It does take a brain scientist
Neuropathologist provides teens with up-close look at human tissue
transplants
By Linda Bicksler
STAFF WRITER
  As more than 150 students scrutinized the process, Jeffrey Kordower
of Chicago's Rush-Presbyterian Hospital held up thick, pork-chop-style
slabs of the human brain, gesturing toward grayish and whitish areas to
review parts and their functions.

     He pointed to various brain sections: the caudate nucleus, the basal
ganglion, the substantia nigra. Frequently, Kordower explained what the
areas would look like if the patient had a disease.

     "Not only is the brain made up of brain and glutea, but spaces," he
told students. "Spinal fluid flows on the outside, and in the brain as well.
If you jarred your head, it wouldn't be the brain banging against the
skull, causing damage. There would be something to protect it."

     Teens from advanced science and psychology classes at Naperville
Central and Naperville North high schools watched intently, absorbed in
the recent demonstration that also included monkey and rat brains.
     Later, the students had questions. This close to the leading edge of
brain research, the issues can be controversial.

     These future medics, researchers and psychologists came to the
presentation knowing brain research is linked to methods for treating
disease that have been hotly disputed by experts — cloning, fetal cell
transplants and stem cell transplants, to name a few. Kordower, as
director of the Research Center of Brain Repair at Rush-Presbyterian,
heads a team that performs transplants using the brain cells of aborted
fetuses.

     A student's experience with these topics should go beyond forming
an opinion, said Len Hopkins, teacher of an advanced-placement
psychology course at Central. He thinks teens should understand how
the processes work.

     "All the research they've looked at has been researched by someone
else," Hopkins said. "I want them to be critical of that research."

     Hopkins' ultimate goal: to verify the methods used by real scientists.
     Though District 203 teachers already identified sections of the human
brain using a plastic model, some details are visible only on live
specimens, Hopkins said.

     The in-class model, for example, showed the brain's central fissure as
"just another set of squiggly lines," Hopkins said. But on Kordower's
sample brain tissue, students saw the wide, darkened band that crosses
the brain.

     "When (Kordower) said 'What does the temporal lobe do?' and they
said 'Memory' — bingo. That clinched the learning for them," Hopkins
said. "The connection was there."

     Halfway through the presentation, Kordower moved from physiology
of the brain to groundbreaking research. His team has tried a number of
methods to improve the symptoms of people who have diseases that are
caused by a reduced amount of the chemical dopamine in their brains.

     The initial treatment for Parkinson's disease, Kordower said, is a pill.
But the pill solves the problem for only about five to seven years.
Eventually, "the window of opportunity shrinks and shrinks," he said.
The symptoms return, with increasingly harsh side effects.

     Via videotape, students witnessed the effect of planting electrical
transmitter devices into the brains of Parkinson's patients.

     Recently approved by the Food and Drug Administration, this new
procedure costs $20,000 and lasts for eight to 10 years.

     The before and after pictures, caught on film, are striking.

     Before surgery, an elderly man held his arms outward. Both arms
wavered, and his right arm trembled violently. But when doctors turned
on a stimulator that was implanted in his brain, the shaking in his left arm
decreased and his right arm showed no movement at all.

     "You can still see the tremor in the left side," Kordower said. "But do
you see how still the tremor in the right side is?"

     In case after case, the electrode produced faster reflexes, less rigidity
and the ability to walk without assistance. Thirty to 40 percent of
patients "get a really good benefit," Kordower said. "In some cases, it's
more dramatic than we showed you."

     A more controversial method used by Kordower's assistants is
transplanting the brain cells of aborted fetuses into the brains of
patients.

     The use of fetal tissue, Hopkins said, began in the 1980s, a time when
such experimentation was banned in the United States. An odd
coincidence occurred, however, when a Swedish scientist and a
California scientist met on a bus and decided to combine their research.

     Fetal tissue from Sweden was implanted into the brains of young
Californians who developed, by taking a bad strain of heroin, symptoms
identical to those caused by Parkinson's disease. That strain, when
duplicated, became known as MPTP.

     The implantation worked, almost entirely removing the Parkinson's
symptoms. Unlike other methods, "Every time you do a fetal cell graft, it
works," Kordower said.

     "This is where we get interesting, when we discuss these issues,"
Hopkins said. "I asked the kids 'Do you have a problem with this?' Some
of the kids do. Some of the kids don't. Is there an ethical issue? Then it
needs to be discussed."

     Saying he recognizes people's views on abortion differ, Kordower
defended the use of fetal tissue for research.

     But he advocates some limits. Ethical constraints mean a fetus should
never be obtained by sale. Nor should an embryo be grown so that it
can be used as a cadaver in research, he said.

     In fact, Kordower said, transplants using fetal tissue are rare. So far,
just 25 Parkinson's patients have had fetal transplants, though a million
and a half fetuses are aborted in the United States each year, he said.

     Ethical and moral issues aside, another problem with fetal transplants
is the number required for each procedure. Eight fetuses are needed to
treat the brain of one patient. And fetuses are hard to obtain from
clinics, Kordower said.

     Moreover, the number of Parkinson's patients exceed the available
fetuses. But Kordower said he sees the wave of the future not in fetal,
but stem cell transplants, which often rely on genes from an adult's bone
marrow.

     The strange discovery of the drug MPTP enabled scientists to
conduct a new kind of research. When MPTP is inoculated into
monkeys, they develop Parkinson's disease. The ability to experiment on
primates with Parkinson's has led scientists, two decades later, to what
Kordower said may be the forefront of a cure. Using stem cell research,
scientists have located GDNF, a substance that prevents a brain from
losing its dopamine, a natural chemical which acts as a stimulator.

     "I've never seen anything as potent as this," Kordower said. "I think
it's safe and effective. Of all the cures we have thought about or looked
at occurring, I think this is the closest."

     When asked what parts of Kardower's presentation stood out,
students' answers varied.

     "I was surprised to find out that Parkinson's patients sometimes
overdo the medication that they take to mask the effects (of the disease)
— and how determined they are to overcome it," student Patrick Strauf
said.

     "I didn't realize it took that many fetuses to help one patient," said
Amy Butz, a junior.

     No matter their stance on the issues, the students praised the process.

     "In class, the teacher went through the slab, and said, 'This is what
the cerebellum looks like — it's like a little flower,'" junior Jenny Dierdorf
said. "Today, you saw — 'Oh, it really does look like that.' It's amazing to
see it firsthand."

     "To this point, all we've seen are models and sketches," junior Dan
Rickert said. "It's a whole new world when you get to see the real thing."
03/02/01

http://www.copleynewspapers.com/sunpub/naper/city/brain0302.htm

..........................