For Parkinson's Awareness Week 2017 (10-16 April), we're publishing a series of blogs throughout the week which will provide unique insights into Parkinson's from a range of perspectives - from those living with Parkinson's to the researchers & clinicians dedicated to developing better treatments.
In 1817, an English surgeon called James Parkinson published his description of a previously unrecognised condition in a work titled ‘An Essay on the Shaking Palsy’.
In this essay, he documented case studies — people who appeared to be affected by the same unknown condition. He wrote about how the condition affected walking, balance, speech and swallowing, and caused symptoms such as ‘trembling’ and changes in the bowels. In the final pages of the essay James Parkinson encourages other surgeons at the time to better understand the causes of the condition so that…
He rightly points out that it is through understanding the condition that treatments, and potentially a cure for this mysterious illness, can be found.
Today, the condition, which now bears his name, is believed to affect over 5 million people worldwide. But in the 200 years since Parkinson’s was first described are we any closer to fulfilling the vision of James Parkinson?
We now know much more about what causes the symptoms of Parkinson’s. It is due to the loss of a type of brain cell that produces a chemical called dopamine.
As dopamine is used by the brain to communicate signals about movement, when the cells that produce this chemical are lost the brain can no longer control movement properly. But replacing dopamine in the brain can work as an effective treatment for Parkinson’s, particularly in the early stages of the condition.
The era of levodopa
It was 1960 when scientists first discovered that there was a lack of dopamine in a particular part of the brain, called the substantia nigra, in Parkinson’s. But dopamine itself cannot reach the brain.
Fortunately, researchers had already isolated a chemical called levodopa , or L-dopa, and figured out that it can enter the brain where it is converted to dopamine. So in 1960, when it became clear that dopamine was lacking in Parkinson’s, levodopa was considered as a treatment.
Today levodopa, the chemical that was first used to treat the condition over 50 years ago, is still the mainstay of Parkinson’s therapy. There are alternative therapies and drugs for Parkinson’s, and improvements have been made to levodopa — it is now combined with other drugs that reduce side effects, such as nausea, and increase the duration of its effects. But, levodopa remains the most effective treatment for Parkinson’s for the majority of people with the condition.
Masking the symptoms
Levodopa is not a cure for Parkinson’s.
It can help to replace the dopamine that the brain is no longer making, but as Parkinson’s progresses more brain cells are lost and more levodopa needs to be taken. The drug does nothing to prevent or slow the loss of cells, and as more drug is taken to manage the symptoms of Parkinson’s the side effects of the drugs themselves become unmanageable.
Eventually many experience a situation where levodopa is no longer an effective treatment — the drug can no longer mask the symptoms caused by the loss of brain cells. Looking back to James Parkinson’s words in 1817, yes we have ascertained the nature of Parkinson’s, and found a mode of relief at least in the short term, but we still don’t have a cure.
Time for new treatments
What is desperately needed is a treatment that can stop Parkinson’s in it’s tracks. In the last 200 years we’ve developed our understanding of what is happening inside the affected brain cells—and this is already being turned into new treatments that are in the research pipeline…
But we need to do more! The science is ready — it’s time to turn all our knowledge about Parkinson’s into better treatments. We’ve waited long enough for drugs that can make a real difference to people’s lives.
With your help we can make new and better treatments a reality. Join us this Parkinson’s Awareness Week, and find out how you can be part of the change at wewontwait.parkinsons.org.uk