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Friday, August 11, 2017

Singing May Be Good Medicine for Parkinson's Patients

August 11, 2017

Voice coaching appears to help swallowing and breathing, study finds






FRIDAY, Aug. 11, 2017 (HealthDay News) -- Singing? To benefit people with Parkinson's disease? It just may help, a researcher says.

"We're not trying to make them better singers, but to help them strengthen the muscles that control swallowing and respiratory function," said Elizabeth Stegemoller, an assistant professor of kinesiology at Iowa State University.
Stegemoller holds a weekly singing therapy class for Parkinson's disease patients. At each session, participants go through a series of vocal exercises and songs.
Singing uses the same muscles as swallowing and breathing control, two functions affected by Parkinson's disease. Singing significantly improves this muscle activity, according to Stegemoller's research.
"We work on proper breath support, posture and how we use the muscles involved with the vocal cords, which requires them to intricately coordinate good, strong muscle activity," she said in a university news release.
Other benefits noted by patients, their families and caregivers include improvements in mood, stress and depression, Stegemoller said.
Her research was published in Complementary Therapies in Medicine.
Parkinson's disease is a chronic and progressive movement disorder. Nearly one million Americans live with the disease. The cause isn't known, and there is no cure at present. But there are treatment options such as medication and surgery to manage symptoms, according to the Parkinson's Disease Foundation.
Symptoms can include tremors of the hands, arms, legs, jaw and face; slowness of movement; limb rigidity; and problems with balance and coordination.
More information
The U.S. National Institute of Neurological Disorders and Stroke has more on Parkinson's disease.
SOURCE: Iowa State University, news release, Aug. 2, 2017
https://consumer.healthday.com/cognitive-health-information-26/parkinson-s-news-526/singing-may-be-good-medicine-for-parkinson-s-patients-725273.html

CBD Improves Quality of Life Measures in Parkinson’s Disease Patients, Trial Finds

11 August, 2017

A clinical trial found that daily cannabidiol (CBD) treatments significantly improved well-being and quality of life measures in patients diagnosed with Parkinson’s disease.




Cannabidiol (CBD) helps improve life quality in patients with Parkinson’s disease, according to a study published in the Journal of Psychopharmacology.
Parkinson’s disease is a progressive neurodegenerative disease characterized by the degeneration of dopaminergic neurons. Previous studies have suggested that CBD, one of the over 85 cannabinoids found in cannabis, interacts with the endocannabinoid system to potentially provide neuroprotective effects that inhibit the loss of neurons. Researchers have suggested that CBD could therefore be beneficial for limiting the progression of neurodegenerative diseases.
In this double-blind clinical trial, researchers from Brazil’s University of São Paulo examined the effects of CBD on 21 Parkinson’s disease patients without dementia or comorbid psychiatric conditions. The participants were split into three equal groups of seven. Over six weeks, one group was treated daily with a placebo, while the other two groups were given daily treatments of 75 mg CBD or 300 mg, respectively. One week before the trial and in the last week of treatment, all 21 participants were tested for motor and general symptoms, well-being and quality of life, and possible neuroprotective effects.
The researchers observed that the group receiving daily 300 mg CBD saw significant improvements in quality of life and well-being.
To measure well-being and quality of life, the researchers used the self-reported instrument, Parkinson’s Disease Questionnaire – 39 (PDQ-39), which examines mobility, activities of daily living, emotional well-being, stigma, social support, cognition, communication, and bodily discomfort.
“Quality of life is an important measure in clinical trials because it refers to a number of areas related to personal well-being,” the researchers concluded. “It is known that many therapies are able to improve the core symptoms of a given disease without corresponding improvements in quality of life.”

