Lindvall O, Sawle G, Widner H, Rothwell J C, Björklund A, Brooks D, Brundin P, Frackowiak R, Marsden C D, Odin P
Department of Neurology, University of Lund, Sweden.
Ann Neurol. 1994 Feb;35(2):172-80. doi: 10.1002/ana.410350208.
Two patients with idiopathic Parkinson's disease (Patients 3 and 4 in our series) were followed up to 3 years after grafting of human embryonic dopamine-rich mesencephalic tissue unilaterally into the putamen. During the first postoperative year both patients showed significant amelioration of parkinsonian symptoms and increased 6-L-[18F]-fluorodopa uptake in the grafted putamen, as assessed with positron emission tomography. Three years after grafting the patients still exhibited increased fluorodopa uptake in the grafted putamen and significant clinical improvements, evidenced by a reduction of the severity of symptoms and of the time spent in the "off" phase, and by a prolongation of the effect of a single dose of L-dopa. Between 1 and 3 years after surgery, Patient 3 showed only minor changes of parkinsonian symptoms on the side contralateral to the graft, whereas there was a worsening on the ipsilateral side. Fluorodopa uptake decreased in the nongrafted putamen but was unchanged in the grafted putamen. Patient 4 continued to improve after the first postoperative year and L-dopa was withdrawn after 32 months. The reduction of parkinsonian symptoms on the side contralateral to the graft became more pronounced between 1 and 3 years after surgery. Fluorodopa uptake further increased in the grafted putamen, whereas no change was detected on the non-grafted side. These results indicate that grafts of embryonic dopamine neurons can survive, grow, and exert functional effects up to at least 3 years after surgery in the parkinsonian brain, despite an ongoing disease process leading to degeneration of the intrinsic dopamine system.
两名特发性帕金森病患者（我们系列中的患者3和患者4）在将富含多巴胺的人胚胎中脑组织单侧植入壳核后接受了3年的随访。术后第一年，两名患者的帕金森症状均有显著改善，正电子发射断层扫描显示，植入的壳核中6-L-[18F]-氟多巴摄取增加。移植后三年，患者移植的壳核中氟多巴摄取仍然增加，临床症状有显著改善，表现为症状严重程度降低、“关”期时间缩短，以及单剂量左旋多巴的效果延长。术后1至3年期间，患者3移植对侧的帕金森症状仅有轻微变化，而同侧症状则有所恶化。未移植的壳核中氟多巴摄取减少，但移植的壳核中则无变化。患者4术后第一年持续改善，32个月后停用左旋多巴。术后1至3年期间，移植对侧的帕金森症状减轻更为明显。移植的壳核中氟多巴摄取进一步增加，而未移植侧未检测到变化。这些结果表明，尽管存在导致内源性多巴胺系统退化的持续疾病过程，但胚胎多巴胺神经元移植在帕金森病大脑中术后至少3年内能够存活、生长并发挥功能作用。
