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} * * * ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn