Better Treatments Sought for Neurological Diseases

William Shakespeare famously described life’s seven stages, none of them in especially happy terms. The final stage of old age is “second childishness and mere oblivion/Sans teeth, sans eyes, sans taste, sans everything.”

Most people with neurological conditions aren’t quite that decrepit, but Shakespeare’s words from “As You Like It” seem to capture accurately the helplessness of mind and body that gradually overtakes people with Alzheimer’s disease and Parkinson’s disease.

So far, there are no cures for these two most common neurological disorders, which affect more than six million Americans. The symptoms are treatable, but no therapy exists to prevent or halt their progressive deterioration. Researchers haven’t given up hope.

“These diseases are merciless. They are cruel. But they are not beyond our ability to defeat them,” said James Greenwood, president of the Biotechnology Industry Organization (BIO) at a Washington, D.C., briefing on neurological diseases last September.

Greenwood and other speakers called for increased research funding to focus not only on causes but on treatments for Alzheimer’s and Parkinson’s diseases. “We really need better therapies,” said Dr. John H. Growdon, a professor of neurology at Harvard Medical School and director of the Alzheimer’s Disease Research Center at Massachusetts General Hospital in Boston.

Finding effective treatments becomes more pressing as the population ages because advanced age is a primary risk factor for neurological disease. The vast majority of the 5.1 million Americans with Alzheimer’s disease are over age 65. About 500,000 to 1 million others suffer from Parkinson’s disease, for which the average age of onset is 60. The number of people with these diseases is expected to skyrocket in the next 20 years.

The five government-approved drugs for Alzheimer’s disease typically yield only short-term improvement in a condition that can last as long as 20 years, Growdon said. Similarly, levodopa and other drugs may temporarily improve motor symptoms in people with Parkinson’s disease, which also lasts for years.

“In the end, people run out of gas. We need curative and even preventive therapies,” Growdon said. There’s been promising research, “but the momentum should not be lost,” he added.

Alzheimer’s disease, named for the German doctor who first described it in 1906, is a type of dementia in which damaged brain cells result in irreversible cognitive decline. It typically begins with memory loss and eventually progresses to the point where patients cannot care for themselves.

Parkinson’s disease is a movement disorder, involving the loss of dopamine-producing brain cells, characterized by tremors, stiff limbs, slow movement and impaired balance and coordination. First described by British doctor James Parkinson in 1817 as a “shaking palsy,” it leaves people unable to control their movements and, ultimately, to remain independent.

“It is going to be a major factor in health care until it is better treated or cured,” said Paula Wittekind, Florida state coordinator for the Parkinson’s Action Network.

Both diseases cost the nation nearly $173 billion annually in medical costs as well as the lost productivity of patients and their caregivers, who are often unpaid relatives—people like Zakia Richburg.

Richburg, of Pikesville, Md., has been caring for her 85-year-old uncle, Richard, a retired construction-union supervisor who was diagnosed with Alzheimer’s disease two years ago. She works full-time as an administrative assistant, then puts in more hours helping her aunt, Gertrude, 88.

“We do it because that’s what families do,” said Richburg, who grew up spending time with her aunt and uncle. “We’re taking it one day at a time.”

Despite the challenges of neurological diseases, there are bright spots on the research and funding fronts, speakers at the briefing said.

Research into rare genetic causes of Parkinson’s and early-onset Alzheimer’s has led scientists to better understand brain changes in the diseases, said Growdon. A new surgery called deep brain stimulation has helped a small portion of Parkinson’s patients, noted Amy Comstock Rick, chief executive officer of the Parkinson’s Action Network.

Pending in the U.S. Senate is the Alzheimer’s Breakthrough Act, which would double federal funding for Alzheimer’s research to $1.3 million, emphasize prevention clinical trials and boost public-education programs. The legislation, sponsored by Sen. Barbara Mikulski (D-Md.), “would restore momentum in the pursuit of better diagnosis, prevention and treatment of this devastating disease,” says the Alzheimer’s Association.

Meanwhile, the Parkinson’s Action Network is looking to legislation to move promising drugs more quickly through the government approval process and a defense-funded research program.

The briefing was co-sponsored by the Alliance for Aging Research, the Alzheimer’s Association and Parkinson’s Action Network and sponsored by BIO. For more information, see the Alliance’s Silver Book®, an up-to-date compendium of statistics and research findings.