Recent decades have brought promising new treatments for Parkinson's disease, a neurological illness that causes tremors, rigidity and loss of balance. Ongoing medical research was a central focus of the first World Parkinson Congress, held in February in Washington, D.C. But participants also explored the benefits of other therapies, everything from exercise to nutrition to the creative arts. Serving as honorary chair of the Creativity and Parkinson's Committee was neurologist and best selling author Oliver Sacks, who has made the link between artistic expression and Parkinson's disease one of the focal points of his research.
Oliver Sacks is perhaps best known for his 1973 book Awakenings, later made into a movie starring Robin Williams and Robert De Niro. The book described his work with victims of a sleeping sickness epidemic that broke out after World War I. The sickness left them in a rigid, trancelike state with similarities to advanced Parkinson's disease. They began to wake up after Dr. Sacks treated them with L-dopa in the late 1960s, now a standard medication for Parkinson's.
In working with those patients, Oliver Sacks also discovered they had what he calls an "extraordinary" response to music. "These people who couldn't utter a syllable or take a step sometimes could sing beautifully and could dance, and music seemed to let them flow in a way they couldn't do in any other circumstances," he says. "We are an intensely musical species, even people who say they are unmusical and tone deaf. There's a remarkable amount of the brain that's concerned with processing music, far more than is concerned with processing language, and I think it's very much part of the human state."
Now teaching at the Albert Einstein and the New York University medical schools, the British-born Dr. Sacks has continued to explore the impact of music on the brain over the decades, expanding his focus to include dementia, Alzheimer's and hallucinations.
He has also gathered examples of other kinds of creativity that appear to have a liberating effect on people diagnosed with Parkinson's. An artist he met in the early 1960s was so disabled by the illness he could hardly move. "He got wheeled up to a big canvas, and then suddenly with a flourish, he did a beautiful opening brush stroke, and then with great energy and large gestures, he did the rest. And then he froze again."
Many other patients have demonstrated the same kind of response to the creative arts, Oliver Sacks adds. "So I think it's very interesting how the mechanisms of voluntary action can partly be bypassed with music and art and dancing and acting. There are Parkinsonian actors who can hold the stage for a long while, but more or less have to be carried off it."
Oliver Sacks says more research needs to be done into the physiological reasons for these cases. But in particular, the basal ganglia, which are affected in Parkinsonism, have to normally permit access to motor programs and memories, and this can get blocked in Parkinson's. And in a sense, I think music can almost act as a sort of prosthesis for this aspect of the basal ganglia and give one a structure of rhythm and a temporal structure which will allow people to walk and to do things."
That link is especially important to people like Charlie Nimovitz, a professional musician and songwriter who performed at the Parkinson Congress. The former leader of a wedding and party band, he was diagnosed with Parkinson's in 2000. He now gives concerts with an expanded repertoire that includes songs about living with the illness. Mr. Nimovitz says music has taken on a deeper meaning since his diagnosis, allowing him to explore lessons he has learned about humility, perseverance and gratitude.
Music has become a form of therapy for Mr. Nimovitz as well. "It can take me away to another place, where I feel more free," he says. And while he says he doesn't necessarily feel better physically when he performs, he does go through an emotional change. "No matter how I'm feeling physically, I get in a zone where I feel safe. And it's a nice thing."
Charlie Nimovitz sings and plays keyboards and accordion on his first CD since being diagnosed with Parkinson's, called Awkward Dance. He also performs for people with the illness, and says they seem to get a kind of healing benefit from his music. He was among an international array of artists -- from sculptors to poets to photographers -- whose work was showcased at the Congress.
Oliver Sacks believes achievements like theirs demonstrate the importance of taking multiple approaches to the treatment of Parkinson's disease. "I'm all for the wonderful technological progresses of brain imaging and all the molecular and cellular approaches which now include neuroprotective drugs and the potential for stem cells and of nerve growth factor. But I think one also needs to address the individual as a whole, and then everything from occupational therapy to music therapy to relationships and love and work. One saw this so clearly with the Awakenings patients. L-dopa was necessary but not sufficient. On top of L-dopa, there had to be a worthwhile life available for these people."
A renowned neurologist who believes doctors should still make house calls, Oliver Sacks says medicine must start with the medicinal, but then move on to include everything else that makes for a full and meaningful life.