Health-related quality of life following bilateral intrastriatal transplantation in Parkinson's disease

Intrastriatal transplantation of embryonic dopaminergic tissue is a new, ex perimental approach for the treatment of Parkinson's disease CPD. Clinical trials have shown longterm graft survival and therapeutically valuable impr ovements with decreased L-dopa dose and time spent in the "off"-phase, and reduced rigidity and hypokinesia. We have measured health-related quality o f life (HRQoL) using the Nottingham Health profile (NHP) in five patients s ubjected to bilateral transplantation in the caudate and putamen to explore the influence of intrastriatal grafts on HRQoL and the value of such measu res in trials of restorative therapies. The results demonstrate improved HR QoL following transplantation, with individual patients showing striking im provements within different dimensions of the NHP as well as the NHP distre ss index (NHPD). The most pronounced improvements after grafting were obser ved for physical mobility along with emotional reactions and energy. These results indicate that intrastriatal transplantation of embryonic dopaminerg ic tissue can give rise to improvements within most areas of HRQoL, and tha t HRQoL measurements provide important information additional to that obtai ned by traditional, symptom-oriented assessment protocols. However, the opt imal approach to HRQoL measurement in PD remains to be determined.