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Fundamental pathological and neuro—chemical changes in Parkinson's disease are loss of midbrain dopamine neurons that innervate the cau—date and putamen.In an effort to replenish the stria—tal dopaminergic innervation, fetal mesencephalic tissue containing dopamine cells was implanted into the unilateral putamen in two patients with severe Parkinson's disease.
The tissue was obtained from three fetuses with gestational ages of 7 to 9 weeks.The cell suspen—sion was stereotactically injected into the unilateral putamen using 5 needle trajectories.Postoperative immune suppression was not performed.
Clinical improvement appeared after 2 months. Both patients showed improvement according to the Activities of Daily Living Scale during the off and practically-defined off state 9 and 14 months after surgery. The motor scores of the Unified Parkin-son's Disease Rating Scale improved during the off and practically-defined off state 9 and 14 months af-ter surgery. Dyskinesia and off state were shorter and less severe than before the transplantation. Although the long-term effects need to be ascer-tained, our short-term observation in these two pa-tients with unilateral transplantation is encouraging and justifies further research trials in selected pa-tients.
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