Sequential bilateral transplantation in Parkinson's disease. Effects of the second graft

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

DOI

  • P. Hagell, Lunds Universitet
  • ,
  • A. Schrag, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London
  • ,
  • P. Piccini, Hammersmith Hospital
  • ,
  • M. Jahanshahi, Medical Research Council Laboratories
  • ,
  • R. Brown, Medical Research Council Laboratories
  • ,
  • S. Rehncrona, Lunds Universitet
  • ,
  • H. Widner, Lunds Universitet
  • ,
  • P. Brundin, Lunds Universitet
  • ,
  • J. C. Rothwell, Medical Research Council Laboratories
  • ,
  • P. Odin, Lunds Universitet
  • ,
  • G. K. Wenning, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London
  • ,
  • P. Morrish, Hammersmith Hospital
  • ,
  • B. Gustavii, Lund University Hospital
  • ,
  • A. Björklund, Lunds Universitet
  • ,
  • D. J. Brooks
  • C. D. Marsden, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, Medical Research Council Laboratories
  • ,
  • N. P. Quinn, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London
  • ,
  • Olle Lindvall, Lunds Universitet, Lund University Hospital

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after their second graft: 'on-off' fluctuations virtually disappeared, movement speed increased, and L-dopa could be withdrawn in one patient and reduced by 70% in the other.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.

Original languageEnglish
JournalBrain
Volume122
Issue6
Pages (from-to)1121-1132
Number of pages12
ISSN0006-8950
DOIs
Publication statusPublished - 1 Jan 1999
Externally publishedYes

    Research areas

  • Dopamine, Neural grafting, Parkinson's disease, Positron emission tomography, Striatum

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