Thoughts on World Parkinson’s day 2014
I’ve written a few articles about Parkinson’s disease over the last year, but with the upcoming World Parkinson’s Disease day, it seems appropriate to revisit the topic. Parkinson’s disease is a movement disorder. It manifests with symptoms including slowness of movement, instability, tremor and muscle rigidity. In Australia, there are approximately 100 000 people living with Parkinson’s disease.
Working at the ENT Wellbeing centre in Sydney means I get to go to Parkinson’s disease support group meetings. At these meetings, I am able to meet with large groups of Sydney-siders who have Parkinson’s disease. Some are young, some are older, but all are battling with changes in their lives. We usually do a 45-minute seminar about communication and swallowing difficulties associated with PD, and then I open the floor for questions and comments. I love going to these groups. If people are keen to express their feelings and experiences, they are able to do so. If people prefer to listen, they can be encouraged and educated by hearing other people’s experiences. I would encourage anyone recently (or not recently) diagnosed with Parkinson’s disease to connect with these groups.
As a young health professional, sometimes it is a little hard to understand exactly the functional and emotional impact of a disease like Parkinson’s disease. I hear the stories first hand, so I do have some idea, but it is certainly not the same as experiencing it. I have no wish to experience it, but then no one ever does. I have found though, that looking back at the history of Parkinson’s disease (even before it was known as Parkinson’s disease), helps me understand the disease a little more.
Here is a crash course covering some of the key points in the history of what was originally called “shaking palsy”:
- In the ancient Indian medical system, PD was referred to as Kampavata.
- Galen of Pergamon (AD 129 – c. 200/c. 216) was noted to say “In order to diagnose, one must observe and reason.” Galen described a disease that was characterised by tremors at rest, postural changes and paralysis. (For those interested, Galen also clarified the anatomy of the trachea and was the first to demonstrate that voice is generated in the larynx).
- Galen referred to the disease he saw as ‘Shaking Palsy’.
- Preceding James Parkinson’s work, a number of authors described elements of the disease (e.g. Hieronymus David Gaubius, a German physician and chemist, described ‘festination’, a term for the gait abnormalities characteristic of PD).
- In 1817, London based physician James Parkinson published his “Essay on the Shaking Palsy” (also known as Paralysis Agitane). The essay was based on six of Parkinson’s own cases and cases he had observed on walks around his neighbourhood.
- Contrary to what you may think, Parkinson did not name the disease after himself. In fact, it was not called Parkinson’s disease until about 60 years later when French neurologist Jean Martin Charcot acknowledged the importance of Parkinson’s work.
- Charcot left behind a significant research legacy. He has been termed: “the founder of modern neurology”, “the father of French neurology and one of the world’s pioneers of neurology” and the “Napoleon of the neuroses”.
- Charcot’s research between 1869 and 1881 advanced the understanding of Parkinson’s disease (e.g. He made the distinction between rigidity, weakness and bradykinesia).
From this time, there has been steady increase in understanding the mechanisms of Parkinson’s disease. Amongst other significant ‘moments’ in 1919, Konstantin Tretiakoff – a Russian Neuropathologist – produced a thesis that identified the substantia nigra as the main cerebral structure affected. Initially, this claim was not widely accepted, but research published by Rolf Hassler in 1938 confirmed this conclusion.
Parkinson’s Disease Treatments
Treatment options prior to Levodopa included anticholinergics and surgery (lesioning of some of the basal ganglia structures). Originally synthesised by Polish biochemist Casimir Funk in 1911, Levodopa was incorporated into general clinical practice in 1967 as a treatment for Parkinson’s disease, with the first study in its effectiveness being published in 1968.
Whilst a cure for Parkinson’s disease is still in progress, there have been significant improvements in the management of Parkinson’s disease. There are large bodies of researchers striving to further understand and treat the disease. There are motivated individuals who, having been diagnosed with PD, have sought to raise funds to further this research (Shake It Up Australia, Michael J Fox Foundation). There are small groups of people, all around the world who work to lift and support others with Parkinson’s disease.
It seems a little clichéd to say, but every little bit helps. From the woman who made the birthday cake for a member of the Sydney Seaforth Parkinson’s support group meeting I attended last week, to the researcher working on new therapy trials, it all makes a difference. As stated by Henry Ford: ‘Coming together is a beginning; keeping together is progress; working together is success.’
Let us end on a musical note and enjoy a hearty collaboration between Coldplay’s Chris Martin and Michael J Fox (who can really play!) – Johnny B. Goode.