Photo credit: Adobe Firefly for C.Denny
In 1817, James Parkinson wrote “An Essay on the Shaking Palsy.” It was the first medical documentation published to be described as a “neurological syndrome.” He defines the condition as “Involuntary tremulous motion, with lessened muscular power, in parts not in action and even when supported; with a propensity to bend the trunk forwards, and to pass from a walking to a running pace: the senses and intellects being uninjured.” This disease, described by Jean-Martin Charcot as Parkinson’s Disease (recognizing that some patients don’t necessarily have tremors and don’t suffer from lack of strength), afflicts more than ten million people worldwide, according to the Parkinson’s Foundation and is the second most common neurodegenerative disease next to Alzheimer’s. A 2022 study backed by the Parkinson’s Foundation finds that nearly 90,000 people are diagnosed with the disease in the U.S. each year and an estimated 60,000 individuals are diagnosed annually.
Finding a Cure
The race to find a cure for this often debilitating and life-changing condition took a step forward in 1961 when Levodopa Therapy was introduced to some Parkinson’s patients followed by a Carbidopa-Levodopa combination that became commercially available in 1975. Today, organizations like The Michael J. Fox Foundation and the Parkinson’s Foundation help fund major research into looking for a cure. With the advancement of technology and artificial intelligence, researchers are taking steps that will put them closer to being able to identify those who may be diagnosed with the disease and help those who are already affected using a variety of medications and therapies.
In addition to speech, occupational, and physical therapy to treat symptoms, other treatments include Deep Brain Stimulation (using electrical impulses to stimulate certain areas of the brain), High-frequency Ultrasound (targeted ultrasound to areas of the brain to eliminate brain cells that contribute to a patient’s difficulty with motor skills and tremors). Produodopa Treatment: A therapy involving the continuous infusion of foslevodopa – foscarbidopa (a drug that supplies Levodopa and an inhibiter) has shown improvements in patients with advanced Parkinson’s, helping them to perform daily activities with greater ease. Foslevodopa-foscarbidopa is available by prescription under the brand name Vyalev. Plus, the ongoing efforts into Stem Cell Research (creating dopamine in the brain by using stem cells).
Stem Cell Research
Stem cells are “precursor cells” from which other cells are created, they are produced during the creation of an embryo and found in amniotic fluid. These “pluripotent” cells can divide to be any type of cell in the body and are used to repair damaged tissue and organs. Since the start of stem cell research, the use of stem cells has been mired in controversy because of the ethical and religious concerns the research has brought. However, there have been results in groundbreaking medical events brought about by the use of the research all over the world. In the case of the use of stem cells in Parkinson’s research, the goal is to use stem cells to help rebuild dopamine production.
According to Dr. Brian Fiske, Chief Science Office of the Michael J. Fox Foundation, and Dr. Harini Sarva, director of the Parkinson’s Disease and Movement Disorders Center on the 2023 Parkinson’s Science POV podcast
Dr. Harini Sarva: “So normally, when the brain produces dopamine, it’s releasing it at a steady rate at a steady stream. And then once that production is reduced and gone because of the loss of the cells, they’re not making enough dopamine for coordinated movement. The way we’re treating patients right now is that we’re not giving them a steady stream of dopamine. We’re kind of giving them dopamine replacement through pills at timed intervals. So, it’s almost as if we’re confusing the brain because it’s not used to that kind of interval delivery of dopamine. So, when you put in stem cells that are precursors or immature dopamine cells, and they eventually mature and make their connections, they’ll be able to produce dopamine at a more physiologic or normal fashion as opposed to this start-stop fashion that we’re giving dopamine to our patients.”
Dr. Brian Fiske: “Again, as we think about what these cells are trying to do, again, they’re not curing you of your Parkinson’s disease in the sense that the disease process may still be continuing in the background, but they really are, again, offering you this additional source of the dopamine in your brain to help address some of these movement problems. In some cases, people may still have to take dopamine medication, maybe they can take less of it or reduce their dosages, which would be obviously beneficial as well. And possibly, in some cases, people may be able to go off medication if the dopamine cells are really working well. But I think it’s important to keep in mind what this will offer to people is, again, just an additional way to really address those motor symptoms, hopefully in a way that would make their quality of life better throughout the day without, again, some of these complications and, again, all the pill-taking and all the other things that they would have to normally do to control those movement issues.“
Parkinson’s Research and Other Neurological Conditions
Parkinson’s research has also pointed out possible neurological similarities between it and adults with Attention-deficit Hyperactivity Disorder (ADHD) when it comes to dopamine distribution within the brain. A study by the Neuropsychopharmacology Journal found that: Of the people diagnosed with basal ganglia or cerebellar disease, 96 of non-ADHD (32.3%) and 56 of people with ADHD (33.7%) were diagnosed specifically with Parkinson’s.
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