Transplantation of Autologous Sympathetic Ganglion into the Brain with Parkinson′s Disease Clinical Trial

We have demonstrated that transplantation of the autologous cervical sympathetic ganglion into the brain ameliorated MPTP-induced parkinsonism in the monkey. According to the encouraging data from this animal model, we have applied this transplantation method to parkinsonian patients. Eight patients (45 59 years, 5 male and 3 female) underwent stereotactic transplantation of the aUtologous stellate ganglion into the unilateral caudate nucleus and putamen. Under local anesthesia a stereotactic frame was fixed to the patient’s head, and the frame and patient’s brain were simultaneously imaged to obtain the coordinates of the target points. Then the stellate ganglion was removed and cut into 100 pieces in a tissue culture solution. The small blocks of the ganglion were stereotaxically transplanted into the head of the caudate nucleus and anterior putamen. One week before transplantation, administration of L-dopa was stopped in all 8 patients. Preand postoperative states of the patients were carefully observed by a neurologist and were scored using the unified parkinsonism rating scale (UPRS), Hoehn & Yahr’s stage and four timed tests. Postoperative courses of the patients were encouraging. Seven out of 8 patients showed amelioration of parkinsonism, but one patient did not. Most patients showed amelioration of gait disturbance and bradykinesia. In contrast, tremor of the 7 patients seemed to be slightly aggravated 2 4 weeks after transplantation. No L-dopa administration was needed in these patients. During follow-up periods from 2 months to 1 year, the seven patients showed gradual and continuous improvement of parkinsonian symptoms, especially gait disturbance and bradykinesia. Unilateral transplantation resulted