Fetal Brain Cell Implants Aid Patients.

• Position: Brief Article

In the first double-blind, placebo-controlled surgical trial testing the safety and effectiveness of fetal dopamine cell implantation for the treatment of Parkinson's disease, many patients who received the implants showed growth of the new brain cells and improvement in their symptoms. Compared to patients who received the placebo operation, transplanted patients were better able to move and perform other activities before taking their daily medications.

There was a great deal of variability in the transplant outcome, so the benefit for any individual patient was unpredictable. When patients were grouped by age, those under 60 benefited, while those over 60 did not. "The results of the placebo-controlled study are critical for guiding our research on improving cell transplantation as a treatment for Parkinson's disease," notes Curt Freed, director of the Division of Clinical Pharmacology and Toxicology, University of Colorado Health Sciences Center, Denver. "We are now testing ways to produce a more uniform response and to understand why older patients are more resistant to the effects of the transplant," he explains.

"While placebo-controlled drug trials have long been the gold standard to test the value of a new drug, only a few placebo-controlled surgical trials have been conducted," indicates Stanley Fahn, director of the Center for Parkinson's Disease and Other Movement Disorders, Columbia Presbyterian Center of New York Presbyterian Hospital. "In Parkinson's disease, about 30% of patients feel better after getting a placebo drug. We found that some patients who had placebo surgery did feel their Parkinson's disease had improved."

Half of the patients had fetal cells implanted in four locations in their brains through a surgical procedure performed under local anesthesia. Patients in the other group had a similar procedure, in which holes were drilled in their skulls...