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In this episode of “Ask the Expert," Krissy Dilger of SRNA spoke with Dr. Barbara Willekens of the University of Antwerp about CAR-T cell therapy, explaining it as genetically engineered T cells (autologous or allogeneic) designed to recognize targets like CD19 on B cells and destroy them [00:01:19]. Dr. Willekens reviewed CAR-T’s development since the 1980s for blood cancers, its severe potential side effects, and why successes targeting B cells prompted exploration in autoimmune diseases, including emerging trials for NMOSD and MOGAD [00:04:25]. She described patient selection, the clinical-trial process, expected B-cell reconstitution in about three months, and risks [00:18:55]. Dr. Willekens discussed research questions, including blood-brain barrier interactions, alternative CAR delivery, and future directions comparing approaches, targets, scalability, and cost [00:31:24]. Barbara M.P. Willekens, MD, PhD, is a neurologist and Clinical Head of Neurology for multiple sclerosis (MS) and other CNS neuroimmunological diseases at Antwerp University Hospital, Belgium, and an Assistant Professor of Neurology at the University of Antwerp. She is an expert in MS and rare neuroimmunological diseases. She founded the University Neuroimmunology Center Antwerp (UNiCA), a multidisciplinary center bringing together patient care, research and education, which has been recognized as a SRNA Center of Excellence for rare neuroimmune disorders. Her clinical and academic career has focused on translating advances in neuroscience and immunology into better treatments and care for people living with neuroinflammatory diseases. Dr. Willekens leads and contributes to research ranging from early-stage translational science to international clinical trials and real-world studies. Her work includes clinical and translational research into immune tolerance and cellular therapies such as tolerogenic dendritic cells and CAR-T cell therapy, as well as approaches aimed at promoting remyelination and neuroprotection in MS and developing biomarkers for more personalized care. She has been a principal investigator in multiple academic trials and industry-led clinical trials and has helped build international collaborations and registries that generate evidence to improve treatment and patient care. Dr. Willekens plays a leadership role in the wider neuroimmunology community: she is Co-chair of the European Academy of Neurology's Coordinating Panel for Translational Neurology and Neuroscience, has previously served as Co-chair of its Scientific Panel for Neuroimmunology, is a member of the MSBase Scientific Leadership Group, of MOGAD Eugen Devic European Network, and is a driving force behind the International Susac Syndrome Consortium. Her leadership reflects a commitment not only to advancing science, but also to bringing researchers, clinicians and patients together to turn scientific progress into meaningful improvements in everyday care. 00:00 Welcome and Guest Intro 01:19 CAR-T Explained Simply 04:25 From Cancer to Autoimmunity 06:35 Why NMOSD and MOGAD 10:58 B Cells and Targets 15:56 One Time Treatment Question 18:55 Who Should Get CAR-T 21:46 What Patients Experience 26:12 Immune Reset and Side Effects 31:24 Dr. Willekens' Lab Research 35:01 Next Steps and Open Questions 36:24 Future CAR-T Approaches 40:12 Closing Thoughts

The "Community Meets Clinic" podcast series introduces clinicians and healthcare personnel specializing in rare neuroimmune disorders. In this episode, Krissy Dilger of SRNA spoke with Drs. Brenda Banwell and Haiwen Chen of Johns Hopkins Children’s Center, a designated Center of Excellence in Rare Neuroimmune Disorders. They shared about their paths into pediatric neurology and focus on rare pediatric neuroimmune disorders [00:01:49]. They described the rapid evolution of diagnosis and treatment over the past 30 years, including advances in MS, MOGAD, and aquaporin-4 disease, expanded pediatric inclusion in diagnostic criteria and trials, and improved outcomes with high-efficacy therapies. The doctors outlined their research approaches—Dr. Banwell’s integrative, imaging-focused team science [00:08:45] and Dr. Chen’s clinical research including a project on IVIG duration for relapsing pediatric MOGAD [00:11:00]. The discussed their multidisciplinary clinic supports, continuity into adulthood within one health system, and emphasis on availability, collaboration, community resources, and hope for the future [00:13:35]. View the medical profile of Dr. Brenda Banwell: https://profiles.hopkinsmedicine.org/provider/brenda-banwell/3154504 View the medical profile of Dr. Haiwen Chen: https://profiles.hopkinsmedicine.org/provider/haiwen-chen/2703784 Brenda Banwell is the director of the Department of Pediatrics, as well as pediatrician-in-chief and co-director of Johns Hopkins Children’s Center, where she helps manage the hospital’s many clinical and research centers. Dr. Banwell is a renowned expert in the research and treatment of pediatric multiple sclerosis (MS) and other neuroimmune disorders. She specializes in and studies the use of neuroimaging to assess the clinical and cognitive impact of the conditions, as well as the function of the immune system in children with these disorders. Dr. Banwell has published more than 250 manuscripts in high-impact journals, along with over 25 book chapters. In addition, she has over 200 national and international invited lectureships and visiting professorships. An advocate for pediatric multiple sclerosis needs and research, Dr. Banwell serves as chair of the International Medical and Scientific Board of the Multiple Sclerosis International Federation, and the Myelin Oligodendrocyte Glycoprotein Antibody–Associated