Implantation of human fetal ventral mesencephalon to the right caudate nucleus in advanced Parkinson's disease
B. T. Henderson, C. G. Clough, R. C. Hughes, E. R. Hitchcock and B. G. Kenny
Department of Neurosurgery, University of Birmingham, Midland Centre for Neurosurgery and Neurology, England, United Kingdom.
Disaggregated ventral mesencephalic tissue from single aborted human
fetuses of 11 to 18 weeks' gestation was implanted stereotaxically into a
consistent striatal site in 12 patients with advanced Parkinson's disease.
All were receiving optimum levodopa therapy and were examined
preoperatively and at 3,6,9, and 12 months postoperatively.
Immunosuppression was not used. There were significant sustained
improvements at 12 months in three patients; motor fluctuations were absent
in two. There were modest group improvements up to 6 months, with increased
quality of "on" and "off" phases, quantity of on times, and specific
improvements in contralateral upper limb bradykinesia. Preoperative
levodopa requirements were reduced to a mean of 64% at 6 months and 61% at
12 months. Deterioration below baseline ratings occurred in three of nine
patients who had consistent follow-up to 12 months. Grafting of
midgestational human fetal tissue can lead to improvement in Parkinson's
disease. Individual disease severity may be critical, and further trials
are needed to identify host factors influencing outcome.
