Paul Beach

Locus coeruleus degeneration is associated with orthostatic hypotension in Parkinson’s disease and multiple system atrophy - Clinical Autonomic Research Purpose We compared locus coeruleus (LC) structural integrity, as measured by neuromelanin-sensitive magnetic resonance imaging (NM-MRI), between patients with Parkinson’s disease (PD) and those with ...

Coeurleophiles and autonomic fanatics, rejoice! I bring you a paper combining both.
Here, we show that orthostatic hypotension must accounted for if attempting to utilize locus coeruleus integrity (with NM-MRI) in the DDx of #Parkinson's and #MultipleSystemAtrophy.
link.springer.com/article/10.1...

Supine hypertension and cardiovascular disease: controversies and advances Elevated blood pressure is one of the most important risk factors for cardiovascular disease (CVD). Despite blood pressure being historically measured in the supine position prior to the 20th centu...

Excited to share this comprehensive review on supine hypertension led by brilliant resident, Sally Zimmerman!
@bidmcreseach.bsky.social
@rueyhu.bsky.social
@pbeach.bsky.social

Supine hypertension and cardiovascular disease: controversies and advances
www.tandfonline.com/doi/full/10....

Clinical Reasoning: A 72-Year-Old Man With Progressive Pan-Dysautonomia | Neurology Dysautonomia is a common clinical feature among many central and peripheral neurologic disorders. Evaluation of patients with dysautonomia can be challenging in the absence of a previously established...

Can you figure out the etiology of this patient's autonomic failure?
www.neurology.org/doi/10.1212/...

Approach to Cardiovascular Autonomic Dysfunction in Patients with Synucleinopathies Background Autonomic dysfunction is a common feature of synucleinopathies such as Parkinson's disease (PD), dementia with Lewy bodies (DLB), multiple system atrophy (MSA), and pure autonomic failure...

Do YOU know the nuances of evaluating and managing cardiovascular autonomic failure in synucleinopathy patients? Check out this hot off the press review by my good friend Abhi Lenka and I, now published in @movedisorder.bsky.social's Clinical Practice journal.
doi.org/10.1002/mdc3...

A quick update re NIH and NSF terminated grant tracking:

Grant Watch has a new name!

We're now called **Grant Witness**

You can find us at grant-witness.us

Please update your bookmarks and spread the word! 🙏

(And no, this wasn't our preference, but trademarks are a thing. 🤦‍♂️🤷‍♂️)

- Exenetide had promise as a disease modifying agent in #Parkinsonsdisease. How about #MSA?
- Single center, *open-label* 48 wk trial lower change in UMSARS score over tme.
- Treatment had no impact on objective findings.
- Placebo/bias effects highly likely.
onlinelibrary.wiley.com/doi/10.1002/...

I am 3 years out of formal training in movement disorders - a two year fellowship - and I only just heard a coherent rationale for why we refer to certain diagnoses as “essential.”

Thanks to Bsky-less podcast from Practical Neurology.

Changes in heartbeat-evoked potentials reflect changes in blood pressure | Journal of Neurophysiology | American Physiological Society The heartbeat-evoked potential (HEP) is a growingly used electrophysiological method to study cardiac interoception; however, cardiovascular influences on these responses are not fully understood. In ...

The heartbeat evoked potential is modulated by fluctuations in blood pressure, as measured during paced breathing and postural changes.

journals.physiology.org/doi/abs/10.1...

Epidural spinal cord stimulation for the management of orthostatic hypotension in Parkinson’s disease: A case report Parkinson's disease (PD) therapies predominantly target motor symptoms via dopaminergic agents and deep brain stimulation (DBS), yet critical non-motor symptoms like orthostatic hypotension (OH) remai...

Chronic low thoracic epidural spinal cord stimulation may work in #Parkinsons with severe orthostatic hypotension.

Previously, a different group showed its feasibility in a patient with multiple system atrophy. Many of us thought it may not work in PD.

www.brainstimjrnl.com/article/S193...

Sage Journals: Discover world-class research Subscription and open access journals from Sage, the world's leading independent academic publisher.

Cerebellar #multiplesystematrophy #MSA & cognition.
Huge number of patients (210).
- 24.8% of patients had cognitive impairment on neuropsych tests of language, memory and processing speed
- *NO* association with OH or HTN
- ⬆️risk w/age, MRI hot-cross bun sign

journals.sagepub.com/doi/full/10....

The heart in attention: evidence for cardiac phase effects in alerting but not executive control Across two experiments, we examined the role of phasic cardiac fluctuations – whether the heart contracts (systole) or relaxes (diastole) – on two att…

#interoception banger alert for new work by @mtsakiris.bsky.social and team.
More evidence on how timing of cardiac phase (systole/diastole) impacts cognitive processes - facilitation of alerting.

www.sciencedirect.com/science/arti...

REM density in Parkinson’s disease: association with motor, cognitive, autonomic function, and dopaminergic medication - npj Parkinson's Disease npj Parkinson's Disease - REM density in Parkinson’s disease: association with motor, cognitive, autonomic function, and dopaminergic medication

Reduced REM sleep density in #Parkinsondisease linked to worse gait. CR levodopa at bedtime increased REM density! Very interesting.
www.nature.com/articles/s41...

