
                                        The need for effective therapies is especially   QUESTION | Do the funding agencies in the
                                        high in these rare, complex diseases             US give enough priority to rare diseases?
                                        that initially sparked my interest in child
                                                                                         There are a number of efforts to support
                                        neurology and subsequently became
                                                                                         rare disease research from federal agencies,
                                        my focus.
                                                                                         including the Food and Drug Administration
                                                                                         (FDA) Office of Orphan Products. The 21st
                                        QUESTION | What are the special
                                                                                         Century Cures Act, passed in late 2016,
                                        challenges that researchers face when
                                                                                         includes several provisions related to rare
                                        they are dealing with rare diseases?
                                                                                         diseases, including reauthorization of the
                                        The key is in that word ‘rare’. By definition,   FDA Rare Disease Priority Review voucher
                                        these are disorders that affect small numbers    program and updates to the FDA Orphan
                                        of people, which, in turn, impacts every         Drug grant program. There are, however,
                                        aspect of care and research—garnering            more than 7,000 rare diseases, the majority
                                        interest in the area, access to expertise,       of which lack disease-modifying treatments.
                                        small numbers of researchers, limited            There is certainly a continued need for
                                        dedicated research funding, and challenges       greater priority and support.
                                        with developing clinical studies of sufficient
                                        size to enable rigorous research.

6      Child Neurology Society | Winter 2018
"The Gold Standard" Humility, Compassion, and Grace - Looking Back on KC, Looking Ahead to 'The Big C'-Chicago 2018 - Child Neurology Society
QUESTION | Are there challenges in motivating                 QUESTION | What was your personal experience with ELF?
pharmaceutical companies to pursue development
                                                              ELF was a fantastic experience and I recommend it
of treatments for rare diseases?
                                                              highly. We spend close to a decade in medical school
The Orphan Drug Act of 1983 was developed to address          and residency (or more with fellowship) preparing for
this specific issue. It provides financial incentives to      the practice of child neurology, building our medical
motivate development of new treatments for rare               knowledge and our ability to work with patients to
diseases. Based on the annual number of treatments            provide high quality, compassionate care. Yet, much of
approved by the FDA for rare conditions, the Act has          what we do involves leadership—leading a clinical team,
been quite successful.                                        building a research program, directing a course, clerkship,
                                                              or residency/fellowship are just a few examples. Dedicated
QUESTION | Are there certain rare diseases of pediatric       opportunities to develop those critical leadership skills and
neurology about which you have particular optimism            structured ways to build professional networks early in
for a new treatment in the near future?                       one’s career can be invaluable. During my participation
                                                              in ELF, Dr. Ann Tilton (President of the Child Neurology
We are seeing new therapeutics emerge with great
                                                              Foundation) was a phenomenal mentor and resource.
impact. A particularly exciting aspect of recently approved
                                                              I am delighted that my relationship with the Emerging
technologies is the potential for use in many diseases.
                                                              Leaders Program continues today, now as a mentor to
As gene transfer, RNA-based approaches, and CNS-
                                                              another Child Neurology Society member, Dr. Mathula
directed enzyme replacement therapies expand in
                                                              Thangarajh of the Children’s National Health System.
application, there is the potential for huge impact on
rare diseases, many of which are genetically based, and
consequently for the entire field of child neurology.

QUESTION | Let’s change the subject a bit and talk
about your experiences with the Emerging Leadership
Program. How about if you start by explaining what
the ELF program is?

The Emerging Leaders Program (formerly Emerging
Leaders Forum, ELF) is a leadership initiative of the
American Academy of Neurology and is part of its
growing portfolio of leadership programs. The Emerging
Leaders Program is a 6-month leadership training
program targeted to individuals in the early career phase,
within 10 years of completion of residency.                   Changing of the Guard: 2018-19 Scientific Program Chair,
                                                              Erika Augustine, exchanges intel with 2016-17 Program
                                                              Chair, Marc Patterson in Kansas City.

Editor’s Note: Dr. Erika Augustine is an Associate            Dr. Augustine’s research interests include methodology
Professor of Neurology and Pediatrics at the University of    of clinical research and experimental therapeutics in rare
Rochester Medical Center where she serves as Assistant        pediatric neurological disorders. She also currently serves as
Program Director for the NINDS-funded Experimental            the Diversity Officer for the NIH-funded Child Neurology
Therapeutics training program. She is a member of the         Career Development Project (CNCDP-K12; see page 12)
NIH Taskforce on Childhood Motor Disorders and is a           and chairs the Scientific Program Committee for the 2018
consultant to the FDA Neurological Devices Panel.             and 2019 CNS Annual Meeting.

                                                                                   Child Neurology Society | Winter 2018       7
"The Gold Standard" Humility, Compassion, and Grace - Looking Back on KC, Looking Ahead to 'The Big C'-Chicago 2018 - Child Neurology Society
From DC to BC to KC to “The Big C”—Chicago

        The last three CNS Annual Meetings (2015 in Washington DC, 2016 in Vancouver BC,
        and last year in Kansas City) all surpassed previous attendance records, setting a new
        “threshold” of 1000+ attendees and 275-300 exhibitors gathered for what is, hands
        down, THE meeting of choice for professionals active in the field of child neurology.
        This year’s meeting in Chicago will shatter those records, lured by the easy access to a
        full menu of flight options and the meeting hotel’s unbeatable proximity to the river,
        the Magnificent Mile, Millenium Park and world-class museums.

