Muhammad Ali, who dazzled the world with his pugnacious wit and victories against foes such as Sonny Liston, Joe Frazier, and George Foreman, would face his greatest battle outside of the ring. After the boxer’s retirement, the three-time world heavyweight champion was diagnosed with Parkinson’s disease, a debilitating nervous disorder that often starts with hand tremors and progressively wears away at motor and non-motor skills until patients may have trouble walking, talking, and swallowing.
More than half a million Americans suffer from Parkinson’s, the second-most-common neurodegenerative disorder after Alzheimer’s. In addition to the slowness of movement, speech problems, and loss of balance that we tend to associate with the disease, it often comes with emotional disorders such as depression and anxiety. “It’s the most complex disease in clinical medicine because it’s not actually one disease,” says Michael S. Okun, MD, national medical director of the National Parkinson Foundation and the administrative director at the Center for Movement Disorders and Neurorestoration at the University of Florida. “It’s a group of more than 20 motor and non-motor symptoms. We like to lump things together, but I like to say that when you’ve seen one Parkinson’s patient, you’ve seen one Parkinson’s patient.”
When Parkinson’s sets in, the neurons in the brain that produce dopamine and enable movement gradually begin to die. The precursor to this diagnosable stage, according to Rebecca Gilbert, MD, PhD, a movement disorders specialist at the Fresco Institute for Parkinson’s & Movement Disorders at NYU, is the formation of protein deposits in the brain called Lewy bodies. Their buildup can usher in a constellation of problems including depression, sleeplessness, and loss of smell. “These can start decades before we see the motor symptoms,” says Dr. Gilbert. “Parkinson’s is defined as a motor disease, but it’s so much more complex than that.”
Like many diseases, Parkinson’s is believed to be partly genetic and partly environmental. Ali’s doctors hypothesized that his may have resulted from a lifetime spent taking repeated blows to the head. His diagnosis came when he was 42, which is earlier than the disease’s average profile (it tends to manifest in men, typically anywhere from one’s late 50s to 60s). A patient can live for decades with the disease, as Ali did; it’s the related dangers that tend to present as the disease progresses—such as falling or aspiration pneumonia due to swallowing disorders—that can be fatal. Ali’s Parkinson’s is believed to have complicated the respiratory illness for which he was hospitalized prior to his death.
One popular therapy is dopamine replacement medication such as Levodopa, though this kind of treatment can lose potency as the disease progresses. Another treatment in use is deep brain stimulation, which can help with motor symptoms. Clinical trials are currently under way in the U.S., looking at the potential healing power of ultrasound. The hope is to use ultrasound waves in lieu of surgery to destroy targeted tissue in the brain that would correct motor capacity.
“There is no cure, but if we could slow the progression, that would make a tremendous impact on the quality of life,” says Tanya Simuni, MD, director of the Parkinson’s Disease and Movement Disorders Center at Northwestern University. She and her colleagues are working on a study looking into the neuroprotective properties of Isradipine—a medication commonly used to treat high blood pressure.
Dr. Simuni adds that exercise has been proven to be a neuroprotector against Parkinson’s in mice, and the doctors at her clinic encourage patients to stay active. Popular forms of exercise are tango and biking, as well as Rock Steady Boxing, which offers classes designed specifically for people with Parkinson’s. “I have no scientific literature,” she says, “but the patients are raving about it.”
The post What Is Parkinson’s Disease? Inside Muhammad Ali’s Final Fight appeared first on Vogue.
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