Friday, March 07, 2008


Parkinson’s Disease

The term “Parkinson’s disease” elicits images of old, feeble patients unable to move enough to care for themselves. When Michael J. Fox became afflicted with Parkinson’s disease, that image changed.

Parkinson’s disease is part of a broad category of neurological illnesses termed neuro-degenerative diseases. Sadly, they are chronic and slowly progressive. Neuro-degenerative diseases are primarily seen in the elderly. As longevity increases, the numbers of those afflicted will continue to rise. Parkinson’s disease specifically affects motor function and is classified as a movement disorder. Over one million people in the United States alone suffer from Parkinson’s disease.

Cells deep in the brain produce a neurotransmitter called dopamine. They are the principal targets in Parkinson’s disease and become either lost or blocked. Dopamine is crucial for motor nerves to coordinate muscle movement. A lack of dopamine results in uncontrollable shaking (tremors), slowed movements (bradykinesia), and joint stiffness (rigidity). Dopamine replacement with a drug called L-DOPA has been the basis for treatment during the past 50 years. Over time, L-DOPA becomes ineffective.

In 1982, Parkinson’s research changed dramatically. Until then, there were no models for testing new treatments. It was in 1982 that a chemical called MPPP was manufactured in primitive home laboratories and sold on the streets of San Francisco as synthetic heroine. MPPP was easily contaminated and could become MPTP. When MPTP is injected, it immediately destroys the cells which produce dopamine. Hospitals began admitting young people with severe, advanced Parkinsonian symptoms. This created that needed model and an urgency for the development of new treatments.

Today, there are many drugs that are used in various combinations to improve motor function in patients with Parkinson’s disease:

• Carbidopa/Levodopa boosts the level of dopamine in the brain.
• Rasagiline slows the enzymes which breakdown dopamine in the brain.
• Ropinirole increases the sensitivity of dopamine receptors.

“This is a very exciting and encouraging time to be involved in treating Parkinson’s disease,” said Dr. Maria L. Moro-de-Casillas, a neurologist who specializes in the treatment of Parkinson’s disease. “Over 70 percent of my patients are able to function independently.”

In addition to a vast armamentarium of medications, surgical treatments including deep brain stimulation hold great promise.

In tomorrow’s Healthy Sports column, some unconventional treatments for Parkinson’s disease will be discussed.

Anthony G. Alessi, MD, is a neurologist on The William W. Backus Hospital Medical Staff in private practice at NeuroDiagnostics, LLC in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Dr. Alessi, or any of the Healthy Living columnists at

Comments: Post a Comment

<< Home

This page is powered by Blogger. Isn't yours?