Transplantation of human fetal dopamine cells for Parkinson's disease. Results at 1 year
C. R. Freed, R. E. Breeze, N. L. Rosenberg, S. A. Schneck, T. H. Wells, J. N. Barrett, S. T. Grafton, S. C. Huang, D. Eidelberg and D. A. Rottenberg
Department of Medicine, University of Colorado Health Sciences Center, Denver 80262.
In an effort to improve the clinical signs of Parkinson's disease, we have
implanted mesencephalic dopamine cells from a 7-week human embryo into the
caudate and putamen of a 52-year-old man with Parkinson's disease. Fetal
tissue was obtained from elective abortion. The woman and the patient with
Parkinson's disease were unknown to each other. The woman gave specific
consent and was not paid. The patient had a 20-year history of parkinsonism
treated with multiple drug therapies including levodopa/carbidopa (Sinemet)
every 2 1/2 hours. His symptoms were worse on the left side. For 5 months
prior to transplantation, the patient underwent clinical evaluations by
both a neurologist and a computer system installed in his home for daily
measurement of walking and hand movements. Preoperative positron emission
tomographic scanning with 6-L[18F]fluorodopa (fluorodopa) demonstrated
severe dopamine depletion bilaterally. Fetal tissue was matched to the
patient for ABO blood antigens, and maternal serum was screened for
hepatitis B and human immunodeficiency virus type 1 prior to surgery. Fetal
tissue was implanted stereotactically throughout the caudate and putamen on
the right side of the brain via 10 needle tracks. The patient was not
immunosuppressed. Results 12 months after surgery showed 42% improvement in
left-hand speed before the first morning dose of drug and 40% greater
response to drug therapy. Right-hand speed increased 15% before drug
therapy and 23% after drug therapy. Reaction time was unaffected. Walking
speed increased 33% after drug administration, although walking speed
before the first morning dose of drugs declined 40%. Walking speed on an
all-day basis improved 17%.(ABSTRACT TRUNCATED AT 250 WORDS)
