Movers and Shakers: What Causes Parkinson's?
This week’s episode of the Podcast of the Year explores a very big question - what causes Parkinson’s? There are all sorts of theories, some of them outlandish in the extreme. When I went public about my diagnosis in May 2019, among the thousands of lovely messages from well-wishers, was a tweet from someone who knew exactly why I had contracted Parkinson’s - I had been standing too close to the new 5G phone masts.
Just last week a message arrived in the Movers and Shakers inbox from someone with another theory - that at least one of our number may have got Parkinson’s because they had been injected with Covid vaccines. Challenged to provide evidence, the correspondent forwarded a scientific paper which talked of the possibility that mRNA vaccines could be linked to a number of neurodegenerative diseases. A quick search revealed the author to. be a long-term opponent of just about all vaccines whose claims that they cause everything from diabetes to autism have been widely discredited. So that email went into the bin.
More convincing is the theory that there are environmental causes behind our condition. We play a clip from the episode we recorded at World Parkinson’s Congress last summer where we interviewed Ray Dorsey, author of a book called Ending Parkinson’s. He says we are breathing in the disease and it’s time to act:
“If I'm right that air pollution, pesticides and dry cleaning chemicals are causing it, you should be avoiding those things like the plague if you have the disease. So buy organic produce, wash all your fruits and vegetables with soap and water, avoid air pollution, avoid subways, if you can do so, avoid dry cleaning your clothes unless you get a green dry cleaner, put a water filter on your water.”
Nick “the judge’ Mostyn passes on a theory, which he has heard from his neurologist Professor Ray Chaudhuri, that Parkinson’s is a disease of old age and if people live long enough all of them will get it.
But our expert guest in the pub this week is sceptical about both of these theories. Professor Matt Farrer is a Brit based at the university of Florida, a geneticist and neuroscientist and something. of a superstar in the world of fundamental research into Parkinson’s.
He quickly disposes of Professor Chaudhuri’s idea that we’ll all get Parkinson’s if we live long enough:”It's not an inevitable consequence of ageing, that's nonsense. It's a disease.”
As for Ray Dorsey’s theory about environmental factors, he concedes that the environment is important but insists that it is in our genes that the real answer lies:
“The environment works on biology, on organisms , on human beings. And some people, unfortunately, have susceptibility to Parkinson's disease that perhaps the environment triggers, but it's very difficult to pin down. One thing we can pin down unequivocally is what that genetic foundation really is.”
Professor Farrer then takes us on a lightning tour of the genetic landscape as it relates to Parkinson’s, and how certain gene mutations can make people more likely to fall victim to the condition, . He compares the progress made by him and other scientists to getting to grips with how a car engine works:
“When I started in this field 25 plus years ago, we had no idea when you lifted up the bonnet, what was underneath it, no notion. And now we know what many of the component parts are. And we're starting to figure out, certainly with the most recent discoveries, how they work together, and it's phenomenal.”
So, I ask him, what will this ever greater understanding of what is going on inside the Parkinson’s brain mean for treatment? Presumably it’s all about gene therapy rather than drugs?
“No, I think it will lead us to small molecule drugs that will basically help stop, slow, prevent the condition.”
Looking round the table at the pub he points out that we all experience Parkinson’s in different ways, with it progressing at different speeds, and that means the job of understanding how it spreads through our brains is all the more complex.
Matt Farrer admits there is still a long way to go but he struck us as realistic but fiercely determined to produce a cure. He has identified a molecule which he thinks shows potential as the answer and is impatient with what he sees as a lack of focus in the research world:
“We have to be pragmatic about it. We have to stop wasting time and effort and money and resources.” He admits that as a geneticist he is biased but he thinks worrying about weedkillers or air pollution is a distraction: “I'd say we have to focus on the real problem. And it's not environmental contributions to this disease.”
And the professor appeals to us - and you, our audience - for help:
“I would like every person with young onset Parkinson's disease in the UK today to go and see their neurologists, and say I was diagnosed with this condition or developed this condition under the age of 50, and I would like to participate in genome sequencing through Genomics England.”
At times we struggled to keep up with Matt Farrer, as gene names poured out of him along with complex explanations of the workings of the brain. But what shone through was his passion for his work, his very personal mission to help people with Parkinson’s:
“I’d really like your help to get to the finish line before I die,” he tells us. We share his urgency, and given the fact that he’s younger than any of us, we would hope that he crosses that finishing line while he is still in his prime.
Superb episode, as always.
I have a lot of respect for Prof Farrer’s views and I think he is right about properly understanding the engine as the route to fixing the problem. However, there are a lot of pieces of the Parkinson’s jigsaw that remain unassembled, and his theories are just some of many competing ideas.
As an aside, PD has run in my family for 4 generations and relevant members of my family had our genomes sequenced 7 years ago but still no news (whatever we have is something previously unknown). Unpicking the genome is exceptionally difficult, so whilst Prof Farrer is right to focus on genetics, the reality is that this is a long hard scientific slog.
I was really interested to hear about your discussion about what causes PD. My husband and I have been together for almost 56 years. Married for 53. My husband John was diagnosed with PD in 2015. He has no one in his family, who has PD. I however had my mum who was diagnosed with PD when she was about 73. We are of interest to PD frontline and both take part in research. We ve probably been exposed to the same environments and have lived from as far away as Devon but mostly in London. So a wide spread of both country and towns and been in similar industries. How is it he has PD and I don’t if there is a genetic link? We have had that testing too and neither have the common PD gene. He does and always had talking in his sleep, not too severe but acting out playing rugby etc. I have heard that can be a precursor to PD. My mother was also diabetic and there can be a link there, I’ve also read. In simple terms that’s why diabetic drugs might be a help with PD, there have been much research about that both here and abroad. Thanks for bringing all the positive publicity to this very complicated condition.