Disease (MOGAD) International Research Consortium. She is also chair of the pediatric committee of the National Institutes of Health NeuroNEXT program, which conducts studies on treatments for neurological diseases through academic, private, and industry collaborations. Dr. Banwell currently serves as past-chair of the International Pediatric Multiple Sclerosis Study Group. Dr. Haiwen Chen is a pediatric neurologist who specializes in caring for children with pediatric onset neuroinflammatory and neuroinfectious diseases, with particular interests in demyelinating disorders and myelitis. Dr. Chen earned her MD and PhD from the University of Maryland School of Medicine. She completed a pediatric neurology residency and fellowship training in neuroimmunology and neurological infectious diseases at The Johns Hopkins Hospital. Dr. Chen’s research training focused on understanding synaptic structure and function using molecular biology and microscopy techniques. Her current research focuses on understanding how oligodendrocyte affect synaptic function in health and disease with the goal of developing strategies for preserving and restoring synaptic function to treat cognitive dysfunction in demyelinating disorders. 00:00 Introduction 01:49 Why Child Neurology 04:24 Choosing Neuroimmunology 08:45 Dr. Banwell's Research Focus 11:00 Dr. Chen's Research Focus 13:35 Clinic Team and Referrals 17:24 Continuity Into Adulthood 20:55 Self Care and Balance 25:26 Advice for New Families 28:57 Hope Through Collaboration 33:45 Closing

In this SRNA “Ask the Expert” episode, Krissy Dilger of SRNA introduced the Rare Neuroimmune Disorder Symposium (RNDS), a three-day hybrid event in Dallas, Texas (October 15–17, 2026) that connects individuals and families with leading experts for education on diagnosis, symptom management, rehabilitation, mental health, and research. You can view details about RNDS, including the agenda and registration, on the event page: https://www.srna.ngo/2026-rnds SRNA founder and president Sandy Siegel recounted how early community isolation and a 1999 gathering helped spark ongoing symposia [00:08:37]. He described the development of a medical advisory board and collaboration with Johns Hopkins that supported research growth, evolving diagnostic definitions, and advances such as plasma exchange and newer therapies for conditions including TM, NMOSD, ON, ADEM, AFM, and MOGAD [00:12:11]. Community support coordinator Leah Campbell shared about her neuromyelitis optica (NMO) diagnosis and described RNDS as invaluable for expert access, treatment decision support, and meaningful connection with others who share similar experiences [00:34:45]. Sandy Siegel is the President of SRNA. Sandy got involved with SRNA shortly after his wife, Pauline, contracted TM in 1994 at the age of 35. At the time of her onset, Pauline was a kindergarten teacher. Sandy has been an officer and a board member of SRNA since its inception. Sandy has also served as SRNA’s newsletter and journal editor during his more than two decades of service to the organization. Sandy is a cultural anthropologist with specializations in Native Americans, psychological anthropology, and culture change. Sandy has worked as an adjunct professor at Capital University, Franklin University, the Urban/Rural Program of the College of Great Falls, and the Intertribal Education Center of the Fort Belknap Reservation. Sandy retired from the State of Ohio in 2011 after more than 35 years of service. Sandy returned to college in the fall of 2011 as a photography student at Columbus State Community College. Sandy and Pauline have two sons, four grandsons, and one granddaughter. Leah Campbell is SRNA's Community Support Coordinator. Leah was diagnosed with neuromyelitis optica (NMO) in May 2006 after 17 years of unexplained symptoms and misdiagnosis. She was the first blind student and salutatorian of Altus High School and the first blind graduate of Rhodes College, earning a BA in mathematics. Following graduation and after a treatment for a disease she had been misdiagnosed with, she became quadriplegic and lost sensation of touch, having to relearn how to navigate life as both blind and paralyzed. She is dedicated to using her experiences to support and advocate for others. 00:00 Welcome 01:03 What the Rare Neuroimmune Disorders Symposium Offers 02:35 Meet Sandy and Leah 03:13 Origins of RNDS 08:37 1999 Breakthrough Symposium 12:11 Centers of Excellence Growth 22:31 How RNDS Evolved 31:30 Why RNDS Still Matters 34:45 Leah's Journey with NMOSD 35:43 Leah's RNDS Experience 38:40 Advice and Closing

The "Community Meets Clinic" podcast series introduces clinicians and healthcare personnel specializing in rare neuroimmune disorders. In this episode, Krissy Dilger of SRNA spoke with Dr. Elena Grebenciucova, an assistant professor of neurology and neurological infections at Northwestern University in Chicago, Illinois, leading its Transverse Myelitis Center, a designated Center of Excellence in Rare Neuroimmune Disorders. She described Northwestern’s multidisciplinary clinic for transverse myelitis, NMOSD, MOGAD, neurosarcoidosis, and related autoimmune conditions, including collaboration with Shirley Ryan AbilityLab and specialists such as pain management, neuro-urology, rehabilitation, and neurosurgery, with an emphasis on faster access to care [04:08]. Dr. Grebenciucova outlined research and clinical trial efforts, including studies on transverse myelitis natural history, optic neuritis therapies, plasma exchange timing, and CAR T-cell strategies [08:36]. View the medical profile of Dr. Grebenciucova: https://www.nm.org/doctors/1467708305/elena-grebenciucova-md Elena Grebenciucova, MD completed neurology residency at the University of Chicago in Chicago, Illinois. Dr. Grebenciucova has been interested in autoimmune disorders of the central nervous system, including rare neuroimmune disorders, since medical school. After residency, she completed a neuroimmunology Fellowship under the mentorship of Dr. Brenda Banwell and Joseph Berger at the Perelman School of Medicine of The University of Pennsylvania. Currently she is an assistant professor of Neurology (MS/Neuroimmunology) and neurological infections at Northwestern University in Chicago, Illinois, and she runs the Transverse Myelitis Center there. Dr. Grebenciucova sees patients with rare autoimmune conditions including NMOSD, MOGAD, transverse myelitis, and autoimmune encephalitis. 