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, Patrik 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.
(Less)
- author
- Lindvall, O
LU
; Widner, H
LU
; Rehncrona, S
LU
; Brundin, Patrik
LU
; Odin, P
LU
; Gustavii, B
LU
; Frackowiak, R S
; Leenders, K L
; Sawle, G V
and Rothwell, J C
- organization
- publishing date
- 1992-02
- type
- 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 & Sons Inc.
- external identifiers
-
- scopus:0026584525
- pmid:1575454
- 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
- 2024-03-31 06:21:05
@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, Patrik 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}},
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}},
language = {{eng}},
number = {{2}},
pages = {{65--155}},
publisher = {{John Wiley & 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}},
doi = {{10.1002/ana.410310206}},
volume = {{31}},
year = {{1992}},
}