Neural transplantation (auto-adrenal, fetal nigral and fetal adrenal) in Parkinson's disease: The Mexican experience

Department of Neurosurgery, Centro Medico La Raza, Mexico City, Mexico.
DOI: 10.1016/S0079-6123(08)62649-7 In book: Progress in Brain Research, pp.593-602


This chapter examines neural transplantation in Parkinson's disease (PD). In the study described in the chapter, 34 male and 8 female PD patients were selected for surgery. They had at least 3 of the 4 major PD symptoms, a Unified Parkinsonism Rating Scale (UPRS) score of less than 120 points in the “off” condition, a 50% response to L-dopa treatment for at least 3 hours, and a respiratory restriction because of rigidity during “off” of less than 40%. Using the same surgical technique in all cases, 39 patients received grafts to the right caudate nucleus (CN) and 3 to the left caudate, because of right sided predominance of the disease. An Ommaya-like reservoir was placed in 15 patients for ventricular fluid sampling. The statistical analyses of the clinical data were done with the Student's paired t test, the Wilcoxon's test for paired samples, and Rankit's normal order statistics. Neuropsychological data were analyzed using the Mann–Whitney U-test. Biochemical data were analyzed using student's t-test, student's paired t-test, and the analysis of variance (ANOVA) test. Biochemical assessments led to the identification of a neurite outgrowth promoting activity (NOPA).

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    • "The techniques for transplanting fetal tissue have been, either open microsurgery (Madrazo et al., 1990; Molina et al., 1992) or stereotactic (Freed et al., 1990, 1992; Hitchcock et al., 1990; Lindvall et al., 1990). Fetal tissue in all cases was obtained from elective abortions (Table II). "
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    ABSTRACT: 1. Parkinson's disease (PD) is a neurodegenerative disorder caused by the loss of neurons in the substantia nigra pars compacta and a striatal deficiency of dopamine. PD typically affects people in late middle age and progresses slowly. In the early stages of the disease, treatment targeting the dopaminergic network is effective. However, with disease progression, transplantation is an option for repairing and replacing missing dopaminergic neurons. 2. In this review, we evaluate the tissue grafts and cellular therapies that have and are being considered. Clinical trials were originally derived from transplants of adrenal medullary chromaffin cells and embryonic nigral dopaminergic neurons in patients with PD. 3. Recently, novel molecular and cellular treatments are being utilized in animals and these include embryonic stem cells, fetal cells from pigs, or transfected cells. In spite of new molecular techniques and some 20 years of experience, the transplantation therapy for PD has today the same problems and results as the first reports which used neural fetal tissue or adrenal grafts.
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