A double‐blind controlled trial of bilateral fetal nigral transplantation in Parkinson's disease
Identifieur interne : 002E89 ( Main/Exploration ); précédent : 002E88; suivant : 002E90A double‐blind controlled trial of bilateral fetal nigral transplantation in Parkinson's disease
Auteurs : C. Warren Olanow [États-Unis] ; Christopher G. Goetz [États-Unis] ; Jeffrey H. Kordower [États-Unis] ; A. Jon Stoessl [Canada] ; Vesna Sossi [Canada] ; Mitchell F. Brin [États-Unis] ; Kathleen M. Shannon [États-Unis] ; G. Michael Nauert [États-Unis] ; Daniel P. Perl [États-Unis] ; James Godbold [États-Unis] ; Thomas B. Freeman [États-Unis]Source :
- Annals of Neurology [ 0364-5134 ] ; 2003-09.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
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Abstract
Thirty‐four patients with advanced Parkinson's disease participated in a prospective 24‐month double‐blind, placebo‐controlled trial of fetal nigral transplantation. Patients were randomized to receive bilateral transplantation with one or four donors per side or a placebo procedure. The primary end point was change between baseline and final visits in motor component of the Unified Parkinson's Disease Rating Scale in the practically defined off state. There was no significant overall treatment effect (p = 0.244). Patients in the placebo and one‐donor groups deteriorated by 9.4 ± 4.25 and 3.5 ± 4.23 points, respectively, whereas those in the four‐donor group improved by 0.72 ± 4.05 points. Pairwise comparisons were not significant, although the four‐donor versus placebo groups yielded a p value of 0.096. Stratification based on disease severity showed a treatment effect in milder patients (p = 0.006). Striatal fluorodopa uptake was significantly increased after transplantation in both groups and robust survival of dopamine neurons was observed at postmortem examination. Fifty‐six percent of transplanted patients developed dyskinesia that persisted after overnight withdrawal of dopaminergic medication (“off”‐medication dyskinesia). Fetal nigral transplantation currently cannot be recommended as a therapy for PD based on these results.Ann Neurol 2003;54:403–414
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DOI: 10.1002/ana.10720
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Warren" last="Olanow">C. Warren Olanow</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Department of Neurology, Mount Sinai School of Medicine, New York</wicri:cityArea></affiliation><affiliation></affiliation></author><author><name sortKey="Goetz, Christopher G" sort="Goetz, Christopher G" uniqKey="Goetz C" first="Christopher G." last="Goetz">Christopher G. Goetz</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Illinois</region></placeName><wicri:cityArea>Department of Neurological Sciences, Rush Presbyterian Medical Center, Chicago</wicri:cityArea></affiliation></author><author><name sortKey="Kordower, Jeffrey H" sort="Kordower, Jeffrey H" uniqKey="Kordower J" first="Jeffrey H." last="Kordower">Jeffrey H. 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Jon Stoessl</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Pacific Parkinson's Research Centre, University of British Columbia, Vancouver, British Columbia</wicri:regionArea><wicri:noRegion>British Columbia</wicri:noRegion></affiliation></author><author><name sortKey="Sossi, Vesna" sort="Sossi, Vesna" uniqKey="Sossi V" first="Vesna" last="Sossi">Vesna Sossi</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Pacific Parkinson's Research Centre, University of British Columbia, Vancouver, British Columbia</wicri:regionArea><wicri:noRegion>British Columbia</wicri:noRegion></affiliation></author><author><name sortKey="Brin, Mitchell F" sort="Brin, Mitchell F" uniqKey="Brin M" first="Mitchell F." last="Brin">Mitchell F. 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Michael Nauert</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>Department of Neurosurgery, University of South Florida, Tampa</wicri:cityArea></affiliation></author><author><name sortKey="Perl, Daniel P" sort="Perl, Daniel P" uniqKey="Perl D" first="Daniel P." last="Perl">Daniel P. Perl</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Department of Pathology, Mount Sinai School of Medicine, New York</wicri:cityArea></affiliation></author><author><name sortKey="Godbold, James" sort="Godbold, James" uniqKey="Godbold J" first="James" last="Godbold">James Godbold</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York</wicri:cityArea></affiliation></author><author><name sortKey="Freeman, Thomas B" sort="Freeman, Thomas B" uniqKey="Freeman T" first="Thomas B." last="Freeman">Thomas B. Freeman</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>Department of Neurosurgery, University of South Florida, Tampa</wicri:cityArea></affiliation></author></analytic><monogr></monogr><series><title level="j">Annals of Neurology</title><title level="j" type="abbrev">Ann Neurol.