The authors present an historical review about the main contributions of Professor Derek Denny-Brown to neurology. Some of his achievements include the first description of sensory neuronopathies, and some of the essential textbooks on the function and anatomy of the basal ganglia. In 2016, on the 35th anniversary of his death, modern neurologists are still strongly influenced by his legacy. © 2017, Associacao Arquivos de Neuro-Psiquiatria. All rights reserved.75212712

Casseb R.F.

Faber I.

França M.C.

Martinez A.R.M.

Martins C.R.

Nucci A.

Teive H.A.G.

Arquivos de Neuro-Psiquiatria

English

Repositorio da Producao Cientifica e Intelectual da Unicamp

127
http://doi.org/10.1590/0004-282X20160190
HISTORICAL NOTE
Derek Denny-Brown: the man behind the ganglia
Derek Denny-Brown: o homem por detrás dos gânglios
Alberto R. M. Martinez1, Ingrid Faber1, Carlos Roberto Martins Jr1, Raphael F. Casseb1, Anamarli Nucci1, 
Marcondes C. França Jr1, Hélio A. G. Teive2
One hundred and fifteen years after his birth in New Zealand 
(June 1st, 1901) and 35 years after his death (April 20th, 1981), 
the accomplishments and scientific work of Derek Ernest 
Denny-Brown (Figure) are a strong foundation for several neu-
rological advances, even in the present day1,2. With his legacy of 
dozens of published papers and books, he has made substantial 
contributions toward a better understanding of the basal gan-
glia’s functions and structure1,3,4. He was also the first to describe 
sensory neuronopathy5. In fact, he contributed in so many fields 
in neurology that it would be unfair and impossible to point out 
only a few.
SHORT BIOGRAPHY
After earning his medical degree in New Zealand and 
initially seeking a better understanding of postural control, 
Denny-Brown moved to Oxford where he delved deeper into 
neurophysiology research carried out under the mentor-
ship of Sir Charles Sherrington. Later, in 1928, after being 
awarded his PhD, he decided to return to clinical practice, 
applying for a post as a house physician. In December of the 
same year, he began his work as a resident medical officer 
1Universidade Estadual de Campinas, Departamento de Neurologia, Campinas SP, Brasil; 
2Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Medicina Interna, Serviço de Neurologia, Unidade de Distúrbios dos Movimentos, 
Curitiba PR, Brasil.
Correspondence: Alberto R.M. Martinez; Rua Tessália Vieira de Camargo, 126; Cidade Universitária “Zeferino Vaz”; 130083-970 Campinas SP, Brasil; E-mail: 
albertommartinez@yahoo.com.br
Conflict of interest: There is no conflict of interest to declare.
Received 13 August 2016; Received in final form 26 September 2016; Accepted 31 October 2016.
ABSTRACT
The authors present an historical review about the main contributions of Professor Derek Denny-Brown to neurology. Some of his 
achievements include the first description of sensory neuronopathies, and some of the essential textbooks on the function and anatomy of 
the basal ganglia. In 2016, on the 35th anniversary of his death, modern neurologists are still strongly influenced by his legacy. 
Keywords: Denny-Brown; neurology; ganglia, spinal; basal ganglia; movement disorders.
RESUMO
Os autores apresentam uma revisão histórica sobre as principais contribuições do Professor Derek Denny-Brown à neurologia. Suas realizações 
incluem a primeira descrição da neuronopatia sensitiva e alguns dos livros fundamentais acerca da função e anatomia dos núcleos da base. 
Em 2016, ano do seu 35o aniversário de falecimento, os neurologistas atuais ainda são fortemente influenciados pelo seu legado.  
Palavras-chave: Denny-Brown; neurologia; gânglios espinais; gânglios da base; transtornos dos movimentos.
(Image in the public domain. Reproduced from The National Library of 
Medicine http://collections.nlm.nih.gov).
Figure. Derek Denny-Brown (1901-1981).
128 Arq Neuropsiquiatr 2017;75(2):127-129
at the National Hospital, Queen Square1. During the follow-
ing years, he had some great medical bulwarks as teachers, 
supervisors and colleagues, including Drs. William Adie, 
MacDonald Critchley, Charles Symonds, Gordon Holmes, 
Kinnier Wilson, Francis Walshe and James Collier1. For the 
next 11 years he continued working in London at Queen 
Square, where he introduced electromyography and muscu-
lar biopsy as tools in neuromuscular investigation1. During 
World War II, he served as a physician in the Royal Army 
Medical Corps from 1939 to 1941, until James Conant, the 
President of Harvard University at that time, requested to 
Sir Winston Churchill to release Denny-Brown from duty. 
This allowed his transfer to Boston.
In 1946, Denny-Brown assumed the position of Professor 
of Neurology at Harvard Medical School and Director of 
Harvard’s Neurological Unit at the Boston City Hospital, 
chairs he held until his retirement in 19671,4.
DENNY-BROWN “SELF-EXPERIMENTATION” 
His commitment and eagerness for science and 
research are shown in two solid examples of peculiar and 
almost mythical stories. First, in order to evaluate and 
describe the phenomena of micturion reflexes, he and 
Graeme Robertson used themselves as subjects in what 
Robertson described years later as an “intimate scien-
tific association”6. Second, and no less impressive, is that, 
with the impending amputation of his third finger due to 
a severe Dupuytren’s contracture, Denny-Brown induced 