00:00 Series Introduction 00:52 Meet Dr. Elena Grebenciucova 01:38 Her Path to Neuroimmunology 04:08 Northwestern TM Clinic Overview 08:36 Research and Clinical Trials 11:16 How to Access the Clinic 12:46 Multidisciplinary Care Team 15:32 Self Care and Lifestyle 18:55 Why Choose Northwestern 21:45 Hope for the Future 23:17 Closing

In this SRNA “Ask the Expert” episode, GG deFiebre spoke with Dr. Michael Levy and Dr. Benjamin Greenberg about optic neuritis and how it is most often linked to multiple sclerosis but can also be idiopathic or associated with MOGAD and NMOSD. They compared differences across these conditions (including age patterns, bilateral involvement, severity, exam findings, and typical recovery), outlined diagnostic workups such as MRI, antibody testing, and spinal fluid studies, and reviewed acute treatments [03:14]. The discussion also covered emerging therapies like Pivikto for neuroprotection and efgartigimod alfa to lower IgG as a potential alternative to plasma exchange, and examined challenges in remyelination and stem-cell delivery approaches like Q-Cells while cautioning against unproven stem cell clinics [11:57]. Benjamin M. Greenberg, MD, MHS is a Professor and the Cain Denius Scholar in Mobility Disorders in the Department of Neurology [https://utswmed.org/why-utsw/departments/neurology/] at UT Southwestern Medical Center in Dallas, Texas. He currently serves as the Vice Chair of Translational Research and Strategic Initiatives for the Department of Neurology. He is also the interim Director of the Multiple Sclerosis Center [https://utswmed.org/locations/aston/multiple-sclerosis-and-neuroimmunology-clinic/] and the Director of the Neurosciences Clinical Research Center. In addition, he serves as Director of the Transverse Myelitis and Neuromyelitis Optica Program and the Pediatric Demyelinating Disease Program [https://www.childrens.com/specialties-services/specialty-centers-and-programs/neurology/demyelinating-disease-program] at Children’s Medical Center. Prior to his recruitment to UT Southwestern in 2009, Dr. Greenberg was on the faculty of the Johns Hopkins Division of Neuroimmunology, serving as the Director of the Encephalitis Center and Co-Director of the nation’s first dedicated Transverse Myelitis Center. Dr. Greenberg splits his clinical time between adult and pediatric patients at William P. Clements Jr. and Zale Lipshy University Hospitals, Parkland, and Children’s Medical Center. His research focuses on better diagnosing, prognosticating, and treating demyelinating diseases and nervous system infections. He also coordinates clinical trials to evaluate new treatments to prevent neurologic damage and restore function to affected patients. Michael Levy, MD, PhD is a recognized neurologist with over 15 years of clinical and research expertise in rare neuroimmunological disorders. He established the Neuroimmunology Clinic and Research Laboratory at Massachusetts General Hospital and is the Research Director in the Division of Neuroimmunology and Neuroinfectious Disease. Previously, Dr. Levy was on the faculty at Johns Hopkins University and was the founding Director of their Neuromyelitis Optica Clinic. Clinically, Dr. Levy cares for patients with MOG antibody disease (MOGAD), neuromyelitis optica spectrum disorder (NMOSD), and idiopathic transverse myelitis (TM). Dr. Levy is also the principal investigator (PI) on numerous patient studies and drug trials for new and improved treatments for these disorders. In 2022, Dr. Levy became the lead principal investigator for the two worldwide clinical trials in MOG antibody disease. In the lab, Dr. Levy’s research focuses on the development of animal models of NMO and MOG with the goal of tolerization as a sustainable long-term treatment. Dr. Levy has more than 200 peer-reviewed research articles, reviews and editorials, and 3 patents covering NMO tolerization therapy, TM diagnostics, and stem cell regeneration approaches. 00:00 Welcome 01:02 Optic Neuritis Basics 02:27 Causes and Percentages 03:14 MS vs NMO vs MOG 06:07 Workup and Testing 07:51 Acute Attack Treatment 09:30 Recovery and Vision Measures 11:57 Pivikto Neuroprotection 15:30 Efgartigimod vs Plasma Exchange 17:59 Repair vs Remyelination 20:15 Q-Cells and Stem Cell Delivery 22:22 Closing

