there are few medical diagnoses more life changing than Parkinson’s disease. This neurodegenerative disorder is detected in some 70,000 people in the U.S. each year; Michael J. Fox and Muhammad Ali are best known for having Parkinson’s disease.
As a neurologist, I find it particularly tragic that most of these patients are referred late and do not find out they have Parkinson’s until they are already suffering from the severe tremors, walking difficulties, loss of smell and other physical manifestations of the disease.
Parkinson’s occurs when dopamine-producing cells, which control aspects of movement, diminish in the brain. we know that the disease starts working its damage long before physical symptoms show up. Parkinson’s can take as long as 12 years or more to develop, and the first mild symptoms are often mistaken as part of the normal aging process.
Because there are no simple tests to detect Parkinson’s in its early stages, it can take up to two to three years to accurately diagnose the disease. By the time someone has their first physical sign (tremor, rigidity or shuffling gait), 50 percent to 70 percent of the brain cells that produce dopamine, which controls movement, have already died.
Unfortunately, there is little that we physicians can offer patients at that point other than damage control. if we could intervene earlier on, we might be able to stave off or delay the progression of disease through neuroprotection.
In Pasadena, we have the first-FDA approved radiopharmaceutical imaging agent that can help physicians evaluate patients with suspected parkinsonian syndromes (PS) and related diseases. It is called DaTscan. Despite the unavailability of a simple blood test, tools like DaTscan can offer evidence that may help lessen diagnostic uncertainty and confusion for early-stage Parkinson’s patients and their families.
When DaTscan is combined with a single photon emission computed tomography (SPECT) brain scanner, it produces visual evidence of the amount of dopamine transporter cells, allowing physicians to determine whether occasional tremors are the result of Parkinson’s or some other cause.
DaTscan has been in available in Europe for more than 10 years; the FDA approved the imaging agent for use in the U.S. in January 2011; I scanned the first patient in Pasadena with it on Sept. 6. I believe that DaTscan will revolutionize both neuroimaging and the treatment of Parkinson’s as more and more hospitals and physicians learn about this method.
DaTscan can also detect Parkinson’s Disease by detecting early risk factors (red flags) alone or in combination, that may appear more than a decade before physical symptoms, such as , decreased or lost sense of smell or certain sleep disorders, but these uses are not yet FDA approved.
Just think how much we could slow down this difficult disease and improve lives of patients and their caregivers if we are able to act before the symptoms of Parkinson’s become debilitating and ensure that treatment recommendations are appropriate. I am certain that early detection is the future for Parkinson’s disease.
Dr. Jerome Lisk is a physician at Southern California Movement Disorder Specialists, 65 N. Madison Ave. Suite 410, Pasadena. 626-792-6683. socalmds.com