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Delayed recovery of movement‐related cortical function in Parkinson's disease after striatal dopaminergic grafts
Author(s) -
Piccini Paola,
Lindvall Olle,
Björklund Anders,
Brundin Patrik,
Hagell Peter,
Ceravolo Roberto,
Oertel Wolfgang,
Quinn Niall,
Samuel Michael,
Rehncrona Stig,
Widner Håkan,
Brooks David J.
Publication year - 2000
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/1531-8249(200011)48:5<689::aid-ana1>3.0.co;2-n
Subject(s) - dopaminergic , parkinson's disease , neuroscience , dopamine , positron emission tomography , psychology , transplantation , medicine , disease
Intrastriatal transplantation of dopaminergic neurones aims to repair the selective loss of nigrostriatal projections and the consequent dysfunction of striatocortical circuitries in Parkinson's disease (PD). Here, we have studied the effects of bilateral human embryonic dopaminergic grafts on the movement‐related activation of frontal cortical areas in 4 PD patients using H 2 15 O positron emission tomography and a joystick movement task. At 6.5 months after transplantation, mean striatal dopamine storage capacity as measured by 18 F‐dopa positron emission tomography was already significantly elevated in these patients. This was associated with a modest clinical improvement on the Unified Parkinson's Disease Rating Scale, whereas the impaired cortical activation was unchanged. At 18 months after surgery, there was further significant clinical improvement in the absence of any additional increase in striatal 18 F‐dopa uptake. Rostral supplementary motor and dorsal prefrontal cortical activation during performance of joystick movements had significantly improved, however. Our data suggest that the function of the graft goes beyond that of a simple dopamine delivery system and that functional integration of the grafted neurones within the host brain is necessary to produce substantial clinical recovery in PD. Ann Neurol 2000;48:689–695