P&S Journal: Spring 1994, Vol.14, No.2
Fetal Tissue Transplants
In a discussion with Parkinson's disease patients in early February, Columbia's Dr. Stanley Fahn outlined the details of the country's first NIH-funded trial for therapeutic use of human fetal brain tissue transplants to treat advanced Parkinson's disease.
Until President Clinton took office in January 1993, a moratorium prohibited the use of federal funds for fetal tissue research. The $4.5 million, four-year landmark grant, shared by University of Colorado, Columbia, and North Shore University Hospital-Cornell University Medical Center researchers, is the first federally sponsored study that exploits human fetal tissue since the ban was lifted. Patients or private foundations paid for previous fetal transplant studies.
The 40 patients in the study will be enrolled through the Movement Disorders Clinic of Columbia-Presbyterian Medical Center under the direction of Dr. Fahn, the H. Houston Merritt Professor of Neurology, scientific director of the Parkinson's Disease Foundation, and an internationally recognized expert on Parkinson's disease. Working with Dr. Fahn will be his colleague, Dr. Paul Greene. Patients will be examined both on and off their standard medications to determine the extent of their disease. Researchers will videotape and conduct computer-timed tests of patients' movements.
Patients also will be evaluated by a physician team headed by Dr. David Eidelberg, director of the Cornell Movement Disorders Program at North Shore University Hospital-Cornell University Medical Center on Long Island. The Long Island researchers use positron emission tomography (PET), a brain imaging technique, to measure the function of brain dopamine-producing cells. Because Parkinson's disease results from the death of brain cells that produce dopamine, a chemical that affects body movement, PET scans will be used before and after surgery to detect changes in dopamine production.
After the CPMC and Cornell tests, patients will undergo transplant surgery at the University of Colorado. Fetal cells will be inserted into both sides of the patient's brain. To assess the effects of the transplant, patients will be examined in New York with video and computer testing and in Long Island with PET scans.
This research protocol is unique in that half of the subjects will be randomized to receive a sham surgical procedure, but after 12 months of follow-up evaluations the patients who received sham surgeries will be given the option to receive fetal tissue implants.
Parkinson's disease patients have responded to treatment by drugs, such as L-dopa, but the drugs tend to lose their effectiveness after five to 20 years of use. The fetal tissue implants are intended to replace the lost dopamine-producing cells to restore more normal movement and provide a better response to drug treatments.