Though most of us have some general idea of Parkinson’s and its effects, it’s a complicated disease with many questions still to be answered about its possible causes. Having worked at the cutting edge of research into Parkinson’s for more than 30 years, BAP founder Jonathan Brotchie has compiled the brief primer below, identifying key aspects of the disease he feels that people should know more about. It may also help to further illuminate BAP’s interest in exploring the connections between art and Parkinson’s.
1. It’s relentless. Parkinson’s disease is a progressive neurological disorder that worsens over time, with the rate of progression varying greatly between individuals. It’s usually diagnosed in people over 50 years of age, but some people might have the disease for decades beforehand.
2. There’s no known cure. While great strides have been made in our understanding of Parkinson’s, there is currently no cure—though medication and surgery can help manage symptoms. Recent breakthroughs, such as the discovery of a biomarker for the disease, have put scientists in a better position than ever in their search for a cure, as they are now able to identify and diagnose Parkinson’s according to certain biological changes in the brain, rather than as just a collection of symptoms.
3. It’s a movement disorder. Motor symptoms include tremors, shaking even when otherwise at rest (not to be confused with dyskinesia, see below), rigidity or stiffness, slowness of movement, bradykinesia, and difficulty with balance and posture.
4. But it’s not only a movement disorder. Many non-motor aspects of Parkinson’s are often overlooked: people with the disease may also experience cognitive impairment (lack of attention and working memory), loss of sense of smell, depression, and sleep disturbances.
5. Its causes are complicated. In most cases, there is no one single cause of Parkinson’s. Rather, many mechanisms combine to cause the disease, and never manifest in the same way in any two patients, with a range of environmental and genetic factors possibly contributing. In only a small number of people is PD purely genetic.
6. It’s all about dopamine (or is it?). Parkinson’s disease is caused by the death of neurons in the brain that produce dopamine, a chemical responsible for coordinating movement. But dopamine is also the brain’s reward signal; for instance, certain recreational drugs cause their effects because they increase dopamine and feelings of reward. Many other brain chemicals are also involved in PD. Jon has spent much of his career championing and developing non-dopaminergic drugs for PD. Some of the neurochemicals involved in PD you may have heard of include serotonin, cannabinoids, opioids, histamine, noradrenaline.
7. It’s a different way of seeing. People with Parkinson’s experience the world differently to those without the disease, which can manifest in many ways including how they see and create art. It is not known if this is because of the disease itself or the drug therapies provided, quite possibly a combination. One of our goals with BAP’s project support is to explore this question of why people with Parkinson’s perceive and appreciate art differently. If we can figure out which chemical(s) and pathways in the brain are responsible for the changed perception then it’s possible we can gain some revealing insights about how all of us process and make sense of art, and indeed the broader world.
8. L-DOPA changed everything, but that was 50 years ago. The most commonly used, and most efficacious, medication is still L-DOPA, also called levodopa (or L-3,4-dihydroxyphenylalanine on its birth certificate), which helps replenish dopamine levels in the brain, thereby improving motor symptoms. It’s not so effective, however, with non-motor symptoms, and does nothing to slow the relentless death of brain cells. Over time, L-DOPA treatment causes a severely debilitating side effect called dyskinesia. These are unwanted, involuntary, uncoordinated, wild movements that limit and eventually diminish the usefulness of L-DOPA.
9. It’s hugely challenging to live with. Parkinson’s can significantly affect many aspects of quality of life, making such everyday tasks as brewing a cup of coffee, buttoning a jacket, sitting still for a play or movie—not to mention walking, and social interactions in general—more challenging as the disease progresses and drugs available become less useful.
Read more about Parkinson’s disease
More readings and research into the links between art and Parkinson's