Famous People with Parkinson Disease

http://elynsgroup.com Copyright: © 2015 Lieberman A, et al. http://dx.doi.org/10.19104/jnn.2015.111 Research Article Journal of Neurology and Neurosurgery Open Access Famous People with Parkinson Disease Abraham Lieberman* and Aman Deep Muhammad Ali Parkinson Disease Center, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, Arizona. USA Received Date: May 21, 2015, Accepted Date: July 07, 2015, Published Date: July 15, 2015. *Corresponding author: Abraham Lieberman, Neuroscience Publications, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, 350 W. Thomas Road; Phoenix, AZ 85013, USA, Tel: 602-406-3593; Fax: 602-406-4104; E-mail: [email protected] Abstract In this manuscript, we assess whether the prevalence of Parkinson disease (PD) among famous people is greater than in a sample of all people. We compared the prevalence of PD in two populations: The first population included people who were named TIME magazine’s Person of the Year, a contemporary measure of fame. The second population considered for analysis included people enrolled in the EuroParkinson Collaborative Study. TIME magazine named 54 individuals as its Person of the Year between 1927 and 2014. Five of these have or had PD: Adolf Hitler (1938), Deng Xiaoping (1978,1985), George HW Bush (1990), Pope John Paul II (1994), and Andy Grove (1997). The prevalence of PD in the EuroParkinson Collaborative Study was 336 of 14,636 people (2.3%). The prevalence of PD among TIME magazine’s Person of the Year was 5 of 54, or 4.1 times the prevalence in the Collaborative Study (odds ratio 4.34, 95% confidence interval 1.72–10.97, P= 0.002). Parkinson disease is more than a movement disorder. Depression and reward-seeking behavior are common among people with the condition. It is possible that the movement disorder symptoms of PD (with or without depression) may be preceded by a period of mania or hypomania, a surge of creative energy, or a lack of inhibition as occurs in bipolar disorder. It may be that during this surge of creative energy and reward-seeking behavior, the basis of fame is laid. Keywords: Famous people; Parkinson disease; TIME magazine Introduction What did Pope John Paul II, one the most respected leaders of the 20th century, have in common with Adolf Hitler? What did the Pope who brought Christians and Jews together have in common with a mass murderer of Christians and Jews? They were both TIME’s Person of the Year (Hitler in 1938 and Pope John Paul II in 1994) and they both had Parkinson disease (PD) [1-3]. What does President George HW Bush have in common with Deng Xiaoping? They were both leaders of their countries, they were both TIME’s Person of the Year (Bush in 1990, Xiaoping in 1978 and 1985), and they both have or had PD [4,5]. And there’s Andy Grove [6], who also has PD and founded Intel, the computer chip company that revolutionized communications. Many other people with PD have achieved fame but have not appeared as TIME’s Person of the Year. The list includes, in alphabetical order, the following: Muhammad Ali, the three-time world boxing champion and Sports Illustrated Greatest Athlete of the 20th Century; Jim Backus, the voice of “Mr. Magoo” [7]; Habib Bourguiba, the founder of modern Tunisia [8]; Salvador Dali, one of the most creative artists of the 20th century [9]; Billy Graham, the evangelist [10]; Michael J Fox, the actor and activist garnering support to find a cure for PD, Francisco Franco, the dictator of Spain [11]; Arthur Koestler, the author of Darkness at Noon [12]; John V Lindsay, the mayor of New York [13]; Davis Phinney, the champion cyclist, Michael Redgrave, the English actor [14]; Janet Reno, U.S. Attorney General [15]; Pierre Trudeau, Prime Minister J Neurol Neurosurg of Canada [16]; Morris Udall, the Congressman for whom the Udall Parkinson Centers are named [17]; Robin Williams, the comedian who suffered from bipolar disease and PD [18]; and Mao Zedong, the revolutionary leader of China [19]. Famous and infamous people get PD and ordinary people get PD. But do a higher percentage of famous people get PD? Is there something about PD that leads to fame? Material and Methods First we must ask: What is fame and how is it measured? One measure of fame is being chosen to be on the cover of TIME Magazine. The person chosen is the one who in the opinion of the editor is, for a week, the most