A long term follow-up of fetal dopaminergic neurons transplantation into the brain of three parkinsonian patients

Abstract

In three parkinsonian patients ages 48, 53, and 50, human fetal dopaminergic cells taken from the ventral part of mesencephalon of 11-12-week-old fetuses were implanted into the head of caudate nucleus. The operation was carried out with a specially designed device to enable safe and precise graft implantation. All patients had been suffering from severe Parkinson's disease for about 10-15 years (stage 4/5 according to Hoehn and Yahr scale) with bradykinesia, rigidity and tremor as the main symptoms. Long-lasting L-dopa therapy resulted in side effects with ON/OFF syndrome and dyskinesias. A detailed clinical examination was performed before and every 3 months after the operation according to the CAPIT battery of standarized tests. The patients were under post-operational observation lasting 30, 20 and 12 months, respectively. Improvement was observed in all patients starting between 3 and 6 months after operation and is still sustained. Significant increases in movement speed for repeated pronation-supination, finger dexterity and foot lifting tests were found. The speed of walking also increased with decreased rigidity. The OFF phase during the day is of shorter duration and less severe; dyskinesias are markedly reduced. Our results indicate that fetal grafting seems to be a valuable experimental approach towards the treatment of selected parkinsonian patients.