Human fetal dopamine neurons grafted into the striatum in two patients with severe Parkinson's disease. A detailed account of methodology and a 6-month follow-up
O. Lindvall, S. Rehncrona, P. Brundin, B. Gustavii, B. Astedt, H. Widner, T. Lindholm, A. Bjorklund, K. L. Leenders, J. C. Rothwell and al. et
Department of Neurology, University of Lund, Sweden.
By using stereotaxic surgical techniques, ventral mesencephalic tissues
from aborted human fetuses of 8 to 10 weeks' gestational age were implanted
unilaterally into the striata in two patients with advanced Parkinson's
disease. The patients were treated with a cyclosporine, azathioprine, and
steroid regimen to minimize the risk for graft rejection. They were
examined for 6 months preoperatively and 6 months postoperatively and
continued to receive the same doses of antiparkinsonian medication. There
were no significant postoperative complications. No major therapeutic
effect from the operation was observed. However, in the clinical tests,
both patients showed small but significant increases of movement speed for
repeated pronation-supination, fist clenching, and foot lifting. The rate
of walking also increased in the one patient tested. For both patients,
there was an initial worsening postoperatively, followed by improvement vs
preoperative performance at 1 to 3 months. Both patients also showed
significant improvement in the magnitude of response to a single dose of
levodopa (L-dopa), but there was no increase in the duration of drug
action. The motor readiness potential increased in both patients
postoperatively, primarily over the operated hemisphere. Neurophysiological
measurements also showed a more rapid performance of simple and complex arm
and hand movements on the side contralateral to transplantation in one
patient at 5 months postoperatively. Positron emission tomography
demonstrated no increased uptake of 6-L-(18F)-fluorodopa in the
transplanted striatum at 5 and 6 months. Taken together, these results
suggest that the fetal nigral implants may have provided a modest
improvement in motor function, consistent with the presence of small
surviving grafts. Although our results support further scientific
experimentation with transplantation in Parkinson's disease, widespread
clinical trials with this procedure are probably not warranted at this
time.
Factors affecting the clinical outcome after neural transplantation in Parkinson's disease
Piccini et al.
Brain 2005;128:2977-2986.
ABSTRACT
| FULL TEXT
Between truth and hope: on Parkinson's disease, neurotransplantation and the production of the 'self'
Moreira and Palladino
History of the Human Sciences 2005;18:55-82.
ABSTRACT
Cognition following bilateral implants of embryonic dopamine neurons in PD: A double blind study
Trott et al.
Neurology 2003;60:1938-1943.
ABSTRACT
| FULL TEXT
Enhancement of Sensorimotor Behavioral Recovery in Hemiparkinsonian Rats with Intrastriatal, Intranigral, and Intrasubthalamic Nucleus Dopaminergic Transplants
Mukhida et al.
J. Neurosci. 2001;21:3521-3530.
ABSTRACT
| FULL TEXT
Embryonic ventral mesencephalic grafts improve levodopa-induced dyskinesia in a rat model of Parkinson's disease
Lee et al.
Brain 2000;123:1365-1379.
ABSTRACT
| FULL TEXT
Bilateral caudate and putamen grafts of embryonic mesencephalic tissue treated with lazaroids in Parkinson's disease
Brundin et al.
Brain 2000;123:1380-1390.
ABSTRACT
| FULL TEXT
Transplantation of embryonic porcine mesencephalic tissue in patients with PD
Schumacher et al.
Neurology 2000;54:1042-1050.
ABSTRACT
| FULL TEXT
Evaluation of surgery for Parkinson's disease: A Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology
Hallett and Litvan
Neurology 1999;53:1910-1910.
FULL TEXT
Sequential bilateral transplantation in Parkinson's disease: Effects of the second graft
Hagell et al.
Brain 1999;122:1121-1132.
ABSTRACT
| FULL TEXT
Long-term Evaluation of Bilateral Fetal Nigral Transplantation in Parkinson Disease
Hauser et al.
Arch Neurol 1999;56:179-187.
ABSTRACT
| FULL TEXT
Understanding Parkinson Disease
Cummings
JAMA 1999;281:376-378.
FULL TEXT
Grafts of fetal dopamine neurons survive and improve motor function in Parkinson's disease
Lindvall et al.
Science 1990;247:574-577.
ABSTRACT
