Contrary to popular belief Parkinson’s was not first discovered and described by Dr. James Parkinson in 1817. It is not a new disease and must have existed throughout time and therefore there are historical references to it. The first known mention of PD is found 5000 years ago in the ancient Indian Ayuverdic medical system. The next believed reference appears 2500 years ago in Chinese medical texts. References are pointed to in Greek and Roman times and in 175 AD the Greek physician Galen referred to PD as “shaking palsy”. Additional references appear for the next 1500 years until 1690 when the Hungarian doctor Ferenc Papai Pariz first described tremor, bradykinesia, rigidity, and postural instability as the four classic symptoms of PD. Don’t write in Hungarian in the 17th century if you want to be widely read and have a disease named after you.
In 1817, Dr. James Parkinson published ”An Essay on the Shaking Palsy” and is mistakenly credited with discovering the disease. 60 years later the French neurologist Jean-Martin Charcot recognized the importance of Dr. Parkinson’s work and named the disease after him. The next 100 years are a blur of mostly misguided treatments: electric shock therapy, surgery on different areas of the brain, bleeding, arsenic, morphine, and mercury where the side effects of the treatment were usually worse than whatever relief they gave. For relief Dr. Parkinson recommended bloodletting from the neck and blistering of the skin with inserting pieces of cork to cause infection.
And then along came the Beatles and medical dopamine in the 1960s. What the Beatles were to popular music, dopamine was to PD. Since its FDA approval in 1970, Levodopa (L-DOPA) has been a staple for the management of Parkinson's disease symptoms and is often referred to as the gold standard for treating PD. Dopamine cannot pass through the protective blood-brain barrier but L-DOPA can. L-DOPA is typically administered with carbidopa which helps preserve orally administered L-DOPA for conversion to dopamine in the brain. When taken orally, a small amount of L-DOPA passes into the brain and is converted into dopamine which may offer relief for some PD symptoms (tremors) for a short period. It doesn’t cure, prevent, or stop the progression of PD but relieves some symptoms for some people as do other drugs and Deep Brain Stimulation.
My doctor saiid he expects significant new treatments for PD to be discovered in the next 10 years. The problem is that he told me that six years ago and so far nothing concrete. I am not expecting a PD medical breakthrough that will hep me in my lifetime but there is a lot of interesting research into new medicines, new medicine delivery systems, new medical procedures, early diagnosis, and a new understanding of the disease which views PD not as one disease but a disease with many subtypes each requiring specialized treatment. After 5000 years and millions of dollars in research and many clinical trials we have medicines and DBS to help relieve some of the suffering but nothing yet to help prevent, delay the progression, or cure the disease.
