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It develops subtly and gradually—perhaps with a barely noticeable tremor in just
one hand, trouble getting out of a chair, soft or mumbled speech, losing track
of thoughts, or feeling tired and irritable for no apparent reason. It occurs
when the dopamine-producing cells in the brain begin to die for unknown reasons.
Messages from the brain telling the body how and when to move are therefore
delivered more slowly, leaving a person incapable of initiating and controlling
movements in a normal way. It is called Parkinson's disease (PD) for which there
is, at present, no known cure and no treatment to slow its course. However, a
new study suggests that a commonly used drug may actually reduce the risk of
developing PD—a discovery that could one day bring an end to this devastating
movement disorder.

Dr. Beate Ritz, of the UCLA School of Public Health, and colleagues analyzed
data from a nationwide Danish medical record system and a pharmacy database.
They discovered that patients treated with calcium channel blockers were 27
percent less likely to be diagnosed with PD. Furthermore, the risk reduction was
not dependent upon the intensity of the drug or the length of usage.

First identified in the late 1960s, calcium channel blockers (CCBs) are commonly
used to treat high blood pressure (hypertension). They work by slowing the rate
at which calcium passes into the heart muscle and into the vessel walls, which
relaxes the vessels and lets the blood flow more easily through them, thereby
lowering blood pressure. Some CCBs have the added benefit of slowing your heart
rate, which can further lower blood pressure, relieve chest pain (angina) and
control an irregular heartbeat (arrhythmia).

Previously, L-type calcium channel blockers were shown to protect animals
against cell loss and motor deficits after administration of MPTP, a neurotoxin
that causes permanent PD symptoms by killing neurons in the brain. "These
findings add to basic science and epidemiologic evidence that L-type calcium
channel blockers may have a protective effect against the occurrence of
Parkinson's disease or the disease process," said Dr. Connie Marras of Toronto
Western Hospital. "This causal relationship remains to be proven, but the
results are exciting given that the L-type calcium channel blockers are widely
available, have a well-known and reasonable safety profile and are not
prohibitively expensive."

PD is one of the most common neurodegenerative diseases, second only to
Alzheimer's disease in the number of people affected. Estimates suggest that
approximately 750,000 Americans have PD, with as many as fifty thousand new
cases each year. There are medications to ease the symptoms of PD, but treatment
can be complex for several reasons. First, because PD is a progressive disease,
meaning that it gets worse over time, the medications and doses that work well
early on may be insufficient later on. Second, there are many different
treatment options and finding the right combination can be time consuming.
Third, the most effective drugs have troubling, long-term side effects and are
difficult to control. Fourth, because of the age in onset, PD patients are
likely to have other conditions associated with advancing age, and these
conditions or their treatment may interfere with treatment for PD.

And, in cases where drugs fail to control symptoms, there is brain surgery. Deep
brain stimulation uses electrical impulses, generated by surgically implanted
wire electrodes, to stimulate a target area in the brain. It does not destroy
brain tissue and has fewer risks than older surgical methods, such as
pallidotomy and thalamotomy, which involve the precise destruction of very small
areas in the deep part of the brain that cause symptoms. Neurotransplantation
surgery, which involves implanting cells that produce dopamine into the brain,
is also being studied for the treatment of PD. However, the procedure is
experimental and information about its effectiveness is limited. At present, it
is not a proven treatment or a realistic option for most people.

The study findings were presented at The Movement Disorder Society's 13th
International Congress of Parkinson's Disease and Movement Disorders, where more
than 3,900 physicians and medical professionals from 90 countries gathered to
learn the latest research findings and state-of-the-art treatment options for
Movement Disorders. Over 1,700 scientific abstracts submitted by clinicians from
around the world were on display.

The Movement Disorder Society, an international society of over 3,000
clinicians, scientists, and other healthcare professionals, is dedicated to
improving patient care through education and research
By: Madeline Ellis
Published: Wednesday, 10 June 2009