Marcus Pinto, MD, MS

I am excited to share my review article, “Amyloid Neuropathies,” published in @ContinuumAAN. My journey caring for patients with amyloid neuropathies began 14 years ago at the Brazilian Amyloidosis Referral Center at my alma mater, @ufrj. Since moving to @MayoClinic, I’ve continued my clinical work and research in amyloidosis, which has given me a unique perspective on patient care across two very different settings. I’ve aimed to simplify this complex topic, including many clinical pearls and a diagnostic flow chart highlighting key red flags.

I’m also proud to share that @LyellJ selected this article as one of the editor’s picks, making it freely available for the next three months. Don’t miss out—download it now! 😊

continuum.aan.com/doi/pdf/10.121…

Lastly, I want to say it's such an honor to write for @ContinuumAAN, which was the most important neurology journal throughout my (long) neurology training journey. The opportunity to give back through this review was very meaningful to me.

I hope you all enjoy it!

I’m so proud of Brazilian neurology. All study sites were in Brazil, and the trial was funded by the Brazilian government and Einstein Hospital and published in @NEJM. What a fantastic achievement and contribution to the field of secondary stroke prevention. Vai Brasil! 🇧🇷

Neurology in 2026 retains the same core clinical reasoning as it did fifty years ago. The neurological examination remains the most vital component of the evaluation. While trainees may get distracted by advanced MRIs, new antibodies, and podcasts, mastery of neurology must be learned at the bedside. What differentiates a Neurologist from an internist is the ability to perform a neurological examination. Without it, one cannot localize the problem, define the syndrome, or provide effective care for neurological patients. We must reinforce the fundamentals of neurology for the new generation. No matter how many tests are available, the basics are the same.

I believe this trial has the potential to revive interest in TTR stabilizers for ATTRv neuropathy. Higher dose Tafamidis (cardiomyopathy dose) or Acoramidis are likely to be as effective as gene silencers for ATTRv neuropathy, as they appear to be for cardiomyopathy. For those unfamiliar with this issue, Tafamidis was tested in ATTRv-PN at 20mg daily and is currently given at this dose for neuropathy in many countries (not in the US), and it's approved for ATTR cardiomyopathy at 61mg daily. Higher doses of tafamidis produce more stabilization of the TTR protein, leading to better efficacy in halting the progression of the disease.

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