|Volume 6 Issue 180 Published - 14:00 UTC 08:00 EST 28-Jun-2004 Next Update - 14:00 UTC 08:00 EST 29-Jun-2004||Editor: Susan K. Boyer, RN
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Procedure may boost motor skills in Parkinson disease patients
Patients with Parkinson disease (PD) who underwent treatment involving embryonic cell implantation had better motor functioning after their procedures than PD patients who did not receive embryonic cells, according to an article in the June issue of The Archives of Neurology, one of the JAMA/Archives journals.
According to information in the article, PD is a neurodegenerative disorder without a known cause or cure. Embryonic nigral cell implantation places dopamine producing cells from embryos (called nigral cells) into the brains of patients with PD, whose own nigral cells no longer produce normal levels of dopamine. Lack of dopamine, a neurochemical involved in movement, is what causes the characteristic unsteady movements many patients with PD experience. Reaction time (RT) scores and motor time (MT) scores measure neural processing and can be used to assess motor functioning in patients with PD. These scores indicate the time it takes a patient to process a command and act on it – for example, touching a screen when prompted. Lower RT and MT scores are typical of patients with PD compared to patients without PD.
Paul H. Gordon, M.D., of NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, and colleagues measured changes in motor performance in patients (aged 35 to 76) with PD who received embryonic cell implants (n=20) and patients who had the surgery but received no embryonic cells (n=19). RT and MT measurements were taken before surgery, and at four and 12 months after surgery. Patients did not take any dopamine-boosting medications within 12 hours before the RT and MT evaluations.
The researchers found that the difference in average combined RT and MT scores between the sham surgery and implant groups was statistically significant and was greatest in those 60 years or older.
“The physiological measures detected significant changes in patients undergoing embryonic nigral cell implants and correlated directly with clinical outcome measures,” the researchers write.
“The greatest differences between sham and implant surgery data were due to worsening in the sham group, presumably reflecting ongoing neurodegeneration in PD, or possibly stabilization in the group receiving implants,” the authors write. “The deterioration in patients who received sham surgery was greatest in patients 60 years and older.”
(Arch Neurol. 2004;61:858-861. Available post-embargo at http://archneurol.com)
Editorial: Positive Potential of Fetal Nigral Implants for Parkinson Disease
In an accompanying editorial, Roger N. Rosenberg, M.D., Editor of The Archives of Neurology, writes that although the findings of Gordon et al were modest, “These documented changes of physiologic benefit recorded in their article do indicate that there are objective markers of motor behavior that were altered for the better with embryonic tissue implantation in patients with PD.”
Dr. Rosenberg writes that “The current information provided by present studies provide an important beginning and basis to design new genomic approaches. Gordon et al in this issue of the ARCHIVES build on the prior observations of Freed et al and Olanow et al in showing that small but definite improvements do occur with embryonic neural implants.”
He concludes: “The challenge now is to build on these nascent findings through genetic and genomic studies. I believe these will provide important insights into neural circuit patterning and formation and will lead to highly specific and effective new genomic-based therapies.”