newsworthy, for good or bad, and by implication the most famous. It’s not a measure with which everyone agrees, including the editors of the Economist, Newsweek, der Spiegel, or U.S. News &World Report. And it’s a fleeting measure; there are 52 issues of TIME each year: 52 famous people or groups of people each year for 87 years since 1927, for a total of 4,524 people. A better measure of fame is being on the cover of TIME as the Person of the Year. There are other measures, such as Nobel Prize Laureates or Saints of the Catholic Church, but they’re more restrictive, and less known to the general public, so TIME it is. During the 88 years (1927–2014) since the first TIME Person of the Year (Charles Lindbergh) was named, single individuals, groups, and inventions have been selected. A total of 54 single individuals were designated as TIME Person of the Year. Among these 54 individuals, 12 were designated twice, and one, Franklin Delano Roosevelt, was designated three times. To calculate the number of individuals from this select group, only one appearance per person was counted. Among the designees are nine U.S. Presidents, three Popes, 22 foreign leaders, and ten business people. For comparison with the general population, the prevalence of Parkinsonism, including PD and atypical Parkinsonism, in the Europarkinson Collaborative Study was used. It is reported to be 336 PD or atypical Parkinsonians among 14,636 people aged 65 years and older: a prevalence of 2.6% [20]. The diagnosis of typical idiopathic PD versus atypical Parkinsonism can be made only by direct examination, by tracking the course of the disorder, and, ultimately, by postmortem examination. Such information is not readily available, nor is such data available for patients in the Europarkinson Collaborative Study. The limitations in our study are similar to those of the Collaborative Study, and, in our estimation, cancel one another out. Odds ratios (OR) for our study were performed utilizing MedCalc Software, version 14.12.0, modified December 3, 2014. Results Among the 54 single individuals designated as TIME Person of the Year were five who have or had PD: Adolf Hitler (1938), Deng Xiaoping (1978, 1985), George HW Bush (1990), Pope John Paul ISSN: 2373-8995 Page 1 of 3 J Neurol Neurosurg ISSN: 2373-8995 II (1994), and Andy Grove (1997). Five of 54 is 9.3%, 3.7 times the prevalence in the Europarkinson Collaborative Study, OR 4.34, 95% confidence interval (CI) 1.72– 10.97, P = 0.002. One could argue that in 1936 Francisco Franco (who had PD) was more newsworthy than Wallis Simpson; that in 1937, Mao Zedong, a person with PD, was more newsworthy than Chiang Kai-shek; and that in 1973, Muhammad Ali, who has PD, was more newsworthy than John Sirica. This would have increased the number of people with PD to eight of 54 (14.8%), which is 5.7 times the prevalence in the Europarkinson Collaborative Study, OR 7.40, 95% CI 3.47–15.8, P= 0.0005. TIME is not all-knowing: famous people with PD who were not named Person of the Year include, Muhammad Ali; Habib Bourguiba; Michael J Fox; Francisco Franco; Arthur Koestler, the author of Darkness at Noon; John V Lindsay; Mao Zedong; Janet Reno; Morris Udall; and Pierre Trudeau. The obituary of Mao Zedong, one of the most important figures of the 20th century, asserts that his death was prompted by complications of PD [19]. Mao was also described by his personal physician as having amyotrophic lateral sclerosis (ALS) [21]. It’s possible that he had a disorder, a combination of PD and ALS, resembling the ALS-PD complex of Guam [22,23]. Several of the people included in the list above were examined by the first author or by his colleagues. Specific information cannot be revealed without violating HIPPA regulations. Discussion Do famous people, like ordinary people, get PD because it’s a disease of aging? Is this a disease that allows its victims sufficient time to become famous and then suffer? It’s not a disease of birth, or infancy, or childhood—a disease that doesn’t allow its victims time to become famous. It’s not Down’s syndrome, or childhood AIDS, or Huntington’s disease. PD is not a disease that destroys the developing or maturing brain. The peak onset of PD is age 60 years. And, by age 60 years, famous people, and ordinary people, have accomplished in life most of what they’re going to accomplish. Or do famous people get PD because