Sequential bilateral transplantation in Parkinson's disease: effects of the second graft

Peter Hagell, A Schrag, P Piccini, M Jahanshahi, R Brown, Stig Rehncrona, Håkan Widner, Patrik Brundin, J C Rothwell, Per Odin, G K Wenning, P Morrish, B Gustavii, Anders Björklund, D J Brooks, C D Marsden, N P Quinn, Olle Lindvall

Research output: Contribution to journalArticlepeer-review

Abstract

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after their second graft: 'on-off' fluctuations virtually disappeared, movement speed increased, and L-dopa could be withdrawn in one patient and reduced by 70% in the other.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
Pages (from-to)1121-1132
JournalBrain
Volume122
Issue number6
DOIs
Publication statusPublished - 1999

Bibliographical note

The information about affiliations in this record was updated in December 2015.
The record was previously connected to the following departments: Neurobiology (013212024), Neurology, Lund (013027000), Neuronal Survival (013212041), Neurosurgery (013026000), Caring Sciences (Closed 2012) (016514020)

Subject classification (UKÄ)

  • Neurology

Keywords

  • neural grafting
  • Parkinson’s disease
  • dopamine
  • striatum
  • positron emission tomography

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