From Chakkorathukulam in Kozhikode to Washington, the life course of Dr T Subrahmanyan has been shaped not merely by patients, but by lives. Stricken by polio at the age of 14 months in 1965 and left with paralysed legs, his journey across the world has been powered by knowledge, resilience and experience.
As researchers across the globe work to unravel Parkinson’s disease and bring it under control, Dr Thyagarajan Subrahmanyan today stands at the forefront of these efforts. He is the Head of the Department of Neurology at the Howard University College of Medicine in Washington. Also, he serves as President of the Association of Indian Neurologists in America, which represents nearly 5,000 neurologists of Indian origin in the United States. He recently spoke to us about recent advances in Parkinson’s treatment and the emerging pathways shaping future research.
Where Parkinson’s really begins
Researchers now believe that, in most cases, Parkinson’s disease does not originate in the brain but in the stomach. Harmful microbes that enter the gut are thought to trigger the condition by converting a protein called alpha synuclein into its amyloid form, which is considered a key factor in the development of Parkinson’s.
Studies have further shown that these harmful microorganisms destroy beneficial gut bacteria, enabling alpha synuclein to travel from the stomach to the brain. This finding has opened up new avenues of research. If Parkinson’s can be identified at this early stage through initial gastrointestinal symptoms, preventing the disease could become far more achievable.
Significant advances in research
Hope is also emerging from steady progress in stem cell research, while significant advances are being made in brain stimulation techniques. Particularly promising are induced pluripotent stem cell experiments, in which stem cells are grown from a patient’s own skin rather than sourced externally.
Years ago, a diagnosis of Parkinson’s disease often meant a life expectancy of no more than seven years. However, continuous research has led to the development of several effective medicines, making long-term life with the disease far more manageable. With proper care and timely treatment, patients can now lead a largely comfortable life without severe distress.
Early detection is crucial
Many people tend to dismiss symptoms such as tremors, difficulty in movement or frequent falls as a normal part of ageing. However, the earlier the disease is detected, the more effective the treatment becomes. Hence, tremors in the hands, movement difficulties, and unexplained falls should not be seen merely as age-related issues. Instead, they warrant consultation with a doctor and a specialist evaluation.
Taking medication at the prescribed time is extremely important. Equally vital are lifestyle modifications that support overall health and mobility. For patients with advanced disease, improvement can also be achieved through Deep Brain Stimulation.
Against the odds
Dr T Subrahmanyan says it was his parents’ unwavering support that taught him to dream beyond physical limitations. His father, Dr Thyagarajan, former Head of the Department of General Surgery at Kozhikode Medical College, and his mother, Parvathi, stood firmly by him at every step. They accompanied him to school and everywhere else he needed to go.
He also recalls with gratitude the role played by the schools he studied in, his teachers and his friends, all of whom helped instil in him the confidence to move forward. He still remembers being included in sports activities at St Joseph’s School, an experience he speaks of with quiet pride.
A significant turning point in his professional journey came with his appointment as Assistant Professor at Emory University in the United States. Soon after, he secured a coveted grant from the US National Institutes of Health (NIH), ushering in an intensive phase of research in movement disorders and advanced neurology. For the past three decades, his work has continued uninterrupted with the support of this grant.
His wife, Kala Venkiteswaram, is an Associate Professor in the US, while their daughter, Megha, is a pre-med student.
Parkinson’s disease
Parkinson’s disease is a neurological disorder that affects the nervous system. It gradually destroys the brain cells that produce dopamine, a crucial neurotransmitter that regulates movement and coordination. As the disease progresses, patients may experience loss of balance and slurred or slowed speech. The root cause of the condition is the accumulation of a toxic protein called alpha-synuclein in neurons and their surrounding tissues.
