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Stereotaxic Implantation of Autologous Adrenal Medulla Into Caudate Nucleus in Parkinsonism, One-Year Follow-up
Arch Neurol 48:813-820, Fazzini,E.,et al, 1991
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Article Abstract
Four patients with levodopa-responsive parkinsonism(aged 26,35,45 and 49 years)received autologous adrenal medullary implants into or near the left caudate nucleus by stereotaxic implantation after flank adrenalectomy.All patients had an immediate response to implantation lasting several days, during which parkinsonian signs and symptoms decreased.This period was followed by a gradual reappearance of symptoms in all but one patient.This patient had had a dramatic increase in"on"time without dyskinesias and a decrease in the severity and duration of"off"time.He died of multifocal glioblastoma 1 year after transplantation.Autopsy revealed no surviving adrenal cells.In one case,the stereotaxic implantation missed the basal ganglia,resulting in the placement of the adrenal medullary tissue into the median thalamus and near the third ventricle;the patient did not improve.In the other two cases,a modest but definite increase in"on"time without dyskinesia and a reduction in the severity and duration of"off" time has been observed.The role of autologous adrenal medullary transplantation in patients with parkinsonism remains to be determined. Patients with a family history of cerebral malignancy may be at increased risk for the development of transplant-induced malignancy.
 
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adrenal medullary tissue
brain transplantation
glioblastoma multiforme(astrocytoma Gr.III)
neoplasm,primary of CNS
Parkinson disease
Parkinson disease,surgical treatment of
Parkinson disease,treatment of
stereotaxic surgery
treatment of neurologic disorder

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