It’s a good thing Congress isn’t alive to see this

You'll need institutional or personal access to view by the link, but can DM for a personal copy!

A reset on our reclined position—a call to prioritize neurogenic supine hypertension in the synucleinopathies - Clinical Autonomic Research Clinical Autonomic Research -

Very glad to share this *just* published viewpoint by myself, @abhilenka.bsky.social @spjuraschek.bsky.social @jeanieparkmdms.bsky.social and media-less Cameron in 'Clinical Autonomic Research'
link.springer.com/article/10.1...

When Americans raised concerns about RFK Jr.'s anti-vaccine views, he said he was "not gonna take away vaccines from anybody."

But now he's taking them away from millions of mommas and babies.

Vaccine recommendations should be based on science, not RFK Jr.'s political agenda.

This is why B12 is always on the differential for autonomic failure.
"Subacute Combined Degeneration Presenting
With Prominent Autonomic Symptoms 12 Years
After Total Gastrectomy: A Case Report"

assets.cureus.com/uploads/case...

Peripheral autonomic failure is associated with more severe postprandial hypotension compared to central autonomic failure - Clinical Autonomic Research Purpose Postprandial hypotension (PPH) defined as a decrease in systolic blood pressure of more than 20 mmHg within 2 h post meal is prevalent in patients with autonomic failure and is associated with...

The excellent @vanderbilt.edu #autonomic team coming through with another great study demonstrating that post-prandial hypotension is more common/severe in autonomic failure due to a peripheral etiology.
link.springer.com/article/10.1...

He's literally holding a red lightsaber.

RFK Jr. asks CDC for new measles treatment guidance amid his unfounded claims Kennedy claimed that drugs like budesonide and clarithromycin "have been shown very effective" for measles, but doctors say they don't fight the infection itself.

‘Kennedy told reporters that there were "many, many good ways to treat measles and doctors need to know that and to know those methods.’

One problem; there is no treatment for measles. Signed, a doctor who’s been forced to deal with measles because of this stupid fraud.

Neuronal α‐Synuclein Disease Stage Progression over 5 Years Background Neuronal α-synuclein disease (NSD) is defined by the presence of an in vivo biomarker of neuronal alpha-synuclein (n-asyn) pathology. The NSD integrated staging system (NSD-ISS) for resea...

No such thing as ‘validation’ of the 'neuronal α-synuclein disease integrated staging system' (NSD-ISS) for #Parkinsons.

It uses αSyn-SAA positivity to anchor an “S-D-G” (Synuclein–Dopamine dysfunction–Genetics) model. Does it hold up? (1/4)
movementdisorders.onlinelibrary.wiley.com/doi/10.1002/...

The science is clear: the more you listen to RFK, the stupider you get. Many scientists are saying this. #Trumpland #TrumpLies

An image showing the key results of the paper, including post-implantation reconstructed 3D T1w imaging of the insular electrode seen in the coronal plane and heart-evoked potentials per condition.

Insightful combination of EEG and iEEG in a patient with epilepsy to study the effects of taVNS on heartbeat-evoked potentials (HEP) in the insula. taVNS enhanced HEPs, but the paper does not say the interaction (vs. sham) was not significant. #neuroskyence
www.sciencedirect.com/science/arti...

Autism is not a disease and these kids are not damaged, despite what HHS Secretary Kennedy says.

The NPR, PBS Grift Has Ripped Us Off for Too Long For years, American taxpayers have been on the hook for subsidizing National Public Radio (NPR) and the Public Broadcasting Service (PBS), which spread

As a biologist, I'm appalled at pride the White House takes in willful ignorance.

In yesterday's executive order about NPR and PBS, their first example of "the trash that passes for `news' at NPR and PBS" is the statement that "banana slugs are hermaphrodites."

But this is unequivocal fact.

Not disagreeing. This is a good piece. It offers some grounded and useful advice for how to advance free thought and good values in today’s autocratic America.

But wow is it depressing. This is where we are at now. An autocratic America.

Still, we will fight on together.

Global coordination of brain activity by the breathing cycle - Nature Reviews Neuroscience Synchrony between neuronal activity and the respiratory cycle has been observed in numerous brain regions and across many species. Tort et al. discuss the mechanisms by which brain activity is modulat...

Global coordination of brain activity by the breathing cycle

(new from Adriano Tort and colleagues)
#neuroskyence 🧠🫁

www.nature.com/articles/s41...

Today is World Parkinson’s Day! 🌎 More than 10 million people worldwide are living with Parkinson’s disease.

The Parkinson’s Foundation is dedicated to making life better for people with Parkinson’s disease by improving care and advancing research toward a cure. (1/2)

Do not normalize children dying from measles. Measles was previously eliminated in the US, thanks to vaccines.

When children die from measles, it means that adults have catastrophically failed to protect them because they have rejected basic science.

RFK Jr. says that the “mistakes”made in mass firing HHS personnel was “always the plan”.

It was always the plan to torture federal workers.

It was always the plan to toy with scientists, to try to humiliate them.

It was always the plan, said RFK Jr .