Jankovic J, Grossman R, Goodman C, Pirozzolo F, Schneider L, Zhu Z, Scardino P, Garber A J, Jhingran S G, Martin S
Department of Neurology, Baylor College of Medicine, Houston, TX 77030.
Neurology. 1989 Sep;39(9):1227-34. doi: 10.1212/wnl.39.9.1227.
We transplanted autologous adrenal medullary tissue into the caudate nucleus of 3 patients with advanced Parkinson's disease. The 1st patient, a 59-year-old man with parkinsonian symptoms for 15 years, had mild improvement in his motor functioning after the operation. However, his postoperative course was characterized by prolonged drowsiness and complex visual hallucinations. The patient died suddenly 8 months after the transplant, and an autopsy revealed coronary atherosclerosis. Examination of the graft site showed necrotic adrenal medullary tissue surrounded by inflammatory cells. The 2nd patient, a 50-year-old man with a 21-year history of parkinsonian symptoms, improved the most after the procedure. The 3rd patient, a 43-year-old man with 12 years of parkinsonian symptoms, had mild improvement in his motor functioning. CSF homovanillic acid increased postoperatively in the 3 patients, but then returned to preoperative levels in all except the 2nd patient. The anatomic, neurochemical, and physiologic basis for the modest clinical improvement shown in these patients is not yet understood.
我们将自体肾上腺髓质组织移植到3例晚期帕金森病患者的尾状核中。第1例患者为一名59岁男性，患有帕金森病症状15年，术后运动功能有轻度改善。然而，他的术后病程特点是嗜睡时间延长和出现复杂的视幻觉。该患者在移植后8个月突然死亡，尸检显示冠状动脉粥样硬化。对移植部位的检查发现坏死的肾上腺髓质组织被炎性细胞包围。第2例患者为一名50岁男性，有21年帕金森病症状病史，术后改善最为明显。第3例患者为一名43岁男性，有12年帕金森病症状，运动功能有轻度改善。3例患者术后脑脊液高香草酸水平均升高，但除第2例患者外，其他患者随后均恢复到术前水平。这些患者所表现出的适度临床改善的解剖学、神经化学和生理学基础尚不清楚。
