Document Detail


Effect of fetal neural transplants in patients with Huntington's disease 6 years after surgery: a long-term follow-up study.
MedLine Citation:
PMID:  16545746     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although we have shown in three out of five patients with Huntington's disease that motor and cognitive improvements 2 years after intracerebral fetal neural grafts are correlated with recovery of brain metabolic activity in grafted striatal areas and connected regions of the cerebral cortex, neural grafts are not known to have protective effects on the host brain per se. We undertook long-term follow-up of previously reported patients with the disease to ascertain the nature and extent of any secondary decline after grafting.
METHODS: Five patients with Huntington's disease from our pilot study were assessed annually with the unified Huntington's disease rating scale, neuropsychological tests, and MRI, for up to 6 years after neural grafting. Resting cerebral activity was recorded at 2 and 6 years.
FINDINGS: Clinical improvement plateaued after 2 years and then faded off variably 4-6 years after surgery. Dystonia deteriorated consistently, whereas chorea did not. Cognitive performance remained stable on non-timed tests, whereas progression of motor disability was shown by deterioration on timed tests. Hypometabolism also affected the brain heterogeneously, sparing the benefits in the frontal cortex and at the precise location of the grafts, but showing a progressive deterioration in other areas. Two patients who had no benefit from grafting at 2 years continued to decline in the same way as non-grafted patients.
INTERPRETATION: Neuronal transplantation in Huntington's disease provides a period of several years of improvement and stability, but not a permanent cure for the disease. Improvement of the surgical procedure and in patient selection could improve the therapeutic value, but neuroprotective treatment seems to be unavoidable in the disease.
Authors:
Anne-Catherine Bachoud-Lévi; Véronique Gaura; Pierre Brugières; Jean-Pascal Lefaucheur; Marie-Françoise Boissé; Patrick Maison; Sophie Baudic; Maria-Joao Ribeiro; Catherine Bourdet; Philippe Remy; Pierre Cesaro; Philippe Hantraye; Marc Peschanski
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Lancet. Neurology     Volume:  5     ISSN:  1474-4422     ISO Abbreviation:  Lancet Neurol     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-03-20     Completed Date:  2006-05-09     Revised Date:  2014-08-15    
Medline Journal Info:
Nlm Unique ID:  101139309     Medline TA:  Lancet Neurol     Country:  England    
Other Details:
Languages:  eng     Pagination:  303-9     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Brain Tissue Transplantation / methods*
Cognition / physiology
Disability Evaluation
Embryo, Mammalian
Fetal Tissue Transplantation / methods*
Humans
Huntington Disease / physiopathology,  surgery*
Longitudinal Studies
Magnetic Resonance Imaging / methods
Middle Aged
Motor Activity / physiology
Neurons / physiology*
Neuropsychological Tests / statistics & numerical data
Pilot Projects
Retrospective Studies
Severity of Illness Index
Time Factors
Treatment Outcome
Comments/Corrections
Comment In:
Lancet Neurol. 2006 Apr;5(4):284-5   [PMID:  16545739 ]
Lancet Neurol. 2007 Jan;6(1):7-8   [PMID:  17166790 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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