CLINICAL-STUDY OF FETAL MESENCEPHALIC INTRACEREBRAL TRANSPLANTS FOR THE TREATMENT OF PARKINSONS-DISEASE

This study reports our findings from 22 patients (ages ranging from 42 to 73 yr; mean = 55.2) with recalcitrant idiopathic Parkinson's disea se (PD) who received implants of fetal ventral mesencephalic tissue us ing an MRI-guided stereotactic procedure and who have been followed fo r at least 6 mo postoperatively, employing the guidelines established by the Core Assessment Program for Intracerebral Transplantations. Eva luations were videotaped and were performed both on and off levodopa m edications, 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 fo und: 1) mean levodopa levels were reduced 46% at 6 mo, 12% at 12 mo, 2 0% at 18 mo, and 54% at 24 mo; 2) Unified Parkinson's Disease Rating S cale (UPDRS) scores with patients on levodopa were improved by an aver age of 38% (6 mo), 50.2% (12 mo), 69.3% (18 mo), and 73.9% (24 mo), wh ile off medication scores showed reductions ranging from 24.7% at 6 mo to 55.1% at 24 mo, Other measures, including Hoehn-Yahr staging, Acti vities of Daily Living, and dyskinesia rating scales, were also signif icantly improved following fetal transplants, Timed motor tasks (finge r dexterity, supination-pronation, foot tapping, and Stand-Walk-Sit) p erformance also demonstrated highly significant improvements, Patient' s self-rating scores indicated that the patients typically perceived s ubstantial improvements in their condition, However, substantial varia bility in the improvements following surgery still persists and range from nominal improvements in performance to significant changes that c an be classified as altering the overall lifestyle of the patients, To date, 4 of the 22 subjects were considered by the physicians to be no nresponders; that is, there were no clinically relevant improvements i n these patients' conditions.