The researchers found no significant differences in motor symptoms and neuroprotective effects between the three groups after six weeks. The study’s small sample, however, prevented them from making any definitive conclusions. They also noted that the lack of observable neuroprotective effects and motor symptom improvements might be related to an insufficient time period or that most participants were in the early stages of the disease and therefore had low baseline scores.
In the study’s discussion, the researchers did acknowledge that other studies have also shown CBD to improve emotional well-being and that many indicate that CBD serves as a neuroprotective agent by interacting with the endocannabinoid system to elicit anti-inflammation, reduce oxidative stress, attenuate glial cell activation, and normalize glutamate homeostasis.
“Nowadays, most drugs used in the treatment of [Parkinson’s disease] act in the dopaminergic system and little is known about the role of other neurotransmitter systems in the disease,” the study reads. “The endocannabinoid system seems to be an important target of investigation, mostly because of its action in those considered as the non-motor symptoms of [Parkinson’s disease and of reports of its possible neuroprotective effects.”
The researchers urged studies with larger sample sizes to more conclusive evidence of CBD’s quality-of-life benefits in patients with Parkinson’s.
The study, “Effects of cannabidiol in the treatment of patients with Parkinson’s disease: An exploratory double-blind trial,” is available to access via SAGE Journals.
Learn more about how cannabinoids like CBD may help in the treatment of Parkinson’s disease and other neurodegenerative disorders by visiting our education page. Keep up with the latest cannabis-related studies through our news feed.
This article may contain certain forward-looking statements and information, as defined within the meaning of Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934, and is subject to the Safe Harbor created by those sections. This material contains statements about expected future events and/or financial results that are forward-looking in nature and subject to risks and uncertainties. Such forward-looking statements by definition involve risks, uncertainties.

http://www.medicalmarijuanainc.com/cbd-improves-quality-life-measures-parkinsons-disease-patients-trial-finds/

JU offers dance class for Parkinson’s patients: ‘Everybody has the right to dance’

By Beth Reese Cravey  August  11, 2017




With instructor Cari Coble leading the way, they moved their hands and arms about as if they were maneuvering the strings of a marionette.

Then members of Coble’s class — most of whom have Parkinson’s disease — tried to mimic her movements as if they were Alice in Wonderland looking through the looking glass. But there were no wrong moves, no possibility of being lost to a Wonderland rabbit hole, she said.

