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Michael is only 37 years old and he started having symptoms seven years ago (at 30). U. S. Attorney General Janet Reno also suffers from Parkinson's but the most memorable celebrity to expose his vulnerability about having the disease is Muhammed Ali.
Concerning Parkinson's Disease, Michael's case is not unusual. According to Dr. Erwin Montgomery, "There is a misconception that only old people get Parkinson's Disease. While it is true that most Parkinson patients develop the disease in their late fifties or early sixties, we know that at least 8 percent develop the disease younger than 40 years of age. And, there is growing concern that the number of young Parkinson patients is increasing. ...We know that Parkinson's Disease affects the young and old in different ways. Young patients tend to have more tremor, but better balance and walking. Young patients sometimes have more involuntary movements or dyskinesia in response to medications, but have fewer problems with thinking abilities. The disease progresses at a slower pace for the young patients, and they are better able to tolerate some of the side-effects of the medications. The psychological and social impact on a working person with family responsibiities is different from someone retired. Many young patients are very concerned about whether they will be able to keep their jobs and continue to support themselves and their families. And, while there are laws to protect working Parkinsonians from unfair termination, despite these laws, finding or maintaining a job can be extremely difficult for the young patient." (For more information in this subject, check out neuro-chief-e.mgh.harvard.edu/parkinsonsweb/Main/Support/youngpark.html )
Parkinson's disease, which mostly afflicts older people, results from gradual degeneration of nerve cells in the portion of the midbrain that controls body movements. The first signs are likely to be barely noticeable - a feeling of weakness or stiffness in one limb, perhaps, or a fine trembling of one hand when it is at rest (activity causes the tremor to disappear). Eventually, the shaking will worsen and spread, muscles will tend to stiffen, and balance and coordination will deteriorate. Depression and other mental or emotional problems are common.
Usually the disorder begins between the ages of 50 and 65, striking about 1 percent of the population in that age group; it is slightly more common in men than women. Medication can treat its symptoms and the disorder is not directly life-threatening. About half of all patients treated with drugs have no major disabilities 10 years after the onset of the disease.
Bodily movements are regulated by a portion of the brain called the basal ganglia, whose cells require a proper balance of two substances called dopamine and acetylcholine, both involved in the transmission of nerve impulses. In Parkinson's, cells that produce dopamine begin to degenerate, throwing off the balanace of these two neurotransmitters. Researchers believe that genetics sometimes plays a role in the cellular breakdown, and in rare instances, Parkinson's may be caused by a viral infection or by exposure to environmental toxins such as pesticides, carbonmonoxide, or the metal manganese. But in the great majority of cases, the cause is unknown.
The disease takes hold slowly, beginning with a sense of weakness and a slight tremor of the head or hands, then gradually progressing to more generalized symptoms. These can include:
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the above symptoms. In the disease's early stages, drugs can be very
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Study finds link between Ecstasy and
But some researchers were skeptical that the results from the animal studies translate to humans and said such studies discourage research that might lead to medical uses for Ecstasy.
A Johns Hopkins University researcher injected squirrel monkeys and baboons with three shots of Ecstasy, also known as MDMA, three hours apart, mimicking dosages "often used by MDMA users at all-night dance parties." He said the drug caused enduring damage to dopamine-producing neurons in the brains of the animals.
The damage was still evident two weeks to six weeks later, said Dr. George A. Recaurte, the lead author the study appearing this week in the journal Science. But he said it is not clear if the damaged neurons will repair themselves, a key factor in whether Ecstasy could cause Parkinson's disease.
Parkinson's disease is a brain disorder triggered by the permanent loss of dopamine-producing nerve cells.
"We already know from the literature that brain dopamine declines with age," he said. "A young individual who sustains injury to these dopamine cells and depletes their reserve may be at greater risk of Parkinsonism."
But Julie A. Holland, a psychiatrist on the faculty of the New York University School of Medicine, said earlier studies on humans have failed to show that Ecstasy causes permanent damage to dopamine neurons.
"It is a big leap to extrapolate what he is seeing in these primates and what you expect to see in Parkinson's syndrome," Holland, the author of a book on the risk and recreational use of Ecstasy.
She said Ricaurte's research has helped "demonize" Ecstasy and prevented studies to determine if the drug could be used to treat post traumatic syndrome.
Dr. Alan I. Leshner, former head of the National Institute on Drug Abuse, however, said the Ricaurte study shows "that even an occasional use of Ecstasy can lead to significant damage to brain systems."
Stephen Kish, a University of Toronto researcher studying Parkinson's disease and Ecstasy, said he analyzed the brain of a deceased habitual Ecstasy user two years ago and found no evidence of dopamine neuron damage.
"Ricaurte's findings do raise a concern that Ecstasy may damage the dopamine neurons and potentially cause Parkinson's," said Kish. But he said the current study "might not translate to humans" and has not proven a clear connection between the drug and the brain disease.
In the study, the animals were given six milligrams for every 2.2 pounds of their weight. One of five monkeys and one of five baboons used in the study died shortly after receiving the shots.
The brains of the surviving animals were examined microscopically and chemically after two to eight weeks. The nerve endings where the dopamine is processed were destroyed, said Ricaurte.
"There hasn't been a single animal that escaped the dopamine (cell) lesions," he said.
Ricaurte said the damage was not enough to cause Parkinson's symptoms, but there is "a clinical concern" that repeated use of Ecstasy will diminish the natural reserve of brain cells and lead to early disease.
Holland said Ricaurte's study in monkeys and baboons does not relate to the experience of human recreational users of Ecstasy.
"The dose that he gave killed 20 percent of the animals immediately," said Holland. "Clearly these animals reacted to the drug differently than humans because not one out of five Ecstasy users drops dead."
Also, she said Ricaurte's study injected Ecstasy, while most human users take the drug orally. Drugs taken orally are less concentrated in the body than drugs that are injected, said Holland.
The NYU psychiatrist said "there is a lot of politics involved" in Ricaurte's study because the government does not want to allow medical research with Ecstasy, even though it has been approved for study by the Food and Drug Administration.
Ricaurte's research has been funded by the National Institute on
Drug Abuse, the agency Leshner once headed. Leshner is now chief
executive officer of the American Association for the Advancement of
Science, the organization that publishes Science, the journal
printing Ricaurte's current study on Ecstasy.
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