Parkinson's Test Fails
Friday, March 9th 2001, 12:00 am
By: News On 6
A new study suggests that transplanting fetal cells into the brains of patients with Parkinson's disease does not benefit people older than 60.
The findings, reported in the New England Journal of Medicine, were so disappointing to the study's lead investigators at Columbia University College of Physicians and Surgeons that they are no longer offering the surgical procedure, said Dr. Stanley Fahn, a neurologist at Columbia overseeing the study. Besides the lack of effectiveness in older patients, researchers were troubled that a larger-than-expected number of patients in the control group, those who did not receive cells, reported feeling better.
The surgery aims to replace damaged dopamine-producing cells, using tissue culled from aborted fetuses. The use of the fetal cells remains controversial.
Dopamine is a neurotransmitter that regulates movement, and having low amounts of it leads to tremors, jerking and slowed movements. It is also involved in mood regulation.
Columbia University joined with scientists at the University of Colorado at Denver in 1993 to begin testing the procedure. Forty patients were enrolled in the study, with half receiving the cell transplants. The others had holes drilled into their skulls but received no transplants. A year later, the second group was given the option of receiving fetal cells, and 14 agreed.
Several problems led scientists to wonder whether the transplants were effective. Dr. David Eidelberg, head of the neuroscience center at North Shore-Long Island Jewish Medical Center, said that 20 percent of those who did not initially receive the cells reported that they felt better, even though their brain scans showed a continued decline. That was an unexpectedly large placebo effect for a surgical procedure, Dr. Eidelberg said.
Although there was evidence of benefit in patients younger than 60, some developed abnormal movements from the transplant itself, Dr. Eidelberg said.
These abnormal movements also occur in some patients on L-dopa, the most common medicine prescribed for Parkinson's. Doctors can decrease the dose of the medicine to alleviate the problem, but they can't reverse the surgery.
"We are hesitant to recommend the surgery," Dr. Eidelberg said.
The study did establish that the cells can be delivered to targeted areas of the brain.