        Kansas City 2017—Largest-ever Gathering in the United States
        Last year’s meeting in KC didn’t quite eclipse Vancouver           the multicenter study group was launched at the
        for attendance, but it did stake a serious claim to being          2002 CNS Annual Meeting in Washington, DC.
        the largest-ever gathering of child neurologists in the
                                                                        • More than 80 PCN members and an additional
        United States to date (again, Chicago is a lock to set a
                                                                          25 members of the Program Coordinators of Child
        new record). And people didn’t come just in time for the          Neurology met on Wednesday afternoon, incorporating
        traditonal Wednesday evening Welcome Reception or leave           for the first time, an audience response system providing
        immediately after the Saturday morning Hower Award                immediate feedback to questions from the podium.
        Lecture and final scientific symposium. They gathered on
        “the shoulders” as well, for special interest meetings before   That all took place before the first wine bottle was uncorked
        and after the main CNS meeting:                                 and the first appetizer served on the Exhibit Floor at the
        • The NIH-funded Child Neurology Career Development             Wednesday evening Welcome Reception, sponsored by
          Program (CNCDP) staged its second annual retreat on           Children’s Mercy Hospital. And it didn’t end on Saturday
          the front end of the CNS Annual Meeting, with nearly          at noon. More than 125 attendees stayed on to attend
          30 young physician-scientists presenting their research       the 3rd Annual Child Neurology Foundation Symposium;
          and/or interviewing for available slots in future years.      this year’s meeting brought neurologists, nurses, parent
                                                                        and advocacy groups together to focus on SUDEP.
        • CNS and CNF Boards both logged long hours before              Nearby, the 2nd Annual Biomedical Writing Workshop
          any general sessions were held.                               attracted early career academic-researchers eager to be
        • Nine faculty members and 58 PGY5 residents gathered           “schooled” by seasoned editors Jon Mink, Marc Patterson,
          on Tuesday evening and all-day Wednesday for the              Scott Pomeroy and Steve Roach.
          2nd Annual CNS John M. “Jack” Pellock Residents
                                                                        And the traditional annual meeting time block in between?
          Seminar on Epilepsy.
                                                                        Lots of networking, a little bit of rain (OK—a lot), an
        • Bernie Maria’s all-day Wednesday Neurobiology of              impressive line-up of continuing medical education,
          Diseases in Children Symposium on Leukodystrophies            including six breakfast seminars, four symposia, four
          drew over 300 attendees.                                      SIG-organized CME sessions, two platform sessions, four
                                                                        satellite programs, three award lectures, scientific posters
        • The Association of Child Neurology Nurses met for
                                                                        and a record-shattering 100 exhibit booths. Toss in a
          their traditional all-day Wednesday educational
                                                                        half-dozen SIG meetings, Wednesday’s first ever Legacy
          program, then added special interest group meetings
                                                                        Reception honoring Drs. Abe Chutorian, Don Shields, David
          to their usual follow-up fare of mid-day Thursday and
                                                                        Coulter and Kenneth Swaiman, the Friday evening Gala
          Friday lunch seminars.
                                                                        Receptions, numerous smaller receptions, and you have
        • The International Pediatric Stroke Study Investigators        a great meeting, setting the table for what will be a truly
          (30+) gathered for their 15th pre-CNS meeting since           memorable meeting this year in Chicago, if...if...if...if...if...

8    Child Neurology Society | Winter 2018
"The Gold Standard" Humility, Compassion, and Grace - Looking Back on KC, Looking Ahead to 'The Big C'-Chicago 2018 - Child Neurology Society
IF...     you remember to mark your calendars, make your reservations, and book your
     flights to arrive on Sunday night or Monday, NOT your traditional Tuesday/Wednesday
     grand entrance. This year’s meeting (and this year’s meeting only) will run from
     Monday thru Thursday.

     In addition to marking your calendars for a Sunday/Monday arrival,
     please note the following:
     • The line-up of seminars and symposia selected from member-submitted
       proposals will be announced in early March.
     • Abstracts will be accepted for review from February 1 to April 2,
       with acceptance letters slated to go out in May.
     • A call for SIG-designed educational fare will be announced in April.
     • Meeting registration and hotel reservations will be available on-line
       beginning mid-June.

                                       th
                     Fo rty -S ev en

                 CNS
                A N N U A L M EE
                                 TI N G
                                  , 2018
                     October 15-18
                                  INOIS
                     CHICAGO, ILL

            Wed            Thu Fri Sat
Sun Mon Tue                     5   6
         2   3              4
     1
         9   10             11 12 13
7    8
14     15 16            17 18 19 20
                23      24  25 26 27
21      22
        29      30      31
28

                                                                                       Child Neurology Society | Winter 2018   9
"The Gold Standard" Humility, Compassion, and Grace - Looking Back on KC, Looking Ahead to 'The Big C'-Chicago 2018 - Child Neurology Society
Thank You CNS Annual Meeting Presenters

