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Reaction Time and Movement Time After Embryonic Cell Implantation in Parkinson Disease Gordon PH, Yu Q, Qualls C, et al Archives of Neurology. 2004;61(6):858-861 Overview Experimental surgery with neural transplantation has shown great promise in the treatment of Parkinson's disease (PD). The belief is that dopamine produced by cells implanted into the striatum can substitute for the damaged nigrostriatal dopaminergic neurons. Fetal mesencephalic grafts have been shown to re- innervate the striatum, release endogenous dopamine, and restore movement- related frontal-cortical activation. Gordon and colleagues conducted a double-blind, placebo-controlled trial to examine the change in motor performance in patients with PD who received implants and to determine whether the physiologic findings correlated with the clinical outcome measures after the transplantation. Results Reaction time (RT) and movement time (MT) are validated quantitative measures of premovement neural processing and motor execution and were used as objective physiologic markers of motor performance in PD. The study group consisted of 39 patients with PD aged 35-76 years. All completed the embryonic cell-transplantation study (19 underwent sham procedures; 20 underwent implant surgery). The main outcome measures were the combined RT + MT scores measured preoperatively and at 4 and 12 months postoperatively in the "off" state. The results of the study revealed that the difference in mean RT + MT scores between the sham and implant groups was statistically significant (P =. 005) and was greatest in those 60 years or older (P =. 003). The MT correlated with improved Unified Parkinson's Disease Rating Scale (UPDRS) off scores at 4 (r = 0.52, P <. 001) and 12 (r = 0.51, P =. 001) months, and with UPDRS subscores for rigidity and bradykinesia at 4 (r = 0.87, P =. 001) and 12 (r = 0.75, P =. 01) months. Of note, significant deterioration in the sham group at 12 months (P =. 03) was noted and attributed to worsening in subjects 60 years and older (P <. 001). Comment Research with cell transplantation is controversial, but the results of the study revealed quantifiable changes in some patients who underwent embryonic nigral cell implantations for PD. The RT and MT analyses appear to be able to document subtle changes in motor performance over time, making it an invaluable tool for future trials. Abstract SOURCE: Medscape http://www.medscape.com/viewarticle/482330_5 * * * ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn