SAN JOSE — The 42-year-old man lay on the bed drooling, unable to speak or even blink.
The doctors gathered around him at Santa Clara Valley Medical Center were perplexed. The patient appeared to have advanced Parkinson's disease, but the doctors had learned that he had exhibited his first symptoms only recently.
A medical student noticed that the man could move his fingers. He wrapped the man's hand around a pen, held a pad in front of him and asked a few questions. The patient replied in a labored scrawl.
Then the doctors asked the man if he had recently taken any drugs.
"Yes," the man wrote. "About four days ago . . . heroin."
The doctors later learned that the man had used a contaminated batch of synthetic heroin. The discovery gave Dr. J. William Langston, chairman of the hospital's neurology department, his first clue in the mystery case and sent him on a trail that has "significantly advanced" the research into Parkinson's disease.
The scenario was an unlikely one--a designer drug disaster in 1982 ended up aiding medical research, and doctors and addicts worked together to track the trail of contaminated drugs.
The patient had suffered a profound loss of motor control identical to advanced Parkinson's disease. The addict's girlfriend, who also had used the drug, also exhibited the same symptoms, as did five others the doctors tracked down.
The doctors discovered that a street chemist had tried to make a synthetic version of the painkiller Demerol, but had overheated the batch and instead turned out a contaminated version known as MPTP, which destroys cells in an area of the brain that controls movement.
Langston, an associate professor at Stanford University's School of Medicine, and his team of doctors and researchers, came up with a number of findings that has given researchers clues into the mysteries of Parkinson's.
Researchers, for the first time, have a chemical model of the drug that produces symptoms of the disease.
"The biggest thing that was retarding Parkinson's research was the inability to create a model of the disease in animals," said Judy Rosner, executive director of the United Parkinson Foundation of Chicago. "Researchers have been trying to do that since the disease was first discovered. Dr. Langston and his team have accomplished that."
'An Interesting Subject'
Doctors found evidence that several chemists who were conducting legitimate research using MPTP also contracted Parkinson's symptoms. They had handled the drug, but had never injected it.
"We're looking into whether Parkinson's could be caused by exposure to some toxin in the environment . . . whether you could absorb it," Langston said. "We know that there was no case of the disease before 1817--that's about the time of the Industrial Revolution. What if, after exposure to the toxin, it takes 30 years to develop before you pick it up? It's an interesting subject for research."
The Parkinson Foundation has sent questionnaires to 36,000 sufferers of the disease around the country asking them to list their drinking-water sources, industries located near their home and every address where they have lived. The foundation is searching for a "common denominator" Rosner said, a clue that could lead them to an environmental source of the disorder.
Studying the addicts gave doctors the "first real proof" that the Parkinson's symptoms were caused by damage to a small group of cells at the base of the brain. This evidence, Langston said, could be useful in brain transplant research.
The research, which also has given doctors insight into medication for the disorder, has "implications beyond Parkinson's," Langston said. It could be useful in studying other movement disorders such as Alzheimer's disease and amyotrophic lateral sclerosis (Lou Gehrig's disease.)
Patients Seek Help
Langston's team currently has been seeing several new patients a month who had taken the MPTP, heard about the problems and exhibited symptoms, or just wanted check-ups.
After the initial cases, Langston, along with researchers from the federal Centers for Disease Control, interviewed patients at drug treatment clinics throughout the Bay Area and followed leads from street sources to track down potential victims and alert them to possible treatment.
They found 150 people who had taken varying amounts of the contaminated drug. In addition to the seven addicts who suffered profound problems, another 40 exhibited milder symptoms of Parkinson's. None of the addicts actually have the disease, but their symptoms, response to therapy and much of the neurological damage they had suffered were identical to a Parkinson's sufferer.
Sharon Romero, 29, had injected the MPTP three times during the summer of 1982. Her hands began falling asleep, her legs often twitched involuntarily and her joints were sore in the morning.
Romero thought her symptoms were caused by her heroin addiction until her sister, who also had used the MPTP, was contacted by Langston. Now Romero, who has mild Parkinson's symptoms, undergoes therapy once a month at Valley Medical Center.
"I know people who took the drugs who are in wheelchairs now," said Romero, a Gilroy resident who is married and has a 9-year-old daughter. "I wonder if I'm going to get worse and worse until I end up like that. I'm glad at least the doctors have been able to learn something. But for me . . . it has ruined my life."