        E
               xpertise is great and the                    JOHN M. “JACK” PELLOCK                SYMPOSIUM II: PRESIDENTIAL
               CNS is no different than                     RESIDENCY SEMINAR ON EPILEPSY         SYMPOSIUM: PRACTICE ISSUES
               any other major medical                      Organizers: Phillip Pearl, MD         IN CHILD NEUROLOGY
         association in showcasing and                                  Renée Shellhaas, MD       Kenneth Mack, MD, PhD, Organizer
         offering it to members at its                                  Elaine Wirrell, MD        Jeffrey Buchhalter, MD, PhD
         annual meeting. What sets                          Faculty:    Carol Camfield, MD        Bruce Cohen, MD
         the CNS apart from many                                        Peter Camfield, MD        Sidney Gospe, Jr., MD, PhD
         organizations is the generosity                                Kevin Chapman, MD
         its members consistently                                       Bill Gaillard, MD         SYMPOSIUM III: GLOBAL HEALTH
         demonstrate by offering their                                  Nancy McNamara, MD        Jorge Vidaurre, MD, Organizer
         expertise pro bono. Fifty CNS                                  Katherine Nickels, MD     Harry Chugani, MD
         members served as faculty on                                   Heather Olson, MD         Dave Clarke, MBBS
                                                                        Carl Stafstrom, MD, PhD   Solomon L. Moshé, MD
         one or more of the seminars
                                                                        Syndi Seinfeld, DO
         and symposia offered at the
         2017 CNS Annual Meeting.                                                                 SYMPOSIUM IV: CONVERSION
                                                            BIOMEDICAL WRITING                    DISORDERS AND PSYCHOGENIC
         Their willingness to present
                                                            WORKSHOP                              NON-EPILEPTIC SEIZURES
         pro bono continued a long and
                                                            E. Steve Roach, MD, Organizer         Steven Leber, MD, PhD, Organizer
         honorable tradition of CNS
                                                            Marc Patterson, MD                    Leon Dure, MD
         members making common
                                                            Jonathan Mink, MD, PhD                Jonathan Mink, MD, PhD
         cause with their colleagues to                     Scott Pomeroy, MD, PhD
         ensure high level CME without
                                                                                                  SYMPOSIUM V: PEDIATRIC
         commensurately high level                          SYMPOSIUM I: NEUROBIOLOGY             NEURO-ONCOLOGY
         registration and course fees by                    OF DISEASE IN CHILDREN                Sonia Partap, MD, MS
         foregoing honoraria, per diems,                    (LEUKODYSTROPHIES)                    Yasmin Khakoo, MD
         waived registration fees, and                      Bernard Maria, MD, MBA                Nicole Ullrich, MD, PhD
         other perks. So, before taking                     Joshua Bonkowsky, MD, PhD
         a backward glance at last fall’s                   Florian Eichler, MD                   SYMPOSIUM VI: CHILD
         meeting in the eight pages to                      Ali Fatemi, MD                        NEUROLOGY FOUNDATION
         follow, let’s pause to offer a                     Sakkubai Naidu MD                     SYMPOSIUM: SUDEP
         special thanks to CNS members                      Adeline Vanderver, MD                 William Trescher, MD, Organizer
         for their generous gift of time                    Keith VanHaren, MD                    Jeffrey Buchhalter, MD, PhD
         and talent in Kansas City.                                                               Elizabeth Donner, MD

         All CNS Annual Meeting photos in this issue by Suzanne Shaff.

10    Child Neurology Society | Winter 2018
SEMINAR 1: UPDATE ON                    SEMINAR 3: HOW TO GET                          SEMINAR 5: THE
PAROXYSMAL MOVEMENT                     STARTED IN CHILD NEUROLOGY                     COMPREHENSIVE EVALUATION
DISORDERS                               RESEARCH AT ANY POINT                          OF MITOCHONDRIAL
Harvey Singer, MD, Organizer            IN YOUR CAREER                                 MYOPATHIES
Donald Gilbert, MD                      Adam Hartmann, MD, Organizer                   Zarazuela Zolkipli, MBChB, MRCP,
Toni Pearson, MD                        Mustafa Sahin, MD, PhD                           Organizer
                                        Courtney Wusthoff, MD, PhD                     Shana McCormack, MD
SEMINAR 2: SEX: WHY THIS
BIOLOGICAL VARIABLE IS                  SEMINAR 4: NEWBORN                             SEMINAR 6: DIAGNOSING
RELEVANT TO THE CHILD                   SCREENING CONSIDERATION FOR                    DRAVET SYNDROME—
NEUROLOGIST                             SPINAL MUSCULAR ATROPHY                        WHAT’S THE RUSH?
Mary Zupanc, MD, Organizer              Han Phan, MD, Organizer                        Kelly Knupp, MD, Organizer
Tallie Z. Baram, MD, PhD                                                               Sookyong Koh, MD, PhD
Bradley Schlaggar, MD, PhD                                                             Elaine Wirrell, MD

                                                                        Thank You to Our Sponsors

  LEADER LEVEL                 PARTNER LEVEL                      SUPPORTER LEVEL
  ($100,000+)                  ($50,000+)                          ($20,000+)

                                                                  Agilis Biotherapeutics        Children’s Mercy
                               Biogen
  Eisai, Inc.                                                     • Unrestricted Grant          Kansas City
                               • Child Neuro News Forum
  • Child Neuro News Wrap                                                                       • Wednesday Welcome
                                 (Thursday poster review)
  • Hotel key cards                                                                               Reception, Host
                               • Satellite Symposium
  • Meeting app                                                                                   Institution
                                                                  AveXis
                                                                  • Connections Courtyard

                               Greenwich Biosciences
                               • Satellite Symposium                                            PTC Therapeutics
  Mallinckrodt
                               • Unrestricted Educational         bluebird bio                  • Unrestricted Grant
  • Charging Stations
                                 Grant                            • Unstricted Grant
                               • Wall-to-Wall Wifi

                                                                                                Sarepta Therapeutics
                                                                                                • Meeting tote bags
                               Jazz Pharmaceuticals               Child Neurology
                               • Satellite Symposium              Foundation
                                                                  • Unrestricted
                                                                    Educational Grant

