Accessible Unlicensed Requires Authentication Published by De Gruyter May 8, 2018

Historical and cross-cultural perspectives on Parkinson’s disease

Lee Xenakis Blonder


Parkinson’s disease (PD) is a common neurodegenerative disorder, affecting up to 10 million people worldwide according to the Parkinson’s Disease Foundation. Epidemiological and genetic studies show a preponderance of idiopathic cases and a subset linked to genetic polymorphisms of a familial nature. Traditional Chinese medicine and Ayurveda recognized and treated the illness that Western Medicine terms PD millennia ago, and descriptions of Parkinson’s symptomatology by Europeans date back 2000 years to the ancient Greek physician Galen. However, the Western nosological classification now referred to in English as “Parkinson’s disease” and the description of symptoms that define it, are accredited to British physician James Parkinson, who in 1817 authored The Shaking Palsy. Later in the nineteenth century, French neurologist Jean-Martin Charcot re-labeled paralysis agitans “Parkinson’s disease” and over a century of scientific research ensued. This review discusses European, North American, and Asian contributions to the understanding and treatment of PD from ancient times through the twentieth century.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


[1] Postuma RB, Berg D, Stern M, Poewe W, Olanow CW, Oertel W, et al. MDS clinical diagnostic criteria for Parkinson’s disease. Move Disorders off J Move Disord Soc. 2015;30:1591–601. PubMed PMID: 26474316.10.1002/mds.26424Search in Google Scholar

[2] McMenemey W. James Parkinson 1755–1824: a biographical essay. In: Critchley M, editor. James Parkinson. London: Macmillan, 1955: 1–143.Search in Google Scholar

[3] Parkinson J. An essay on the shaking palsy. London: Sherwood, Neely, and Jones, 1817.Search in Google Scholar

[4] Critchley M. James Parkinson. London: McMillan, 1955.Search in Google Scholar

[5] Goetz CG. Charcot on Parkinson’s disease. Move Disorders off J Move Disord Soc. 1986;1:27–32. PubMed PMID: 3332804.10.1002/mds.870010104Search in Google Scholar

[6] Blonder LX, Slevin JT. Emotional dysfunction in Parkinson’s disease. Behav Neurol. 2011 Jan 1;24:201–17. PubMed PMID: 21876260. Pubmed Central PMCID: 3177157. Epub 2011/08/31.eng.10.1155/2011/14385721876260Search in Google Scholar

[7] Bereczki D. The description of all four cardinal signs of Parkinson’s disease in a Hungarian medical text published in 1690. Parkinsonism Relat Disord. 2010 May;16:290–93. PubMed PMID: 19948422.10.1016/j.parkreldis.2009.11.006Search in Google Scholar

[8] Stern G. Did parkinsonism occur before 1817?. J Neurol Neurosurg Psychiatry. 1989 Jun;52:11–12.10.1136/jnnp.52.Suppl.11Search in Google Scholar

[9] Zhang ZX, Dong ZH, Roman GC. Early descriptions of Parkinson disease in ancient China. Arch Neurol. 2006 May;63:782–84. PubMed PMID: 16682554.10.1001/archneur.63.5.78216682554Search in Google Scholar

[10] Zheng GQ. Therapeutic history of Parkinson’s disease in Chinese medical treatises. J Altern Complementary Med. 2009 Nov;15:1223–30. PubMed PMID: 19922254.10.1089/acm.2009.0101Search in Google Scholar

[11] Lee SH, Lim S. Clinical effectiveness of acupuncture on Parkinson disease: a PRISMA-compliant systematic review and meta-analysis. Medicine. 2017 Jan;96:e5836. PubMed PMID: 28099340. Pubmed Central PMCID: 5279085.10.1097/MD.0000000000005836Search in Google Scholar

[12] Tian T, Sun Y, Wu H, Pei J, Zhang J, Zhang Y, et al. Acupuncture promotes mTOR-independent autophagic clearance of aggregation-prone proteins in mouse brain. Sci Rep. 2016 Jan 21;6:19714. PubMed PMID: 26792101. Pubmed Central PMCID: 4726430.2679210110.1038/srep19714Search in Google Scholar

