Parkison’s disease research has come a long way over the past two centuries. (Yes, there’s still much to be discovered, but, nonetheless, progress is welcomed.) During the early 1800s and before, the symptoms of Parkinson’s disease were believed to stem from multiple diseases. From the time Parkinson’s disease was first classified as a group of interrelated symptoms, various pharmacological (drug) treatments have been discovered. Here’s background on the journey that’s led to what we understand about Parkinson’s disease today.
The first time Parkinson’s disease was documented in writing was in 1817, when British physician James Parkinson penned an essay about a trembling paralysis that he called “the shaking palsy.” Parkinson was born north of London in 1755. After completing his medical education, he took over the medical practice of his father, who had died suddenly.
In his descriptive study, Parkinson wrote about findings from the medical histories of three people he treated, as well as three separate people he casually observed but didn’t treat. He described the gait, posture, tremors, and degenerative nature of the condition as presented in all six people.
Parkinson also mentioned nonmotor symptoms in his essay, including:
About 50 years later, French neurologist Jean-Martin Charcot expanded on Parkinson’s work and officially labeled the condition after his predecessor. Although James Parkinson is now the person credited for discovering Parkinson’s disease, during his life he was more closely associated with his geological work on fossils. And he was also an early pioneer for the smallpox vaccine. Further, Parkinson was a post-French Revolution political activist who advocated for better conditions for prisoners and greater access to education for the poor class.
Several physicians contributed to the next decades of research on Parkinson’s disease, including a doctor named William Gowers. In the 1880s, Gowers helped define the joint deformities characteristic of Parkinson’s disease based on observations of 80 of people he treated. As the 1900s approached, scientists at a French neurological school developed drawings that depicted the progression of the disease. Between the 1920s and 1960s, Parkinson’s disease became understood as a disease related to the midbrain and brainstem.
In his essay, James Parkinson’s discussion of the nonmotor symptoms of Parkinson’s disease was somewhat ahead of its time. That is evident in the research that followed, which often left out symptoms considered to relate to a person’s quality of life. While physicians historically focused on treating visible motor issues, many people were on their own to deal with the full effects of the disease, including social stigmas, feelings of isolation, and depression.
Perceptions of people with conditions like Parkinson’s vary greatly among different cultures and time periods. In the past, people with certain disabilities may have been suspected of being cursed or possessed by demons. Stigmas could extend beyond the individual displaying symptoms and affect public perceptions of their family members as well. On the other end of the spectrum, some West African cultures associated disabilities with good luck and even spiritual power.
Today, people with Parkinson’s disease may worry that their outward symptoms will be mistaken for cognitive disabilities or drunkenness. However, as awareness about Parkinson’s disease grows, there’s hope for better legal protections and more social acceptance of the condition, two things that can boost the self-esteem of those living with the disease. Workplace accommodations can now make it easier for people with Parkinson’s to overcome challenges at work, too. Such advances allow a person to further their career and maintain social connections.
During the early years of Parkinson’s disease treatment, the only medications used were antimuscarinic alkaloids derived from the belladonna plant. By blocking involuntary nerve impulses, these therapies reduced tremors and were quickly popularized for their ability to manage this symptom of Parkinson’s disease. In the 1940s and 1950s, synthetic versions like trihexyphenidyl, which debuted in 1949, came about.
In the early 1960s, a few scientists separately became interested in the role of the neurotransmitter dopamine and the use of levodopa (L-dopa) for the treatment of Parkinson’s disease. Early treatment with levodopa came with troublesome gastrointestinal side effects. George Cotzais found that increasing the dosage of the drug gradually improved a person’s tolerance to it. Within the same year (1967), dopamine decarboxylase (“DOPA decarboxylase,” or DDC) inhibitors were paired with levodopa to enhance absorption while reducing unwanted side effects. Although neurosurgery (brain surgery) has long been considered as a potential treatment for Parkinson’s disease, breakthroughs in treatment with levodopa put surgery on the back burner.
There’s no cure for Parkinson’s disease, but the outlook is getting brighter with each passing year. Medical advancements have led to earlier diagnosis, longer life spans, and treatment options beyond medication (such as deep brain stimulation). Cellular and genetic treatments have been discussed since the 1980s and are gradually gaining traction in Parkinson’s research. Learning more about the genetic aspects of Parkinson’s disease offers better insight into Parkinson’s disease progression and could help treat symptoms before they grow severe.
The future of Parkinson’s disease treatment aims to slow down the rate of degeneration, prolong personal independence, and reduce social stigmas associated with the condition. As both the scientific community and the general population become more familiar with Parkinson’s disease, the chances of discovering a cure can only continue to increase.
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