                               Sunovion Pharmaceuticals
                               • Connections Corridor

  Thanks to the following for their continued support of awards presented at the CNS Annual Meeting

  Akron Children’s Hospital      Arnold P. Gold Foundation                        Blue Bird Circle
  • Hower Award Lecture          • Humanism in Medicine Award & Luncheon          • CNS/PCN Training Director Award

                                                                                            Child Neurology Society | Winter 2018   11
Connecting to the Future

        Child Neurologist Career Development Program
        (CNCDP-K12) Funded by NIH-NINDS

         T
                 he NIH Child Neurologist Career Development       PhD, UPenn; and Autumn Ivy, MD, PhD, Stanford. Dr. Chao
                 Program held its second annual retreat            also presented a paper at one of the Friday morning platform
                 just prior to the CNS Annual Meeting in           sessions, for which she received one of four CNS Outstanding
         Kansas City. The retreat brought together key             Junior Member Awards (photo on page 15). Dr. Boes is the
         program directors from the NINDS, division chiefs         subject of this issue’s Research Focus (see page 26).
         representing more than a dozen child neurology
         training programs, and more than three dozen child
         neurology residents and fellows. CNCDP PI and
         Director, Dr. Michael Johnston outlined the program
         in a piece published last year in CNS Connections,
         noting that it was “the brainchild” of Dr. Stephen
         Korn, Director of Training at NINDS, who envisioned
         “an open selection process whereby child neurology
         residents completing their clinical training at any
         institution in the country would receive three years of
         critically important funding and focused mentorship
         that would lead, over time, to increased number
         of child neurologists actively pursuing NIH-funded
         research careers.” The first cohort, selected at the
         retreat in Vancouver in 2016 and presenting their
         work for critique at the 2017 retreat included
         Hsaio-Tuan Chao, MD, PhD, Baylor University;
         Aaron Boes, MD, PhD, University of Iowa; Christa
         Habela, MD, PhD, Johns Hopkins; Mai Dang, MD,

12    Child Neurology Society | Winter 2018
2nd Annual CNS John M. “Jack” Pellock
Resident Seminar on Epilepsy

M
            eanwhile, in another section of the
            Sheraton Crown Center, a select cohort
            of 58 PGY5 residents participated in
the 2nd Annual CNS John M. “Jack” Pellock
Resident Seminar on Epilepsy, organized by
Drs. Phillip Pearl, Renée Shellhaas and Elaine
Wirrell. One of the primary objectives of the
seminar, in addition to providing a significant
opportunity for the next generation of child
neurologists to meet peers from around the
country and launch the kind of lifelong,
career-enhancing friendships and collaborations
driving the Child Neurology Society’s mission
and success, is to cultivate an ethos of “dual
citizenship” typified by Jack Pellock. To that end,
the CNS, AES, and CNF launched a three-year
pilot program in 2017, funded by Upsher-Smith,
that will select and recognize two residents from
each Pellock Seminar cohort as “Pellock Fellows”.
The fellows will receive both CNS and AES
membership dues and annual meeting fee waivers,
and follow up their participation in the Pellock
Seminar with active participation in a leadership
development program at the following year’s
AES Annual Meeting. The first two CNS Pellock
Fellows selected in 2017 were Dr. Thomas Foutz,
from Seattle Children’s Hospital, and Dr. Lila
Worden, from Massachusetts General Hospital.

                                                      Faculty pictured left. Front Row (l-r):Drs. Syndi Seinfeld (who was
                                                      trained by and practiced with Jack Pellock), Carl Stafstrom,
                                                      Karen Nickels, Carol Camfield, Elaine Wirrell, Heather Olsen.
                                                      Back Row (l-r): Drs. William Gaillard, Phillip Pearl, Kevin Chapman.
                                                      Not Pictured: Drs. Nancy McNamara, Renée Shellhaas.

                                                                                           Child Neurology Society | Winter 2018   13
Legacy Reception

        I
            n a conference devoted to sharing insights and              mentor, Don Shields, and Leonardo Garcia introduce his old
            information about the developing brain, one doesn’t         friend, Abe Chutorian, each recipients of the 2017 Roger and
            hear much talk about the heart. Even less about the soul.   Mary Brumback Lifetime Achievement Awards; to link the
        But if one were to search for the vital center of the Child     memories Dr. Mary Cerreto shared introducing her husband,
        Neurology Society, that place where the heart and mind and      David Coulter, to the Arnold P. Gold Foundation Award
        soul are most radiantly and resonantly present and alive,       for Humanism in Medicine Award he was about to receive;
        one need look no further than the Legacy Reception in           and then to hear each of these honored men speak with
        Kansas City on the opening night of the 2017 CNS Annual         wisdom and humor and humility—and even a little poetry—
        Meeting. To listen to friends and colleagues of Ken Swaiman     was to learn or re-learn more, perhaps, about how and why
        recall the animating vision and relentless drive he and a       you came to be here in Kansas City with 1000 other child
        supporting cast, now largely gone, summoned in service          neurologists on this night, at this Legacy Reception, than
        to the founding of the CNS, PCN, CNF and the journal            you might have ever thought possible. It was a night to
        Pediatric Neurology; to hear Chris Giza tell tales about his    remember.

14    Child Neurology Society | Winter 2018
Child Neurology Society Awards

                                                 CNS President, Kenneth Mack        Melissa A. Walker, MD, PhD,
                                                 and Philip R. Dodge Young          from Massachusetts General
                                                 Investigator Awardee, Audrey       Hospital, received the Shields
                                                 Brumback, MD, PhD.                 Research Grant. Pictured (L-R):
CNS/PCN Blue Bird Circle Training Director                                          Dr. Roy Elterman, President,
Award recipient, Sidney M. Gospe, Jr, MD,                                           Pediataric Epilepsy Research
PhD stands alongside the traditional award                                          Foundation (PERF); Dr. Walker;
profile board.                                                                      W. Donald Shields, MD.