[13] Li F, Harmer P, Fitzgerald K, Eckstrom E, Stock R, Galver J, et al. Tai chi and postural stability in patients with Parkinson’s disease. N Engl J Med. 2012 Feb 09;366:511–19. PubMed PMID: 22316445. Pubmed Central PMCID: 3285459.2231644510.1056/NEJMoa1107911Search in Google Scholar

[14] Yang Y, Qiu WQ, Hao YL, Lv ZY, Jiao SJ, Teng JF. The efficacy of traditional Chinese medical exercise for Parkinson’s disease: a systematic review and meta-analysis. PLoS One. 2015;10:e0122469. PubMed PMID: 25830664. Pubmed Central PMCID: 4382160.Search in Google Scholar

[15] Cheung F. TCM: made in China. Nature. 2011 Dec 22;480:S82–3. PubMed PMID: 22190085.10.1038/480S82a22190085Search in Google Scholar

[16] Zijlstra FJ, Van Den Berg-De Lange I, Huygen FJ, Klein J. Anti-inflammatory actions of acupuncture. Mediators Inflamm. 2003 Apr;12:59–69. PubMed PMID: 12775355. Pubmed Central PMCID: 1781596.10.1080/096293503100011494312775355Search in Google Scholar

[17] Ye Y, Zhu W, Wang XR, Yang JW, Xiao LY, Liu Y, et al. Mechanisms of acupuncture on vascular dementia-A review of animal studies. Neurochem Int. 2017 Jul;107:204–10. PubMed PMID: 28034725.2803472510.1016/j.neuint.2016.12.001Search in Google Scholar

[18] Bower JE, Irwin MR. Mind-body therapies and control of inflammatory biology: a descriptive review. Brain Behav Immun. 2016 Jan;51:1–11. PubMed PMID: 26116436. Pubmed Central PMCID: 4679419.10.1016/j.bbi.2015.06.01226116436Search in Google Scholar

[19] Pan W, Liu J, Chen X, Wang Q, Wu Y, Bai Y, et al. A practical consensus guideline for the integrative treatment of Parkinson’s disease in Shanghai. China Integr Med Int. 2015;2:56–62. Epub September 12, 201510.1159/000435813Search in Google Scholar

[20] Mishra L, Singh BB, Dagenais S. Ayurveda: a historical perspective and principles of the traditional healthcare system in India. Altern Ther Health Med. 2001 Mar;7:36–42. PubMed PMID: 11253415.11253415Search in Google Scholar

[21] Manyam BV. Paralysis agitans and levodopa in “Ayurveda”: ancient Indian medical treatise. Move Disorders off J Move Disord Soc. 1990;5:47–48. PubMed PMID: 2404203.10.1002/mds.870050112Search in Google Scholar

[22] Ovallath S, Deepa P. The history of Parkinsonism: descriptions in ancient Indian medical literature. Move Disorders off J Move Disord Soc. 2013 May;28:566–68. PubMed PMID: 23483637.10.1002/mds.25420Search in Google Scholar

[23] Vaidya AB, Rajagopalan TG, Mankodi NA, Antarkar DS, Tathed PS, Purohit AV, et al. Treatment of Parkinson’s disease with the cowhage plant-Mucuna pruriens Bak. Neurol India. 1978 Dec;26:171–76. PubMed PMID: 753996.753996Search in Google Scholar

[24] Vaidya RA, Sheth AR, Aloorkar SD, Rege NR, Bagadia VN, Devi PK, et al. The inhibitory effect of the cowhage plant-Mucuna pruriens-and L-dopa on chlorpromazine-induced hyperprolactinaemia in man. Neurol India. 1978 Dec;26:177–78. PubMed PMID: 753997.753997Search in Google Scholar

[25] Damodaran M, Ramaswamy R. Isolation of l-3:4-dihydroxyphenylalanine from the seeds of Mucuna pruriens. Biochem J. 1937 Dec;31:2149–52. PubMed PMID: 16746556. Pubmed Central PMCID: 1267191.1674655610.1042/bj0312149Search in Google Scholar

