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Study Looks at Use of Drug to Slow Progress of Parkinson's

Jan 24 2008

When Sheryl Jedlinski was 45, she started to notice a slight tremor in her left pinky finger.

It was 1998, the year a 37-year-old actor Michael J. Fox announced that he had been battling Parkinson’s disease for seven years. Still, the first two doctors Jedlinski consulted told her she was too young to be suffering from the same thing.

The third doctor, movement disease specialist Dr. Cynthia Comella, said within three minutes of examining her, “I hate to be the one to tell you this, but you have Parkinson’s.”

Comella pointed out the twisting in Jedlinski’s wrists and the lack of swing her left arm, Jedlinski said.

Now Jedlinski takes medication and does exercises to ease the symptoms of the disease. But so far doctors have not found a cure.

Now researchers at Rush University Medical Center are examining whether a drug used to treat the symptoms of Parkinson’s disease can also slow its progression.

Parkinson’s is a movement disorder with symptoms that worsen over time. Symptoms include tremors of the hands, arms, legs, jaw and face; rigidity of the limbs and the trunk; slowness of movement; and impaired balance and coordination.

Rush is looking for volunteers recently diagnosed with Parkinson’s to participate in a national clinical study of the drug pramipexole. In order to determine whether pramipexole slows the development of Parkinson’s, researchers will begin administering the drug to half of the study participants immediately but give a placebo to the other half for six months before switching them to pramipexole.

“If it only improved symptoms, people in the placebo group would catch up to the other group,” said Comella, head investigator for the trial. “But if there is disease modification, when you start the placebo group, they’ll get better, but they’ll never catch up to the other group.”

People experience the symptoms of Parkinson’s disease when a group of cells that produce the chemical dopamine in the brain begin to malfunction and die. Dopamine is a neurotransmitter that passes signals from the brain to tell the body when and how to move. When the cells that produce it begin to die, those signals are transmitted more slowly, which affects movement and coordination.

Pramipexole was approved by the U.S. Food and Drug Administration in the 1990s as a way to treat Parkinson’s symptoms.

Other drugs used to treat Parkinson’s disease manage symptoms by transforming into dopamine in the brain. Pramipexole acts on dopamine receptors, but it is a man-made chemical with a longer half-life than dopamine.

“Parkinson’s is such a debilitating disease,” Comella said. “If we find a way to slow it, a physician will be able to address the disease itself” instead of simply treating symptoms.

Especially for early-onset patients like Jedlinski, slowing the progression of the disease is an important goal.

“When you first find out, you have a lot of anger and fear,” Jedlinski said. “It wasn’t supposed to turn out that way. You worry what the progression is going to be like. You wonder: Will you see your children get married? Your grandchildren?”

Jedlinski started fighting the effects of Parkinson’s with exercise when she saw her strength failing.

“I could no longer lift a gallon of milk from my trunk,” Jedlinski said. Now she lifts weights at the gym.

“Sometimes I’m slower,” Jedlinski said. “I have back pain. I have some rigidity; when the trainer stretches me I can feel it.”

But Jedlinski, who takes pramipexole, said she has been lucky to be able to regulate her Parkinson’s for the past 10 years. And she has benefited from the help of her friends.

“I play bridge and I don’t shuffle the cards,” Jedlinski said. “You learn it’s OK to accept that kind of help.”

For more information about the pramipexole trial, contact Luci Blasucci at (312)563-2900 or e-mail clinical_trials@rush.edu.

Source Publication: Medill Reports
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