                                                 Lauren Singer, recipient of
                                                 the CNS Bhuwan Garg High
Hower Award Lecturer, Nina Schor (center) was    School Neuroscience Award.
introduced by her twin sons, Jonathan (L) and
Stanford (R), flanked here by CNS Executive
Director, Roger Larson (L) and her husband,
Robert Schor (R).

CNS Outstanding Junior Member Award
recipients: (L-R) Carla Watson, MD, Children’s
Hospital of Michigan; Rachel Goldstein
Hirschberger, MD, MPH, Boston Children’s
Hospital; Hsaio-Tuan Chao, MD, PhD, Baylor       2017 Sachs Award Lecturer, Solomon Moshé,
College of Medicine, Ka Ye Clara Chan, MD,       MD (center) with his wife, colleagues, and
Loma Linda University Medical Center.            past trainees.

                                                                                      Child Neurology Society | Winter 2018   15
Scientific Sessions

16    Child Neurology Society | Winter 2018
Exhibits

         Poster Review

Child Neurology Society | Winter 2018   17
Networking

18    Child Neurology Society | Winter 2018
Child Neurology Society | Winter 2018   19
Forty-Seventh

                             CNS
                          ANNUAL MEETING
                                  October 15-18, 2018
                                  CHICAGO, ILLINOIS

                This year’s meeting
           (and this year’s meeting only)
                   will run from
              Monday thru Thursday.

                                  at
         M o n Tu e Wed Thu Fri S
     Sun                     5   6
                2    3   4
          1
                9    1 0 11 12 13
     7     8
                     1 7 1 8 19 20
      14  15    1 6
                2 3  2 4 25 26 27
      21  22
      28   29   30 31

                  Remember to mark your calendars, make your reservations, and book your flights to arrive on
                         Sunday night or Monday, NOT your traditional Tuesday/Wednesday grand entrance.

20   Child Neurology Society | Winter 2018
CONNECTING WITH THE FUTURE
                                                                                                                           Deadline
                                                                                                                         April 2, 2018

2018 Abstract Submission Guidelines
Submissions                                        6. Abstracts accepted for presentation will     Future Leaders Program
                                                      be published in an Annals of Neurology       (Grant pending; awarded only if
(Deadline: April 2, 2018; 11:59 pm PDT)
                                                      supplement. Submitting authors               outside funding is secured.)
1. CNS Membership not required for
                                                      assume all responsibility for accuracy of    Registration fee waiver for CNS Junior
   abstract submission or presentation.
                                                      information submitted and printed.           Members presenting as first/ primary
2. First Author listed will be required to
                                                   7. Authors of abstracts accepted for            author. To qualify, author must be:
   verify work submitted is their own.
                                                      presentation are required to register        • Primary/first author enrolled in child
3. Multiple submissions allowed. Multiple
                                                      for the 47th Annual CNS Meeting.                neurology or neurodevelopmental
   authors allowed. (Max. 3 submissions)
                                                      A registered proxy listed as contributing       disabilities training program as of
4. Word Count: 250 (does not include title,
                                                      author may present for author unable            April 2, 2018
   authors, or text embedded in graphs or
                                                      to attend.                                   • CNS Junior Member (or have
   graphics) (Maximum of 2 graphics)
                                                   8. Authors are responsible for all expenses        application for Junior Membership
5. Work presented at other meeting(s) and
                                                      related to attending and presenting             completed and pending approval
   or recently published will be reviewed;
                                                      at the meeting. No honoraria will be            as of May 15, 2018).
   author must identify previous presentation
   venues and verify work was presented               awarded for poster or platform/plenary
   before a substantially different audience          presentations.                               Questions? Contact...
   in space provided.                                                                              nationaloffice@childneurologysociety.org
6. Abstracts should be broken into four-           Junior Member Awards &
   header format: Objective, Methods,              Registration Fee Waivers
                                                                                                   Please Note:
   Results, Conclusions.                           Notification of acceptance for presentation
7. SAVE & FINALIZE when submission is                                                              • The Abstract Submission site is
                                                   will be emailed to contact author listed on
   completed. Once your submission is                                                                independent of the CNS.
                                                   or before May 7; notice of non-acceptance
   completed. Submitter is required to click                                                       • You will be required to create a
                                                   will be emailed on or before May 25.
   “Publish” and the submitter will receive                                                          username and password before
                                                   Junior Members of the CNS may qualify
   a confirmation email to verify completed                                                          beginning a submission.
                                                   for the following awards:
   submission has been received.                                                                   • You may use the same username/
                                                                                                     password as you have for the CNS,
                                                   Outstanding Junior Member Awards (4)
                                                                                                     however, you will be required to
Review & Presentation                              Presented to four qualifying first/primary
                                                                                                     create this independently on the
1. Abstracts will be reviewed by minimum           author of abstracts submitted by CNS              Abstract website.
   five members of the CNS Scientific Selection    Junior Members. Includes hotel/air/             • All auto generated emails will appear as
   and Program Planning Committee as               registration fee waiver, plaque.                  they are coming from Emily McConnell
   assigned by the committee chair.                                                                  (ermcconnell@childneurologysociety.
2. Anonymous review; author ID is not              M. Richard Koenigsberger Scholarship              org).
   available to reviewers prior to final           Presented to best abstract submitted by           Some auto generated emails show
   selection of abstracts.                         CNS Junior Member in following subject            up in your spam folder. Please be
3. Notification of acceptance and guidelines       areas: neonatal neurology, genetics diseases,     sure to check your spam mail if
   for presentation will emailed to first          HIV, metabolic disorders. Includes $300           you do not receive an email after
   author on or before May 7, 2018.                scholarship and registration fee waiver.          completing a submission.
4. Notification of non-acceptance will be                                                          • Please begin a submission only after
   emailed to first author on or after             AAP Section on Neurology                          1. Completely reading guidelines and
   May 25, 2018.                                   Trainee Travel Award                              2. When final abstract is ready to
5. Authors presenting papers in platform/          Criteria for selection will include the               upload/submit
   plenary session(s) will be required to adhere   significance of the question addressed,
   to ACCME financial disclosure/conflict of       methodological rigor, and broad relevance       Abstract Submission Link:
   interest guidelines as defined by the meeting   to child health. All eligible submitted         https://catalyst.omnipress.
   Joint CME Sponsor, MN Medical Association.      abstracts will automatically be considered.     com/#collection/302/submission