a digital nerve injury to experience the symptoms of 
post-traumatic neuralgia. He later described his findings 
in a paper published in Brain7.
Denny-Brown and the dorsal root ganglia
 It was in 1939 that two patients crossed Denny-Brown’s 
path, resulting in one of his most remarkable accom-
plishments – the first description of sensory neuronop-
athies. Both patients presented with sensory ataxia, 
with a sensory loss following a non-length-dependent 
and asymmetric pattern. With his analytical mindset, 
Denny-Brown identified the commonalities between the 
two cases: a massive destruction of the dorsal root gan-
glia, polymyositis and bronchial carcinoma. At that time, 
he attributed the disease to metabolic consequences of 
the neoplasm. Even though today it is known that the 
etiology of the dorsal root ganglion damage is not attrib-
utable simply to metabolic issues, Denny-Brown’s work 
stands as the first description of sensory ataxia due to 
dorsal root ganglion injury, also known as Denny-Brown’s 
syndrome5. It is important not to confuse this entity with 
the Denny-Brown and Foley’s syndrome, which is related 
to benign fasciculations8. 
Denny-Brown and the Basal Ganglia
Some other remarkable achievements were made by 
Denny-Brown towards the better understanding of the 
basal ganglia and their influence on movement disor-
ders. In fact, between the 1940s and 1960s, he published 
the three classical books regarding this topic: Diseases 
of the Basal Ganglia and Subthalamic Nuclei(1946), The 
Basal Ganglia (1962) and The Cerebral Control of Movement 
(1966)1,2,4. In these books, for the first time, Denny-Brown 
went into deep discussion of the anatomy and physiology 
of the basal ganglia and several types of movement disor-
ders, such as tremor, chorea, athetosis, dystonia, and par-
kinsonism1,4. In his most famous book The Basal Ganglia 
and Their Relation to Disorders of Movement, he also eval-
uated the classical diseases, including hepatolenticular 
degeneration (Wilson’s disease), Huntington’s chorea, dys-
tonia musculorum deformans, and Hallerworden-Spatz 
syndrome, among others4. Finally, he presented his experi-
mental lesions of the basal ganglia in monkeys, particu-
larly in the caudate nucleus, putamen, and globus pal-
lidus4. The impressive amount of experimental data 
involving about 450 monkeys, acquired during his lifetime 
and especially during the period after his “retirement” 
from clinical practice (1967), when he worked at the New 
England Regional Primate Research Center, was published 
just before his death in 19812.
It is well known that, for the first time in the world, 
Denny-Brown used the expression “disorders of move-
ment” (nowadays movement disorders), instead extrapy-
ramidal syndromes3,4,9.
CONCLUSION
Even after his death from multiple myeloma, Denny-
Brown’s legacy continued in the memory of his wife Sylvia 
Summerhayes and their four sons, as well as in the annals 
of modern neurology1. He is known as one of the most 
embattled defenders of neurology as a distinct specialty. 
In his famous paper: The Changing Pattern of Neurologic 
Medicine he stated that “…equipped with a special knowl-
edge of the vagaries of neurological disorders and their 
underlying pathology and with a flexibility of investigative 
technique, the neurologist has no difficulty in holding his 
own in a changing world…”10. 
Denny-Brown impressed not only his trainees, who later 
became neurology advocates, but also names like Gordon 
Holmes, who wrote a letter to Denny-Brown in the 1950s 
that read: “I have had many letters of congratulations on my 
80th birthday, but not one pleased me more than that from 
you. Rosalie truthfully said that I became quite emotional in 
reading it. It at least has made me feel that my work at Queen 
Square has not been wasted . . .”1.
129Martinez ARM et al. Derek Denny-Brown
References
1. Foley JM. Derek Denny-Brown, 1901-1981. Ann Neurol. 
1982;11(4):413-9. http://doi.org/10.1002/ana.410110416
2. Vilensky JA, Gilman S. The Denny-Brown collection. Neurology. 
1990;40(10):1636.
3. Denny-Brown D. Diseases of the basal ganglia: their relation 
to disorders of movement. Lancet. 1960;276(7161):1155-62. 
http://doi.org/10.1016/S0140-6736(60)92353-9
4. Denny-Brown D. The basal ganglia and their relation to disorders 
of movement.. London: Oxford University Press; 1962. (Oxford 
Neurological Monographies)
5. Denny-Brown D. Primary sensory neuropathy with muscular 
changes associated with carcinoma. J Neurol Neurosurg Psychiatry. 
1948;11(2):73-87.
6. Vilensky JA, Bell DR, Gilman S. “On the physiology of micturition” 
by Denny-Brown and Robertson: a classic paper revisited. Urology. 
2004;64(1):182-6. http://doi.org/10.1016/S0090-4295(03)00341-8
7. Denny-Brown D. The release of deep pain by nerve injury. Brain. 
1965;88(4):725-8. http://doi.org/10.1093/brain/88.4.725
8. Denny-Brown D, Pennybacker JB. Fibrillation and 
fasciculation in voluntary muscle. Brain. 1938;61(3):311-2. 
http://doi.org/10.1093/brain/61.3.311
9. Denny-Brown D. The nature of dystonia. Bull N YAcad Med. 
1965;41(8):858-69.
10. Denny-Brown D. The changing pattern of neurologic 
medicine. N Engl J Med. 1952;246(22):839-46. 
http://doi.org/10.1056/NEJM195205292462201


Derek Denny-brown: O Homem Por Detrás Dos Gânglios

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