Latest Neurology News
By Matt McMillen
WebMD Health News
Reviewed by Michael W. Smith, MD
June 4, 2016 - Boxing champion Muhammad Ali, known as much for his public persona as his prowess in the ring, died Friday, a family spokesman told the media. He was 74.
Noting Ali's "singular DNA pattern of beauty, grace and bravado," Time magazine, in 2001, described Ali as "perhaps the most idolized, vilified and complex public figure of the 20th century."
He was born Cassius Marcellus Clay Jr., on January 17, 1942, in Louisville, KY. He started training as a boxer at age 12 and fought more than 100 bouts before he turned pro in 1960. Earlier that year, he had brought home a gold medal from the Olympic Games in Rome. Less than four years later, in 1964, he beat Sonny Liston to become the heavyweight champion of the world. It was a title he would hold for the next three years.
In 1964, controversy and criticism erupted over his conversion to the Nation of Islam and his name change, first to Cassius X and then to Muhammad Ali. In 1967, Ali, a vociferous champion of civil rights, refused to serve in Vietnam, having the previous year declared himself a conscientious objector based on his new faith and position in the Nation of Islam.
As a result, he was stripped of his boxing title by the New York State Athletic Commission and the World Boxing Association and sentenced to five years in prison for draft evasion. The conviction, which Ali appealed, was overturned by the U.S. Supreme Court in 1971. He returned to the ring in 1970. The story of his legal battle was told in the 2013 documentary The Trials of Muhammad Ali.
In 1974, he regained the heavyweight crown following his defeat of George Foreman in Zaire, the fight dubbed the "Rumble in the Jungle." The following year saw a rematch between Ali and Joe Frazier, who had knocked out Ali after 15 rounds in 1971. Fought in the Philippines, the "Thrilla in Manila" is considered to be one of the greatest fights in boxing history. Ali emerged victorious.
Ali lost his title to Leon Spinks, in 1978. Later that year, he reclaimed it, defeating Spinks to become the first boxer to hold the heavyweight title three separate times. Three years later, at age 39, Ali was defeated by Trevor Berbick. The following day, he announced his retirement from the ring.
In 1984, at age 42, Ali announced that he had Parkinson's disease. A chronic and progressive disease that attacks the central nervous system, Parkinson's is considered a movement disorder because it causes tremors and imbalance, rigidity and slowness due to a loss of dopamine, a brain chemical known as a neurotransmitter.
Usually, the disease strikes people over the age of 60, but as many as 10% of patients, like Ali, are diagnosed prior to age 50. In such cases, the disease is referred to as early-onset Parkinson's.
The earlier the disease is diagnosed, the better the prognosis, says neurologist Zoltan Mari, MD, director of the National Parkinson Foundation Center of Excellence at Johns Hopkins University in Baltimore, MD.
"Younger patients who have had the disease for 10 years do better than older patients who have had the disease for 10 years," says Mari. "We don't know why."
Younger patients also tend to be spared some of the cognitive decline associated with the disease, Mari continues. And the motor difficulties respond fairly well to treatment.
"But once you start losing ground in cognition, there is very little that we can do," Mari says.
While the causes of Parkinson's disease are not known, nor its progression fully understood, there are some predictors of the severity of the disease. Those whose disease starts with its hallmark tremors frequently do better than those who have balance problems and suffer from falls. Also, patients who develop dementia early on fare more poorly than those who don't.
"But nothing is absolute," says Mari. "These are not 100% correlations."
The greatest risk factor for the disease is advancing age, but genes and the environment likely play a role as well. In Ali's case, it's easy to question whether the onset of the disease was related to boxing and the decades of blows to the head he experienced.
Mari, who did not treat Ali, says it is one possible factor, but that many things likely contributed to his diagnosis.
Boxers do have a somewhat higher risk of developing Parkinson's. "It's slight, but it is there," says Mari, "but it is not risky enough to dissuade potential boxers. It is only one of many, many factors, and more research is needed. If a kid does not have the genes that predict PD - and chances are he doesn't - there's more of a downside from not letting him pursue a career he wants to pursue."
The end of his boxing career was hardly the end of Ali's time in the spotlight. In 1990, he met with Iraqi leader Saddam Hussein and negotiated the release of 15 American hostages. In 1996, he lit the Olympic torch in Atlanta. In 1998, Kofi Annan, then United Nations Secretary General, named Ali a U.N. messenger of peace for his long history of humanitarian efforts on behalf of people in Africa and Asia.
In 2015, Ali issued a statement through the National Press Club calling on Iran to release jailed Washington Post correspondent Jason Rezaian. Rezaian, who was released in January 2016, called Ali "a hero all people could believe in" on Twitter following news of his death.
"Thank you Muhammad Ali," Rezaian tweeted early Saturday. "Your words of support moved me during the darkest time of my life."
In 2005, the Muhammad Ali Center opened in Louisville, KY. The center is both a museum and cultural center that seeks "to preserve and share the legacy and ideals of Muhammad Ali, to promote respect, hope, and understanding, and to inspire adults and children everywhere to be as great as they can be."
That same year, President George W. Bush awarded Ali the Presidential Medal of Freedom, the highest civilian honor in the United States. In 2009, the NAACP honored Ali with the President's Award for special achievement and distinguished public service.
And his fights continue to make history. In February 2015, the gloves that Ali and Liston wore in their controversial 1965 rematch bout - Ali KO'ed Liston in round 1 - sold at auction for nearly $1 million.
Ali's fame kept his brand alive long after his boxing career ended. In 2015, clothing maker Under Armour announced a new line of products featuring the former world champion, despite the fact that he'd been out of the ring for more than 33 years.
In October of 2014, amid speculation about his declining health, three of Ali's daughters told USA Today that there was no immediate cause for concern. "He was joking again about making a comeback," Hana Ali said. Shortly after that, Ali posted his first selfie to Twitter. He was hospitalized in December 2014 for suspected pneumonia and in January 2015 for a severe urinary tract infection, but was released shortly before his 73rd birthday. He posted another selfie on Twitter in March, celebrating daughter Laila's new job as a boxing analyst on NBC.
Throughout his illness, Ali made a substantial contribution to the fight against Parkinson's disease. He raised an estimated $100 million for the Muhammad Ali Parkinson Center in Phoenix, AZ, through the annual fundraiser, Celebrity Fight Night.
His efforts may someday benefit future Parkinson's patients, says Mari: "This tragic moment gives us an opportunity to advance research and public awareness and perhaps eventually minimize the impact of a horrible disease."
Ali, who was married four times, is survived by his wife, Yolanda Ali, and nine children.
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