Transplantation of Human Fetal Mesencephalic Tissue in Caudate Nucleus as a Treatment for Parkinson′s Disease. Long‐Term Follow‐Up

Molina, H.; Quinones, Ralph; Álvarez, L.; Suárez, Cristina; Ortega, Ignacio Gil; Muñoz, Josep Lluís García; Rachid, Milene Alvarenga; Torres, Oscar V.; León, M.; García, J. A.; Macıás, R.; Lorigados, Lourdes; Perry, Tracy Ann; J, Piedra; González, Carmen; Araújo, F.; Hernandez, Oliva

doi:10.1155/np.1992.323

Cited by 9 publications

(9 citation statements)

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“…For this purpose it is of critical importance to be able to correlate any clinical improvement with the demonstration of a surviving dopaminergic graft. A majority of patients with PD subjected to fetal mesencephalic grafting; have bcen reported t o exhibit improved motor function [9][10][11][12][13][14], but few attempts to show graft survival have been undertaken. Autopsy studies in 2 patients w h o died 1 and 4 months, respectively, after implantation of fetal mesencephalic tissue have been reported to show surviving central nervous system (CNS) tissue; however, n o surviving D A neurons could be identified in the grafts (J. Dymecki, personal communication,…”

mentioning

confidence: 99%

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

Lindvall

Widner²,

Rehncrona³

et al. 1992

Annals of Neurology

341

110

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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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mentioning

confidence: 99%

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

Lindvall

Widner²,

Rehncrona³

et al. 1992

Annals of Neurology

341

110

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“…Intrastriatal transplantation with dopamine-rich fVM tissue was initiated almost three decades ago with the aim of restoring the dopaminergic denervation and neurotransmission deficits in advanced cases with PD. Although some PD cases exhibited remarkable motor function improvement, overall the results were inconclusive and controversial [31][32][33][34]36,40,42,[133][134][135][136][137][138][139][140][141][142][143][144] as a number of patients developed post-operational GIDs, which were present when 'off' their drugs [34,37,[39][40][41][42][43][44]144].…”

Section: Graft-induced Dyskinesiasmentioning

confidence: 99%

Dyskinesias in Parkinson's disease: views from positron emission tomography studies

Niccolini

Loane

Politis

2014

Euro J of Neurology

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Levodopa-induced dyskinesias (LIDs) and graft-induced dyskinesias (GIDs) are serious and common complications of Parkinson's disease (PD) management following chronic treatment with levodopa or intrastriatal transplantation with dopamine-rich foetal ventral mesencephalic tissue, respectively. Positron emission tomography (PET) molecular imaging provides a powerful in vivo tool that has been employed over the past 20 years for the elucidation of mechanisms underlying the development of LIDs and GIDs in PD patients. PET used together with radioligands tagging molecular targets has allowed the functional investigation of several systems in the brain including the dopaminergic, serotonergic, glutamatergic, opioid, endocannabinoid, noradrenergic and cholinergic systems. In this article the role of PET imaging in unveiling pathophysiological mechanisms underlying the development of LIDs and GIDs in PD patients is reviewed.

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“…In PD the putamen is targeted with 4-5 trajectories as described previously (Molina 1992, Mendez 2000. The protocol uses one burr hole (entry point) at the level of the coronal suture (2 cm laterally to the midline).…”

Section: Transplantation In Pdmentioning

confidence: 99%

Clinical neurotransplantation protocol for Huntington's and Parkinson's disease

López

Nikkhah

Kahlert

et al. 2013

Restorative Neurology and Neuroscience

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Purpose: The concept of transplantation of neuronal cells to treat Huntington's and Parkinson's diseases is based on the proven principle that dopaminergic and GABA-ergic progenitor neurons (from the human developing ventral mesencephalon and whole ganglionic eminence) can survive, differentiate and functionally integrate into an allogenic host brain. However, several donor and host-specific variables play a major role in the safety and outcome of this procedure. In this paper, we seek to summarize an updated neural transplantation protocol, based on our institutional experience and many years of collaboration with other neurotransplantation centers. Methods: We present a detailed clinical neurotransplantation protocol for Parkinson's (PD) and Huntington's (HD) diseases with special emphasis in understanding the anatomical relationships of the human fetal tissue that are relevant for selection of the desired cell populations. Results: Two detailed step-wise neurotransplantation protocols are presented, outlining strategies facilitating the avoidance of possible procedure-related complications. Conclusions: In this paper we delineated some crucial technical factors enabling the execution of a safe and effective neural transplantation. The protocols presented here might contribute to further development of the experimental clinical neurotransplantation towards a routine therapeutic procedure.

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Transplantation of Human Fetal Mesencephalic Tissue in Caudate Nucleus as a Treatment for Parkinson′s Disease. Long‐Term Follow‐Up

Cited by 9 publications

References 0 publications

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

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

Dyskinesias in Parkinson's disease: views from positron emission tomography studies

Clinical neurotransplantation protocol for Huntington's and Parkinson's disease

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