                                                                                                   Child Neurology Society | Winter 2018      21
CONNECTING WITH COLLEAGUES
   Focus on Young Investigators

     Child Neurology Society and Foundation Awards and Grants
                            Dr. Kenneth Swaiman was honored at the 2017 CNS Annual Meeting Legacy Reception for his
                            seminal role in founding the Child Neurology Society in 1972 and the Child Neurology Foundation
  Deadline                  in 2001. While the Society is the professional organization for the nation’s pediatric neurologists,
April 1, 2018               the Foundation is committed to serving as a connective center of education and support for children
                            and their families living with neurologic conditions. Together, the CNS and CNF have developed
                            a joint committee, chaired by Dr. Nigel Bamford, to review applications and work submitted by
                            young members of the CNS for the following Awards and Grants:

     The Philip R. Dodge Young                         The Child Neurology Shields                  Pediatric Epilepsy Research
     Investigator Award is an award                    Research Grant supports                      Foundation (PERF) Scientific
     for basic science or clinical research by         translational or clinical research by a      Research Grant supports clinical
     promising young investigators who are             child neurologist or developmental           or basic science research by a
     members of the Child Neurology Society.           pediatrician early in his/her academic       child neurologist or developmental
     Applications will be judged on the basis          career. The selected investigator will       pediatrician early in his/her academic
     of originality, scientific merit, succinctness    receive a $100,000 grant of $50,000          career. The selected investigator will
     and relevance. The recipient of the Dodge         per year for two years. The Shields          receive a $100,000 grant of $50,000
     award will receive a $30,000 grant-in-aid         Grant is supported by the Winokur            per year for two years. The PERF Grant
     and will be invited to present their work at      Family Foundation and the Pediatric          is supported fully by PERF.
     the Annual Meeting of the Child Neurology         Epilepsy Research Foundation (PERF).
     Society immediately prior to the CNS                                                           Eligibility Criteria
     Bernard Sachs Award Lecture, signaling a          Eligibility Criteria                         1. The applicant completed
     line of succession between established            1. The applicant must be a junior               training in child neurology or
     and emerging researchers in the field of             faculty member who has developed             neurodevelopment disabilities in
     child neurology.                                     clinical research skills and has a           an ACGME-approved program
                                                          plan for further development of              no more than seven years prior
     Eligibility Criteria                                 that research or has basic science           to application.
     1. The applicant completed a pediatric               research skills related to child          2. The applicant is a legal resident
        neurology residency on or after June 30,          neurology and who has a plan                 of the United States or Canada.
        2013 or a neurodevelopmental disability           to translate the new knowledge            3. The applicant is a Junior or
        residency on or after June 30, 2014,              into clinical care for children with         Active member of the Child
        and graduated medical school on or                neurologic diseases.                         Neurology Society.
        after May 2008, or after May 2007 if           2. The Shields Grant must have               4. Applicants with current or approved
        the applicant completed a 3-year                  a clinical research/patient                  pending NIH funding will be
        pediatric residency.                              care component.                              excluded. No NIH grant is allowed,
     2. The scientific work is mainly the result       3. The applicant is a legal resident            other than an institutional (i.e. K12,
        of the applicant’s efforts.                       of the United States or Canada.              T32) or training grant (i.e. NRSA).
     3. The applicant is a Junior or Active            4. The applicant is a Junior or
        member of the Child Neurology Society.            Active member of the Child                APPLICATIONS FOR THESE AWARDS
     4. Candidates are NOT disqualified if                Neurology Society.                        ARE DUE APRIL 1. APPLICANTS WILL
        they have received NIH funding.                5. Candidates are NOT disqualified if        BE INFORMED OF THE COMMITTEE’S
     5. Candidates should consider applying               they have received NIH funding.           DECISION BY MAY 10.
        before their final year of eligibility.        6. A pre-application is no longer
                                                                                                    To access full criteria and application,
                                                          required.
                                                                                                    go to CNS website.

