OVERNIGHT, ADDICTS GET PARKINSON'S, SCIENTISTS GET BREAKTHROUGH

Dr. Phil Ballard had seen all sorts of bizarre patients in psychiatric
emergency rooms. But he'd never seen one like George Carillo.

It was 1982, and Ballard - now head of the Movement Disorder Center at
Swedish Medical Center - was completing a neurology fellowship at
Stanford University. He'd been called in to consult on a 42-year-old
man who sat frozen mid-gesture, unblinking and lifeless except for
normal organ function. There was no evidence of mental activity.

"He had a blank stare and was stiff as a board," Ballard said. Since
the patient had come from jail, many doctors who saw him suspected he
was faking catatonic schizophrenia to get out of trouble.

But it was no act.

After seven days with no change and no diagnosis, Ballard noticed a
slight twitching in the man's fingers. He slipped him a pad and pencil.

"I'm not sure what is happening to me," the patient wrote, using just
his fingertips. " I can't move right. I know what I want to do. It
just won't come out right."

Ballard was elated to discover a normal mind trapped inside the body.
Slowly, he pieced together the patient's history. The patient and his
girlfriend were heroin addicts. They'd come down with symptoms after
injecting a street-synthesized version of Demerol, a "designer drug"
meant to act like heroin.

With that information in hand, Ballard and his boss, Dr. J. William
Langston, set out to solve the mystery of one patient and ended up
making a major breakthrough in the study of Parkinson's disease.

Over the next few weeks, more addicts in strangely frozen postures
began turning up in emergency rooms all over the San Francisco Bay
area. They had one thing in common. Each had been using designer
street narcotics.

Investigators suspected a bad batch caused the outbreak, but they
couldn't identify the contaminant.

Then, by chance, one of the team recalled reading an obscure journal
report years earlier of a young college student who had ended up with
identical symptoms after synthesizing his own drugs in 1976. After he
died 18 months later, an autopsy revealed the distinctive brain damage
associated with Parkinson's disease. Until then, doctors had almost
never seen Parkinson's in someone so young. And they'd never seen it
develop overnight.

Ballard set out to find the article, which wasn't even in the medical
center library. "I dug it out of the dusty reaches of the racks of
Stanford library," he said. "I realized as I was reading it that this
is it, this has got to be it."

Indeed, it turned out that a contaminant called MPTP caused both the
college student's symptoms and those of the street addicts.

MPTP can slip across the blood-brain barrier, where it converts into a
chemical that kills the dopamine-producing cells in the brain. A
shortage of dopamine - the main neurotransmitter involved in
coordinating movement - leads to Parkinson's disease.

In their quest for a new high, the addicts had inadvertently given
themselves an irreversible, debilitating disease.

But they gave the scientific community something else: a clue to what
causes Parkinson's disease. MPTP resembles many environmental
chemicals, including pesticides, which led to the now widely accepted
theory that toxins induce Parkinson's.

In addition to providing a key breakthrough in understanding the
disease, MPTP gave researchers a way to induce Parkinson's disease in
animals, giving them for the first time a model for testing new drugs
and other therapies.

Several of the original addicts received experimental treatments, such
as fetal cell implants, that grew out of that research. In some cases,
it dramatically improved their symptoms, allowing them to resume a
more normal life.

"It was quite a chase," Ballard said. "We had a lot of dead ends and a
lot of lucky breaks."