The search for answers continues to motivate the Molecular Medicine Institute, which promoted on June 19 at the Grand Auditorium João Lobo Antunes the 3rd session of the iMM Horizon Talks: a question in three parts. This session’s topic was Parkinson disease and, as usual, a physician, a researcher and a patient were invited to answer the question.

The session had a full house, not only for the topic’s relevance, but also for the homage paid to the late Professor João Lobo Antunes, who would’ve celebrated another birthday this month.

Why does the brain stop communicating with the body? – This is the question that raises the discussion between researcher Luísa Lopes, Prof. Joaquim Ferreira and Dr Paulo Teixeira Pinto, moderated by António Barreto.

According to Prof. Joaquim Ferreira, the brain does not stop communicating with the body, it just provides the wrong orders. Otherwise, how would we explain that the patient has difficulties walking, but shows total dexterity when riding a bicycle, as a video has proved to happen. Curious, isn’t it?

Intriguing seems to be the appropriate adjective to characterise a disease that lacks an identification of its own, having inherited the last name of the English doctor that better described it in the 19th century – James Parkinson.

At the beginning of the session moderated by António Barreto, Prof. Joaquim Ferreira, as a physician and a patient, provides a framing for this disease about which we know very little, considering that the Prof. himself states: “We know a lot about the disease, but we’re aware that we know very little.”

What is Parkinson’s? Disease – A neurodegenerative disease that implies the gradual loss of cerebral cells and, therefore, affects the patient’s motor coordination and cognitive function. We do not know the cause for cellular death, but we know that cellular death affects the production of dopamine – the substance that acts as a brain messenger for movement of the remaining body limbs. The symptoms are familiar, considering that, according to the Professor, the disease is so frequent that it is estimated to affect at least one member of every Portuguese family. Shaking, movement restriction, slowness in executing tasks, dragging walk, smaller calligraphy are just a few of the symptoms named as most representative of the disease, although we must not underestimate other symptoms with an equal effect on the patients state of mind, such as dreams, memory disturbances, speech and thought impairment.

When requested, the legal expert, ex-banker and ex-politician Paulo Teixeira Pinto walks towards the pulpit to provide his testimony as a Parkinson’s disease patient. After naming the above mentioned symptoms, we would expect to identify some motor difficulty during this short walk, but we are surprised by his steady step and logical diction. During his testimony, he shows great courage and determination when stating that “ Parkinson’s is not the worst thing that can happen to someone”. Despite the disease prognosis telling us there is no cure, Paulo Teixeira Pinto shares with the audience that he has never refused to try all treatment propositions, even if experimental, and also wants to donate his body to science upon his death.

What is the treatment? – The current treatment aims to control symptoms through medication that stimulate the release of dopamine, namely, Levodopa. But, it’s while listening to researcher Luísa Lopes, Group Leader of iMM, that we realise science’s efforts to better know the disease. The greatest challenge for researchers is to realise whether there are patients at risk as soon as possible. In spite of this, it is currently possible for researchers to differentiate neurons from patient’s skin cells, as it is unusual to remove brain tissue from a patient, a procedure commonly known as biopsy. In parallel with this advancement, there are also 2 approaches, tested in clinical trials and considered promising by the researcher, immunotherapy and medicine infusion into the patient’s brains. Despite seemingly encouraging, both experimental approaches have risks for being considered invasive procedures: “The brain is biologically protected so that nothing gets to it easily (…) Therefore, we have to transpose these barriers, which makes any intervention invasive” states Luísa Lopes.

Is it possible to prevent the disease? – While science continues to pursue alternative treatments and assessing their feasibility, this physician, this scientist and this patient make it very clear that it is necessary to invest in a multidisciplinary medical team to monitor the patient, which includes not only a neurologist, but also a physical therapist, a speech therapist and a nutritionist, as nutrition and physical exercise are fundamental to any human’s well-being, and this is not any different for a patient with Parkinson’s. It is, however, Paulo Teixeira Pinto who assumes that the common denominator to face Parkinson’s is attitude: “We must face this disease as it is“”.

As means of conclusion, the audience got the chance to provide a few comments and ask questions, but it is the session’s moderator, António Barreto, who asks the difficult question about the way the National Healthcare System deals with Parkinson’s disease. Despite the sensitivity of the question, Prof. Joaquim Ferreira is the most adequate person to explain that the existing medical body of our hospitals is highly competent, and that the greatest demands are related to the absence of centres of excellence where research can be developed, and the lack of access to healthcare in rural areas.

Isabel C. Varela
Editorial Team