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Sequential bilateral transplantation in Parkinson's disease: effects of the second graft

Hagell, Peter LU ; Schrag, A; Piccini, P; Jahanshahi, M; Brown, R; Rehncrona, Stig LU ; Widner, Håkan LU ; Brundin, Patrik LU ; Rothwell, J C and Odin, Per LU , et al. (1999) In Brain 122(6). p.1121-1132
Abstract
Five parkinsonian patients who had received implants of human embryonic mesencephalic tissue unilaterally in the striatum 10-56 months earlier were grafted with tissue from four to eight donors into the putamen (four patients) or the putamen plus the caudate nucleus (one patient) on the other side, and were followed for 18-24 months. After 12-18 months, PET showed a mean 85% increase in 6-L-[18F]fluorodopa uptake in the putamen with the second graft, whereas there was no significant further change in the previously transplanted putamen. Two patients exhibited marked additional improvements after their second graft: 'on-off' fluctuations virtually disappeared, movement speed increased, and L-dopa could be withdrawn in one patient and... (More)
Five parkinsonian patients who had received implants of human embryonic mesencephalic tissue unilaterally in the striatum 10-56 months earlier were grafted with tissue from four to eight donors into the putamen (four patients) or the putamen plus the caudate nucleus (one patient) on the other side, and were followed for 18-24 months. After 12-18 months, PET showed a mean 85% increase in 6-L-[18F]fluorodopa uptake in the putamen with the second graft, whereas there was no significant further change in the previously transplanted putamen. Two patients exhibited marked additional improvements after their second graft: 'on-off' fluctuations virtually disappeared, movement speed increased, and L-dopa could be withdrawn in one patient and reduced by 70% in the other. The improvement in one patient was moderate. Two patients with atypical features, who responded poorly to the first graft, worsened following the second transplantation. These findings indicate that sequential transplantation in patients does not compromise the survival and function of either the first or the second graft. Moreover, putamen grafts that restore fluorodopa uptake to normal levels can give improvements of major therapeutic value. (Less)
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Contribution to journal
publication status
published
subject
keywords
neural grafting, Parkinson’s disease, dopamine, striatum, positron emission tomography
in
Brain
volume
122
issue
6
pages
1121 - 1132
publisher
Oxford University Press
external identifiers
  • pmid:10356064
  • scopus:0032692348
ISSN
1460-2156
DOI
10.1093/brain/122.6.1121
language
English
LU publication?
yes
id
34c0957e-8abe-4244-9645-8dfd6bd43a4e (old id 1114613)
date added to LUP
2008-07-04 14:27:17
date last changed
2017-11-05 03:31:12
@article{34c0957e-8abe-4244-9645-8dfd6bd43a4e,
  abstract     = {Five parkinsonian patients who had received implants of human embryonic mesencephalic tissue unilaterally in the striatum 10-56 months earlier were grafted with tissue from four to eight donors into the putamen (four patients) or the putamen plus the caudate nucleus (one patient) on the other side, and were followed for 18-24 months. After 12-18 months, PET showed a mean 85% increase in 6-L-[18F]fluorodopa uptake in the putamen with the second graft, whereas there was no significant further change in the previously transplanted putamen. Two patients exhibited marked additional improvements after their second graft: 'on-off' fluctuations virtually disappeared, movement speed increased, and L-dopa could be withdrawn in one patient and reduced by 70% in the other. The improvement in one patient was moderate. Two patients with atypical features, who responded poorly to the first graft, worsened following the second transplantation. These findings indicate that sequential transplantation in patients does not compromise the survival and function of either the first or the second graft. Moreover, putamen grafts that restore fluorodopa uptake to normal levels can give improvements of major therapeutic value.},
  author       = {Hagell, Peter and Schrag, A and Piccini, P and Jahanshahi, M and Brown, R and Rehncrona, Stig and Widner, Håkan and Brundin, Patrik and Rothwell, J C and Odin, Per and Wenning, G K and Morrish, P and Gustavii, B and Björklund, Anders and Brooks, D J and Marsden, C D and Quinn, N P and Lindvall, Olle},
  issn         = {1460-2156},
  keyword      = {neural grafting,Parkinson’s disease,dopamine,striatum,positron emission tomography},
  language     = {eng},
  number       = {6},
  pages        = {1121--1132},
  publisher    = {Oxford University Press},
  series       = {Brain},
  title        = {Sequential bilateral transplantation in Parkinson's disease: effects of the second graft},
  url          = {http://dx.doi.org/10.1093/brain/122.6.1121},
  volume       = {122},
  year         = {1999},
}