Why Can't We Solve the Puzzle?

"Parkies’ Progress"

Posy likes her little play on words, but she is also trying to draw a parallel between the Christian allegory "Pilgrim’s Progress" (by John Bunyan, 1678) and the current efforts of the scientific community to find a cure for Parkinson’s.

The rather dark, stark, dauntingly slow progress from Earth to Heaven of the character Christian always unsettled Posy as a child. Now, it is the seemingly agonizingly slow progress in research and development for Parkinson’s disease (PD) that is concerning Posy.

Getting our hopes up

Posy is utterly grateful for levodopa/carbidopa, rasagiline and any other drugs that were developed to manage this condition. However, our collective heart beats a little faster each time we hear of the "next big thing" as it goes to trial. It may be gene therapy, cell-based treatments, or the re-purposing of diabetes drugs. But, oh, how often do our hopes get smashed to pieces?

Posy’s friend, recently diagnosed with Parkinson’s, is efficiently reading up on and chasing every appropriate treatment and trial available. Posy scan-reads articles by trusted sources such as the Michael J. Fox foundation, but her knowledge is still pretty limited. Useful free time must be ring-fenced when days are ruled by a pill schedule!

It is often a challenge just keeping up with her piano practice, conducting, composing, worrying about her daughter’s health, and cleaning the house. Always, the next item on Posy’s to-do list is exercise, as there never seems to be a spare functioning moment to devote to that. Posy is making excuses, but let us not digress ...

Much of the hopeful PD literature that Posy has read focusses on finding a way to diagnose Parkinson’s earlier. This makes sense if the treatment itself does not lose its effectiveness over time. Why are there so many cases where the patient is not diagnosed correctly?

Better technology to identify PD

Maybe the medical profession just needs better technology. Basically, just as the NHS in the UK already keeps a record of our individual medical histories, it should also have a specially targeted diagnostic app for every disease. Posy is not in the medical profession, so she might be suggesting something that was developed aeons ago.

However, doctors still do not seem to be able to recognize the early symptoms as precursors to PD! A diagnostic app is a fairly simple prospect. After all, we already diagnose ourselves with all sorts of outrageously hideous, terminal illnesses on the internet!

At its inception, the app might focus on diseases that are awkward to identify. It could pick up on any correlating ailments and alert the person’s physician that Parkinson’s may be developing. Then the patient could start appropriate treatment promptly. Yes, but which treatment?

Are we any closer to a cure?

Posy is not sure where we are with knowledge of and achievable hopes for the treatment/cure of this very common disease. We all know that the "gold standard," levodopa, replaces our dopamine to a certain extent and enables us to move more freely and shake less severely. But how are scientists getting on with those other, ghastly issues of cognitive impairment and autonomic dysfunction that take away the patient’s soul?

Brain training

Is brain training the next big thing? (This is Posy’s suggestion, not a reality!)

Maybe this is too "sci-fi," but Posy wonders if anyone has researched how the brain itself might be retrained to act differently? It would be wonderful if the brain could learn how to conserve its dopamine long before any of it disappears. (Is that what exercise does?)

It would probably need to be a preventative measure at first, long before Parkinson’s is usually identified. The prospect of training a human brain to control dopamine in order to prevent or cure PD is probably a flight of fancy.

Posy is certainly not an IT mastermind nor a medical genius (you could at least try to look surprised). OK, Posy is aware that this would not be simple! Not only would the brain need to be trained to preserve dopamine, but something would also need to tackle the accumulation of alpha-synuclein proteins in the first place.

Maybe we need a hypnotist?

There are plenty of hypnotists available and willing to train us not to smoke or eat too much junk food. Could the best of them be medically trained to teach us to control actual functioning in our brains? (Stay with me, here.) Posy has often considered hypnosis to reduce her sugar cravings. A life-long "fussy eater," Posy thinks Parkinson’s may be responsible for turning her erstwhile teenage palette into that of a toddler.

Some people have had marvelous results with hypnosis. Others, not so much. The jury is out as far as Posy’s friend is concerned, that’s certain! This friend had hypnosis to help her to make healthier eating choices.

However, having spent over an hour and too much money, focusing on food had obviously made her hungry, as she just could not resist buying fish and chips on the way home! So, where do we stand? Well, wherever it is, sit up first, and drink some water, or you may wobble over!