Blinded positron emission tomography study of dopamine cell implantation for Parkinson's disease

Authors

  • Toshitaka Nakamura MD,

    1. Functional Brain Imaging Laboratory, North Shore-Long Island Jewish Research Institute, Manhasset, NY
    2. Department of Neurology, New York University School of Medicine
    Search for more papers by this author
  • Vijay Dhawan PhD,

    1. Functional Brain Imaging Laboratory, North Shore-Long Island Jewish Research Institute, Manhasset, NY
    2. Department of Neurology, New York University School of Medicine
    Search for more papers by this author
  • Thomas Chaly PhD,

    1. Functional Brain Imaging Laboratory, North Shore-Long Island Jewish Research Institute, Manhasset, NY
    2. Department of Neurology, New York University School of Medicine
    Search for more papers by this author
  • Masafumi Fukuda MD,

    1. Functional Brain Imaging Laboratory, North Shore-Long Island Jewish Research Institute, Manhasset, NY
    2. Department of Neurology, New York University School of Medicine
    Search for more papers by this author
  • Yilong Ma PhD,

    1. Functional Brain Imaging Laboratory, North Shore-Long Island Jewish Research Institute, Manhasset, NY
    2. Department of Neurology, New York University School of Medicine
    Search for more papers by this author
  • Robert Breeze MD,

    1. Department of Neurology, Columbia College of Physicians and Surgeons, New York, NY
    Search for more papers by this author
  • Paul Greene MD,

    1. Department of Neurosurgery and
    Search for more papers by this author
  • Stanley Fahn MD,

    1. Department of Neurosurgery and
    Search for more papers by this author
  • Curt Freed MD,

    1. Neuroscience Center and Division of Clinical Pharmacology and Toxicology, University of Colorado Health Sciences Center, Denver, CO
    Search for more papers by this author
  • David Eidelberg MD

    Corresponding author
    1. Functional Brain Imaging Laboratory, North Shore-Long Island Jewish Research Institute, Manhasset, NY
    2. Department of Neurology, New York University School of Medicine
    • Functional Brain Imaging Laboratory, North Shore-Long Island Jewish Research Institute, 350 Community Drive, Manhasset, NY 11030
    Search for more papers by this author

Abstract

We assessed nigrostriatal dopaminergic function in Parkinson's disease (PD) patients undergoing a double-blind, placebo-controlled surgical trial of embryonic dopamine cell implantation. Forty PD patients underwent positron emission tomography (PET) imaging with [18F]fluorodopa (FDOPA) prior to randomization to transplantation or placebo surgery. The 39 surviving patients were rescanned 1 year following surgery. Images were quantified by investigators blinded to treatment status and clinical outcome. Following unblinding, we determined the effects of treatment status and age on the interval changes in FDOPA/PET signal. Blinded observers detected a significant increase in FDOPA uptake in the putamen of the group receiving implants compared to the placebo surgery patients (40.3%). Increases in putamen FDOPA uptake were similar in both younger (age ≤60 years) and older (age >60 years) transplant recipients. Significant decrements in putamen uptake were evident in younger placebo-operated patients (–6.5% ) but not in their older counterparts. Correlations between the PET changes and clinical outcome were significant only in the younger patient subgroup (r = 0.58). The findings suggest that patient age does not influence graft viability or development in the first postoperative year. However, host age may influence the time course of the downstream functional changes that are needed for clinical benefit to occur.

Ancillary