I had the good luck to stumble across a collection of assorted medical books recently and of course looked PD up. What I read was pretty interesting. The gist is this:

1. in the 1950s, PD was not a "disease", but was rather referred to as simply "parkinsonism". The cause was actually stated to be arterial deterioration in the brain (helLO, Dr. Jannetta, again) Yes, a cause was listed, and quite unequivocally so.

Equally astounding was the statement in this book that parkinsonism does not affect mental faculties at all. You read that right. What was this amazing book from whence I read these things? The American Medical Association's New Medical Encyclopeodia (sp), published in the 1950s.

How in the world did we get to where we are today, from what was stated back in the 1950s? Personally, I believe that since brain vascular issues cannot be fixed by a pill, (at least not that I know of, and has anyone even tried?) this whole line of thinking was shelved.

PWP now are regularly reported to have mental issues---is this because of PD? People with parkinsonism were not reported to have any cognitive issues up to the 1950s...what changed? Were PWP living longer, such that mental decline could now be observed? No doubt this argument has been/will be made. But maybe the subsequent reporting of mental decline, barely a decade later, is more attributable to the drugs that had come out since this encyclopeodia was written. This is the more plausible explanation to me, since most everyone lists "brain fog" as a side effect of several PD drugs...this fog seems to disappear if you are lucky enough to be able to get off of the drug, usually an agonist. What does this tell us? Shouldn't we be looking at the affect of these PD drugs on the blood vessels in the brain?

2. Fast forward a mere decade, in the 1960s. Now, "parkinsonism" has been replaced with "Parkinson's Disease", its own disease with its own chapter in almost every book I looked at. Cause is now listed as "unknown", and any reference to what I crudely call "brain vein" issues being involved has been eliminated. Oh, and mental impairment is now also listed as part and parcel of the disease.

3. NPH has symptoms remarkably similar to PD...if I understand this problem, it has to do with pressure in the brain which would impede the natural function/flow of the brain's blood vessels...put in the shunt, natural function/flow restored, problem solved.

Remember Jannetta? Put in the teflon pad under the compressed cerebral artery, patient wakes up PD-free. Remember that Dr. Jannetta's discovery was almost an accident-he had theory which fortuitously he was able to test when performing surgery on a patient who had trigeminal neuralgia AND well-documented PD...and he was right.

4. Enter nicotine....pretty common knowledge now that smokers are less likely to get PD. I have read they are also less likely to get Alzheimer's. I think it was in 2000 that scientists discovered that nicotine helps form new blood vessels in the brain...again, there is that brain vein connection. If the brain veins you are born with have started to deteriorate, twist, compress, get thick and tough, whatever, but because you smoke, you are making more brain blood vessels, it makes sense that you will be much less likely to see the symptoms of those old blood vessels deteriorating because new ones are being formed to help perform their function.

5. Diet as a factor...I think I've already posted about this before but as our diet has shifted from the healthy one our ancestors ate to the Franken-foods most eat today, our rates of disease have skyrocketed. For decades healthy fats were taboo, critical to maintaining healthy blood vessels in the body, particularly the brain. Most of us are deficient in more than one mineral, also critical to vascular health.

But a healthy diet can only do so much: are the drugs we take causing more damage to our delicate brain blood vessels, which may, under this theory, already be compromised? Has anyone ever studied the actual effect of PD drugs on blood vessels in the brain?

We know that low blood pressure can be a side effect of PD drugs (how can this be good?...low blood pressure = less blood flowing, less oxygenation which is required by all cells for normal function). And relatively recently, more scientists are finally acknowledging that maybe the cells previously thought to have died in PD were not actually dead but merely sick, struggling, or, as I am thinking....suffocating from lack of sufficient oxygen. Perhaps this is why exercise is so helpful for PD: it increases the oxygen flow. (Is anyone thinking "Duh" about now? All of this seems to so obviously point to brain vascular issues being THE, if not a main, factor in PD...)

If scientists could find a way to deprive the basal ganglia cells of optimal oxygen in a rat/rodent model of PD, would they see PD symptoms?
This would be a fabulous study and could tell us a great deal.

Just my thoughts, I welcome any comments.