 |
 |
----- Original Message ----- From: "WE MOVE" <[log in to unmask]> To: <[log in to unmask]> Sent: Monday, June 19, 2000 3:21 PM Subject: Long-term Outcomes in PD Fetal Transplants (MovDis Congress 2000) > E-MOVE reports from the 6th International Congress of Parkinson's Disease > and Movement Disorders, held in Barcelona, Spain, 11-15 June 2000. > Citation numbers refer to abstract numbers published in Movement Disorders > 2000;15 (Supplement 3). > > Double-blind controlled trial of embryonic dopaminergic tissue transplants > in advanced Parkinson's disease > S Fahn > M114 > > Fetal transplants for Parkinson's disease can lead to modest improvement > in motor scores for younger patients, but at the risk of unpredictable and > disabling dyskinesias, according to this platform presentation by Dr. > Stanley Fahn. Fahn presented results from a double-blind study and > long-term, open-label continuation. > > Forty patients were randomized to receive either fetal implants or sham > surgery. Results at one year showed significant, modest motor improvements > as determined by "off" UPDRS scores, in patients younger than age 60, with > the majority of improvement in rigidity and bradykinesia. Older patients > did no show significant improvement. "Freezing and gait did not improve, > and if anything, they got worse in older patients," Fahn said. Two thirds > of operated patients, but no sham patients, showed improved PET scans of > the putamen, which was correlated with motor improvements in young, but > not old, patients. Acute significant adverse events were statistically > significantly higher in operated patients, but not related to the > procedure, according to Fahn. One patient who died due to accidental > injury in a storm showed about 5% cell survival on autopsy. > > Following the breaking of the blind, 14 sham-operated patients received > open-label implantation. Analysis of all operated patients with follow-up > of 16-36 months showed younger patients continue to improve. Older > patients have shown some improvement, "but follow-up lengths are still > short, and there is also no more blind," noted Fahn. Nine of 33 operated > patients report being better than before surgery. > > However, Fahn went on to report the late emergence of unexpected, > disabling "off" period dyskinesias in 4 patients. Patients have shown arm > and leg dyskinesias that interfere with activities of daily living and > walking, as well as facial dystonia. Some patients had difficulty > swallowing, with one requiring a gastrostomy tube. "These patients are not > on medicines, but are still having dyskinesias. We've never seen that > before in Parkinson's disease," Fahn said. > > Fahn concluded, "We've established the proof of principle, that > bradykinesia and rigidity can be helped with surgery. However, we did not > anticipate these "runaway dyskinesias," and if I knew they were going to > occur, I would not have done the study. Until we can figure out how to > prevent or control them in animal studies, I can't recommend this > procedure." > > Copyright 2000 WE MOVE > Editor: Richard Robinson ([log in to unmask]) > > This service is provided free of charge to the Internet community, > courtesy of WEMOVE.org. This document may be freely redistributed by > email only in its unedited form. We encourage you to share it with your > colleagues. > > E-MOVE archives, plus information on subscribing, are > available at http://www.wemove.org/emove. > To unsubscribe, send an e-mail to [log in to unmask], > with "unsubscribe e-move" in the message body. > > E-MOVE is a service of WE MOVE (Worldwide Education and Awareness for > Movement Disorders) > 204 West 84th Street > New York, NY 10024 > > TEL 800-437-MOV2 > TEL 212-875-8312 > FAX 212-875-8389 > http://www.wemove.org