Overnight, addicts get Parkinson's, scientists get breakthrough
Thursday, April 1, 1999: Dr. Phil Ballard had seen all sorts of bizarre
patients in psychiatric emergency rooms. But he'd never seen one like
George Carillo.
It was 1982, and Ballard - now head of the Movement Disorder Program at
Swedish Medical Center - was completing a neurology fellowship at Stanford
University. He'd been called in to consult on a 42-year-old man who sat
frozen mid-gesture, unblinking and lifeless except for normal organ
function. There was no evidence of mental activity.
"He had a blank stare and was stiff as a board," Ballard said. Since the
patient had come from jail, many doctors who saw him suspected he was
faking catatonic schizophrenia to get out of trouble.
But it was no act.
After seven days with no change and no diagnosis, Ballard noticed a slight
twitching in the man's fingers. He slipped him a pad and pencil.
"I'm not sure what is happening to me," the patient wrote, using just his
fingertips. "I can't move right. I know what I want to do. It just won't
come out right."
Ballard was elated to discover a normal mind trapped inside the body.
Slowly, he pieced together the patient's history. The patient and his
girlfriend were heroin addicts. They'd come down with symptoms after
injecting a street-synthesized version of Demerol, a "designer drug" meant
to act like heroin.
With that information in hand, Ballard and his boss, Dr. J. William
Langston, set out to solve the mystery of one patient and ended up making a
major breakthrough in the study of Parkinson's disease.
Over the next few weeks, more addicts in strangely frozen postures began
turning up in emergency rooms all over the San Francisco Bay area. They had
one thing in common. Each had been using designer street narcotics.
Investigators suspected a bad batch caused the outbreak, but they couldn't
identify the contaminant.
Then, by chance, one of the team recalled reading an obscure journal report
years earlier of a young college student who had ended up with identical
symptoms after synthesizing his own drugs in 1976. After he died 18 months
later, an autopsy revealed the distinctive brain damage associated with
Parkinson's disease. Until then, doctors had almost never seen Parkinson's
in someone so young. And they'd never seen it develop overnight.
Ballard set out to find the article, which wasn't even in the medical
center library. "I dug it out of the dusty reaches of the racks of Stanford
library," he said. "I realized as I was reading it that this is it, this
has got to be it."
Indeed, it turned out that a contaminant called MPTP caused both the
college student's symptoms and those of the street addicts.
MPTP can slip across the blood-brain barrier, where it kills the
dopamine-producing cells in the brain. A dopamine shortage leads to
Parkinson's.
In their quest for a new high, the addicts had inadvertently given
themselves an irreversible, debilitating disease. But they gave the
scientific community something else: a clue to what causes Parkinson's
disease. MPTP resembles many environmental chemicals, including pesticides,
which led to the now widely accepted theory that toxins induce Parkinson's.
In addition to providing a key breakthrough in understanding the disease,
MPTP gave researchers a way to induce Parkinson's disease in animals,
giving them for the first time a model for testing new drugs and other
therapies.
Several of the original addicts received experimental treatments, such as
fetal cell implants, that grew out of that research. In some cases, it
dramatically improved their symptoms, allowing them to resume a more normal
life.
"It was quite a chase," Ballard said. "We had a lot of dead ends and a lot
of lucky breaks."
By CAROL SMITH P-I REPORTER
SEATTLE POST-INTELLIGENCER REPORTER
Copyright 1999 Seattle Post-Intelligencer.
All rights reserved.
http://www.seattle-pi.com/pi/local/mptp01.shtml
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