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Blinded positron emission tomography study of dopamine cell implantation for Parkinson's disease
Author(s) -
Nakamura Toshitaka,
Dhawan Vijay,
Chaly Thomas,
Fukuda Masafumi,
Ma Yilong,
Breeze Robert,
Greene Paul,
Fahn Stanley,
Freed Curt,
Eidelberg David
Publication year - 2001
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/ana.1075
Subject(s) - putamen , medicine , positron emission tomography , placebo , parkinson's disease , dopaminergic , transplantation , clinical trial , randomization , nuclear medicine , dopamine , surgery , disease , pathology , alternative medicine
We assessed nigrostriatal dopaminergic function in Parkinson's disease (PD) patients undergoing a double‐blind, placebo‐controlled surgical trial of embryonic dopamine cell implantation. Forty PD patients underwent positron emission tomography (PET) imaging with [ 18 F]fluorodopa (FDOPA) prior to randomization to transplantation or placebo surgery. The 39 surviving patients were rescanned 1 year following surgery. Images were quantified by investigators blinded to treatment status and clinical outcome. Following unblinding, we determined the effects of treatment status and age on the interval changes in FDOPA/PET signal. Blinded observers detected a significant increase in FDOPA uptake in the putamen of the group receiving implants compared to the placebo surgery patients (40.3%). Increases in putamen FDOPA uptake were similar in both younger (age ≤60 years) and older (age >60 years) transplant recipients. Significant decrements in putamen uptake were evident in younger placebo‐operated patients (–6.5% ) but not in their older counterparts. Correlations between the PET changes and clinical outcome were significant only in the younger patient subgroup ( r = 0.58). The findings suggest that patient age does not influence graft viability or development in the first postoperative year. However, host age may influence the time course of the downstream functional changes that are needed for clinical benefit to occur.