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Advanced Neurology

REVIEW ARTICLE
George Cotzias’ achievements and levodopa

therapy: Their contribution to medical science

Konstantina Kotsaki * and Mehmet Doğan 2
1
1 School of Psychology, University of Central Lancashire, Preston, Lancashire, United Kingdom
2 Council of Forensic Medicine, Ministry of Justice, Istanbul, Republic of Türkiye

Abstract

George Cotzias was a tireless physician who conducted a variety of studies, focusing
mainly on neurological diseases. After leaving his medical studies to serve the Greek
army voluntarily, Cotzias was relocated to the United States of America where he
continued his studies at Harvard University. His first research was on hypertension,
metabolism, and energy balance issues. Later on, he became the chief director of
a project on chronic manganese poisoning. It was there that he identified the
common characteristics between chronic manganese poisoning and Parkinson’s
disease, which led him to be referred to the cyclotron. Furthermore, he noted the
presence of dyskinetic, motor fluctuation abnormalities, and hypersensitivity caused
by levodopa (L-DOPA). He was a pioneer in demonstrating the revolutionary practical
benefits of L-DOPA therapy. This accomplishment was a consequence of his patience
*Corresponding author: and insistence to monitor closely, even with cinematographic recording, the health
Konstantina Kotsaki condition of his patients while modifying the L-DOPA dose for optimal health benefit.
(kotsaki394@gmail.com) Cotzias also developed drugs combining L-DOPA and dopamine agonists, defined
Citation: Kotsaki K, Doğan M. the phenomenon of the brain’s ability to store chemical memory, and established
George Cotzias’ achievements and the correlation between L-DOPA and cancer. His work significantly improved the
levodopa therapy: Their contribution
to medical science. Adv Neurol. lives and longevity of many individuals. Before his death from cancer in 1977, Cotzias
2025;4(2):41-53. received numerous distinctions and awards for his outstanding contributions to
doi: 10.36922/an.5177 medicine. After his death, his legacy was honored through the establishment of
Received: October 17, 2024 various scholarships, professorships, conferences, and a movie dedicated to his
medical achievements.
1st revised: November 16, 2024
2nd revised: December 7, 2024
Keywords: Cotzias; Levodopa; Parkinson’s disease; Neurodegenerative diseases;
Accepted: December 26, 2024 Neuroscience; Neurology; Medicine
Published online: January 13,
2025
Copyright: © 2025 Author(s).
This is an Open-Access article 1. Introduction
distributed under the terms of the
Creative Commons Attribution The investigation of Parkinson’s disease (PD) began in 1817 when James Parkinson
License, permitting distribution, first described it as a separate neurological disease. People with PD experience
1-9
and reproduction in any medium,
provided the original work is many endogenous and exogenous irregularities. 10-17 PD is estimated to be the second
properly cited. most prevalent neurodegenerative disease. 18-25 Its characteristic pathological features
Publisher’s Note: AccScience include injury to the substantia nigra (SN), neuronal loss, neuromelanin depletion,
Publishing remains neutral with and dopamine deficiency within the SN. 21-33 The most widely recognized movement
regard to jurisdictional claims in 34-42
published maps and institutional distortions of PD are bradykinesia and rigidity. Yet, numerous other voluntary and
affiliations. involuntary movement impairments have also been documented. 43-51 The presence of gait

Volume 4 Issue 2 (2025) 41 doi: 10.36922/an.5177