Some people believe that Parkinson's Disease (PD) is a new diagnosis, or a neurological disorder of the modern era. It also seems as if over the past 10 to 15 years that there's been a surge in the prevalence of PD. There is some truth to both those statements. With the substantial percentage of the “baby-boomer” population entering their 6th decade, we are indeed observing a spike in all geriatric conditions, including PD. Currently in the United States, there are approximately 6.2 million individuals living with Parkinson's Disease, and there are about 630,000 new cases diagnosed each year. With an estimated cost of $22,800 per person per year, to maintain the condition, the total economic burden of Parkinson's is substantial, at approximated $14.4 billion annually. This amount is suspected to double by the year 2040.
However, Parkinson’s disease is certainly not a modern day disease. As a matter of fact, Parkinson’s disease had a much higher prevalence in the early 20th century following the influenza epidemic of 1916-1917.
The history of Parkinson's Disease is fairly well documented. As early as 1200 BCE, there was an ancient Egyptian papyrus written about how the Pharaoh was drooling out on the side of his mouth, had shaking hands, and stooped posture. Then in 185 CE, Galen of Pergamon, a physician to the Roman gladiators wrote about “the shaking palsy”. He wrote about how he started to observe people in his community that were walking really slowly, and they had shaking of their hands.
About 2 centuries later, in the year 1817, Dr. James Parkinson wrote the essay on “The Shaken Palsy”, as Galen called it. The essay on the Shaking Palsy was essentially a letter, or an essay, about how he observed six cases of different people, who had similar characteristics:
A shaking of body parts that decreased with voluntary movement
A bending of the trunk forward, or a stooped posture
Festinating, in which patients that try to walk forward, are forced to run
Preservation of intellect
Fifty years later, Professor Jean-Martin Charcot, who was the lead doctor at Salpêtrière Hospital in Paris and later known as “The Father of Neurology” later refined the disease and identified that a slowness of movement is another hallmark feature of Parkinson’s Disease, and solidified the name of Parkinson’s Disease. He became interested in this disorder where people had mask like faces is where they lose their ability to show expression, where they had slowness of movement, tremor, shuffling gait, and other signs that we'll talk about; all the features of Parkinson's disease.
For the following 80 years, intermittent research was performed in the field of Parkinson's disease. In the early 20th century, microscopic particles in the affected Parkinson’s brain were discovered, which were later named Lewy bodies, after Fredrick Lewy. In 1919, a researcher by the name of Konstantin Tretiakoff identified the compacted portion of the substantia nigra as the main neurological structure affected by Parkinson’s disease.
Substantia nigra pars compacta. Whoa! Big word. Let’s dissect it. Substantia means, substance. Nigra means black, so it's a black substance. Pars means part. Compacta means compacted. So it's a black substance, in a part of our brain that is very compacted in our midbrain. This is a part of the brain mainly responsible for producing a neurotransmitter called dopamine.
Dopamine is, it's a very important neurotransmitter involved in controlling movement, motivation, emotion, learning, and all of the different types of activities that make humans, human.
In 1967, Levodopa, which is now the medication that is that kind of the gold standard for Parkinson’s, entered into clinical practice for Parkinson's disease. Levodopa (or “L-Dopa”) is a synthetic form of dopamine that aids in restoring some function as a consequence of having Parkinson’s Disease. L-Dopa does not replenish or heal the neurons that have degnerated in the midbrain. It doesn’t even help them to make more dopamine. What it does is just gives exogenous, or “outside”, dopamine to the brain so that the motor system and the learning system and emotional system can function better. We'll talk about that in a future blog post.
In 1982, a very important thing happened by accident. In Santa Carla, California a group of six individuals that were admitted to the hospital around the age of 35 to 50 years old. They all were developing severe Parkinson's disease, tremor, all of the signs that Charcot and Parkinson discussed in relation to PD. All of the physicians at the hospital were baffled about how a group of individuals, so young, could all be developing Parkinsonism. They began running tests. In their blood they found a substance called MPTP. MPTP is a by-product of synthesizing a recreational opiop drug, similar to heroin, called MPPP. These individuals were making and consuming their own drugs. The story didn't end so well for them, but it was great for the scientific community. Now we have an agent that we can administer to rats and animals that allows us to study Parkinson's disease.
Well, that's a quick little history of Parkinson's disease, for now. I think I’m going to write a little more about the more modern-day physiological findings that we see associated with Parkinson’s, and how that allows us to help individuals diagnosed, or suspecting that they may have Parkinson’s Disease.
If you, or a loved one has Parkinson's disease, and are looking for a drug-free way to improve quality of life, function, and independence, contact Plasticity Brain Centers, or a chiropractic neurologist near you.
If you would like to learn more about the history of Parkinson’s Disease, here is a couple resources for you: