Michael Okun

Could a cough syrup slow Parkinson’s disease? Ambroxol clinical trials move forward. New Viewpoint paper in Movement Disorders describes how Ambroxol, a frequently used cough medicine in many countries, is being studied as a potential disease modifying therapy for Parkinson’s disease.

Should we build urban concussion centers to improve brain injury recovery? YES! New paper in Neurology Clinical Practice explains how the NYU Langone Concussion Center was designed to deliver interdisciplinary concussion care and address major gaps in urban brain injury treatment.

Spirituality and neurological diseases like Parkinson’s and Alzheimer's. Could faith, meaning and purpose shape how folks cope and heal? Spirituality can play a powerful role in neurologic disease care, including PD and AD and how health care providers can better address it as part of whole care.

Rotator cuff abnormalities on MRI were present in 99% of adults aged 41 to 76. We need to avoid over-reaction to rotator cuff findings, especially in Parkinson’s and Alzheimer’s. New paper in JAMA Internal Medicine how rotator cuff abnormalities on MRI may be nearly universal after age 40.

Can we bring Parkinson’s physical therapy into the living room? A new telerehabilitation feasibility trial says YES. New paper in the Journal of Parkinson’s Disease how individualized real time physiotherapy delivered via videoconference may improve activity and motor outcomes in early Parkinson’s.

Do you know what the honeycomb brain pattern may be telling you if you see it on a MRI? Spoiler alert: could it be hidden small vessel disease? Think NIT1 gene. Nice paper in resident and fellow section of Neurology.

The dreaded hospital UTIs in Parkinson’s. A silent trigger for delirium and longer hospital stays. New paper in Movement Disorders Clinical Practice how UTIs impact hospitalized Parkinson’s disease and what risk factors and outcomes health care providers should know about. I am biased as an author.

Does vitamin B12 play a role in Parkinson’s disease risk? What do the genes tell us? New paper in Neurology Genetics how genes involved in vitamin B12 metabolism may relate to Parkinson’s disease risk, onset and progression. Looks like the B12 related genes not as important to risk.

Could your physical capacity determine whether walking helps or harms falls risk in Parkinson’s disease? McArdle and colleagues describe in a new paper in the J of PD how physical capacity changes the relationship between daily walking and falls in the setting of Parkinson’s disease.

What can we learn from lung cancers in never smokers? What are the silent clues hiding beyond cigarettes? New paper about never smokers w/ lung cancer is emerging as a biologically distinct disease. Will it unlock clues for prevention, early detection and precision therapies.
cutt.ly/Rtm11UqH

Should we ever turn off or let the deep brain stimulation (DBS) battery expire in late-stage Parkinson’s disease? Spoiler alert: In most cases NO. New paper in Movement Disorders Clinical Practice how to think about risk-benefit considerations when discontinuing DBS in late stage Parkinson’s.

A new randomized fecal microbiota transplantation study just dropped in Parkinson’s disease. Spoiler alert: Disappointing motor effects, however some positive non-motor signals. A single colonoscopy delivered FMT tested over 12 months.

Mini-brains in a dish reveal hidden inflammation in Parkinson’s disease. What are organoids? Organoids are three dimensional clusters of human cells grown from stem cells that mimic key features of real brain tissue, but do it in the confines of a laboratory dish.

This is one of the most rigorous long-term prospective looks at coffee, tea and cognitive outcomes. The signal is consistent across dementia diagnosis, subjective complaints and telephone based cognitive testing. The pattern matters. Moderate intake = sweet spot. More is not necessarily better.

Exergaming for Parkinson’s disease: can play unlock better quality of life in advanced Parkinson’s stages? Exergaming refers to video games that require physical movement and mental engagement. They transform exercise into interactive play.

Blood and CSF biomarkers take a multiplex leap in Parkinson’s and MSA. What does NULISA mean? NULISA stands for Nucleic Acid Linked Immuno-Sandwich Assay, a highly sensitive method that can measure many proteins at once from very small blood or CSF samples.

Can a skin pump smooth dopamine delivery in Parkinson’s disease? A fresh look at subcutaneous levodopa. Subcutaneous means medication is delivered under the skin using a small pump to provide more continuous drug levels, rather than pills taken by mouth.

Check out my latest Substack column.
A Growing Blind Spot: Microplastics and the Future of Brain Health.
Floating in our air, sitting in our food, and bottled in our water.
substack.com/home/post/p-...
Nice new paper in NPJ Parkinson's on the topic:
www.nature.com/articles/s41...

Can big data finally untangle neurodegeneration? Lessons from the 'omics era.' Omics refers to large scale biological measurements such as genes, RNA proteins and metabolites that together help to explain how diseases start and progress. This paper addresses where the field has learned hard lessons.

Can policy lower dementia risk at scale? Who isn't interested in this question? The Nottingham consensus just weighed in. New paper describes how an international expert panel reached consensus on actionable dementia risk reduction policies to move evidence into real world public health action.

When hands move and the mouth ‘joins in.’ An under-appreciated motor signal in Parkinson’s disease. Motor overflow refers to involuntary movements that appear in body parts not intentionally being used when another movement is being performed. Makhoul and Jankovic describe in a new paper.

Is dirty air accelerating ALS and motor neuron disease? Particulate matter refers to tiny air pollution particles that can be inhaled deep into the lungs and can enter the bloodstream, potentially triggering inflammation and injury in the brain and nervous system.

When fats go wrong: lipid dysmetabolism in Parkinson’s disease. De-Paula and colleagues describe in a new paper in Brain how genetic risk for Parkinson’s disease links to specific disruptions in lipid metabolism that may be part of driving the disease biology.

Normal pressure hydrocephalus (NPH): Is this the comeback story of a treatable brain disorder? New Viewpoint in JAMA Neurology how idiopathic normal pressure hydrocephalus has entered a new era driven by better evidence, improved patient selection and renewed engagement across care teams.

Genes meet environment in Parkinson’s risk: enter the ‘dual risk axis.’ What does dual risk axis mean? Üstündağ and colleagues describe a new paper that just dropped in Journal of Parkinson’s Disease how GBA1 mutations and occupational pesticide exposure intersect in Parkinson’s disease.

Postmortem blood biomarkers and relationship to Alzheimer’s pathology. Kivisäkk and colleagues describe a new paper that just dropped in Neurology how blood biomarkers, measured before death, related to what was found in the brain at autopsy across Alzheimer’s disease and related dementias.

MRI assessment of the nigrosome in Parkinson’s disease: Is it ready for everyday clinical practice? Spoiler alert: It is not ready for prime time. What is a nigrosome? A nigrosome is a small cluster of dopamine producing nerve cells frequently lost in Parkinson’s disease.

Hearing loss in Parkinson’s: the silent non motor symptom we keep missing. Spoiler alert: hearing loss is twice as common in Parkinson's. New paper in Movement Disorders how hearing loss is common in Parkinson’s disease and involves both the ear and the brain. @parkinsondotorg.bsky.social

Does gabapentin really cause dementia? Spoiler alert: It likely does not. What does the data actually tell us. Tsai and colleagues in a paper in Journal of Affective Disorders examining whether gabapentin use in adults w/ chronic pain was linked to dementia risk.
pubmed.ncbi.nlm.nih.gov/38729220/

Are there divergent recovery paths in musicians’ dystonia? Spoiler alert: mouth related dystonia does far worse. Doll-Lee and colleagues describe in a new paper that just dropped in Tremor and Other Hyperkinetic Movements how recovery differs between embouchure dystonia and musician’s hand dystonia.