In this "Community Spotlight Edition" of "Ask the Expert," Landy Thomas of SRNA spoke with Cindy Ranii about living with transverse myelitis (TM). Cindy described her diagnostic journey, rehabilitation, accessibility, and financial challenges [00:53]. She discussed returning to work briefly before retiring, emphasizing the importance of support, love, and community [08:51]. Cindy shared her path from wheelchair tennis to international wheelchair table tennis, and her pursuit of Paralympic qualification through point-based global competition [13:17]. She also discussed writing and self-publishing her book, Parakeet Races and Other Stories, inspired by family memories and her experience with TM [31:58]. Cindy Ranii is a 79-year-old retired educator who lives with her wife Shelly and service dog Hollis in Santa Cruz, California. In 2005, her life changed drastically when she was diagnosed with transverse myelitis (TM). Within four days, she went from golfing, playing tennis, and working vigorously as the Superintendent of a local high school district to being a paraplegic (T-3 complete). Six months after her diagnosis she was back at work, using a wheelchair fulltime. Eighteen months later she decided to retire to have enough energy to enjoy her family (four children and 13 grandchildren) and to rebuild an active lifestyle. She competed in wheelchair tennis and then pursued table tennis with her eyes on the Paralympics. Currently she is training to compete in the 2028 LA Paralympics in wheelchair table tennis, saying, “My quest is to be the oldest Paralympian in history. It’s a long shot; but why not!” Cindy has written numerous articles regarding living with a disability for New Mobility Magazine and authored a memoir, Parakeet Races and Other Stories, which is available through Amazon: https://rebrand.ly/cindy-ranii 00:00 Welcome 00:53 Cindy's Diagnosis Overview 01:37 Early Symptoms and ER Rush 06:07 Hospital Transfer and TM Diagnosis 08:51 Rehab Reality and New Life 11:27 Accessibility Costs and Support 13:17 Paralympic Table Tennis Quest 17:52 Disability Community and Pride 20:25 Finding Resilience Through Sport 22:34 Mentors and New Athletic Path 28:27 Work Return Then Retirement 31:58 Writing Her Memoir 37:09 Closing Reflections

The "Community Meets Clinic" podcast series introduces clinicians and healthcare personnel specializing in rare neuroimmune disorders. In this episode, Krissy Dilger of SRNA spoke with Dr. Ayşe Altıntaş, Professor of Neurology at Koç University School of Medicine in Istanbul, Turkey, which has been designated as a Center of Excellence in Rare Neuroimmune Disorders. Dr. Altıntaş described the unmet needs in rare neuroimmune disorders and noted her role on an international panel developing updated NMOSD diagnostic criteria [00:03:40]. She outlined current research on mechanisms of optic neuritis, pregnancy complications and aquaporin-4 antibodies, and developing accessible biomarkers beyond CSF with a future goal of remote monitoring [00:06:01]. Dr. Altıntaş also explained Koç University’s multidisciplinary demyelinating disease center model, emphasizing coordinated consultations, advanced MRI capabilities, shared decision-making, and the value of specialized centers, while expressing hope due to rapid advances in biomarkers and targeted therapies [00:11:43]. You can view the medical profile of Dr. Ayşe Altıntaş here: https://www.kuh.ku.edu.tr/doctors/ayse-altintas Ayşe Altıntaş, MD is a professor of neurology at Koç University School of Medicine in Istanbul, Türkiye. She graduated from Ege University Faculty of Medicine in 1986 and completed her neurology residency there in 1992. She received early training in neuroimmunology as a fellow at Mayo Clinic under Prof. Moses Rodriguez and later continued her research at Mayo Clinic with Prof. Claudia Lucchinetti and Prof. Brian Weinshenker, focusing on the animal model, immunopathology, and imaging correlates of multiple sclerosis. Prof. Altıntaş served at Istanbul University Cerrahpaşa School of Medicine for 23 years before joining Koç University in 2018, where she established a neuroimmunology laboratory and continues to lead clinical and translational research. Her work focuses on multiple sclerosis, neuromyelitis optica spectrum disorders (NMOSD) and MOG antibody-associated diseases (MOGAD), with an emphasis on biomarkers and disease mechanisms. She is actively involved in international organizations, including BioMS-eu, The MOG Project, Siegel Rare Neuroimmune Association (SRNA), MEDEN, the MSBase Scientific Leadership Group, and the Guthy-Jackson Charitable Foundation International Scientific Consortium. 00:00 Welcome and Guest Intro 01:39 Why Neurology 03:40 Choosing Rare Disorders 06:01 Current Research Projects 11:43 Clinic Team and Workflow 15:48 Advanced Imaging and Coordination 17:20 Self Care and Balance 20:20 Advice for New Patients 22:17 Hope for the Future 24:34 Closing

Dr. GG deFiebre of SRNA spoke with Dr. Michael Levy and Dr. Benjamin Greenberg about CAR-T therapy for aquaporin-4-positive NMOSD. They described why targeting B cells may reduce aquaporin-4 antibodies over time and could enable long-term remission or reduced need for ongoing drugs [01:37]. The physicians outlined an autologous Phase 1 study at Mass General and UT Southwestern [07:02]. They discussed eligibility rationale and how lessons from this NMOSD-focused trial could inform future neuroimmune disorder research [09:10]. You can find more information about the trial here: https://clinicaltrials.gov/study/NCT07573332?cond=NMOSD&intr=CAR-T&viewType=Card&rank=1 Benjamin M. Greenberg, MD, MHS is a Professor and the Cain Denius Scholar in Mobility Disorders in the Department of Neurology [https://utswmed.org/why-utsw/departments/neurology/] at UT Southwestern Medical Center in Dallas, Texas. He currently serves as the Vice Chair of Translational Research and Strategic Initiatives for the Department of Neurology. He is also the interim Director of the Multiple Sclerosis Center [https://utswmed.org/locations/aston/multiple-sclerosis-and-neuroimmunology-clinic/] and the Director of the Neurosciences Clinical Research Center. In addition, he serves as Director of the Transverse Myelitis and Neuromyelitis Optica Program and the Pediatric Demyelinating Disease Program [https://www.childrens.com/specialties-services/specialty-centers-and-programs/neurology/demyelinating-disease-program] at Children’s Medical Center. Dr. Greenberg earned his medical degree at Baylor College of Medicine before completing an internal medicine