Author: Kevin J. Black, M.D.

Dr. Black is a movement disorders neuropsychiatrist who has cared for patients at the Movement Disorders Center at Washington University in St. Louis for over 20 years. He is listed in Best Doctors in America®. Dr. Black uses innovative brain imaging methods to study movement disorders including Tourette syndrome, the effects of dopamine on the brain, and how the precise location of deep brain stimulation (DBS) changes its clinical effects.

Using beat patterns to treat Parkinson’s disease

If you’ve ever tried to tune a musical instrument against another sound of the same frequency—another instrument or a tuning fork or a digital pure tone generator—you’ll know what I mean by interference beats. If you haven’t, here is an example: Here’s a concert A (440 Hz): This next sound is slightly sharp (444 Hz, […]

Preliminary FDA report on safety of GLP-1 agonist diabetes / weight loss drugs

The U.S. Food and Drug Administration (FDA) was aware of reports of people developing suicidality after use of these drugs (example: Ozempic®/Wegovy®). After examining the available data, they recently reported, “Our preliminary evaluation has not found evidence that use of these medicines causes suicidal thoughts or actions. … However, because of the small number of […]

Why choose WUSTL for psychiatry residency training?

Notes from an email to an applicant Psychiatry residency training at Wash.U. has several strengths that I think are not widely appreciated. One is clinical experience. WU is rightly known for superb research infrastructure, both human and physical. But I think the breadth and depth of the clinical exposure our residents have are second to […]

Update on UK median nerve stimulation trial for Tourette syndrome

The U. Nottingham spinoff company NeuPulse writes, “The clinical trial investigating the effects of median nerve stimulation on Tourette syndrome and associated symptoms has completed recruitment and all participants are now in the ‘follow-up period’, in which participants health is monitored for 6 months. The results from the trial will be published in 2023.”

An advance in Huntington disease biology

This isn’t from the Black lab, but colleagues here at Wash.U. have used cells from people with Huntington disease (HD) to discover abnormally high levels of a messenger RNA. That mRNA decreases autophagy–a cell’s ability to clean up its insides–and that hastens the death of the cell. The authors went on to show that they […]

Panic disorder: just get treated already!

A friend wrote me recently to describe horrible discomfort from panic attacks, but also significant concerns about the medications his doctor had prescribed. Here’s my answer, in hopes that it may help others out there, too. Dear [friend], Thanks for being willing to reach out. Here are my thoughts. Yes, I know a lot about […]

A recent review of anxiety in PD

A collection of PD neuropsychiatry experts recently published a thorough review article of anxiety in PD. They note that anxiety consistently ranks among the top 2 or 3 areas of unmet needs identified by people with Parkinson’s. The review discusses what we know—and don’t know—about phenomenology, etiology and treatment. It’s worth a read. Pontone, G.M., […]

Parkinson disease dementia risk predicted by eye measurements?

The recently published study cited below shows evidence that various measurements of eye function (especially contrast sensitivity and the thickness of the inner plexiform layer in the retina) correlated very strongly with a summary measure of clinical variables associated with dementia risk in people with Parkinson disease (PD). We have long known that the back […]

Is lumateperone good for psychosis in Parkinson disease?

Lumateperone is a new drug recently approved by the FDA for treatment of schizophrenia. The key clinical trial was just published and includes data on motor side effects of the drug. The sponsor, Intra-Cellular Therapies, Inc., may have data on use in Parkinson disease (PD), but I don’t think any of it is public. So […]

TS research from 2018

For 5 years, my colleagues and I have written a yearly article reviewing recent key publications related to Tourette syndrome and other tic disorders. The finished “Highlights” articles are published in the Tics collection on the F1000Research platform. That task is getting harder as more and more research is published (see Figure). We are in the process […]

“I’ve found the answer to TS,” or why science isn’t faster

Recently someone with TS wrote me to say that he had discovered a trigger for tics and a potential treatment that might apply to others. I applaud his careful observations and willingness to share. But how can we move this observation forward? After all, numerous potential cures to TS have been proposed, ranging from antibiotics […]

Cannabidiol and the DEA

The US FDA approved Epidiolex® (cannabidiol, or CBD) for certain seizure syndromes in June, and today the DEA listed it as a Schedule V controlled substance (the least restrictive). This action will greatly facilitate clinical use and clinical trials of CBD in the U.S. Note that there is little evidence at this point that CBD […]

Testing a new strategy to treat Tourette syndrome in children

We were happy to participate in the first-ever study of a dopamine D1 blocking drug in children with TS. The study results were recently published, showing evidence of benefit without substantial side effects. Click here for additional background information, a summary of the results, and a link to the publication. (https://goo.gl/gh5YfM)

Tic suppression research

This web page describes a recent publication from Wash.U. and several other research sites on factors associated with successful tic suppression in 99 children and adolescents with a tic disorder.

Management of tardive dyskinesia

A colleague asked me about treatment for tardive dyskinesia and I thought I’d share my answer. Experts have reached different conclusions from the available evidence (e.g., here vs. here). Here is a rough outline as I see it. Consult your doctor for personalized treatment recommendations. Best treatment changes with time.

A measured response to CNN’s article on Nuplazid®

A recent article from CNN discussed Nuplazid® (pimavanserin), a medication approved by the FDA in 2016 for treatment of hallucinations or delusions in Parkinson’s disease (a.k.a. PDP, for Parkinson disease psychosis). The article made some efforts to present a balanced perspective, but the title and overall tenor of the article focused on the possibility that this new […]

Gentle steps to open publishing

Next time you think you have to give your copyright away to a big-name journal, there are alternatives. Read more here. Sample quote:

Marijuana for tics?

Here’s a brief summary of what we know about cannabis and related drugs for treatment of tics.