[26] Hussain GaM B. Mucuna pruriens Proves more effective than L-DOPA in Parkinson’s disease animal model. Phytotherapy Res. 1997;11:419–23.10.1002/(SICI)1099-1573(199709)11:6<419::AID-PTR120>3.0.CO;2-QSearch in Google Scholar

[27] Katzenschlager R, Evans A, Manson A, Patsalos PN, Ratnaraj N, Watt H, et al. Mucuna pruriens in Parkinson’s disease: a double blind clinical and pharmacological study. J Neurol Neurosurg Psychiatry. 2004 Dec;75:1672–77. PubMed PMID: 15548480. Pubmed Central PMCID: 1738871.10.1136/jnnp.2003.02876115548480Search in Google Scholar

[28] Hornykiewicz O. L-DOPA: from a biologically inactive amino acid to a successful therapeutic agent. Amino Acids. 2002;23:65–70. PubMed PMID: 12373520.1237352010.1007/s00726-001-0111-9Search in Google Scholar

[29] Ni M, Mooney K, Signorile JF. Controlled pilot study of the effects of power yoga in Parkinson’s disease. Complement Ther Med. 2016 Apr;25:126–31. PubMed PMID: 27062960.10.1016/j.ctim.2016.01.00727062960Search in Google Scholar

[30] Roland KP. Applications of yoga in Parkinson’s disease: a systematic literature review. J Parkinsonism Restless Legs Syndrome. 2014;4:1–8.Search in Google Scholar

[31] Schmalzl L, Kerr CE. Editorial: neural mechanisms underlying movement-based embodied contemplative practices. Front Hum Neurosci. 2016;10:169. PubMed PMID: 27199700. Pubmed Central PMCID: 4844845.27199700Search in Google Scholar

[32] Horowski R, Horowski L, Vogel S, Poewe W, Kielhorn FW. An essay on Wilhelm von Humboldt and the shaking palsy: first comprehensive description of Parkinson’s disease by a patient. Neurology. 1995 Mar;45:565–68. PubMed PMID: 7898719.10.1212/WNL.45.3.565Search in Google Scholar

[33] Goetz CG. The history of Parkinson’s disease: early clinical descriptions and neurological therapies. Cold Spring Harb Perspect Med. 2011 Sep;1:a008862. PubMed PMID: 22229124. Pubmed Central PMCID: 3234454.10.1101/cshperspect.a008862Search in Google Scholar

[34] Gowers WR. A manual of diseases of the nervous system. Philadelphia, PA: Blakiston Son and Co., 1888.Search in Google Scholar

[35] Critchley M. Sir William Gowers, 1845–1915; a biographical appreciation. London: Heinemann, 1949: 118.Search in Google Scholar

[36] Lees AJ, Selikhova M, Andrade LA, Duyckaerts C. The black stuff and Konstantin Nikolaevich Tretiakoff. Move Disorders off J Move Disord Soc. 2008 Apr 30;23:777–83. PubMed PMID: 18383531.10.1002/mds.21855Search in Google Scholar

[37] Vogt M. The concentration of sympathin in different parts of the central nervous system under normal conditions and after the administration of drugs. J Physiol. 1954 Mar 29;123:451–81. PubMed PMID: 13152692. Pubmed Central PMCID: 1366219.1315269210.1113/jphysiol.1954.sp005064Search in Google Scholar

[38] Greenfield JG. Pathology of Parkinson’s disease. In: Critchley M, editor. James Parkinson. London: MacMillan, 1955: 219–43.Search in Google Scholar

[39] Ehringer HHO. Verteilung von Noradrenalin und Dopamin (3-Hydroxytyramin) im Gehirn des Menschen und ihr Verhalten bei Erkrankungen des extrapyramidalen Systems. Klin Wochenschr. 1960;38:1236–39.10.1007/BF01485901Search in Google Scholar

[40] Spillantini MG, Schmidt ML, Lee VM, Trojanowski JQ, Jakes R, Goedert M. Alpha-synuclein in Lewy bodies. Nature. 1997 Aug 28;388:839–40. PubMed PMID: 9278044.927804410.1038/42166Search in Google Scholar