internship at Chicago’s Rush Presbyterian-St. Luke’s Medical Center. He performed his neurology residency at the Johns Hopkins School of Medicine. He also holds an M.H.S. in molecular microbiology and immunology from the Bloomberg School of Public Health, as well as a bachelor’s degree in the history of medicine – both from Johns Hopkins. Prior to his recruitment to UT Southwestern in 2009, Dr. Greenberg was on the faculty of the Johns Hopkins Division of Neuroimmunology, serving as the Director of the Encephalitis Center and Co-Director of the nation’s first dedicated Transverse Myelitis Center. Dr. Greenberg splits his clinical time between adult and pediatric patients at William P. Clements Jr. and Zale Lipshy University Hospitals, Parkland, and Children’s Medical Center. His research focuses on better diagnosing, prognosticating, and treating demyelinating diseases and nervous system infections. He also coordinates clinical trials to evaluate new treatments to prevent neurologic damage and restore function to affected patients. Michael Levy, MD, PhD is a recognized neurologist with over 15 years of clinical and research expertise in rare neuroimmunological disorders. He established the Neuroimmunology Clinic and Research Laboratory at Massachusetts General Hospital and is the Research Director in the Division of Neuroimmunology and Neuroinfectious Disease. Previously, Dr. Levy was on the faculty at Johns Hopkins University and was the founding Director of their Neuromyelitis Optica Clinic. Clinically, Dr. Levy cares for patients with MOG antibody disease (MOGAD), neuromyelitis optica spectrum disorder (NMOSD), and idiopathic transverse myelitis (TM). Dr. Levy is also the principal investigator (PI) on numerous patient studies and drug trials for new and improved treatments for these disorders. In 2022, Dr. Levy became the lead principal investigator for the two worldwide clinical trials in MOG antibody disease. In the lab, Dr. Levy’s research focuses on the development of animal models of NMO and MOG with the goal of tolerization as a sustainable long-term treatment. Dr. Levy has more than 200 peer-reviewed research articles, reviews and editorials, and 3 patents covering NMO tolerization therapy, TM diagnostics, and stem cell regeneration approaches.

Krissy Dilger of SRNA welcomed University of Washington neuroimmunologist Dr. Shuvro Roy for an open Q&A on transverse myelitis (TM). Dr. Roy explained how TM can be both a presentation and a diagnosis, with “idiopathic TM” used when extensive testing finds no underlying cause and noted that recurrence should prompt reevaluation for conditions like NMOSD, MOGAD, or neurosarcoidosis and consideration of preventive immunotherapy [00:06:16]. He addressed audience questions about lifestyle and rehabilitation topics including diet, metabolic health, exercise, sleep issues, and safe considerations around CBD or THC-containing gummies, and reviewed approaches to chronic pain, spasticity, physical therapy timelines, and spinal cord stimulation (including ArcX) [00:13:20]. Dr. Roy also discussed the current status of peptides and stem cells, highlighted emerging cell-based therapies like CAR-T, and answered a case question about a high MOG antibody titer and its diagnostic implications [00:24:53]. Shuvro Roy, MD is an Assistant Professor of Neurology at the University of Washington, specializing in neuroimmunology, with a specific focus on multiple sclerosis (MS) and related neuroimmunologic disorders. He is Co-Director of the UW SRNA Center of Excellence for Rare Neuroimmune disorders. He is also a core teaching faculty member for the UW Medicine Multiple Sclerosis Center’s fellowship program, contributing to clinical education and research initiatives like the ECHO MS program in collaboration with the National MS Society. Dr. Roy is actively engaged in projects aimed at improving access to care, addressing healthcare disparities, and enhancing patient safety for individuals living with MS and related conditions. He has co-authored recent research articles in medical journals on a variety of topics, including studies on stiff person syndrome, encephalomyelitis, MOG-antibody disorder, and multiple sclerosis treatment protocols. Dr. Roy is dedicated to helping his patients thrive amid challenging, lifelong neurological conditions. 00:00:00 Welcome and Introductions 00:01:24 What Is Transverse Myelitis 00:03:30 Common Causes and Mechanisms 00:06:16 Diagnosis Versus Presentation 00:10:39 Monophasic or Recurrent 00:13:20 Diet Do’s and Don’ts 00:17:25 Aging and Long-Term Health 00:24:53 Peptides and Stem Cells 00:33:07 Fatigue Sleep and CBD or THC-containing gummies 00:37:58 Chronic Pain Options 00:43:55 Physical Therapy Recovery 00:47:56 Spinal Cord Stimulation ArcX 00:51:46 Stopping Pregabalin Safely 00:52:59 Trials and Rehab at Any Age 00:56:00 MOG Titer and Diagnosis 01:00:02 Closing

The "Community Meets Clinic" podcast series introduces clinicians and healthcare personnel specializing in rare neuroimmune disorders. In this episode hosted by Krissy Dilger of SRNA, we met Dr. Benjamin Greenberg of the UT Southwestern Medical Center. He outlined his translational research, including the Q Study, a Phase 1 trial assessing the safety and feasibility of transplanting human glial restricted progenitor cells into the spinal cord of people who have been diagnosed with transverse myelitis (TM) [05:49]. He also described research on immune-remodeling therapies for NMO aimed at reducing long-term immunosuppression. Dr. Greenberg illustrated multidisciplinary care at UT Southwestern and Children’s Medical Center, emphasized options for second opinions and clinician-to-clinician remote consultation, and shared hopes for nervous system repair trials and curative