Intraputaminal infusion of nerve growth factor to support adrenal medullary autografts in Parkinson's disease. One-year follow-up of first clinical trial
L. Olson, E. O. Backlund, T. Ebendal, R. Freedman, B. Hamberger, P. Hansson, B. Hoffer, U. Lindblom, B. Meyerson, I. Stromberg and al. et
Department of Histology, Karolinska Institutet, Stockholm, Sweden.
Experimental studies in rodents show that beta-nerve growth factor can
increase the survival, neurite outgrowth, and functional effect of grafts
of adrenal chromaffin cells to the basal ganglia. We, therefore, have begun
to investigate whether treatment with nerve growth factor might also
increase the functional effect of autografts of adrenal medullary tissue in
patients with Parkinson's disease. Previous studies have shown that
stereotactic implantation of adrenal tissue pieces produces a transient
functional improvement that lasts for a few months. This report describes a
trial of grafting of adrenal chromaffin tissue into the putamen, supported
by infusion of nerve growth factor. The patient is a 63-year-old woman with
a 19-year history of Parkinson's disease, now complicated by on-off
phenomena and drug-induced hyperkinesia, despite optimized medical
management. The left adrenal gland was removed, and the medulla was
dissected into 1- to 2-mm3 pieces in a solution containing nerve growth
factor purified from mouse submandibular gland. Pieces were implanted in
six tracts 3 to 4 mm from a previously placed cannula in the left putamen.
Through the cannula, nerve growth factor was infused for 23 days for a
total dose of 3.3 mg. Clinical assessment consisted of global ratings for
rigidity and/or hypokinesia and for drug-induced hyperkinesia. Measures of
gait and fine-motor control were also made. The motor readiness potential
and auditory evoked potentials were recorded.(ABSTRACT TRUNCATED AT 250
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