[41] Braak H, Del Tredici K, Rub U, De Vos RA, Jansen Steur EN, Braak E. Staging of brain pathology related to sporadic Parkinson’s disease. Neurobiol Aging. 2003 Mar-Apr;24:197–211. PubMed PMID: 12498954. Epub 2002/12/25.eng.10.1016/S0197-4580(02)00065-912498954Search in Google Scholar

[42] Burke RE, Dauer WT, Vonsattel JP. A critical evaluation of the Braak staging scheme for Parkinson’s disease. Ann Neurol. 2008 Nov;64:485–91. PubMed PMID: 19067353. Epub 2008/ 12/11.eng.10.1002/ana.2154119067353Search in Google Scholar

[43] Jellinger KA. A critical evaluation of current staging of alpha-synuclein pathology in Lewy body disorders. Biochim Biophys Acta. 2009 Jul;1792:730–40. PubMed PMID: 18718530.1871853010.1016/j.bbadis.2008.07.006Search in Google Scholar

[44] Holtz PHR, Lüdtke K. Fermentativer Abbau von LDioxyphenylalanin (Dopa) durch Niere. Naunyn-Schmiedeberg’s. Arch Exp Path Pharmak. 1938;191:87–118.10.1007/BF01994628Search in Google Scholar

[45] Fahn S. The medical treatment of Parkinson disease from James Parkinson to George Cotzias. Move Disorders off J Move Disord Soc. 2015;30:4–18 (Epub was Dec 2014).10.1002/mds.26102Search in Google Scholar

[46] Montagu KA. Catechol compounds in rat tissues and in brains of different animals. Nature. 1957 Aug 3;180:244–45. PubMed PMID: 13451690.10.1038/180244a013451690Search in Google Scholar

[47] Raab W, Gigee W. Concentration and distribution of “encephalin” in the brain of humans and animals. Proc Soc Exp Biol Med Soc Exp Biol Med. 1951 Jan;76:97–100. PubMed PMID: 14816401.10.3181/00379727-76-18398Search in Google Scholar

[48] Weil-Malherbe H, Bone AD. Intracellular distribution of catecholamines in the brain. Nature. 1957 Nov 16;180:1050–51. PubMed PMID: 13483601.1348360110.1038/1801050a0Search in Google Scholar

[49] Holtz PBH, Westermann E, Wezler E. Beeinflussung der Evipannarkose durch Reserpin. Iproniazid Biogene Amine Arch Exp Path Pharmakol. 1957;231:333–48.Search in Google Scholar

[50] Bertler A, Rosengren E. Occurrence and distribution of dopamine in brain and other tissues. Experientia. 1959 Jan 15;15:10–11. PubMed PMID: 13619664.1361966410.1007/BF02157069Search in Google Scholar

[51] Hornykiewicz O. The action of dopamine on the arterial blood pressure of the guinea-pig. Br J Pharmacol Chemother. 1958 Mar;13:91–94. PubMed PMID: 13523142. Pubmed Central PMCID: 1481693.1352314210.1111/j.1476-5381.1958.tb00197.xSearch in Google Scholar

[52] Sano I, Gamo T, Kakimoto Y, Taniguchi K, Takesada M, Nishinuma K. Distribution of catechol compounds in human brain. Biochim Biophys Acta. 1959 Apr;32:586–87. PubMed PMID: 14441532.10.1016/0006-3002(59)90652-314441532Search in Google Scholar

[53] Carlsson A, Lindqvist M, Magnusson T, Waldeck B. On the presence of 3-hydroxytyramine in brain. Science. 1958 Feb 28;127:471. PubMed PMID: 13529006.1352900610.1126/science.127.3296.471Search in Google Scholar

[54] Carlsson A. The occurrence, distribution and physiological role of catecholamines in the nervous system. Pharmacol Rev. 1959 Jun;11:490–93. PubMed PMID: 13667431.13667431Search in Google Scholar