the brain, unknowingly, makes a Faustian bargain? Is there something about PD that leads to fame? Does something energize the brain before slowing it down? While PD may be a disorder of aging, 15% of people get PD before they’re 50. Muhammad Ali and Michael J Fox both developed PD in their 40s. Adolf Hitler developed PD at 45 years of age, possibly as the result of encephalitis that he contracted during the Great Encephalitis epidemic of 1918-1926 [24]. The substantia nigra is one of the main regions affected by PD. The substantia nigra is located midway between the cortex and the spinal cord and has 400,000 neurons, four for every 100,000 of the brain’s 100,000,000,000 neurons. When, because of the process of Parkinson, 240,000 of the neurons in the substantia nigra, 60% of the total, die, the motor symptoms of PD appear [25,26]. It’s estimated that the process of PD, as distinct from its symptoms, begins years before the symptoms appear and the disease is diagnosed. It’s reasonable to ask how a disease that affects less than 0.04% of the brain’s neurons, a disease that apparently only affects mobility, can lead to greatness–to fame. The best available answer is that PD is more than a disease of movement. Disorders including depression and lack of impulse control are common: 40% or more of all PD patients are depressed [26,27]. Also, 6.1% have impulsive reward-seeking behavior, behavior present before patients are treated, but behavior increased by dopamine agonists. Depression accompanied by feelings of gloom is an integral part of PD. The depression may be reactive: a natural reaction to having Vol. 2. Issue. 1. 21000111 PD—a chronic, progressive, and debilitating disorder. However, many, if not most, people with PD suffer from an endogenous depression, a depression not in reaction to knowledge of the disease. In fact, in 20% of those with PD, depression may be the first symptom of PD [27,28]. Of course a depression appearing before the onset of the symptoms of tremor, bradykinesia, and postural instability can only, in retrospect, be appreciated as the start of PD. The endogenous depression of PD is marked by apathy, indifference, passivity, and a loss of energy. These qualities are opposite to those which empowered, in a good way, Muhammad Ali, Pope John Paul II, George HW Bush, Deng Xiaoping, and Andy Grove, and, in an evil way, Adolf Hitler. What is the basis for the endogenous depression, the lack of energy in PD? And could this depression be preceded by a surge of creative energy such as occurs in bipolar disorder including impulsivity and rewardseeking behavior? In PD the motor symptoms result from a loss of dopamine neurons in the brainstem. In addition to the loss of dopamine neurons there is a loss of nor-epinephrine and serotonin neurons (chemicals involved in depression). The nor-epinephrine and serotonin neurons are also in the brainstem, adjacent to, or in the vicinity of, the substantia nigra. The process of PD begins years before the motor symptoms appear [24,25]. Thus it’s possible that before the depression appears, there is a stage of excitation, a lack of inhibition, a surge of energy and reward-seeking behavior and that’s when the basis of fame is laid. References 1. Lieberman A. Hitler’s Parkinson’s disease began in 1933. Mov Disord. 1997;12(2):239-40. 2. Dellinger RW. The doctor who diagnosed John Paul’s Parkinson’s disease. Angelus The Tidings Online; 2014. Available from: http://www. angelusnews.com/news/local/the-doctor-who-diagnosed-john-paulsparkinsons-disease-4783/#.VZvKRhuqqko 3. 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Depression in Parkinson’s disease -- a review. Acta Neurol Scand. 2006;113(1):1-8. *Corresponding author: Abraham Lieberman, Neuroscience Publications, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, 350 W. Thomas Road; Phoenix, AZ 85013, USA, Tel: 602-406-3593; Fax: 602-406-4104; E-mail: [email protected] Received Date: May 21, 2015, Accepted Date: July 07, 2015, Published Date: July 15, 2015. Copyright: © 2015 Lieberman A, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Citation: Lieberman A, Deep A (2015) Famous People with Parkinson Disease. J Neurol Neurosurg 2(1): http://dx.doi.org/10.19104/jnn.2015.111. Elyns Publishing Group Explore and Expand Citation: Lieberman A, Deep A (2015) Famous People with Parkinson Disease. J Neurol Neurosurg 2(1):111. Page 3 of 3