Originally published in The Campus on June 2018
“My world got smaller…my handwriting. My voice. My walk…my spirit…the space in the world I take up.”
This is how Andy McDowell, a middle aged father from New Zealand, describes the daily experience of living with Parkinson’s disease in his Youtube video “Smaller- A Poem about Parkinson’s.” Andy is one of the ten million people worldwide that suffer from the disease. As a result of its prevalence, the medical community has conducted extensive research into the nature of the disease and how it can be cured. Dr. Kottmann, a professor at City College, has met Andy twice.
Dr. Kottmann is a Medical Professor in the CCNY Center for Discovery and Innovation and a faculty of the CUNY School of Medicine. His laboratory focuses on studying Parkinson’s disease, a debilitating neurological disorder that causes slow movement (bradykinesia), tremors, and rigidity in people afflicted with the disease. This happens as a result of a gradual loss of neurons that are meant to supply dopamine, a neurotransmitter required for normal brain function. According to Kottmann, “[Parkinson’s Disease] is ever so slowly, relentlessly and insidiously progressive. It is unstoppable.”
Current treatment of Parkinson’s disease depends on the administering of drugs that restore dopamine, called L-DOPA. “L-DOPA alleviates [the symptoms of Parkinson’s Disease]. Patients feel in control of their body movements. However, after eight years of chronic L-DOPA treatment, they experience utterly debilitating dyskinesia.”
Dyskinesia, which are uncontrollable, random and erratic movements, is the eventual result of chronic L-DOPA treatment. The interplay of having Parkinson’s disease and relying on L-DOPA to relieve slow movement depicts the double-edged sword that patients with the disease must deal with. “Once [dyskinesia] develops, patients are in between a rock and a hard place. If they don’t take L-DOPA, then they can’t move. If they take L-DOPA, they get these dyskinesia that are completely debilitating. At that point [patients] have no choices left…they are either akinetic and sit in their chair, or they take L-DOPA and experience dyskinesia that can be so strong they can’t even feed themselves.”
Dr. Kottmann’s lab is dedicated towards finding the underlying cause of L-DOPA-induced dyskinesia, as well as finding a cure for the underlying condition. Currently, Deep Brain Stimulation surgery is used to treat dyskinesia by surgically implanting electrodes into a patient’s brain. The electrodes release an electrical impulse into the brain, reducing the severity of dyskinesia. However, the large price tag, health disparity in accessing this treatment for minority groups, incomplete effectiveness in stopping dyskinesia, and the invasiveness of the surgical procedure are major disadvantages of the procedure. Kottmann’s research discovered that Dopamine neurons do not only secrete dopamine but also many other chemicals. Kottmann explains: “We found that these neurons are multi-lingual. They talk to their targets in the brain not just in the language of dopamine”. This turned out to be an important discovery: When dopamine neurons degenerate in the course of the disease all of these different factors they produce will diminish, not just dopamine. This realization spurred Kottmann to ask a simple question: Could they inhibit the formation of dyskinesia when they treat mice that suffer from Parkinson’s with L-Dopa together with the other factors? The experiments were successful. Kottmann says: “We could not believe it. Just adding one extra factor that these cells normally produce, called Shh, blocked the formation of dyskinesia”.
The Kottmann lab’s experimentation to understand the function of dopamine neurons in the normal brain is driven by the pursuit of knowledge common to all scientific pursuits, as well as by the goal of helping patients who suffer from the neurological condition by one day implementing the results of their research in the clinic. “While [the lab is] motivated by the basic science to understand how the brain works in more detail…at the same time, we, as basic scientists, also understand that in case our science does lead to a treatment that reduces suffering, we have a responsibility to bring it to the patients. We are very lucky that we can pursue both, basic research and its translation.” For Dr. Kottmann, interacting with those who actually suffer from the disease, such as Andy from New Zealand, can provide the motivation for the hard work required to obtain meaningful results in the laboratory. “I would not be doing what I do if I didn’t had the chance to meet [Andy].”
At the end of Andy’s poem in “Smaller- A Poem about Parkinson’s,” Andy transitions from melancholy over his condition to resilience in the face of physiological impediment, stating, “I may be smaller, and slower…but I’m still me.” The research conducted by Dr. Kottmann and his laboratory perhaps is one factor that gives Andy and countless others with Parkinson’s disease the confidence to continue moving forward in their lives.
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