The L-DOPA story revisited. Further surprises to be expected?

L-DOPA therapy for Parkinson's disease is one of the major achievements of twentieth century neurology; Parkinson's disease was the first in which specific neurochemical deficits in defined brain regions were identified, and thus for which a rational, chemical therapy could be developed, ushering in the era of clinical neurochemistry. The contributions of Birkmayer and Hornykiewicz (Vienna), Barbeau and Sourkes (Montreal) and of Cotzias (New York) to this story are well-known. Almost completely forgotten, on the other hand, is a paper presented by the Japanese neurologist Isamu Sano in 1960 which reported what is probably the first attempt to treat Parkinson's disease patients with DOPA. This is all the more remarkable as the author was also responsible for one of the key papers which led to the use of DOPA in Parkinson's disease by other workers. Despite the negative outcome of his experience with L-DOPA, Sano deserves to be remembered as one of the pioneers in catecholamine research, having been the first to map dopamine levels in the human brain, and identified the reduction of dopamine levels in the substantia nigra and striatum in Parkinson's disease.