“It’s all interpretive,” she said. “If you fall in the hole, we’ll come and get you.”
The free dance therapy class is the brainchild of Coble, a dance professor at Jacksonville University who is working toward becoming Northeast Florida’s only certified Parkinson’s dance therapy instructor. Teaching a community class is a required part of the certification process at Dance for PD in Brooklyn, N.Y.
But Coble said she also has other motives: to help two local relatives who have the disease and to show her students there are “other aspects of dance” to consider as careers once they graduate. For her relatives and the community, she views the weekly class not so much as therapy, but opening up “dance arts” to people who might think they are unable to participate.
“Everybody has the right to dance, everybody should be able to dance,” she said. “You don’t have to be good at it. You just have to enjoy it.”
Parkinson’s is a progressive disorder of the nervous system that affects movement. Dance therapy classes allow patients “to experience the joys and benefits of dance while creatively addressing symptom-specific concerns related to balance, cognition, motor skill, depression and physical confidence,” according to Dance for PD.
“The bad thing about Parkinson’s is that your body is acting strange … but the mind is all there,” Coble said. Dance therapy can give patients “more stability in … day-to-day life, even in the first week,” she said. “Having an activity where you’re not focused on what your body can’t do but on what it can do is really beneficial.”
Jay van Gerpen, a neurologist at Mayo Clinic’s campus in Jacksonville, said he was “very enamored” of such dance therapy.
“It’s well-known that patients with Parkinson’s have better functional outcomes with exercise, particularly types associated with movement such as walking and dancing,” he said. “Indeed, exercise has been shown convincingly to decrease the rate of disease progression in Parkinson’s. Dancing has the added benefits of enhancing balance and increasing socialization for Parkinson’s patients. It’s also fun.”
At a recent class in a JU dance studio, Coble and dance student Hanny Mena Smith led a handful of Parkinson’s patients and accompanying friends in a series of exercises. They were accompanied by largely upbeat — but not exhaustingly upbeat — music. They twisted, they clapped, they stretched their arms toward the ceiling and toward the floor. They gestured as if they were pushing, then pulling something with their arms, and flowing-river movements.
When Coble moved a dance barre to the center of the room, they held on and mimicked ballet dancers’ movements.
“Elevate, balance, step up, stretch,” she said. “Rock, step, step, step.”
When “Take Me Out to the Ballgame” played, they mimicked the movements of pitcher, catcher and hitter.
“Sliding into home,” Coble said, “may not be the best choice.”
Her cousin, Gail Cobb, 76, was diagnosed with Parkinson’s in 2004. She said the exercises help loosen her up, and the group-setting of Coble’s class keeps her going.
“Exercise is probably the best thing to do with Parkinson’s,” she said. “But it’s hard to get motivated by yourself.”
Class members follow Coble’s movements at their own ability and pace, so some arms may stretch further than others. Some may take more breaks than others. But everyone accepts everyone else’s limits, Cobb said.
“If we all did it perfect, we wouldn’t be here,” she said.
Florence Le Fur, 77, was diagnosed 13 years ago. The class is a bright spot in her life, she said.
“It’s just fun,” she said. “When something’s fun, you want to do it. … When you put music in it, it’s even better.”
Despite Parkinson’s, she and other patients in the class are still alive and kicking, she said, “because we move.”
Beth Reese Cravey: (904) 359-4109
Jacksonville University Parkinson’s Dance Therapy
The free class is normally 1 p.m. Mondays but is now taking a break until Aug. 28. For more information contact JU dance professor Cari Coble at (904) 256-7398 or ccoble@ju.edu.
Dance for PD
Founded in 2001, the nonprofit Dance for PD offers specialized dance classes to people with Parkinson’s, their families, friends and care partners in eight locations around New York City and through affiliates in about 100 communities in 20 countries. For more information, contact Dance for PD at Mark Morris Dance Group, 3 Lafayette Ave., Brooklyn, N.Y. 11217 or (800) 957-1046 or go to danceforparkinsons.org.

http://jacksonville.com/news/health-and-fitness/2017-08-11/ju-offers-dance-class-parkinson-s-patients-everybody-has-right

Senior Helpers® Expands in Chicago

August 11, 2017




BALTIMOREAug. 11, 2017 /PRNewswire/ -- Senior Helpers®, one of the nation's premier providers of in-home senior care, today announced it has acquired Handle with Care in Elmhurst, Ill. Handle with Care has served the Windy City and surrounding areas for over eight years. As part of Senior Helpers continuing expansion, the new acquisitionmarks the second location to be corporate-owned and operated by Senior Helpers, its 12th location in the Greater Chicago area, and joins more than 311 franchised Senior Helpers businesses worldwide.

