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Seattle PI Special Parkinson’s Report

Tuesday April 03, 2001

Overnight, addicts get Parkinson’s, scientists get breakthrough
By CAROL SMITH P-I REPORTER

April 1, 1999 - Dr. Phil Ballard had seen all sorts of bizarre patients in psychiatric emergency rooms. But he’d never seen one like George Carillo.


It was 1982, and Ballard - now head of the Movement Disorder Program at Swedish Medical Center - was completing a neurology fellowship at Stanford University. He’d been called in to consult on a 42-year-old man who sat frozen mid-gesture, unblinking and lifeless except for normal organ function. There was no evidence of mental activity.


"He had a blank stare and was stiff as a board," Ballard said. Since the patient had come from jail, many doctors who saw him suspected he was faking catatonic schizophrenia to get out of trouble.


But it was no act.


After seven days with no change and no diagnosis, Ballard noticed a slight twitching in the man’s fingers. He slipped him a pad and pencil.


"I’m not sure what is happening to me," the patient wrote, using just his fingertips. "I can’t move right. I know what I want to do. It just won’t come out right."


Ballard was elated to discover a normal mind trapped inside the body. Slowly, he pieced together the patient’s history. The patient and his girlfriend were heroin addicts. They’d come down with symptoms after injecting a street-synthesized version of Demerol, a "designer drug" meant to act like heroin.


With that information in hand, Ballard and his boss, Dr. J. William Langston, set out to solve the mystery of one patient and ended up making a major breakthrough in the study of Parkinson’s disease.


Over the next few weeks, more addicts in strangely frozen postures began turning up in emergency rooms all over the San Francisco Bay area. They had one thing in common. Each had been using designer street narcotics.


Investigators suspected a bad batch caused the outbreak, but they couldn’t identify the contaminant.


Then, by chance, one of the team recalled reading an obscure journal report years earlier of a young college student who had ended up with identical symptoms after synthesizing his own drugs in 1976. After he died 18 months later, an autopsy revealed the distinctive brain damage associated with Parkinson’s disease. Until then, doctors had almost never seen Parkinson’s in someone so young. And they’d never seen it develop overnight.


Ballard set out to find the article, which wasn’t even in the medical center library. "I dug it out of the dusty reaches of the racks of Stanford library," he said. "I realized as I was reading it that this is it, this has got to be it."


Indeed, it turned out that a contaminant called MPTP caused both the college student’s symptoms and those of the street addicts.


MPTP can slip across the blood-brain barrier, where it kills the dopamine-producing cells in the brain. A dopamine shortage leads to Parkinson’s.


In their quest for a new high, the addicts had inadvertently given themselves an irreversible, debilitating disease. But they gave the scientific community something else: a clue to what causes Parkinson’s disease. MPTP resembles many environmental chemicals, including pesticides, which led to the now widely accepted theory that toxins induce Parkinson’s.


In addition to providing a key breakthrough in understanding the disease, MPTP gave researchers a way to induce Parkinson’s disease in animals, giving them for the first time a model for testing new drugs and other therapies.


Several of the original addicts received experimental treatments, such as fetal cell implants, that grew out of that research. In some cases, it dramatically improved their symptoms, allowing them to resume a more normal life.


"It was quite a chase," Ballard said. "We had a lot of dead ends and a lot of lucky breaks."

P-I reporter Carol Smith can be reached at 206-448-8070 or via e-mail: <a href="mailto:carolsmith@seattle-pi.com">carolsmith@seattle-pi.com</a><P> <i>See the <a href="http://www.seattle-pi.com/local/park01.shtml">original special report</a> in the Seattle Post-Intelligencer