22      Child Neurology Society | Winter 2018
CONNECTING WITH COLLEAGUES GLOBALLY

 2018 Bernard D’Souza International Fellowship Award
 The Child Neurology Society is now accepting applications     Expenses Covered
 for the 2018 Bernard D’Souza International Fellowship         • CNS Annual Meeting registration fee waiver
 Award, which will sponsor two child neurologists from         • Round-trip coach fare originating and ending in
 developing countries to attend the 47th Annual Meeting of       home country with in-between flights to/from
 the Child Neurology Society to be held in Chicago, Illinois     Chicago, IL and a single host training program
 (October 15-18, 2018). Following the meeting, D’Souza           (strong preference for child neurology programs
 fellows will spend one week visiting a selected training        within 250 mile radius of Chicago, IL). Travel must
 program in North America before returning home.                 be arranged through CNS designated travel agent.
 The purpose of the award is to promote child neurology        • Hotel room nights at CNS Annual Meeting and
 in developing countries.                                        up to one-week at host training program in a
                                                                 CNS-designated hotel.
 A link will be published on the CNS 2018 Annual Meeting
                                                               • Standard per diem payment for up to five days in
 page March 1 for applications to be submitted on-line
                                                                 Chicago and seven days in host training program
 thru May 1, 2018. Applicants will be required to upload
                                                                 city (including transportation to and from airport).
 a CV and up to three letters of recommendation.
                                                               • Award recipient will be responsible for all
                                                                 other expenses.
 Requirements
 • Applicant trained in a developing country.
 • Applicant is practicing child neurology in an
   academic environment in a developing country.
 • Applicant should be prepared to present a
   scientific paper in English.
 • Preference will be shown to applicants less
   than age 45 years.

                                        Deadline
                                                               CNS International Affairs Committee Chair,
                                       May 1, 2018             Dr. Jorge Vidaurre is pictured here with the
                                                               two 2018 Bernard D’Souza International
                                                               Fellowship Awardees: (Above): Dr. Charles
                                                               Hammond, from Kumasi, Ghana. (Below):
                                                               Dr. Aye Mya Min Aye, from Yangon, Myanmar.

                                                                               Child Neurology Society | Winter 2018    23
24   Child Neurology Society | Winter 2018
Child Neurology Society | Winter 2018   25
CONNECTING WITH COLLEAGUES
   Focus on Young Researchers

            Thinking Outside the Lesion:
            Lesion Network Mapping
            By Daniel J. Bonthius, MD, PhD | CNS Connections Editor

                                                                                         Currently, neurologists’ ability
                                                                                             to accurately predict the
                                                                                         clinical outcome of stroke and
                                                                                            other focal lesions is poor.
                                                                                           Dr. Boes hypothesizes that
                                                                                          information regarding lesion
                                                                                            location and the networks
                                                                                            associated with the lesion
                                                                                          can improve the accuracy of
                                                                                               outcome predictions.

            Aaron Boes, MD, PhD

            I
               mportant advances in neurology often begin             small stroke in the non-visual region of the thalamus
               with an intellectually curious physician observing     induce visual hallucinations? Aaron hypothesized that
               an interesting patient. Such was the case that         this condition—peduncular hallucinosis—is due to
            led Dr. Aaron Boes to the discovery of lesion             brain dysfunction not restricted to the lesion site itself,
            network mapping.                                          but to neuronal networks connected to the lesion.

            Aaron was a resident in child neurology at                With the help of his colleagues, Aaron investigated
            Massachusetts General Hospital when he encountered        the lesions of 23 patients with peduncular hallucinosis.
            an unusual teenager. The patient was a previously-        He utilized the 3D volume of each lesion in a large
            healthy 17-year-old girl, who had the sudden onset of     normative database of functional connectivity MRI
            visual hallucinations. She was previously a straight-A    to examine the networks associated with each lesion
            student and captain of her soccer team, but she           location. In this way, he was able to infer the remote
            was suddenly impaired by the presence of vivid            sites impacted by the lesions.
            visual symptoms, including the perception of objects
            coming in and out of focus “like a zoom lens” and         Dr. Boes found that there was much more overlap in
            of the scenery around her being drawn in by crayon.       the networks associated with the lesions than in the
            A toxicology screen and head CT scan were negative,       lesion locations themselves. He further found that
            but an MRI scan of the brain revealed a small stroke      22 of the 23 studied lesions in peduncular hallucinosis
            in the thalamus.                                          fell along a single network with connectivity to the
                                                                      ventral extrastriate visual cortex, a brain region
            Aaron realized that the MRI results could explain the     long-hypothesized to be involved in the generation
            etiology of the patient’s symptoms, but could not         of hallucinations.
            adequately explain their mechanism. Why would a

26   Child Neurology Society | Winter 2018
To conduct these studies, Dr. Boes developed a novel method         In a second project, Dr. Boes is attempting to improve the
to assess the effects of cerebral lesions on remote brain regions   accuracy of prognosis following the onset of focal brain lesions.
and networks. The technique involves mapping a brain lesion         Currently, neurologists’ ability to accurately predict the clinical
from a clinical scan onto a reference brain, then using the         outcome of stroke and other focal lesions is poor. Dr. Boes
lesion volume as a seed region of interest for a resting state      hypothesizes that information regarding lesion location and
functional connectivity MRI analysis that uses normative data       the networks associated with the lesion can improve the
from a large representative cohort (see figure). Aaron named        accuracy of outcome predictions.
this technique lesion network mapping and published his
findings in Brain (138: 3061-3075).                                 In a third set of projects, Dr. Boes is studying TMS.
                                                                    He is working with neurosurgical colleagues, who implant
Now an Assistant Professor of Pediatrics at the University of       intracranial electrodes, to examine the remote effects of
Iowa, Dr. Boes utilizes lesion network mapping in several           TMS on network dynamics and to identify the basic
exciting projects. In one project, he is examining the neural       mechanisms through which TMS improves outcome in some
basis for posterior fossa syndrome (PFS). Following surgery         patients with depression. He hopes that understanding the
of the cerebellum, many pediatric patients develop dramatic         basic mechanisms of TMS will expand its clinical indications.
neuropsychiatric symptoms, including mutism and other
behavioral problems. With the use of lesion network mapping,        Dr. Boes’ research idea—utilizing network localization to
Dr. Boes is examining the neuroanatomical and neural                explain symptoms—originated from a single patient with
network basis for this syndrome. Elucidation of the involved        visual hallucinations. The technique is proving versatile
structures could guide neurosurgical approaches to avoid PFS.       and durable, as it is now being used in a wide range of
In addition, knowledge of the lesion-associated networks could      applications, and may, someday, become a standard tool
augment rehabilitation for those who develop PFS.                   in neurology.

