Autotransplantation of human carotid body cell aggregates for treatment of Parkinson's disease

• Published in: Neurosurgery Vol. 53; no. 2; pp. 321 - 330
• Main Authors: Arjona, Ventura, Mínguez-Castellanos, Adolfo, Montoro, Rafael J, Ortega, Angel, Escamilla, Francisco, Toledo-Aral, Juan José, Pardal, Ricardo, Méndez-Ferrer, Simón, Martín, José M, Pérez, Miguel, Katati, Majed J, Valencia, Eduardo, García, Teresa, López-Barneo, José
• Format: Journal Article
• Language: English
• Published: United States 01-08-2003
• Subjects: Basal Ganglia - physiopathology; Basal Ganglia - surgery; Carotid Body - physiopathology; Carotid Body - transplantation; Cell Aggregation - physiology; Feasibility Studies; Female; Follow-Up Studies; Humans; Male; Middle Aged; Outcome Assessment (Health Care); Parkinson Disease - physiopathology; Parkinson Disease - surgery; Pilot Projects; Recovery of Function - physiology; Time Factors; Transplantation, Autologous
• ISSN: 0148-396X
• DOI: 10.1227/01.neu.0000073315.88827.72

In this study, we assessed the feasibility of autotransplantation of carotid body (CB) cell aggregates into the striatum for the treatment of patients with Parkinson's disease (PD).
Six patients with advanced PD underwent bilateral autotransplantation of CB cell aggregates into the striatum. They were evaluated clinically preoperatively and for 18 months after surgery according to the recommendations of the Core Assessment Program for Intracerebral Transplantation.
No major complications or adverse events resulted from the cell implantation or surgical procedures. During the course of the study, there was no significant aggravation of dyskinesia or decline in cognitive function in any of the patients. Five of the six patients who underwent transplantation manifested a measurable degree of clinical improvement evidenced by standardized clinical rating scales for PD. A decrease in the blinded Unified Parkinson's Disease Rating Scale Part III in the "off" state, the main measure of transplant efficacy in our study, was found to be maximal (between 26 and 74%) at 6 months after surgery. At 1 year, clear reductions in the blinded Unified Parkinson's Disease Rating Scale Part III were maintained in three patients (24, 38, and 52%, respectively). Modest improvement was seen in two patients (13 and 17%), and the sole patient who showed no improvement had the most fibrosis in the CB. The age of the patient and the state of the CB tissue were adversely correlated with clinical improvement after CB autotransplantation.
This pilot study indicates that CB autograft transplantation is a relatively simple, safe, and viable therapeutical approach for the treatment of patients with advanced PD. More studies are needed to optimize the procedure and to assess its general applicability for the treatment of patients with PD.