What is Parkinson's?

20 January 2013

Interview with

Dr James Rowe, Cambridge University

Kick-starting the programme, I went in search of answers about Parkinson's disease.  First up, I wanted to get some idea of how many people it affects and how.

James -   Yes, hello.  I'm James Rowe.  I'm a Consultant Neurologist at Addenbrooke's Hospital and I work with the Cambridge University on some of the research studies in Parkinson's disease and related disorders.  

Well, Parkinson's is diverse and challenging.  It's not just because it affects up to 100,000 people in the UK, but because of the range of problems it can cause.  Many people will be familiar with the idea that it causes a tremor and slowness and stiffness, but not everyone will be aware it causes many other problems - what we call non-motor symptoms.  These include sleep problems, affecting mood - of anxiety and depression, pain even, and many other problems.  Even constipation is remarkably common too so, a wide range of symptoms.  

Many people, even quite early than others have difficulty PET scanwith thinking flexibly or planning ahead and multitasking in their mind.  This is distinct to what can happen later on in the others which is, some patients can go on to get a dementia.  So, two very different sorts of thinking on memory problems, but both very challenging.

Hannah -   And do we know much about what's going on in the brain in order to give rise to these very complex and wide ranging symptoms associated with Parkinson's?

James -   Well, it's been known for many years that a key chemical in the brain called dopamine is lacking.  The cells that make dopamine appear to die back early in Parkinson's disease.  In fact, by the time that somebody presents to their doctor with Parkinson's disease, you may already have lost 78 or even 90% of the dopamine cells.  So, the mainstay of treatment for the last 45 years has been dopamine drugs - either to mimic dopamine or help your body boost the amount of dopamine it can make.

Hannah -   So, this highly prevalent disorder, most famously now affecting Michael J. Fox is known to have a biological cause, this dying off of the dopamine nerve cells.  We can treat it by giving patients L-Dopa or similar to replace some of the lacking chemical messenger dopamine and alleviating some of the symptoms.  But in the main, this only helps mask the symptoms for short amount of time.  Researchers are hoping to improve available treatments by coming up with clever new techniques to gain a much better understanding of the disorder.  

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