Adrenal medullary transplant to the striatum of patients with advanced Parkinson's disease

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Abstract
We studied motor and psychomotor changes over 1 year after surgery in 7 patients with severe idiopathic Parkinson9s disease (PD) who underwent intrastriatal autologous adrenal medulla transplant. Significant clinical improvements were present 1 year after surgery and primarily involved increased quantity of “on” time and increased quality of “off9 time: “on” time increased from a mean 60.7% of the waking day to 82.7%, and “off9 function improved. In contrast, although “on” function also improved, statistically significant improvement occurred in only 1 measure, the Unified Parkinson9s Disease Rating Scale activities of daily living subscale. Medications did not change, and motor fluctuations persisted. Improvement began several weeks after surgery, was maximal at 4 to 6 months, and was sustained thereafter. There was significant group improvement in quality of life measures of sleep and rest, social isolation, and ambulation. One patient had severe, recurrent depression postoperatively. The efficacy of adrenal transplant surgery is not transient, and specific functional improvements can be prolonged.