Battling Parkinson’s

By Mark Ackerman, PA

In October of 1954 a 12-year-old boy named Cassius Clay Jr., had his bicycle stolen. Determined to “pummel” the person who stole it, he went to the police to report the theft. The police officer listening to his story, advised Cassius that before he “pummeled” anyone that he should learn how to fight first. The officer’s name was Joe Martin. Martin, besides being a police officer in Cassius’ home town of Louisville Kentucky, was also a boxing trainer and took the young man on as a student. Six years later Cassius Clay won his first boxing match and then went on to become probably, the greatest heavy weight boxer in the world.
In 1964, Cassius Clay changed his name to Muhammed Ali after his conversion to Islam. We know Muhammed Ali well for several things including his incredible boxing ability, his showmanship and his poetic prose when he predicted his first Heavy Weight championship with the self-description that he “Floats like a butterfly, stings like a bee.” The other thing he was well known for is that in 1984, he was diagnosed with Parkinson’s disease.
I mention this because April is Parkinson’s disease awareness month. Parkinson’s is a neurological disorder first well described by an English Physician, James Parkinson, in 1817 in an essay entitled “The Shaking Palsy” which highlighted the symptoms of having a tremor at rest with rigidity, postural instability and slow movements. Despite that, it is felt that Parkinson’s was described in ancient writings including the ancient Indian language of Sanskrit, which dates from 6500-1500 BC. Evidently, the word Kampavata in ancient medical manuscripts is redacted as “shaking muscular movement” in that the word Kampa means “shaking” and the word vata means “lack of muscular movement.”
In the mid 1800’s the French Physician, Jean-Martin Charcot, the Father of Neurology, formed a hospital in which he took care of 3,000 patients who had neurological diseases. Charcot named the disease after James Parkinson and tried multiple treatments for the disorder. The initial treatment was bloodletting from the neck, thinking that patients needed pressure removed from their spinal cord and brain. One of his most interesting treatments was a shaking chair. After noting that Parkinson patients seem to have improvement of their symptoms after a horse ride, Charcot developed a chair that tried to reproduce this movement and help ameliorate the symptoms. Interestingly, Charcot’s disciples later invented a shaking helmet, feeling that it was only the brain that needed to be shaken. Later, electrical stimulation was used and in Russia, physicians devised a harness that would wrap under a patient’s chin and the back of their head to suspend them from a rope. The idea was to extend the spine in order to relieve pressure from the nerves exiting the spinal cord.
While it sounds a bit crazy, all these treatments did have some effect. Fortunately, even though there is no cure for Parkinson’s yet, there was a breakthrough in treatment in the 1950’s. While a new drug class called neuroleptics was invented to treat psychiatric disorders like schizophrenia, it was found that some of these drugs caused a Parkinson like action in the patients who took them. From that study, it was found that Parkinson’s symptoms were caused by a lack of the chemical Dopamine in the brain. A new class of medications was developed to treat Parkinson’s. The most common of these medications are carbidopa and levodopa which help with increasing dopamine in the brain thus impacting symptoms.
It is thus felt that Parkinson’s is caused by the progressive loss of dopamine producing neurons in a part of the brain called the basal ganglia. Dopamine is a neurotransmitter that helps communication between different neurons. As a chemical, it is involved in movement and coordination as well as happy moods and the reward system in the brain. But, Dopamine is also a hormone that is produced to make people feel good. When you don’t have enough dopamine, you get problems with muscular movement and coordination, but the other thing you get is a poor mood that leads to depression, fatigue, apathy and pain. These later symptoms can often be overlooked problems with Parkinson’s.
What is also important to understand is that there are several things that can put someone at risk for Parkinson’s. These are things like exposure to pesticides, heavy metals, recurrent head injuries and drinking well water. From a medical standpoint, the chronic conditions that are associated with Parkinson’s are obesity and type II diabetes as well as some forms of cancer.
So back to Ali. Probably the most difficult fight of his life was the one having to battle Parkinson’s disease, which could have been caused by the multiple punches he took to the head as a boxer. One of Ali’s strategies was called the “Rope a Dope-“ a strategy where he would pretend to be trapped by the rope allowing his opponent to throw multiple punches at him in attempt to win the match. After his opponent tired himself out, Ali would then fight back against his fatigued opponent and win.
It was apparent that Ali was developing symptoms of Parkinson’s at the end of his boxing career in his late 30’s. This was felt to be premature given that typically people develop the disease after the age of 60. But. in retirement, Ali was a fierce competitor against Parkinson’s. He devoted much time in volunteer work towards the cause of helping people who struggle with Parkinson’s. Ironically, Ali who was known for his showmanship and taunting of his opponents was left with a serious speech problem in retirement and was completely speechless several days before his death in 2016.
So, while a stolen bicycle lead to the rise of one of the greatest boxers in the world, it also lead to a huge awareness of Parkinson’s by that same boxer. It is true that some of our sufferings in life can lead to greater things.