SAFETY OF INTRASTRIATAL NEUROTRANSPLANTATION FOR HUNTINGTONS-DISEASE PATIENTS

Fetal neural transplantation has been shown to be a feasible, safe, an d according to a number of recent reports, effective treatment for Par kinson's disease (PD). Fetal striatal transplantation may be as feasib le, safe, and effective a treatment for Huntington's disease (HD), a d isorder for which there is currently no effective treatment. This repo rt describes our experience with fetal striatal transplantation to adu lt striatum in three HD patients. Three moderately advanced, nondement ed HD patients received transplantation of fetal striatal tissue. The striatal precursor was selectively obtained from the lateral ganglioni c eminence. Each patient received bilateral grafts from five to eight donors, placed into the caudate nucleus (one graft on each side) and t he putamen (four grafts on each side). All three patients had HD as do cumented by family history, DNA heterozygosity (17-20 and 48-51 repeat s), magnetic resonance imaging (MRI) revealing striatal atrophy, and a -deoxyglucose positron emission tomography revealing striatal hypometa bolism. All patients had been evaluated using the Unified Huntington's Disease Rating Scale and appropriate neuropsychological tests for at least 3 months prior to transplantation. One year following transplant ation, MRI of all three patients revealed that the grafts survived and grew within the striatum without displacing the surrounding tissue. N o patients demonstrated adverse effects of the surgery or the associat ed cyclosporin immunosuppression, nor did any patient exhibit deterior ation following the procedure. The limited experience provided by thes e three patients indicates that fetal tissue transplantation can be pe rformed in HD patients without unexpected complications. (C) 1998 Acad emic Press.