C. David Marsden (1938–1998)

Abstract

David Marsden’s extraordinary capacity for life was coupled with an infective enthusiasm for science. He could dance the samba until the early hours and then give a superb keynote lecture the following morning. He inspired his students even if they had problems keeping up with him physically or intellectually.His early career involved an astonishingly fast rise up the usually staid ladder of British neurology. He trained at St Thomas’ and the National Hospitals and was only 34 when he was appointed as the first Professor of Neurology at King’s College and Maudsley hospital, London. Thirteen years later he was elected to the premier post in clinical neurology in the UK at the National Hospital for Neurology and Neurosurgery in Queen Square, London.His career was marked by a unique ability to synthesize clinical observation with neurophysiological and neuropharmacological insights into brain function. He was one of the principal contemporary neurologists who reappraised the then poorly understood field of movement disorders. He recognized that writer’s cramp and torticollis, considered by many at that time to be psychological conditions, were organic diseases of the nervous system and he saw them as part of a much larger group of disorders that have become known as the dystonias. In retrospect, it is remarkable how often his classifications were correct and how clearly he described the conditions that he saw. Indeed, his work in this field has set the standard for the past 25 years.He was never satisfied unless he could understand the mechanisms that produced the clinical symptoms that he described. His scientific mentor was Prof. P.A. Merton from the University of Cambridge, UK, whom he first met in the late 1960s at the same time as he was researching the effect of adrenaline on arm tremor. Guided by Merton and the technical wizardry of H.B. Morton, he set up a physiology laboratory in order to identify the neural circuits that functioned abnormally in patients with movement disorders. He was instrumental in describing the long-latency stretch reflex and pioneered the study of various types of myoclonus, dystonia and chorea. This was paralleled by the development of a pharmacology group with Dr (now Prof.) P. Jenner that aimed to describe the chemical changes in the brain that accompanied disorders of movement, and sought to test new methods of treating them. This work formed the basis of our present understanding of the effects of neuroleptic drugs and, more recently, led to the discovery of a role for oxidative stress in the pathogenesis of Parkinson’s disease. All of this research was finally complemented by the establishment of a centre for the storage of brains from patients with movement disorders who had died. An idea created over an airline meal with Prof. A. Lees, has now grown into the Parkinson’s Disease Society’s Brain Bank, which now has over 800 brains available for researchers from all over the world.David Marsden had a singular ability to combine clinical skill with scientific insight that has rarely been equalled. It was this that lifted the study of movement disorders from a quiet backwater to the forefront of clinical neurology. He attracted some of the best young neurologists from around the world to his laboratory and many of these are now leaders of their field in their own countries. In 1986, when his students were spread throughout the globe, he set up, together with Dr S. Fahn of Columbia University, NY, USA the extraordinarily successful Movement Disorders Society and was the first joint editor of the first video-illustrated Movement Disorders Journal.His success in science did not prevent him from being dearly loved by many of his patients. He was an excellent clinician who had the knack of recognizing, often in difficult circumstances, the real needs of his patients and how these needs changed over the course of their illness. He was sent referrals from all over the world and always relished the challenge of a difficult diagnosis.When he took up the Chair of Neurology at Queen Square his administrative responsibilities soared, and his direct involvement in science grew smaller. He hated this. Despite being blessed with a voice and a demeanour that was an instant advantage in committee work, he would never rate his considerable success as an administrator before his scientific achievement. He established a new research unit in movement and balance that was directly funded by the Medical Research Council, UK, and was instrumental in helping to establish the highly acclaimed Functional Imaging Laboratory in Queen Square. Both of these facilities enriched clinical neuroscience immeasurably, but both were secondary to the full-time experimental and clinical work that he loved.Tragically, he died of a heart attack just one month after he had started his first ever sabbatical at the National Institutes of Health, MD, USA.