Friday, January 26, 2007

A shory history of the shaking palsy

Another Friday, another fascinating lecture on the history of medicine to the second-year medical students! Given by Dr. John Nutt, Director of the OHSU Parkinson Center of Oregon (and, incidentally, holder of the new world's record for Director of the Entity with the Biggest Acronym: PVAMC PADRECC), the lecture focused on the history of Parkinson's Disease.

Parkinson's Disease (PD) was first described in 1817
by James Parkinson, an English physician and polymath who also wrote the first book on English fossils, the first English language description of ruptured appendix, and several political tracts which got him into trouble with the law. (An interesting side note: no pictures of Parkinson are extant today; makes the labor we spend on our Historical Image Collection seem all the more worthwhile for the potential Parkinsons of tomorrow.)

He based his entire description of the disease on six cases--only three of which he saw in the office. The other three were people he'd observed on the streets of London. Finally, a way to make people-watching into a productive enterprise! Parkinson called his new disease the "shaking palsy" or paralysis agitans. It was Jean Charcot, the great French neurologist, who suggested it be renamed in Parkinson's honor. Gowers went on to write the first textbook of neurology, which compiled all contemporary knowledge on the disease--which was then often confused with multiple sclerosis. Lewy discovered his eponymous bodies in 1913, but it wasn't until Arvid Carlsson noticed the relationship of dopamine levels to akinesia that the groundwork for treatment of PD was laid. (Carlsson went on to win the Nobel for his work, in 2000.)

Since then, advances in genetics have shed more light on the nature of the disease. Heiko and Eva Braak, who developed the staging system for Alzheimers, have now turned attention to PD. Most recently (2002), researchers have shown reduced dopamine takeup in myocardial tissue in patients with PD, indicating that this may be not just a disease of the central nervous system, but a much broader disease, possibly systemic in nature.

Two hundred years later, Parkinson himself would be pleased!

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