immune therapies [07:18]. You can view Dr. Benjamin Greenberg's medical profile here: https://utswmed.org/doctors/benjamin-greenberg/ Benjamin M. Greenberg, MD, MHS is a Professor and the Cain Denius Scholar in Mobility Disorders in the Department of Neurology [https://utswmed.org/why-utsw/departments/neurology/] at UT Southwestern Medical Center in Dallas, Texas. He currently serves as the Vice Chair of Translational Research and Strategic Initiatives for the Department of Neurology. He is also the interim Director of the Multiple Sclerosis Center [https://utswmed.org/locations/aston/multiple-sclerosis-and-neuroimmunology-clinic/] and the Director of the Neurosciences Clinical Research Center. In addition, he serves as Director of the Transverse Myelitis and Neuromyelitis Optica Program and the Pediatric Demyelinating Disease Program at Children’s Medical Center [https://www.childrens.com/specialties-services/specialty-centers-and-programs/neurology/demyelinating-disease-program]. Dr. Greenberg earned his medical degree at Baylor College of Medicine before completing an internal medicine internship at Chicago’s Rush Presbyterian-St. Luke’s Medical Center. He performed his neurology residency at the Johns Hopkins School of Medicine. He also holds an M.H.S. in molecular microbiology and immunology from the Bloomberg School of Public Health, as well as a bachelor’s degree in the history of medicine – both from Johns Hopkins. Prior to his recruitment to UT Southwestern in 2009, Dr. Greenberg was on the faculty of the Johns Hopkins Division of Neuroimmunology, serving as the Director of the Encephalitis Center and Co-Director of the nation’s first dedicated Transverse Myelitis Center. Dr. Greenberg splits his clinical time between adult and pediatric patients at William P. Clements Jr. and Zale Lipshy University Hospitals, Parkland, and Children’s Medical Center. His research focuses on better diagnosing, prognosticating, and treating demyelinating diseases and nervous system infections. He also coordinates clinical trials to evaluate new treatments to prevent neurologic damage and restore function to affected patients. 00:00 Welcome and Guest Intro 01:41 Path to Neurology 03:50 Why Neuroimmunology 05:49 Research Focus and Trials 07:18 Clinic Team and Referrals 10:31 Self Care and Hobbies 12:17 How the Clinic Can Help 14:16 Hope for Future Therapies 15:56 Wrap Up

Krissy Dilger of SRNA moderated an open Q&A on acute disseminated encephalomyelitis (ADEM) with pediatric neurologist Dr. Linda Nguyen of the University of Texas Southwestern Medical Center. Dr. Nguyen discussed how widespread MOG antibody testing has shifted many cases previously labeled ADEM to MOG antibody-associated disease, recommended MOG testing at onset, and reviewed relapse risk, mimics, and follow-up imaging [00:05:07]. Questions from the community covered acute treatments, recovery, guidance on pseudo-relapse, rehabilitation, and transition from pediatric to adult care [00:14:41]. Dr. Linda Nguyen completed her MD, PhD training at West Virginia University in 2017, and then pediatric neurology residency at the University of California, San Diego in 2022. She then completed a combined pediatric and adult neuroimmunology fellowship at the University of Texas Southwestern in 2024, where she now serves as an Assistant Professor in the Department of Pediatrics. Dr. Nguyen currently sees patients in the Demyelinating Disease Clinic at Children’s Medical Center Dallas. 00:00 Welcome and Guest Intro 01:08 What Is ADEM 01:51 Causes and Who Receives This Diagnosis 02:55 Early Signs and Onset 04:20 Diagnosis and MRI Criteria 05:07 MOG Antibodies and ADEM 07:21 Testing and Relapse Risk 09:06 Recurrent ADEM and Labels 12:34 Mimics and Differential Diagnosis 14:41 Acute Treatment Options 15:38 Recovery Timeline and Rehab 17:47 Long Term Effects and Seizures 21:23 Family Support and Accommodations 24:47 Follow Up Imaging and Relapse Signs 27:25 Managing Fatigue and Headaches 29:31 Supplements, Vaccines, and Genetics 33:40 Pseudo Relapse and Exercise Balance 37:41 Research and Predicting Outcomes 43:14 Transition to Adult Care 45:36 Weakness Sleep Issues and Final Thoughts

Krissy Dilger of SRNA hosted Dr. Benjamin Greenberg of UT Southwestern to share updates on the Q Study, a Phase 1 trial assessing the safety and feasibility of transplanting human glial restricted progenitor cells into the spinal cord of people who have been diagnosed with transverse myelitis (TM). Dr. Greenberg cautioned the audience against stem cell tourism [00:03:03]. He described the decades-long development of the cell line and safety monitoring for this study [00:01:35]. He reported no safety signals prompting a trial pause and noted the FDA-approved expansion of eligibility from non-ambulatory participants to those who can walk with assistance, while efficacy results were not yet being shared [00:08:31]. Finally, Dr. Greenberg outlined potential next steps, including Phase 2 studies and expanded populations (e.g., MOGAD and NMOSD diagnoses), as well as future targets [00:17:02]. Benjamin M. Greenberg, MD, MHS is a Professor and the Cain Denius Scholar in Mobility Disorders in the Department of Neurology [https://utswmed.org/why-utsw/departments/neurology/] at UT Southwestern Medical Center in Dallas, Texas. He currently serves as the Vice Chair of Translational Research and Strategic Initiatives for the Department of Neurology. He is also the interim Director of the Multiple Sclerosis Center [https://utswmed.org/locations/aston/multiple-sclerosis-and-neuroimmunology-clinic/] and the Director of the Neurosciences Clinical Research Center. In addition, he serves as Director of the Transverse Myelitis and Neuromyelitis Optica Program and the Pediatric Demyelinating Disease