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Transplantation of fetal dopamine neurons in Parkinson's disease : one-year clinical and neurophysiological observations in two patients with putaminal implants

Lindvall, O LU ; Widner, H LU ; Rehncrona, S LU ; Brundin, P LU ; Odin, P LU ; Gustavii, B LU ; Frackowiak, R S; Leenders, K L; Sawle, G V and Rothwell, J C (1992) In Annals of Neurology 31(2). p.65-155
Abstract

Ventral mesencephalic tissue from aborted human fetuses (age, 6-7 weeks' postconception) was implanted unilaterally into the putamen using stereotaxic surgery in 2 immunosuppressed patients (Patients 3 and 4 in our series) with advanced idiopathic Parkinson's disease. Tissue from 4 fetuses was grafted to each patient. Compared with our previous 2 patients, the following changes in the grafting procedure were introduced: the implantation instrument was thinner, more tissue was placed in the operated structure, and the time between abortion and grafting was shorter. There were no postoperative complications. Both patients showed a gradual and significant amelioration of parkinsonian symptoms (most marked in Patient 3) starting at 6 and 12... (More)

Ventral mesencephalic tissue from aborted human fetuses (age, 6-7 weeks' postconception) was implanted unilaterally into the putamen using stereotaxic surgery in 2 immunosuppressed patients (Patients 3 and 4 in our series) with advanced idiopathic Parkinson's disease. Tissue from 4 fetuses was grafted to each patient. Compared with our previous 2 patients, the following changes in the grafting procedure were introduced: the implantation instrument was thinner, more tissue was placed in the operated structure, and the time between abortion and grafting was shorter. There were no postoperative complications. Both patients showed a gradual and significant amelioration of parkinsonian symptoms (most marked in Patient 3) starting at 6 and 12 weeks after grafting, respectively, reaching maximum stability at approximately 4 to 5 months; patients remained relatively stable thereafter during the 1-year follow-up period. Clinical improvement was observed as a reduction of the time spent in the "off" phase and the number of daily "off" periods; a lessening of bradykinesia and rigidity during the "off" phase, mainly but not solely on the side contralateral to the graft; and a prolongation and change in the pattern of the effect of a single dose of L-dopa. Neurophysiological measurements revealed a more rapid performance of simple and complex arm and hand movements bilaterally, but primarily contralateral to the graft. The results indicate that patients with Parkinson's disease can show significant and sustained improvement of motor function after intrastriatal implantation of fetal dopamine-rich mesencephalic tissue. The accompanying paper by Sawle and colleagues describes the results of repeated positron emission tomography scans in these patients.

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organization
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Contribution to journal
publication status
published
subject
keywords
Combined Modality Therapy, Dopamine, Fetal Tissue Transplantation, Humans, Levodopa, Male, Mesencephalon, Middle Aged, Parkinson Disease, Putamen, Treatment Outcome, Case Reports, Journal Article, Research Support, Non-U.S. Gov't
in
Annals of Neurology
volume
31
issue
2
pages
65 - 155
publisher
John Wiley and Sons Inc.
external identifiers
  • scopus:0026584525
ISSN
0364-5134
DOI
10.1002/ana.410310206
language
English
LU publication?
yes
id
7d87da55-9b7b-4525-9333-61a9b7ccaec9
date added to LUP
2017-04-19 18:31:20
date last changed
2017-06-22 13:46:19
@article{7d87da55-9b7b-4525-9333-61a9b7ccaec9,
  abstract     = {<p>Ventral mesencephalic tissue from aborted human fetuses (age, 6-7 weeks' postconception) was implanted unilaterally into the putamen using stereotaxic surgery in 2 immunosuppressed patients (Patients 3 and 4 in our series) with advanced idiopathic Parkinson's disease. Tissue from 4 fetuses was grafted to each patient. Compared with our previous 2 patients, the following changes in the grafting procedure were introduced: the implantation instrument was thinner, more tissue was placed in the operated structure, and the time between abortion and grafting was shorter. There were no postoperative complications. Both patients showed a gradual and significant amelioration of parkinsonian symptoms (most marked in Patient 3) starting at 6 and 12 weeks after grafting, respectively, reaching maximum stability at approximately 4 to 5 months; patients remained relatively stable thereafter during the 1-year follow-up period. Clinical improvement was observed as a reduction of the time spent in the "off" phase and the number of daily "off" periods; a lessening of bradykinesia and rigidity during the "off" phase, mainly but not solely on the side contralateral to the graft; and a prolongation and change in the pattern of the effect of a single dose of L-dopa. Neurophysiological measurements revealed a more rapid performance of simple and complex arm and hand movements bilaterally, but primarily contralateral to the graft. The results indicate that patients with Parkinson's disease can show significant and sustained improvement of motor function after intrastriatal implantation of fetal dopamine-rich mesencephalic tissue. The accompanying paper by Sawle and colleagues describes the results of repeated positron emission tomography scans in these patients.</p>},
  author       = {Lindvall, O and Widner, H and Rehncrona, S and Brundin, P and Odin, P and Gustavii, B and Frackowiak, R S and Leenders, K L and Sawle, G V and Rothwell, J C},
  issn         = {0364-5134},
  keyword      = {Combined Modality Therapy,Dopamine,Fetal Tissue Transplantation,Humans,Levodopa,Male,Mesencephalon,Middle Aged,Parkinson Disease,Putamen,Treatment Outcome,Case Reports,Journal Article,Research Support, Non-U.S. Gov't},
  language     = {eng},
  number       = {2},
  pages        = {65--155},
  publisher    = {John Wiley and Sons Inc.},
  series       = {Annals of Neurology},
  title        = {Transplantation of fetal dopamine neurons in Parkinson's disease : one-year clinical and neurophysiological observations in two patients with putaminal implants},
  url          = {http://dx.doi.org/10.1002/ana.410310206},
  volume       = {31},
  year         = {1992},
}