"Our strategic acquisition of Handle with Care builds upon our already strong market presence in Greater Chicago," said Peter Ross, CEO and co-founder of Senior Helpers. 
"We're proud to have the opportunity to serve even more people throughout the region and to help ensure that local families have access to trusted senior care for their loved ones."
Handle with Care, a well-known senior care business which opened in 2009, will continue being managed by the previous owners under the Handle with Care brand, but will leverage Senior Helpers' expertise, national resources and legacy of excellent client service.
"After eight years of providing Elmhurst-area residents with dignified, trusted care, we are so excited to begin a new chapter under the Senior Helpers umbrella," said Julie Kastholm, co-founder of Handle with Care. 
"We're looking forward to staying on as managers and will remain close to our clients who have brought us so much joy through the years."
Based in Towson, Maryland, Senior Helpers was purchased by Altaris Capital Partners, LLC in late 2016, enabling the organization to expand into new territories, including Fountain Valley, CAFranklin, OHNew City, NYFairfield, CT and more. The company currently operates more than 300 franchises worldwide. Its first company-owned franchise opened in Baltimore in April 2017
Founded in 2001 with a vision to help seniors who wish to remain in their homes – despite age-related illnesses and mobility challenges – Senior Helpers serves elderly individuals and their families around the world. Senior Helpers differentiates itself with its proprietary, specialized programs that have been developed in collaboration with leading medical experts. The company was the first provider in the industry to offer specialized care services for individuals with Alzheimer's, dementia and Parkinson's disease. Senior Helpers also added a new Parkinson's Care Program in 2016, a specialized training and certification program created in conjunction with leading experts from the National Parkinson Foundation's Center of Excellence.
For more information about the company, visit http://www.seniorhelpers.com. To learn more about franchising opportunities, visit http://seniorhelpersfranchise.com or call Amy Petersen-Smith at (443) 921-1783.
About Senior Helpers Senior Helpers is a premier in-home senior care provider in the U.S. with 311 franchised businesses operating across the globe. Founded in 2001 with a vision to help seniors who wish to remain in their homes despite age-related illnesses and mobility challenges, Senior Helpers has now cared for tens of thousands of seniors with a pledge to provide "care and comfort at a moment's notice." Senior Helpers offers a wide range of personal care and companion services, including trained Alzheimer's, dementia and Parkinson's care, to assist seniors who wish to live independently. Learn more by visiting http://www.seniorhelpers.com

Contact: 
Lindsay Anthony 
Havas Formula 
(619) 234-0345 

http://www.bioportfolio.com/news/article/3273293/Senior-Helpers-Expands-in-Chicago.html

Therapy improves mobility for Parkinson's disease patients

By Laura Garcia
Aug. 10, 2017

Mary Blanton, 74, front, walks for six minutes with Mary Drost, a physical therapist, at Victoria Physical Therapy. Blanton was diagnosed with Parkinson's disease three years ago. She has postural instability and gait disorder from Parkinson's, which impairs her mobility. Drost recently trained to be certified in the LSVT BIG program, which helps patients retrain their brains to improve their motor skills.

Mary Blanton, 74, noticed years ago she was dragging her foot a little bit.
"It just kept on getting worse," she said.
Three years ago, she was diagnosed with Parkinson's disease by a Houston doctor.
The neurodegenerative brain disorder progresses slowly in most people and, in her case, affects her gait and balance.
So when her doctor recommended a specific type of therapy called LSVT BIG, she turned to a physical therapist she has trusted for the past 20 years or so.
Mary Drost, 55, was working on a doctorate degree at the University of Texas Medical Branch at the time.
Drost's professor recommended she become certified in the therapy for her last semester because it complemented her coursework.
When Blanton learned Drost would be able to provide the specialized treatment locally, she was able to breathe a sigh of relief.
Drost said with an aging population, this protocol will become more crucial.
Laura Guse, chief clinical officer of LSVT BIG, said the program should be prescribed early in the course of Parkinson's disease.
"Don't wait till you're falling over or having severe problems with your mobility or speech. Do something now," she said.
Physical and occupational therapists can be certified to offer the treatment intervention, which was developed from a speech treatment called LSVT LOUD.
Guse said they first started training these therapists in 2007 and have since then trained more than 13,000 globally.
"People with Parkinson's are not aware of how small and how slow their movements are because there's a sensory deficit," she said.
The treatment is more than a general exercise approach because it changes a patient's brain and motor learning, she said.
"We very systematically address sensory impairment so the person learns how big they have to move to be moving normally," Guse said.
Last week, during her last visit to Victoria Physical Therapy's office, Blanton learned just how helpful the treatment was.
Drost said the goal was to work one-on-one four consecutive days a week to retrain her brain to use bigger movements.
"She's doing great," Drost said as she timed and took detailed notes during Blanton's most recent therapy session.
She watched Blanton's balance and how quickly she was able to get up from a chair and walk.
The final test was a six-minute test to see how many feet she could walk continuously.
Drost walked closely behind as Blanton took off down a hallway, determined to do better than she did four weeks before.
"Keep walking big and fast to the very end," Drost encouraged Blanton.
And she did.
The first time she did the test, she walked 493 feet within six minutes. This time, she walked 1,381 feet.
"That's very significant," Drost said. "We have to attribute it to the intervention."
Blanton just completed the four-week treatment program and plans to continue the exercises at home with the help of her husband of 57 years, Jeff Blanton.
"He is wonderful," she said. "He didn't expect me to be so much better after just one time."
Traveling to doctor's appointments in Houston is tough, but even a trip to the store is tiring.
"With Parkinson's, I have to watch what I do because I get super tired," she said.
Guse said this treatment gives people hope after they've been diagnosed with a devastating disease like Parkinson's.

