Short- and long-term survival and function of unilateral intrastriatal dopaminergic grafts in Parkinson's disease.

Abstract:

:Six patients with Parkinson's disease were followed for 10 to 72 months after human embryonic mesencephalic tissue from four to seven donors was grafted unilaterally into the putamen (4 patients) or putamen plus caudate (2 patients). After 8 to 12 months, positron emission tomography showed a 68% increase of 6-L-[18F]-fluorodopa uptake in the grafted putamen, no change in the grafted caudate, and minor decreases in nongrafted striatal regions. There was therapeutically valuable improvement in 4 patients, but only modest changes in the other 2, both of whom developed atypical features. Patient 4 was without L-dopa from 32 months and had normal fluorodopa uptake in the grafted putamen at 72 months. Overall, the L-dopa dose was reduced by a mean of 10 and 20%, "off" time was reduced by 34 and 44%, and the "off" phase Unified Parkinson's Disease Rating Scale motor score by 18 and 26%, and the duration of the response to a single L-dopa dose increased by 45 and 58% during the first and second years after surgery, respectively. Rigidity and hypokinesia improved bilaterally, but mainly contralateral to the implant. No consistent changes in dyskinesias were observed. We conclude that transplantation of embryonic mesencephalic tissue leads to highly reproducible survival of dopaminergic neurons, inducing clinically valuable improvements in most recipients.

journal_name

Ann Neurol

journal_title

Annals of neurology

authors

Wenning GK,Odin P,Morrish P,Rehncrona S,Widner H,Brundin P,Rothwell JC,Brown R,Gustavii B,Hagell P,Jahanshahi M,Sawle G,Björklund A,Brooks DJ,Marsden CD,Quinn NP,Lindvall O

doi

10.1002/ana.410420115

subject

Has Abstract

pub_date

1997-07-01 00:00:00

pages

95-107

issue

1

eissn

0364-5134

issn

1531-8249

journal_volume

42

pub_type

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