Clinical Study of Fetal Mesencephalic Intracerebral Transplants for the Treatment of Parkinson's Disease
This study reports our findings from 22 patients (ages ranging from 42 to 73 yr; mean = 55.2) with recalcitrant idiopathic Parkinson's disease (PD) who received implants of fetal ventral mesencephalic tissue using an MRI-guided stereotactic procedure and who have been followed for at least 6 mo...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
1996-03-01
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| Series: | Cell Transplantation |
| Online Access: | https://doi.org/10.1177/096368979600500221 |
| _version_ | 1819042542553923584 |
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| author | Oleg V. Kopyov Ph.D., M.D. Deane “Skip” Jacques Abraham Lieberman Christopher M. Duma Robert L. Rogers |
| author_facet | Oleg V. Kopyov Ph.D., M.D. Deane “Skip” Jacques Abraham Lieberman Christopher M. Duma Robert L. Rogers |
| author_sort | Oleg V. Kopyov Ph.D., M.D. |
| collection | DOAJ |
| description | This study reports our findings from 22 patients (ages ranging from 42 to 73 yr; mean = 55.2) with recalcitrant idiopathic Parkinson's disease (PD) who received implants of fetal ventral mesencephalic tissue using an MRI-guided stereotactic procedure and who have been followed for at least 6 mo postoperatively, employing the guidelines established by the Core Assessment Program for Intracerebral Transplantations. Evaluations were videotaped and were performed both on and off levodopa medications. To date, we have seven patients with 24 mo, three with 18 mo, three with 12 mo, and nine with 6 mo of postsurgical assessments. Comparing surgical outcomes to levels prior to fetal transplants we found: 1) mean levodopa levels were reduced 46% at 6 mo, 12% at 12 mo, 20% at 18 mo, and 54% at 24 mo; 2) Unified Parkinson's Disease Rating Scale (UPDRS) scores with patients on levodopa were improved by an average of 38% (6 mo), 50.2% (12 mo), 69.3% (18 mo), and 73.9% (24 mo), while off medication scores showed reductions ranging from 24.7% at 6 mo to 55.1% at 24 mo. Other measures, including Hoehn-Yahr staging, Activities of Daily Living, and dyskinesia rating scales, were also significantly improved following fetal transplants. Timed motor tasks (finger dexterity, supination-pronation, foot tapping, and Stand-Walk-Sit) performance also demonstrated highly significant improvements. Patient's self-rating scores indicated that the patients typically perceived substantial improvements in their condition. However, substantial variability in the improvements following surgery still persists and range from nominal improvements in performance to significant changes that can be classified as altering the overall lifestyle of the patients. To date, 4 of the 22 subjects were considered by the physicians to be nonresponders; that is, there were no clinically relevant improvements in these patients' conditions. |
| first_indexed | 2024-12-21T09:42:33Z |
| format | Article |
| id | doaj.art-566d75cf4c594fc5809d0ac5448a3f3a |
| institution | Directory Open Access Journal |
| issn | 0963-6897 1555-3892 |
| language | English |
| last_indexed | 2024-12-21T09:42:33Z |
| publishDate | 1996-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Cell Transplantation |
| spelling | doaj.art-566d75cf4c594fc5809d0ac5448a3f3a2022-12-21T19:08:25ZengSAGE PublishingCell Transplantation0963-68971555-38921996-03-01510.1177/096368979600500221Clinical Study of Fetal Mesencephalic Intracerebral Transplants for the Treatment of Parkinson's DiseaseOleg V. Kopyov Ph.D., M.D.0Deane “Skip” Jacques1Abraham Lieberman2Christopher M. Duma3Robert L. Rogers4Neurosciences Institute, Good Samaritan Hospital, Los Angeles, CA 90017 USANeurosciences Institute, Good Samaritan Hospital, Los Angeles, CA 90017 USABarrow Neurological Institute, Phoenix, AZ USANeurosciences Institute, Good Samaritan Hospital, Los Angeles, CA 90017 USANeurosciences Institute, Good Samaritan Hospital, Los Angeles, CA 90017 USAThis study reports our findings from 22 patients (ages ranging from 42 to 73 yr; mean = 55.2) with recalcitrant idiopathic Parkinson's disease (PD) who received implants of fetal ventral mesencephalic tissue using an MRI-guided stereotactic procedure and who have been followed for at least 6 mo postoperatively, employing the guidelines established by the Core Assessment Program for Intracerebral Transplantations. Evaluations were videotaped and were performed both on and off levodopa medications. To date, we have seven patients with 24 mo, three with 18 mo, three with 12 mo, and nine with 6 mo of postsurgical assessments. Comparing surgical outcomes to levels prior to fetal transplants we found: 1) mean levodopa levels were reduced 46% at 6 mo, 12% at 12 mo, 20% at 18 mo, and 54% at 24 mo; 2) Unified Parkinson's Disease Rating Scale (UPDRS) scores with patients on levodopa were improved by an average of 38% (6 mo), 50.2% (12 mo), 69.3% (18 mo), and 73.9% (24 mo), while off medication scores showed reductions ranging from 24.7% at 6 mo to 55.1% at 24 mo. Other measures, including Hoehn-Yahr staging, Activities of Daily Living, and dyskinesia rating scales, were also significantly improved following fetal transplants. Timed motor tasks (finger dexterity, supination-pronation, foot tapping, and Stand-Walk-Sit) performance also demonstrated highly significant improvements. Patient's self-rating scores indicated that the patients typically perceived substantial improvements in their condition. However, substantial variability in the improvements following surgery still persists and range from nominal improvements in performance to significant changes that can be classified as altering the overall lifestyle of the patients. To date, 4 of the 22 subjects were considered by the physicians to be nonresponders; that is, there were no clinically relevant improvements in these patients' conditions.https://doi.org/10.1177/096368979600500221 |
| spellingShingle | Oleg V. Kopyov Ph.D., M.D. Deane “Skip” Jacques Abraham Lieberman Christopher M. Duma Robert L. Rogers Clinical Study of Fetal Mesencephalic Intracerebral Transplants for the Treatment of Parkinson's Disease Cell Transplantation |
| title | Clinical Study of Fetal Mesencephalic Intracerebral Transplants for the Treatment of Parkinson's Disease |
| title_full | Clinical Study of Fetal Mesencephalic Intracerebral Transplants for the Treatment of Parkinson's Disease |
| title_fullStr | Clinical Study of Fetal Mesencephalic Intracerebral Transplants for the Treatment of Parkinson's Disease |
| title_full_unstemmed | Clinical Study of Fetal Mesencephalic Intracerebral Transplants for the Treatment of Parkinson's Disease |
| title_short | Clinical Study of Fetal Mesencephalic Intracerebral Transplants for the Treatment of Parkinson's Disease |
| title_sort | clinical study of fetal mesencephalic intracerebral transplants for the treatment of parkinson s disease |
| url | https://doi.org/10.1177/096368979600500221 |
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