Quickly some answers:
Fetal tissue transplants:
Curt Freed, MD - University of CO - Denver
Skip Jacquas, MD - Neurosciences Institute - Los Angeles
It is also actively performed in Cuba
Stanley Fahn, MD - Columbia - NYC: Double blind study on FTT
Pallidotomy
It is always wonderful to hear of people getting their freedom back. Each
story brings tears to my eyes. Please continue to tell of experiences with
surgery. Good, Bad or indifferent, we all need to know it.
Who is a good canidate for surgery?
This can vary widely depending on who is doing the surgery and as to any
research protocall that may limit participants General guidelines may be the
following
Good physical health without brain problems such as strokes, severe memory
issues, etc.
Should have Parkinson's Disease and not PD+
As to PD, usually strong dyskinesia can be reduced if tremor is debilitaing,
seek a thallimotomy and not the pallidotomy.
Under some conditons gait and balance can improve. In general, each program
will set requirements for the surgery. General considerations in selecting
program: Experience, experience, experience - there is an art to doing it
right and that takes experience. Talk to people who have had the surgery at
selected center Talk to the staff and surgeon and learn about requirements
Thallimotomy
This is the surgey for debilating tremor only.
Stimulation
Both the pallidotomy and thallimotomy are being tested for use of
stimulators rather than destroying a section of the brain. Early
results look promising. Don Stanstrom is a double stimulator
winner. He had his surgery in Europe.
Future??
I expect pallidotomy and thallimotomy, either direct or stimulation will
be around for some time. Fetal tissue will die due to access to fetal
material. This will be replaced by some form of genetic engineered cells
along with growth factors. The advantages are many.
1. No rejection of transplant due to foreign origin
2. Results of surgery will be experienced almost right away
3. Some restorative value will happen from growth factors
4. Better control of surgery benefits
Lets me just say that I think all the training the neurosurgeons are getting
doing current procedures, will be a great benefit for future surgery for PD.
Finally, depression is a major issue with PD. Do not over look it. It is a
potential killer. It is treatable.
Regards,
Alan Bonander
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