Document Detail


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.
MedLine Citation:
PMID:  2786405     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
O Lindvall; S Rehncrona; P Brundin; B Gustavii; B Astedt; H Widner; T Lindholm; A Bj?rklund; K L Leenders; J C Rothwell; R Frackowiak; D Marsden; B Johnels; G Steg; R Freedman; B J Hoffer; A Seiger; M Bygdeman; I Str?mberg; L Olson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of neurology     Volume:  46     ISSN:  0003-9942     ISO Abbreviation:  Arch. Neurol.     Publication Date:  1989 Jun 
Date Detail:
Created Date:  1989-07-07     Completed Date:  1989-07-07     Revised Date:  2010-04-14    
Medline Journal Info:
Nlm Unique ID:  0372436     Medline TA:  Arch Neurol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  615-31     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurology, University of Lund, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Contingent Negative Variation
Corpus Striatum / physiopathology*,  radionuclide imaging
Dopamine / metabolism*
Female
Fetus
Follow-Up Studies
Humans
Levodopa / diagnostic use
Methods
Middle Aged
Movement
Nerve Tissue / cytology,  embryology*
Neurologic Examination
Neurons / metabolism,  transplantation*
Neuropsychological Tests
Parkinson Disease / physiopathology,  therapy*
Self Concept
Tomography, Emission-Computed
Chemical
Reg. No./Substance:
0/Levodopa

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


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