</title><idno type="ISSN">0364-5134</idno><idno type="eISSN">1531-8249</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2003-09">2003-09</date><biblScope unit="volume">54</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="403">403</biblScope><biblScope unit="page" to="414">414</biblScope></imprint><idno type="ISSN">0364-5134</idno></series><idno type="istex">A8D3242B12EDFFC644757E93B405B06B1A476637</idno><idno type="DOI">10.1002/ana.10720</idno><idno type="ArticleID">ANA10720</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0364-5134</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Advanced stage</term><term>Catecholamine</term><term>Chemotherapy</term><term>Corpus striatum</term><term>Dopamine</term><term>Dopamine agonist</term><term>Dyskinesia</term><term>Fetal origin</term><term>Homograft</term><term>Human</term><term>Parkinson disease</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Catécholamine</term><term>Chimiothérapie</term><term>Corps strié</term><term>Dopamine</term><term>Dyskinésie</term><term>Homme</term><term>Homogreffe</term><term>Origine foetale</term><term>Parkinson maladie</term><term>Stade avancé</term><term>Stimulant dopaminergique</term><term>Traitement</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Thirty‐four patients with advanced Parkinson's disease participated in a prospective 24‐month double‐blind, placebo‐controlled trial of fetal nigral transplantation. Patients were randomized to receive bilateral transplantation with one or four donors per side or a placebo procedure. The primary end point was change between baseline and final visits in motor component of the Unified Parkinson's Disease Rating Scale in the practically defined off state. There was no significant overall treatment effect (p = 0.244). Patients in the placebo and one‐donor groups deteriorated by 9.4 ± 4.25 and 3.5 ± 4.23 points, respectively, whereas those in the four‐donor group improved by 0.72 ± 4.05 points. Pairwise comparisons were not significant, although the four‐donor versus placebo groups yielded a p value of 0.096. Stratification based on disease severity showed a treatment effect in milder patients (p = 0.006). Striatal fluorodopa uptake was significantly increased after transplantation in both groups and robust survival of dopamine neurons was observed at postmortem examination. Fifty‐six percent of transplanted patients developed dyskinesia that persisted after overnight withdrawal of dopaminergic medication (“off”‐medication dyskinesia). Fetal nigral transplantation currently cannot be recommended as a therapy for PD based on these results.Ann Neurol 2003;54:403–414</div></front></TEI><affiliations><list><country><li>Canada</li><li>États-Unis</li></country><region><li>Floride</li><li>Illinois</li><li>État de New York</li></region></list><tree><country name="États-Unis"><region name="État de New York"><name sortKey="Olanow, C Warren" sort="Olanow, C Warren" uniqKey="Olanow C" first="C. Warren" last="Olanow">C. Warren Olanow</name></region><name sortKey="Brin, Mitchell F" sort="Brin, Mitchell F" uniqKey="Brin M" first="Mitchell F." last="Brin">Mitchell F. Brin</name><name sortKey="Freeman, Thomas B" sort="Freeman, Thomas B" uniqKey="Freeman T" first="Thomas B." last="Freeman">Thomas B. Freeman</name><name sortKey="Godbold, James" sort="Godbold, James" uniqKey="Godbold J" first="James" last="Godbold">James Godbold</name><name sortKey="Goetz, Christopher G" sort="Goetz, Christopher G" uniqKey="Goetz C" first="Christopher G." last="Goetz">Christopher G. Goetz</name><name sortKey="Kordower, Jeffrey H" sort="Kordower, Jeffrey H" uniqKey="Kordower J" first="Jeffrey H." last="Kordower">Jeffrey H. Kordower</name><name sortKey="Nauert, G Michael" sort="Nauert, G Michael" uniqKey="Nauert G" first="G. Michael" last="Nauert">G. Michael Nauert</name><name sortKey="Perl, Daniel P" sort="Perl, Daniel P" uniqKey="Perl D" first="Daniel P." last="Perl">Daniel P. Perl</name><name sortKey="Shannon, Kathleen M" sort="Shannon, Kathleen M" uniqKey="Shannon K" first="Kathleen M." last="Shannon">Kathleen M. Shannon</name></country><country name="Canada"><noRegion><name sortKey="Stoessl, A Jon" sort="Stoessl, A Jon" uniqKey="Stoessl A" first="A. Jon" last="Stoessl">A. Jon Stoessl</name></noRegion><name sortKey="Sossi, Vesna" sort="Sossi, Vesna" uniqKey="Sossi V" first="Vesna" last="Sossi">Vesna Sossi</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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