"It gives them a chance at empowerment that they can't get from a pill," she said.
https://www.victoriaadvocate.com/news/2017/aug/10/therapy-improves-mobility-for-parkinsons-disease-p/

Good Samaritan offering treatment for Parkinson's disease

August 11, 2017




Good Samaritan has joined the movement for what is thought by many in the field of physical medicine to be the finest treatment for Parkinson’s disease to date. Joy Uy, physical therapist, and James Schenk, occupational therapist of Good Samaritan are certified providers for this Parkinson’s treatment program.
LSVT is a relatively new approach to treatment of Parkinson’s disease involving the concept of neuroplasticity, the brain’s ability to reorganize itself by forming new neural connections throughout life. This approach aims to address the “internal” aspects of Parkinson’s disease symptoms, leading to significant functional movements.
There are two sections of LSVT, BIG and LOUD. LSVT BIG is a standardized treatment protocol, which is customized to the unique goals of each patient including both gross and fine motor skills. LSVT LOUD is customized to the unique communication goals of each person across a range of disease severity and communication impairments.
Over the last 25 years, the National Institutes of Health have been researching and developing LSVT BIG and LOUD to help treat patients with symptoms associated with Parkinson’s disease.
Uy says she and Schenk are currently utilizing the LSVT treatment protocol to manage the symptoms of Parkinson’s patients in Good Samaritan’s Rehabilitation Center.
Research on LSVT BIG has documented improved ratings for people with Parkinson’s disease on faster walking with bigger steps, improved balance, increased trunk rotation, improvements in activities of daily living and improved motor skills.
LSVT LOUD documented improvements in Parkinson’s patients on increased vocal loudness, improved articulation and speech intelligibility, improved intonation, improvements in facial expression and changes in neural functioning related to voice and speech.
Patients usually can see and feel a significant change “after one hour daily” of LSVT treatment Uy said. Results from this treatment are “long term but patients need to carry over tasks and home exercises,” explained Uy. Without continually performing the exercises the improvements will slowly diminish and the symptoms will return.
LSVT treatment consists of 16 sessions of four consecutive days over a four week span for one hour at a time. Each patient is given individualized homework practices and carryover exercises to perform on their own to keep symptoms at bay and continue to increase progress.
http://www.washtimesherald.com/community/good-samaritan-offering-treatment-for-parkinson-s-disease/article_ff5fa334-9186-58b2-a3ae-e2fcbaec950d.html

Ocular Tremor in Parkinson's Disease: Inherent or Compensatory?

August 10, 2017

It remains unclear whether ocular tremors are inherent in Parkinson’s or not.



