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Graft-induced dyskinesias in Parkinson's disease: High striatal serotonin/dopamine transporter ratio

Authors

  • Marios Politis MD, PhD,

    Corresponding author
    1. Centre for Neuroscience, Division of Experimental Medicine, Faculty of Medicine, Hammersmith Hospital, Imperial College London, London, United Kingdom
    2. Clinical Sciences Center, Medical Research Council, Hammersmith Hospital, Imperial College London, London, United Kingdom
    • Cyclotron Building, Hammersmith Hospital, Imperial College London, London W12 0NN, UK
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  • Wolfgang H. Oertel MD, PhD,

    1. Department of Neurology, Philipps-University, Marburg, Germany
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  • Kit Wu MRCP,

    1. Centre for Neuroscience, Division of Experimental Medicine, Faculty of Medicine, Hammersmith Hospital, Imperial College London, London, United Kingdom
    2. Clinical Sciences Center, Medical Research Council, Hammersmith Hospital, Imperial College London, London, United Kingdom
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  • Niall P. Quinn MD,

    1. Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, Queen Square, London, United Kingdom
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  • Oliver Pogarell MD,

    1. Department of Psychiatry, Ludwig-Maximilian-University of Munich, Munich, Germany
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  • David J. Brooks MD, DSc, FRCP, FMedSci,

    1. Centre for Neuroscience, Division of Experimental Medicine, Faculty of Medicine, Hammersmith Hospital, Imperial College London, London, United Kingdom
    2. Clinical Sciences Center, Medical Research Council, Hammersmith Hospital, Imperial College London, London, United Kingdom
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  • Anders Bjorklund PhD,

    1. Neurobiology Unit, Wallenberg Neuroscience Center, Lund, Sweden
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  • Olle Lindvall MD, PhD,

    1. Laboratory of Neurogenesis and Cell Therapy, Wallenberg Neuroscience Center, Lund, Sweden
    2. Lund Stem Cell Center, Lund, Sweden
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  • Paola Piccini MD, PhD, FRCP

    1. Centre for Neuroscience, Division of Experimental Medicine, Faculty of Medicine, Hammersmith Hospital, Imperial College London, London, United Kingdom
    2. Clinical Sciences Center, Medical Research Council, Hammersmith Hospital, Imperial College London, London, United Kingdom
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  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • Full financial disclosures and author roles may be found in the online version of this article.

Abstract

Graft-induced dyskinesias are a serious complication after neural transplantation in Parkinson's disease. One patient with Parkinson's disease, treated with fetal grafts 14 years ago and deep brain stimulation 6 years ago, showed marked improvement of motor symptoms but continued to suffer from OFF-medication graft-induced dyskinesias. The patient received a series of clinical and imaging assessments. Positron emission tomography and single-photon emission computed tomography 14 years posttransplantation revealed an elevated serotonin/dopamine transporter ratio in the grafted striatum compatible with serotonergic hyperinnervation. Inhibition of serotonin neuron activity by systemic administration of a 5-HT1A agonist suppressed graft-induced dyskinesias. Our data provide further evidence that serotonergic neurons mediate graft-induced dyskinesias in Parkinson's disease. Achieving a normal striatal serotonin/dopamine transporter ratio following transplantation of fetal tissue or stem cells should be necessary to avoid the development of graft-induced dyskinesias. © 2011 Movement Disorder Society

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