Program at Children’s Medical Center [https://www.childrens.com/specialties-services/specialty-centers-and-programs/neurology/demyelinating-disease-program]. Dr. Greenberg earned his medical degree at Baylor College of Medicine before completing an internal medicine internship at Chicago’s Rush Presbyterian-St. Luke’s Medical Center. He performed his neurology residency at the Johns Hopkins School of Medicine. He also holds an M.H.S. in molecular microbiology and immunology from the Bloomberg School of Public Health, as well as a bachelor’s degree in the history of medicine – both from Johns Hopkins. Prior to his recruitment to UT Southwestern in 2009, Dr. Greenberg was on the faculty of the Johns Hopkins Division of Neuroimmunology, serving as the Director of the Encephalitis Center and Co-Director of the nation’s first dedicated Transverse Myelitis Center. Dr. Greenberg splits his clinical time between adult and pediatric patients at William P. Clements Jr. and Zale Lipshy University Hospitals, Parkland, and Children’s Medical Center. His research focuses on better diagnosing, prognosticating, and treating demyelinating diseases and nervous system infections. He also coordinates clinical trials to evaluate new treatments to prevent neurologic damage and restore function to affected patients. 00:00 Welcome and Guest Intro 01:35 Origins of Q Study 02:46 Getting Cells Into Cord 04:49 Phase One Trial Design 06:31 Safety and Efficacy Measures 08:31 Eligibility Expanded Criteria 11:39 Screening and Selection 14:05 Travel and Site Logistics 15:15 Early Safety Findings 17:02 Next Steps After Phase One 19:01 Beyond Idiopathic Myelitis 23:07 Damage Differences by Disease 25:20 Optic Nerve and Brain Targets 27:29 Expected Outcomes and Vision 28:58 Final Thanks

En este episodio de «Pregúntale al Experto» de SRNA, moderado por Jesús Loreto, la Dra. Glendaliz Bosques explica por qué la rehabilitación es un componente fundamental en la recuperación de las personas con trastornos neuroinmunes poco frecuentes. Destaca que el proceso de rehabilitación debe iniciarse lo antes posible —incluso antes de contar con un diagnóstico definitivo— para prevenir complicaciones y maximizar la función física. Durante la conversación, la especialista describe cómo se evalúan la discapacidad y el potencial de recuperación mediante la historia clínica, el examen neurológico y la revisión de estudios médicos. También resalta la importancia de un enfoque multidisciplinario que integre neurología, fisiatría, terapia física, terapia ocupacional, terapia del habla, apoyo psicológico y servicios sociales. Además, explica cómo establecer metas realistas centradas en la participación activa del paciente y en su capacidad para retomar sus roles familiares, sociales y laborales. La Dra. Glendaliz Bosques es una fisiatra certificada por la junta y es Jefa de Medicina de Rehabilitación Pediátrica en UT Health Austin Pediatric Neurosciences at Dell Children’s, una colaboración clínica entre el Dell Children's Medical Center y UT Health Austin. Se especializa en el tratamiento de niños con discapacidades físicas, ya sean congénitas o adquiridas. Además, la Dra. Bosques es profesora asociada en el Departamento de Neurología de la Facultad de Medicina Dell (Dell Medical School) de la Universidad de Texas en Austin. La Dra. Bosques obtuvo su licenciatura en Ciencias Naturales en la Universidad de Puerto Rico, Recinto de Río Piedras (Río Piedras, Puerto Rico), donde se graduó *summa cum laude*. Obtuvo su título de médica en la Facultad de Medicina de la Universidad de Puerto Rico (San Juan, Puerto Rico), donde se graduó *magna cum laude*. Completó un internado en medicina de transición en el San Juan City Hospital (San Juan, Puerto Rico); una residencia en medicina física y rehabilitación en la Alianza de Medicina Física y Rehabilitación del Baylor College of Medicine y el Centro de Ciencias de la Salud de la Universidad de Texas en Houston; y una subespecialización (*fellowship* en Medicina de Rehabilitación Pediátrica en el Cincinnati Children's Hospital / Universidad de Cincinnati. A la Dra. Bosques le apasiona comprender las inquietudes de sus pacientes, no solo tal como se manifiestan durante la consulta médica, sino también en lo que respecta a sus dificultades funcionales en el hogar, la escuela y su contexto social. Sus intereses clínicos incluyen la rehabilitación avanzada de enfermedades paralíticas en niños —abarcando etiologías tanto traumáticas como no traumáticas—, mientras que sus intereses académicos se centran en la integración de la gestión de la discapacidad en la educación médica. Forma parte del Consejo de Educadores Médicos y ejerce como Presidenta fundadora de "LatinX in Physiatry", una comunidad destinada a los miembros de la Academia Estadounidense de Medicina Física y Rehabilitación con raíces latinas. Asimismo, es miembro activo de la Asociación de Fisiatras Académicos. 00:00 – Bienvenida y contexto 01:48 – ¿Por qué es importante la rehabilitación? 04:08 – ¿Cuándo debe comenzar la terapia? 05:55 – Trastornos monofásicos vs. recurrentes 10:39 – Evaluación y pronóstico funcional 13:36 – El papel del equipo multidisciplinario 17:07 – Cómo establecer metas realistas 18:07 – Terapias clave en la rehabilitación 20:12 – Rehabilitación pediátrica 23:40 – Manejo del dolor 26:12 – Control de la espasticidad 31:58 – Fatiga y conservación de energía 37:14 – Salud mental y motivación 40:00 – El rol de la familia y los cuidadores 46:15 – Esperanza, innovación y tecnología