Observations of ocular tremor in patients with Parkinson's disease (PD) have triggered intensive debate over the past 5 years on whether it represents an early clinical marker of PD or a compensatory vestibulo-ocular reflex (VOR) to head tremor.
In a review recently published in Frontiers in Neurology, Diego Kaski, MRCP, PhD, and Professor Adolfo Bronstein, MD, PhD, FRCP, both of  Imperial College London and authors of numerous articles on the topic, laid out evidence in support of both arguments.1 To date, no study has conclusively proven either theory to be correct.
Ocular tremor was first described by Duval and Beuter in 1998, in 3 of 5 patients with monocular oscillations localized to the side of the body most affected by PD.2 The frequency of the oscillations, which the investigators believed were pathophysiologic in origin, aligned closely with resting limb tremor in those patients, but the amplitudes did not match. The investigators concluded that an “attractor effect” from the movement of the resting limb tremor was responsible.
Dr Kaski and Professor Bronstein noted that this study was largely ignored until 2012, when Gitchel et al identified a “pervasive ocular tremor” in all of 112 PD patients studied.3 Recorded oscillations showed a continuous fixation instability with an average frequency of 5.7 Hz (relative to limb tremors ranging from 4 Hz to 7 Hz) and mean horizontal and vertical amplitudes of 0.27 and 0.33, respectively.

Theory 1: Ocular Tremor Is Inherent in PD

Several pieces of evidence from these and other studies support an inherent role of ocular tremor in PD, including:
  • The lack of a direct relationship between resting limb tremor and amplitude of ocular oscillations in the Duval and Beuter study pointing to independent mechanisms between the two
  • Duval and Beuter had participants bite down on a tongue depressor attached to the chair in order to stabilize the head, which could have caused activation of the VOR and that would have explained their findings of asymmetrical oscillations between the eyes
  • All patients in the Gitchel study, including those who were not medicated, showed evidence of ocular tremor
  • Using a magnetic tracker to detect head movement in a subset of 62 patients, the Gitchel study did not identify any evidence of motion
  • A second study by Gitchel et al4 identified ocular tremor in PD, irrespective of whether the head was fixed
  • No evidence of ocular tremor was found in patients with essential tremor5

Theory 2: Ocular Tremor Is Due to Head Oscillation

In their own work, Dr Kaski and Professor Bronstein provided substantial evidence against an inherent basis for ocular tremor, suggesting instead that it was more likely the result of compensatory mechanisms to head tremor in PD. Fundoscopic examinations showed ocular oscillations in patients with head tremor and bilaterally impaired VOR, resulting in pendular pseudonystagmus. They pointed to a lack of observations in Parkinson's studies over the past 30 years6,7 (with the exception of Duval and Beuter) as the first clue. In these cases, the patients reported oscillopsia that was clinically evident. Kaski et al1 determined that oscillopsia is indicative of an intact VOR and is specifically not reported by patients with PD and head tremor.
In another study of 2 eye clinic patients with head tremor, Kaski and colleagues8 reported ocular oscillations that revolved in the opposite direction of head movement and were minimized by restraint, leaving them to conclude that the ocular tremor was a compensatory response — in complete opposition to conclusions reached by Gitchel et al.
Other clinical features that support nonpathologic mechanisms include:
  • Observations that nearly every form of ocular oscillation is affected by eye movements such as saccades and blinks— with the exception of pervasive ocular tremor—suggesting a lack of involvement of the ocular motor system9
  • Expectations that the high frequency of ocular tremor in PD would induce oscillopsia,9 and that pervasive ocular tremor should be visible during direct ophthalmoscopy10
  • Uniocular tremor observed in a patient with asymptomatic oculopalatal tremor secondary to a brain bleed affecting the inferior olivary nucleus,11 which challenged Gitchel's presumption of tremor as a fundamental feature of preclinical PD

The extensive disagreement between the 2 scientific camps on the origins of ocular tremor has become at times publicly confrontational, as indicated by a letter published in Parkinsonism Related Disorders in 2014,4 in which Baron, Gitchel, and Wetzel argued that:
“Our manuscripts consistently provide comprehensive scientific evidence that ocular tremor is a fundamental feature of Parkinson's disease, which is not influenced by head movement or peripheral tremor.15,29 This finding arguably has major implications for diagnosing PD, offering a much sought after, dependable, and non-invasive biomarker. Unfortunately, Kaski, Saifee, and colleagues continue to question the validity of our findings.8,12 Now that we have provided evidence of absolute head stability from numerous independent sensors in multiple patients, they suggest that the ocular tremor could represent improper filtering of signals.”
The Kaski-Bronstein review,1 while accepting some of the arguments put forward by the Gitchel papers, also reiterated concerns over potential recognition of pervasive ocular tremor as a predictive biomarker of PD, strongly suggesting the need for research from other laboratories “to identify whether head tremor is indeed a ubiquitous finding in PD, and whether such tremor could be identified using eye movement recordings,” they wrote.

