Michael J. Fox then and now

Parkinson's Disease Then and Now

Our understanding of Parkinson's disease has evolved over the years, yielding improved treatments and hope for the future.

By Krisha McCoy

Medically Reviewed by Pat F. Bass III, MD, MPH

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Parkinson's disrupts the brain's nerve cells, causing tremors.
Parkinson's disrupts the brain's nerve cells, causing tremors.

Medical experts have probably been treating what we now call Parkinson's disease for thousands of years.

Symptoms and possible treatments for Parkinson's were discussed in Ayurveda, an ancient Indian medical practice that's been around since as early as 5,000 B.C. A condition like Parkinson's was also mentioned in the first Chinese medical text,Huang Di Nei Jing Su Wen, more than 2,500 years ago. And today, are in development.

But while researchers have made progress in treating the disease, they are still seeking a cure.

James Parkinson and Parkinson’s Disease

Parkinson's disease was formally recognized in James Parkinson's 1817 classic paper, "An Essay on the Shaking Palsy."

Parkinson (1755-1824) was a doctor in London who observed what are now known as the classic symptoms of Parkinson's disease in three of his patients, and in three people he saw on the streets of the city. His essay contained clear descriptions of some of the main symptoms: tremors, rigidity, and postural instability. He theorized that the disease developed because of a problem in the brain's medulla region.

Although Parkinson encouraged the medical community to study the disease and had hoped for a cure, his essay received little attention until 1861. It was then that French neurologist Jean-Martin Charcot and his colleagues distinguished the disease from other neurological conditions and termed it "Parkinson's disease."

The History of Parkinson's Disease Treatment

For many decades, doctors couldn't treat Parkinson's disease effectively, and thought it was a terminal illness. The drugs used to treat the symptoms of tremor in the late 1800s included arsenic, morphine, hemlock, and cannabis, according to Chrisopher Goetz's review published in September 2011 inCold Spring Harbor Perspectives in Medicine.

By the 1940s and 1950s, neurosurgeons began to perform surgery on the basal ganglia of the brain, which resulted in improvements in Parkinson's disease symptoms. While this surgery was sometimes effective, it was also risky, and about 10 percent of patients died as a result of the operation.

Recent Treatment Successes

The biggest advance in Parkinson's treatment came in the 1960s. Researchers identified differences in the brains of people with Parkinson's disease that were associated with low levels of dopamine, a brain chemical that allows smooth, coordinated movement.

This research revolutionized the treatment of Parkinson's disease. It led to the development of levodopa (also called L-dopa) in now-discontinued brands Larodopa and Dopar — a medication that can be used by nerve cells to produce dopamine. Levodopa is still the cornerstone of Parkinson's treatment today. Interestingly, the traditional Indian Ayurveda medical treatment included cow itch plants (also known as cowitch, cow-hage, and velvet beans) now known to contain naturally occurring levodopa.

Today, most Parkinson’s disease patients are first treated with Sinemet, a combination of levodopa and carbidopa; the drug combination can reduce some of levodopa's side effects. These therapies are usually effective for 5 to 10 years, but eventually stop working and lead to adverse effects such as involuntary movements and tics (dyskinesia).

RELATED: Home Remedies to Help With Parkinson's Symptoms

Other Parkinson's medications called dopamine agonists, like Mirapex (pramipexole), Cycloset or Parlodel (bromocriptine), and Requip (ropinirole), have been developed and can play a part in the management of Parkinson's disease symptoms. These drugs mimic the effect of dopamine. They may be used together with a form of levodopa, but come with side effects like sleepiness and hallucinations, notes the .

Drugs called MAO-inhibitors, such as selegiline and rasagiline, work along with levodopa medications to help with Parkinson's symptoms. The potential side effects include hallucinations, particularly for elderly patients. In addition, COMT-inhibitors (entacapone, tolcapone) help levodopa therapy last longer in some patients.

Brain surgery for Parkinson's, which was once a common practice but was rarely used after levodopa was discovered, is being used more today due to advancements in surgical procedures.

In some cases, surgery to destroy selective areas of the brain can relieve Parkinson's disease symptoms. Neurosurgeons have developed a safer, more commonly used operation known as deep brain stimulation, in which they implant an electrode into the brain that can stop many Parkinson's disease symptoms.

Home remedies are also helpful in relieving Parkinson's symptoms, including exercise and physical therapy routines. In addition, speech therapy, occupational therapy, and psychological counseling benefit people living with Parkinson's.

The Future: Parkinson's Clinical Trials

Researchers are continuously working on ways to slow the progression of Parkinson's disease, restore lost functioning, and help prevent the disease from developing in the first place.

Video: Michael J. Fox's fight against Parkinson's

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Date: 02.12.2018, 04:22 / Views: 84483