                                                                                         Figure Legends: Lesion network mapping
                                                                                         involves two steps. First, a brain lesion from
               Lesion Network Mapping Method                                             a clinical scan is mapped onto a reference
                                                                                         brain (columns 1 & 2). Second, the lesion
                                                                                         volume is used as a seed region of interest
                                                                                         for a resting state functional connectivity
                                                                                         MRI analysis that uses normative data
                                                                                         (column 3). The lesion-associated networks
                                                                                         derived from the latter step can be used for
                                                                                         research or clinical applications, providing
                                                                                         more information than is available from the
                                                                                         lesion location alone.

                                                                                         Dr. Boes directs the Noninvasive
                                                                                         Brain Stimulation Clinical Program at
                                                                                         the University of Iowa and the Iowa
                                                                                         Neuroimaging and Noninvasive Brain
                                                                                         Stimulation Laboratory.

                                                                                             Child Neurology Society | Winter 2018        27
CONNECTING WITH COLLEAGUES
   Committee Rosters

Strategic Goals of the Child Neurology Society
                                             1. Provide current, relevant, and           4. Achieve awareness among the
                                                engaging mechanisms for life-long           public and national policy makers
                                                learning among child neurologists           of general health needs and
                                                Archives, Awards, Electronic                challenges for individuals with
                                                communication, Ethics, International        chronic neurological conditions
                                                affairs, Practice, Research Scientific      of childhood origin
                                                Program                                     Electronic communication,
                                             2. Establish for the CNS stable and            Legislative affairs
                                                consistent funding sources for           5. Engage and encourage the child
                                                specific, longitudinal, targeted            neurology workforce of the future
                                                initiatives                                 Archives, Awards, Electronic
                                                Finance                                     communication, International affairs,
                                             3. Achieve awareness among the public          Membership
                                                and national policy makers of the        6. Provide a robust infrastructure and
                                                importance and cost-effectiveness           consistent direction for the CNS
                                                of child neurologist workforce              Bylaws, Finance, Long-range
2018 CNS Executive Committee: Front (L-R):      Archives. Awards, Electronic                planning, Membership, Nominating,
Peter Kang, Mary Zupanc, Gary Clark. Back       communication, Legislative affairs          Administrative liaison
(L-R): Bruce Cohen, Kenneth Mack, Jonathan
Mink, Donald Gilbert, Michael Shevell.

Archives                                     Proximate Goal and Deliverable:             Awards
                                             The 50th anniversary of the CNS will
Co-Chairs: E. Steve Roach and                occur in 2021-2022, beginning with          Chair: Nigel Bamford
Robert Rust                                  the 50th Annual Meeting of the CNS.         Emeritus: Dean Timmons
Liaison: Michael Shevell                     The Archives Committee is charged with      Liaison: Don Gilbert
Staff Liaison: Roger Larson                  organizing and presenting historical        Staff Liaison: Roger Larson
                                             documents/displays for presentation
1. Collect and categorize materials of       on-site at the 50th Anniversary Meeting     1. Solicit nominations and select
   historic significance to the CNS.         in Boston in October 2021, and on-line         recipients: Hower and Sachs
   These materials might include             before, during and after.                      Lectureships, Roger and Mary
   videos or other information about                                                        Brumback Memorial Lifetime
   prominent members, information            Archives Committee Members                     Achievement Awards, and the
   about the founding of the Society,        Dara Albert (2019)                             Arnold P. Gold Foundation
   or materials about the development        Stephen Ashwal (2020)                          Humanism in Medicine Award.
   of significant concepts in the field of   James Bale (2021)                           2. Solicit submission of proposals and
   child neurology.                          Audrey Brumback (2019)                         select recipient: Philip R. Dodge
2. Create displays for the annual            Pat Crumrine (2019)                            Young Investigator Award.
   meeting that illustrate the career of     Francis DiMario (2019)                      3. Work with Finance Committee to
   the Society’s award winners or the        Claudio de Gusmao (2019)                       secure sustainable funding for awards.
   history of the Society.                   John Mytinger (2019)                        4. Work with Archives Committee to
3. Pursue and create innovative uses,        Farooq Osman (2019)                            ensure publicity of award winners
   showcasing, and publicizing of            Phillip Pearl (2021)                           in lay and professional press and
   materials created that serve to educate   Thomas Reynolds (2018)                         to awardees’ respective U.S.
   the public and national policy makers     Robert Safier (2019)                           governmental representatives.
   about the contributions of child          Nina Schor (2021)                           5. Work with Child Neurology Foundation
   neurology and child neurologists                                                         to review and select CNF Scientific
   to healthy communities and cost-                                                         Grant/Awards submissions.
   effective, high-quality health care.

28   Child Neurology Society | Winter 2018
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