Krissy Dilger of SRNA spoke with Matt Rathbun and Charlotte Engebrecht from the University of Rochester Center for Health and Technology about the Neuromyelitis Optica Spectrum Disorder-Health Index (NMOSD-HI) study, which aims to develop and validate an NMOSD-specific patient-reported outcome survey for use in clinical trials and routine care [02:25]. They explained that existing measures are often adapted from multiple sclerosis and may not reflect NMOSD patients’ unique experiences [04:38]. They shared phase one insights from interviews with 15 individuals showing multi-system impacts [09:51]. They described eligibility for the current anonymous survey (adults 18+ with NMOSD, aquaporin-4 positive or negative, in the US, Canada, EU, UK, or Australia) and noted prior participants can join later phases [13:22]. You can learn more about the study here: https://redcap.link/nmo-hi Questions can be sent to Matt and Charlotte: [email protected] [email protected] Matt Rathbun, BA, graduated from Nazareth University in May of 2025 and is currently pursuing his Master of Public Health degree at Nazareth University. At the University of Rochester Center for Health + Technology (CHeT), he works as a Human Subject Research Specialist, where he coordinates translational research studies focused on the lived experiences of individuals living with rare diseases. This work supports the development and validation of disease-specific PRO measures that capture aspects of disease burden most meaningful to patients. Matt’s interests center on strengthening the relevance, inclusivity, and equity of clinical research. He aims to ensure that clinical research more accurately reflects the real-world impact of disease on patients’ lives. He also works to advance more equitable and patient-centered approaches to treatment evaluation in rare disease communities. Charlotte Engebrecht, BS, is a graduate of Hobart and William Smith Colleges and a current Master of Science in Clinical Investigations student at the University of Rochester. She serves as a Clinical Trials Project Specialist at the University of Rochester Center for Health + Technology (CHeT), where her work centers on the development and validation of patient-reported outcome (PRO) measures for rare diseases. Charlotte conducts research that is grounded in a commitment to elevating the patient voice as a central pillar of clinical research. Patient-reported outcomes offer critical insight into how diseases and treatments truly impact daily life. She is particularly passionate about ensuring that these perspectives are not only included, but prioritized, in the design and evaluation of clinical trials. Her work focuses on rare diseases, with a specific interest in neuromyelitis optica spectrum disorder (NMOSD), where traditional clinical endpoints often fail to capture the full burden of illness. By integrating patient-centered measurement tools into therapeutic development, Charlotte aims to advance more meaningful and responsive approaches to evaluating new treatments. 00:00 Welcome 02:25 Study Overview 04:38 Why Patient Voices Matter 06:16 How the Study Works 08:29 Who Can Participate 09:51 Phase One Findings 13:22 Join the Survey 15:43 Wrap Up

The "Community Meets Clinic" podcast series introduces clinicians and healthcare personnel specializing in rare neuroimmune disorders. In this episode hosted by Krissy Dilger of SRNA, we met Dr. Grace Gombolay and Dr. Varun Kannan, both from Emory University and Children's Healthcare of Atlanta, designated Centers of Excellence in Rare Neuroimmune Disorders. Dr. Kannan discussed learning alongside families as conditions like MOG antibody disease emerged clinically and his focus on tailoring treatment and supporting clinical trials in a field with few approved therapies [03:37]. Dr. Gombolay outlined her research on biomarker development, a Children’s biobank, advanced MRI collaborations, and participation in the Network of Pediatric MS Centers covering disorders such as MOGAD, NMOSD, optic neuritis, ADEM, and TM [06:36]. They described their multidisciplinary clinic team, highlighted home infusions and telemedicine to reduce burden, and shared personal self-care strategies [10:22]. Dr. Gombolay and Dr. Kannan expressed hope for more trials, remyelination, prevention, and earlier diagnosis aided by AI prompts [20:43]. You can view Dr. Grace Gombolay's medical profile here: https://www.choa.org/doctors/grace-gombolay You can view Dr. Varun Kannan's medical profile here: https://www.choa.org/doctors/varun-kannan Grace Gombolay, MD, MSc, FAAN is an Associate Professor at Emory University and Director of the Pediatric Neuroimmunology and Multiple Sclerosis Clinic at Children's Healthcare of Atlanta. Her research interest involves biomarker development in pediatric neuroinflammatory diseases including autoimmune encephalitis, multiple sclerosis, MOGAD, and NMOSD. Varun Kannan, MD graduated from Emory University School of Medicine in 2017. He then completed child neurology residency in 2022, followed by pediatric neuroimmunology and multiple sclerosis fellowship at Baylor College of Medicine and Texas Children's Hospital in 2023. He returned to Emory and Children's Healthcare of Atlanta in 2023, where he has worked closely with Dr. Grace Gombolay in the neuroimmunology program. He is interested in clinical research regarding severe/relapsing forms of rare neuroimmune disorders including autoimmune encephalitis and MOGAD. He is currently involved in multiple upcoming phase 3 clinical trials exploring new disease modifying treatments for pediatric rare neuroimmune disorders. He is also passionate about medical education and is currently one of the Associate Program Directors for the Emory child neurology residency. 00:00 Welcome 01:56 Dr. Grace Gombolay's Journey 03:37 Dr. Varun Kannan's Path 05:06 Kannan's Research Focus 06:36 Biomarkers and Biobank 10:22 Clinic Team and Care 13:44 Self Care and Balance 16:15 Children's Healthcare of Atlanta 20:43 Hopeful Future Ahead 24:49 Closing