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Advanced Neurology George Cotzias and L-DOPA therapy

disturbances represents another hallmark characteristic of National Laboratory (BNL), where he focused on
PD. 39,42,44,47,51 These motor deficits affect the patient’s quality cyclotron research, Cotzias began studying manganese
7,38
of life (QoL). 20 poisoning 7,38,45,46 and catecholamines. 7,38,53 Cotzias
George Cotzias was born in Greece. 1,7,33,38 Cotzias discovered the ability of the brain to remember the chemical
7
studied at leading educational institutions in Greece content of a drug and respond to it upon reintroduction.
and the United States of America (USA). 7,33,38,46 His first Even while struggling with cancer, Cotzias never stopped
7,46
distinction was at Harvard University as one of the top working on challenging research studies. He stated that
graduates. 1,7,33,38,46 He received specialized training at L-DOPA deficiency could be an early indicator of future
New York’s leading hospitals. 1,7,38 breast cancer. 7
Cotzias emphasized the importance of existing Cotzias received numerous international awards and
knowledge on levodopa (L-DOPA), identified novel distinctions. 1,2,7,38,46 After his passing, his body was returned
46
3,46
L-DOPA-related properties, and developed combination to Greece, where state-organized funeral was held.
therapies involving L-DOPA and dopamine inhibitors. He Greece further honored him by issuing a commemorative
1,7
became the pioneer in uncovering the practical therapeutic stamp bearing his image and his name. Nowadays, many
effects and previously unrecognized side effects of L-DOPA academic courses, events, and scholarships are named after
7
in the treatment of PD. 52-56 Before Cotzias, many physicians him. The current article was written to provide a concise
have tried to translate the theoretical benefits of L-DOPA biography of George Cotzias as a mark of honor to his
into clinical practice through extensive studies, but all memory and all his great novel achievements. Furthermore,
had failed. 41,47,55-58 Cotzias used science and art to be sure this article intends to provide a comprehension of how
and precise about L-DOPA features. 2,3,7,8,19,21,26,33,47,59 It was Cotzias created the successful formula of L-DOPA, the
because of Cotzias that the resistance to neurodegenerative revolutionary therapy. The article also explores how
PD treatment was addressed. 1,7,30,33,46,55,60 Cotzias leveraged the new research models to combine
L-DOPA with other substances, extending its application
The conclusions of Cotzias on L-DOPA were verified to the diagnosis and understanding of other diseases. In
by many other scientists. L-DOPA was proven to be the addition, this work seeks to highlight the significance
61
standard, cheapest, and most successful PD therapy. 35,42,62-67 of detailed scientific observation in achieving medical
Providing L-DOPA to Parkinsonian patients has been breakthroughs. Another aim of this article is to have a
proven to be a synonym for longer life expectancy and better comprehension of the nervous system and consider
improved QoL. 35,37,66,68,69 It was a great gift for medicine, the seriously the possibility of restoring health in PD patients.
health condition, and the lives of many PD patients. 46,66,68,70-72 Finally, the article provides a comprehensive review of PD
They were “awakened” and found themselves from being and its evolving treatment modalities, from past to present.
breathing statues to having the ability to perform daily
activities. 73,74 Oliver Sacks named his book “Awakenings” 2. Brief history of PD
after being impacted by Cotzias using the term
1-3
“awakenings” to describe L-DOPA’s effect. At present, the PD named Kampavata was first mentioned in Ayurvedic
74
th
1
th
movie “Awakenings,” based on the book by Oliver Sacks, texts between the 5 and 12 centuries. However, James
reminds laymen of the importance of translating L-DOPA Parkinson, through his book “An Essay on the Shaking
from theory to practice. Certain allegations about the Palsy” published in 1817, was the first to define the
75
neurodegenerative and toxical properties of L-DOPA were standard symptoms of PD. His work also introduced the
not substantiated. 17,22,37,41,69 Another unique achievement pathophysiological framework that was recognized by the
of Cotzias was the formulation of carbidopa/L-DOPA medical community, classified PD as a distinct neurological
medicine. 1,3,7,19,32 Within a year Cotzias published the disease, and inspired many researchers to pursue further
results of carbidopa/L-DOPA, the first oral formulation investigations on the disease. 1-9
of this therapy became commercially available. 3,5,32 Its PD is characterized by internal as well as external
efficacy in treating PD and gastroenterological problems disorders. 10-17 Affecting no fewer than 10 million people
led to the development of an intestinal gel formulation in globally, it was defined as the second most common and
Sweden. 5,10,19 progressive neurodegenerative disorder. 1,18-25 The disease
Later, a skin patch option of carbidopa/L-DOPA was impacts the patient’s QoL. The distinguishable internal
20
produced. 2,5,8,32 Beyond its use in neurological disorders, abnormality and the most studied and strongly damaged
L-DOPA was also effective in curing other diseases. 56,72 part of the brain in PD are the SN, a component of the basal
It was an essential tool for a further explanation of other ganglia. 5,11,15,21,26-28 The SN is composed of neuromelanin,
illnesses, not always neurological. At Brookhaven over 1,200,000 neurons, and high levels of dopamine - a
7,56

Volume 4 Issue 2 (2025) 42 doi: 10.36922/an.5177