References

  1. Kaski D, Bronstein AM. Ocular tremor in Parkinson's disease: discussion, debate, and controversyFront Neurol. 2017;8:134.
  2. Duval C, Beuter A. Fluctuations in tremor at rest and eye movements during ocular fixation in subjects with Parkinson's diseaseParkinsonism Relat Disord. 1998;4:91-97.
  3. Gitchel GT, Wetzel PA, Baron MS. Pervasive ocular tremor in patients with Parkinson diseaseArch Neurol. 2012;69:1011-1017.
  4. Gitchel GT, Wetzel PA, Qutubuddin A, Baron MS. Experimental support that ocular tremor in Parkinson's disease does not originate from head movement. Parkinsonism Relat Disord.2014;20:743-747.
  5. Gitchel GT, Wetzel PA, Baron MS. Slowed saccades and increased square wave jerks in essential tremorTremor Other Hyperkinet Mov (NY). 2013;3.
  6. Otero-Millan J, Schneider R, Leigh RJ, Macknik SL, Martinez-Conde S. Saccades during attempted fixation in parkinsonian disorders and recessive ataxia: from microsaccades to square-wave jerks. PLoS One. 2013;8:e58535.
  7. Chen AL, Riley DE, King SA, et al. The disturbance of gaze in progressive supranuclear palsy: implications for pathogenesisFront Neurol. 2010;1:147.
  8. Kaski D, Saifee TA, Buckwell D, Bronstein AM. Ocular tremor in Parkinson's disease is due to head oscillationMov Disord. 2013;28:534-537.
  9. Leigh RJ, Zee DS. The Neurology of Eye Movements. 5th ed. New York, NY: Oxford University Press; 2015. 
  10. Younge BR, McLaren JW, Brown WL. Retinal image stability in head tremor and nystagmus: counterintuitive observations. J Neuroophthalmol. 2007;27:107-114.
  11. Jang L, Borruat FX. Micronystagmus of oculopalatal tremor. Neurology. 2013;80:e27.
  12. Saifee TA, Kaski D, Buckwell D, Bronstein AM. Tremor of the eye in Parkinson's disease: merely a measure of the head movementParkinsonism Relat Disord. 2014;20:1447e8./
http://www.neurologyadvisor.com/movement-disorders/ocular-tremor-in-parkinsons-disease-pathologic-origin/article/681184/-tremor-in-parkinsons-disease-pathologic-origin/article/681184/

Melanoma and Parkinson's: A Surprising Connection

Arefa Cassoobhoy, MD, MPH
August 11, 2017




Hello. I'm Dr Arefa Cassoobhoy, a practicing internist, Medscape advisor, and senior medical director for WebMD. Welcome to Morning Report, our 1-minute news story for primary care.

Linked Diseases: Parkinson's and Melanoma

A Mayo Clinic study[1] looked at a cohort of almost 1000 patients with Parkinson's disease and found a fourfold increased risk for preexisting melanoma. Next, they assessed the prevalence of Parkinson's in more than 1500 skin and ocular melanoma patients. They also had a fourfold increased risk for Parkinson's.
Researchers don't yet know which environmental, genetic, or immunologic abnormality is linking these two diseases, but it doesn't seem to be the Parkinson's drug levodopa. For now, it's too early to recommend changing routine screening. However, it's still important for clinicians to be aware of the link-to be vigilant for one disease in patients who have the other, and to counsel those patients about their increased risk.
Follow Dr Cassoobhoy on Twitter at @ArefaMD
To see another Video :
http://www.medscape.com/viewarticle/884070