Future looks bright for Parkinson's research,
experts say on eve of Ali visit

HELEN BRANSWELL

Canadian Press

Thursday, October 17, 2002

TORONTO (CP) - His is, perhaps, the public face
of Parkinson's disease. Muhammad Ali, one of the
greatest athletes of the 20th century, is now a shuffling,
stiff giant. The man who is the prototype for the
cocksure, quotable athlete rarely speaks in public.

The disease that afflicts him often renders clear,
strong speech a thing of the past.

But Ali's mere presence is as big a drawing card
as ever, even if the humorous rhymes and brash
proclamations are things of the past. These days Ali
mainly speaks to those around him with subtle
changes in his facial expression or small gestures.
A lift of the eyebrows. A widening of the eyes.
A feigned punch.

Ali's appeal will likely prove itself, yet again,
on Sunday as he makes a rare appearance
in Canada at a CFL football game - home team
Toronto Argonauts vs. Ottawa Renegades - and
a special telethon on TSN to raise funds for
Parkinson's research at the University of Toronto
and for the Parkinson Society Canada.

"Muhammad Ali - he's the greatest ambassador
that we've ever had," says John Levangie, 56,
who was diagnosed with Parkinson's disease
at age 42.

High-profile individuals like Ali or Michael J. Fox,
who also has Parkinson's, draw attention
and dollars to research efforts to puzzle out
the mysteries of what triggers the disease
and how that process can be stopped.

"And that's precisely why Michael Fox
came forward," says Mary Jardine,
national executive director of Parkinson Society
Canada. "And overnight - literally overnight -
Parkinson's became a household word."

The disease is a degenerative one.
Neurons in the brain that produce a substance
called dopamine are inexplicably but progressively
killed off. Dopamine is the chemical that allows
nerve cells in the brain to pass each other
messages, which are then transmitted via
the central nervous system to the muscles
throughout the body.

The brain can't replace these neurons. So when
the number of neurons - we all start out with
about 450,000 - is cut to 50 per cent or fewer,
the brain doesn't produce enough dopamine
to function properly. Without enough dopamine,
the messages between the nerves
and the muscles become distorted.

The result is what Levangie and about 100,000
other Canadians live with every day. Decreased
muscle control. Rigidity. Tremors and twitches.
Balance problems. Impaired speech or soft speech.
Fatigue. Personality changes. Reduced facial
expression. And, in about a third of cases,
some dementia.

The cause remains a mystery, though evidence
increasingly points to both genetic
and environmental causes. There is no cure,
though drugs can mitigate the severity
of the symptoms.

Still, life with Parkinson's is a daily lesson
in adjustment, says Levangie, who lives in
Prospect Bay, N.S.

"You're a different person. You just feel like
you're digging a hole every day and the hole
is getting deeper and deeper," he explains
in the soft, hurried speech that is the product
of the disease.

Despite the frustrations and limitations,
the losses of mobility and memory, Levangie
finds himself deeply hopeful that the extensive
research being done on Parkinson's will lead
to breakthroughs that will make a difference
in his lifetime.

"The sense that I'm getting - and I'm getting it
over and over again, from all sorts of places
- is the future looks bright," he says.

He's not alone in that belief. Scientists
working in the field say signs are pointing
to significant gains in their knowledge
about the way Parkinson's works and steps
that could be taken to lessen its impact
on people who have it.

"I think it (the future) is very bright,"
says Dr. Edward Fon, a neurologist and
Parkinson's researcher with the Montreal
Neurological Institute.

Stem cell research is providing hope science
may one day be able to help the brains
of affected individuals generate new
dopamine- producing neurons.

Stem cells are essentially the modelling clay
of the human body, capable of becoming
heart cells, skin cells, kidney cells, whatever.
Currently stem cells differentiate - turn into
specific types of cells - in the womb.
 But scientists are working to see if
stem cells, applied to in this case
the affected portion of the brain of adults,
could be coaxed into differentiating there.

"It's promising. It has been found to be
of some use in animal models. But they are
of short duration follow up," says Dr. Ali Rajput,
chair of the scientific committee
of the Parkinson Society.

Researchers still have to figure out
if the process will work safely in humans.

"If all things go well, in my opinion,
within a decade we can probably have stem cell
transplants in humans," Rajput predicts.

Other teams are working on modifying viruses
to produce proteins that would slow
the breakdown of dopamine in the brain,
mitigating the symptoms of the disease.

Another promising area is early detection,
Rajput said. Currently, there is no test
for Parkinson's. Doctors only arrive
at the diagnosis by a process of elimination.

But if they could figure out how to tell
who was going to suffer from Parkinson's
- who was losing massive numbers of neurons
- those people could be put on medication
to supplement their dopamine supplies
before they became symptomatic.

"I'm a big believer that there will not be one
answer to this," Jardine says. "We're not
going to wake up one morning and find
that, oh, they have found the cure
for Parkinson's.

"What's going to happen is that it's going
to be a series of developments. And that's
actually what's happening right now.
They are on the cusp. And I really believe
this, that there will be major breakthroughs
in the next five years. Five to 10 years
at most."

That's not only good news for Parkinson's
patients. The research into Parkinson's
is providing insights for scientists trying to
unearth the causes and potential cures
for a bunch of related neurodegenerative
diseases - conditions like Alzheimer's,
ALS or Lou Gehrig's disease,
and other forms of dementias.

"As far as these diseases as a whole,
neurodegenerative diseases go, Parkinson's is
certainly the one where we have the most chance
of getting at the actual causes and maybe
trying to stop the . . . premature dying of neurons,"
Fon says.

"Everything that's happening in the chronic
diseases of the nervous system is based on
what has happened in Parkinson's disease,"
Rajput adds. "Parkinson's leads the research
in all these areas."

Some facts about Parkinson's disease:

Named after: English physician James Parkinson's,
who first described the disease in 1817.

Cause: Unknown, though strong evidence
suggests some cases are brought on
by genetic factors and others by environmental
ones such as some pesticides.

What happens: Neurons in the brain that produce
dopamine die off in huge numbers, starving
the brain of this essential chemical, which
allows nerve cells to transmit messages
to muscles throughout the body.

Result: People with Parkinson's suffer impaired
mobility and speech, loss of flexibility,
memory loss, dementia in some cases,
tremors, balance problems. These problems
leave them more prone to illnesses
like pneumonia, which is difficult
for a Parkinson's patient to get rid of.

Rates: It's estimated that one in 300
Canadians will develop Parkinson's.
Most cases manifest themselves
after age 65, though about 10 per cent
are diagnosed before age 50.

Cure: None, at this point. But drugs
and surgical procedures such as
deep brain stimulation can mitigate
the symptoms.

Parkinson's patients: Muhammad Ali,
Michael J. Fox, the late Pierre Trudeau,
evangelist Billy Graham.
The Pope is also believed to have Parkinson's.

SOURCE: The Canadian Press
http://www.canada.com/news/story.asp?id={E47BFA3E-7A5D-484A-8362-
208E62209317}

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