[55] Carlsson A. A half-century of neurotransmitter research: impact on neurology and psychiatry. Nobel lecture. Biosci Rep. 2001 Dec;21:691–710. PubMed PMID: 12166820.1216682010.1023/A:1015556204669Search in Google Scholar

[56] Lees AJ, Tolosa E, Olanow CW. Four pioneers of L-dopa treatment: arvid Carlsson, Oleh Hornykiewicz, George Cotzias, and Melvin Yahr. Move Disorders off J Move Disord Soc. 2014 Dec 8. PubMed PMID: 25488030.Search in Google Scholar

[57] Foley P. The L-DOPA story revisited. Further surprises to be expected?. J Neural Transm Supplementum. 2000;60:1–20. PubMed PMID: 11205132.Search in Google Scholar

[58] Sano I. Biochemistry of the extrapyramidal system Shinkei Kennkyu No Shinpo, Advances in Neurological Sciences. (ISSN 0001-8724) Tokyo, October 1960;5:42-48. Parkinsonism Relat Disord. 2000 Jan;6:3–6. PubMed PMID: 18591145.Search in Google Scholar

[59] Birkmayer W, Hornykiewicz O. Der L-Dioxyphenylalanin (=DOPA)-Effekt bei der Parkinson-Akinese. Wien Klin Wochenschr. 1961;73:787–88.Search in Google Scholar

[60] Barbeau A, Murphy GF, Sourkes TL. Excretion of dopamine in diseases of basal ganglia. Science. 1961 May 26;133:1706–07. PubMed PMID: 13686753.1368675310.1126/science.133.3465.1706-aSearch in Google Scholar

[61] Barbeau A, Sourkes TL, Murphy GF. Les catécholamines dans la maladie de Parkinson. In: De Ajuriaguerra J, editor. Monoamines et Système Nerveux Central. Geneva: Georg et Cie, 1962: 247–62.Search in Google Scholar

[62] Hornykiewicz O. Die topische Lokalisation und das Verhalten von Noradrenalin und Dopamin (3-Hydroxytyramin) in the Substantia nigra des normalen und Parkinsonkranken Menschen. Wien Klin Wochenschr. 1963;75:309–12.Search in Google Scholar

[63] Hornykiewicz O. The discovery of dopamine deficiency in the parkinsonian brain. J Neural Transm Supplementum. 2006;70:9–15. PubMed PMID: 17017502.10.1007/978-3-211-45295-0_3Search in Google Scholar

[64] Cotzias GC, Van Woert MH, Schiffer LM. Aromatic amino acids and modification of Parkinsonism. N Engl J Med. 1967 Feb 16;276:374–79. PubMed PMID: 5334614.10.1056/NEJM1967021627607035334614Search in Google Scholar

[65] Cotzias GC, Papavasiliou PS, Gellene R. Modification of Parkinsonism–chronic treatment with L-dopa. N Engl J Med. 1969 Feb 13;280:337–45. PubMed PMID: 4178641.10.1056/NEJM1969021328007014178641Search in Google Scholar

[66] Tang LC. A personal and scientific biography of Dr George C. Cotzias. Neurotoxicology. 1984 Spring;5:5–12. PubMed PMID: 6425745.Search in Google Scholar

[67] Yahr MD, Duvoisin RC, Schear MJ, Barrett RE, Hoehn MM. Treatment of Parkinsonism with levodopa. Arch Neurol. 1969 Oct;21:343–54. PubMed PMID: 5820999.10.1001/archneur.1969.004801600150015820999Search in Google Scholar

[68] Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology. 1967 May;17:427–42. PubMed PMID: 6067254.10.1212/WNL.17.5.4276067254Search in Google Scholar

[69] Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology. 1967;17:427–42.10.1212/WNL.17.5.4276067254Search in Google Scholar

[70] Fahn S. A new look at levodopa based on the ELLDOPA study. J Neural Transm Supplementum. 2006;70:419–26. PubMed PMID: 17017562.10.1007/978-3-211-45295-0_63Search in Google Scholar

Received: 2016-07-12
Accepted: 2018-03-22
Published Online: 2018-05-08

© 2018 Walter de Gruyter GmbH, Berlin/Boston