Growth of Parkinson Disease Knowledge: Rodolfo Savica, MD, PhD

"The mistake we’ve been doing over the years, even in the medication trial and neuroprotective trials, is that we lump everything together. We know that Parkinson disease is not 1 disease. If we are able to identify differences in groups, it’s possible that agents that failed in the past, may be used now.”

Although symptoms of possible Parkinson disease (PD) can be found in very early documents, the first clear medical description was written in 1817 by James Parkinson. The first treatments for PD were based on empirical observation, and anticholinergic drugs were used as early as the nineteenth century. The discovery of dopaminergic deficits in PD and the synthetic pathway of dopamine led to the first human trials of levodopa, a drug that is still considered the standard treatment today.

Since then, the knowledge of PD has grown, but unfortunately there is still no cure. Other medications doctors have prescribed for patients include carbidopa-levodopa infusion, dopamine agonists, MAO B inhibitors, Amantadine, and anticholinergics. According to Rodolfo Savica, MD, PhD, knowledge of the disease has increased the most in the sense that clinicians understand the final pathology of the accumulation of alpha synuclein Lewy bodies.

Savica, consultant in the Department of Neurology at Mayo Clinic, believes that we are on the verge of a revolution that will include a molecular diagnosis of PD, with the ability to identify a subgroup or many subgroups that share similar particular biological and biochemical characteristics. He recently sat down with NeurologyLive to discuss the areas of PD that clinicians have gained a better understanding for.

REFERENCE

Goetz CG. The history of Parkinson disease: early clinical descriptions and neurological therapies. Cold Spring Harb Perspect Med. Published online September 1, 2011. doi: 10.1101/cshperspect.a008862