Levodopa for Parkinson’s Disease 1957 – A Miraculous Treatment

In 1961, Austrian researchers Oleh Hornykiewicz and Walther Birkmayer published a report on L-dopa, an apparently miraculous treatment for Parkinson's disease, a central nervous system disease impairing movement control and other brain functions. The report stated:

“After L-dopa injection, bedridden patients, patients unable to sit up, patients unable to rise from a seated position and patients unable to walk when standing could perform all these activities with ease... They could even run and jump. Quiet speech... became strong and clear.”

People with Parkinson's disease (PD) experience muscle tremors, rigidity and slowed movement. PD usually involves certain brainstem  nerve cells  failing to produce enough of the  neurotransmitter  dopamine. In 1817, British apothecary James Parkinson described PD in detail in an essay on  “the shaking palsy”. In 1957, Swedish scientist Arvid Carlsson found dopamine in a brain region important for movement control. He also showed that lowering dopamine levels in animals could produce PD symptoms, which could be reversed by giving  levodopa  (a psychoactive drug also known as L-dopa).

Levodopa can cross the blood–brain barrier, enter the brain and be converted into dopamine by certain nerve cells. When levodopa is metabolised outside the brain, it can cause adverse effects such as nausea and sudden movements. Other drugs can be given to suppress this metabolism. When drug treatment is no longer effective, electrical impulses can be used as deep brain stimulation treatment.

Researchers continue to study stem-cell transplants within the brain as a possible treatment. 

Neurologist Oliver Sacks used levodopa to treat patients with encephalitis lethargica who had not moved or spoken for years.

PD is also associated with Lewy bodies  (protein deposits)  formed by abnormal accumulation of alpha-synuclein in the brain, which may lead to brain-cell death. Several genetic mutations causing Parkinson's disease are also known.

Description of the article image: A famous illustration of a patient with Parkinson's disease from British neurologist William Richard Gowers's A Manual of Diseases of the Nervous System (1886).

Historical figures mentioned in the article: James Parkinson (1755–1824), Walther Birkmayer (1910–1996), Arvid Carlsson (b. 1923), Oleh Hornykiewicz (b. 1926), Oliver Wolf Sacks (b. 1933)

• Previous topic: Cardiopulmonary Resuscitation 1956 – Emergency Intervention to Restore Life
• Next topic: Fetal Monitoring 1957 – Medical Monitoring of the Baby in the Womb