ELLIE'S BLOG on Living Well with Disability

Parkinson's Disease is one of the complex chronic debilitating neurological diseases that will greatly benefit from basic research.  It affects 500,000 people in the U.S. and is second only to Alzheimer's. World wide it is estimated 6.3 million people have the disease. It is caused by a loss of dopamine-producing brain cells. It usually affects people over 60 but does affect those younger in their 40's. The 4 major problems are: tremor, rigidity, slow movement and impaired balance and co-ordination. For more information:

http://www.pdamerica.org/forms/sign/save-one-trillion-dollars-in-ten

This is not a new disease but one that has been recorded in various medical practices since 5000 BC. In modern times it was formally recognized by James Parkinson's as "Shaking Palsy" in 1817 .   http://viartis.net/parkinsons.disease/history.htm

All this time it was only thought of as a terminal disease with no effective treatment.

    But in the 1940's and 50's neurosurgeons began surgery on the basal ganglia of the brain. There was some improvements in some patients, but it was risky.

However in the 1960's researchers in Parkinson's disease were able to compare the brains of those with Parkinson's and controls. Importantly the researchers discovered that the brain chemical Dopamine that allows for smooth co-ordinated movement was much lower than the controls  in the brains of Parkinson's patients.

This basic research led to drug trials of Levodopa in 1961 and 1962.

And finally the big breakthrough for Parkinson's patients "Levodopa Pills" were available for patient's treatment in 1968. Many people with Parkinson's Disease could now lead almost normal lives. 

When I graduated from college in 1957 as a Physical Therapist I thought I would be working mostly with polio patients. But when the polio vaccine which prevented polio was discovered  I became aware my patient load would be changing.  And it was.  MD's were now increasing their referrals to Physical Therapists and other rehab specialties for rehabbing their patients with Parkinson's Disease.

I had patient's with Parkinson's disease that were extremely advanced, moderately advanced and those with initial symptoms. Prior to the use of the levodopa pills the patients I saw were mostly extremely advanced. Many had contractures, most were wheelchair or bedridden and unable to communicate even with facial expression. I saw them in Chronic Disease Hospitals and in Home Care then in Rehab centers. I noticed the exciting change in my patients who were put on Levodopa Pills.

Unfortunately it was not a cure but a symptom reliever as progression in Parkinson patients continued. It also had some very unpleasant side effects.  Parkinson's can be a devastating disease. I found that it robs the person not only the ability to mobilize oneself or speak but the rigidity also involves the facial expressions so communication was just so difficult and was lost as the disease progressed.

  But over time basic research has continued.  And it has been very beneficial to people with Parkinson's disease. The first new drug following Levadopa  was Sinemet.  It was developed in the 1970's to help with the negative side affects of the drug Levadopa. This drug Sinemet was improved over time and received FDA approval in 1991. Then over time as patients progressed there have been newer drugs developed to ward off the devastating symptoms of the disease itself.  These drugs are  Mirapex, Requip, drugs known as COMT inhibitors, and  Comtan and Tasmar. They have even gone back to Surgery. The surgery is known as deep brain stimulation and is much safer than the earlier surgeries. Neurosurgeons now implant an electrode into the brain to stop many of the Parkinson's symptoms.

This has made the amazing difference  in allowing people with Parkinson's Disease to lead productive lives for a longer period of time.

This is why continued basic research is so vital in complex chronic progressive diseases. As research continues the knowledge grows and on the way to finding a cure drugs or procedures to help control symptoms are found.  And lets be honest the only way cures will be found will be to truly understand all the small ramifications of the central nervous system.This is where basic research is vital. I talk about how research is done in the US in a previous article.Dollars allocated to different kinds of research in USA

A week or so ago I read an excellent informative article on the current state of care for Parkinson's disease in the New York Times. The article including videos of people explaining how the disease affected their lives. http://www.nytimes.com/2010/08/24/health/24first.html

  I'm so afraid in this period of time where we're concerned about budgets that we'll forget the importance of continuing on with this basic research. Research that is needed before one can get to the point where a surgical procedure or a drug can be developed to alleviate all these devastating symptoms for these people and finally ....  A Cure !!!!

ellie