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John Hammerstad and Jay Nutt developed center devoted to researching movement disorders and treating patients 

COURTESY PHOTO - Jay Nutt (left) and John Hammerstad pose for a photo with a fellow Mary's Woods resident at recent ceremony.

Twice in his life, John Hammerstad recruited Jay Nutt.

The second time occurred when he encouraged Nutt to move to Mary's Woods retirement community in Lake Oswego. More significantly, however, Hammerstad asked Nutt over four decades prior to join him and fellow Oregon Health and Sciences University colleague Julie Carter in their efforts to start the first center in Oregon dedicated to movement diseases like Parkinson's.

In both instances, Nutt was happy to follow Hammerstad's lead.

Recently at Mary's Woods, more than 250 people gathered to celebrate the impact that the two have had on neurocognitive research and treatment.

"It was an exciting and challenging and fun career, and John and Julie and I remain good friends with lots of memories of struggles and triumphs and so forth. In that way it's been wonderful," Nutt said.

Hammerstad joined the OHSU department of neurology in 1972, where he researched chemicals that transmit information from one cell to another in the part of the brain where Parkinson's develops. Via Hammerstad's recruiting, Nutt came over from the National Institute of Health to jumpstart a center devoted to diseases related to the degeneration of these transmitters. At the time, research into how to treat Parkinson's using the drug called levodopa was in its relative infancy.

"There were absolutely none (movement disorder clinics) in Oregon. It was a relatively new subspeciality that had arisen over the preceding 15 years maybe," Nutt said.

The clinic eventually turned into what is now known as the Parkinson's Center, which started with just four employees and has ballooned to 22 people. The center performs research, treats patients and trains professionals.

One of the center's foremost discoveries during Nutt and Hammerstad's tenures regarded the use of levodopa, which lessens Parkinson's symptoms like shaking, rigid muscles and changes in speech and writing. The instructions for using the drug at the time said to take it with a meal. However, after hearing a patient talk about instances of "Big Mac attacks" — a worsening of symptoms after eating the McDonald's hamburger — they realized that the amino acids from meat blocked the entrance of the drug into the brain.

"He said 'I love Big Macs and every time I go in to get a Big Mac and a bunch of fries I become really stiff and rigid, and it's painful and I oftentimes need help getting out of the restaurant,'" Nutt said.

Their work on this topic was published in the New England Journal of Medicine and led to changes in the way the drug is administered.

The center also performed research regarding the administration of growth hormones to lessen the effects of Parkinson's and to correct balance and gait for people with the disease. Further, the OHSU center was one of the first centers in the country to use brain stimulation to lessen Parkinson's symptoms, Hammerstad said, and conducted research on how to best conduct the stimulation.

They also researched the treatment of other movement disorders like dystonia, which causes muscles to contract involuntarily. They figured out that using a toxin to partially paralyze overactive muscles helped lessen the symptoms.

Nutt said the center emphasized to patients that all is not lost and that their choices can have a big impact on the quality of their life. The center also treats thousands of patients a year. The key to living with Parkinson's, Nutt said, is having a positive mindset.

"The patient needs to realize that although they have this disease, it doesn't necessarily keep them from doing lots of things and they have to work hard to keep active, keep intellectually active as well. Some of them did really well for well over 20 years," he said. "People live a long time with Parkinson's, or they can. Others are defeated or depressed and don't remain active. Those people don't do well."

Hammerstad noted the many people they trained at the center, which offers fellowships, graduate training, postdoctoral programs and more.

"I'm proud of all of the fellows we trained who have gone out and become experts and specialized in treating Parkinson's disease and other disorders. It's a combination of research we accomplished and the people we were able to train," he said.

A cure for Parkinson's does not exist. Instead, researchers are trying to figure out how to stop the progression of the disease as well as find a way to detect it as early as possible, Hammerstad said. Nutt added that researchers are hoping to slow the synthesis of a protein that leads to the degeneration of dopamine and neurons.

"If you catch it early, patients can live basically a normal life — so it's similar to a cure," Hammerstad said.


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