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Also for ethical reasons the patients were allowed to take home a supply of THC:CBD as rescue medication to use while they were on the trial, though the investigators report that many of the patients did not use it.These considerations together with the heterogeneity of patients and wide range of symptoms measured complicated the study.It is important therefore that we continue to search for environmental risk factors for the disease.The greatest limitation of case control studies is the introduction of recall bias that occurs when exposure status is determined retrospectively.Information derived from large cohorts of individuals followed up prospectively therefore represents a particularly valuable resource.Follow up of these cohorts has identified incident cases of PD in men, and in women based on self reporting with confirmation sought from medical records.Comparison of the highest and lowest quartiles of intake of dairy products for the highest intake after adjustment for covariates such as smoking, caffeine and physical activity. This association was not seen in women, and no other food groups were associated with PD risk in either sex.Since this study has used information collected prospectively with long follow up periods, in large numbers of patients, it would be wrong to dismiss these results as chance findings alone, although the differential effect between the sexes is puzzling.Recently, protein characterised inclusion bodies known as aggresomes have been found close to the centrosome in various cells.Functionally, aggresomes are thought to help break down abnormal proteins and keep them away from the rest of the cell.Lewy bodies were immunoreactive for the proteins gammatubulin and pericentrin in patient brain tissue analysed postmortem.Staining depended upon specific neurodegenerative disease neuropathology.The smaller aggregates of ubiquitinated proteins remained elusive when stained with usual antiubiquitin and antialpha synuclein antibodies.Investigating abnormal protein is already prominent in neuroscientific research for neurodegenerative conditions. GDNF was first identified in, where it was found to have a profound effect on dopaminerg ic neuronal surv ival in the substantia nigra.Subsequently many studies have investigated this further in vitro, and in different animal models of PD using a variety of delivery systems with encouraging results.It was on this background that the current study was conceived in which patients with moderately advanced PD were randomised to receive an intracerebroventricular infusion of either placebo or one of various different doses of GDNF.None of the different doses of GDNF offered any benefit to the patients.This negative study is clearly a disappointment but is not surprising given the postmortem study, published already, in a patient receiving GDNF from this trial, which showed no dopaminergic cell rescue or axonal sprouting.However it has long been suspected that the diffusion of such factors from the CSF into the brain parenchyma is poor, and thus efficacy is much more likely with direct intraparenchymal delivery of the neurotrophic factor.In this intriguing study the authors investigated this possible relationship in high school athletes.A group of athletes with no previous concussion history was compared with a group in whom there was a history of three or more previous concussive episodes.The latter group was more likely to show evidence of loss of consciousness, post traumatic amnesia and confusion following a subsequent concussive episode, when examined on the field of play.

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