Relevant conflicts of interest/financial disclosures: Nothing to report.
Developing dopaminergic cell therapy for Parkinson's disease—give up or move forward?
Article first published online: 11 FEB 2013
Copyright © 2013 Movement Disorder Society
Volume 28, Issue 3, pages 268–273, March 2013
How to Cite
Lindvall, O. (2013), Developing dopaminergic cell therapy for Parkinson's disease—give up or move forward?. Mov. Disord., 28: 268–273. doi: 10.1002/mds.25378
Full financial disclosures and author roles may be found in the online version of this article.
- Issue published online: 21 MAR 2013
- Article first published online: 11 FEB 2013
- Manuscript Accepted: 3 JAN 2013
- Manuscript Revised: 25 DEC 2012
- Manuscript Received: 31 OCT 2012
- Parkinson's disease;
- dopaminergic neurons;
- neural grafts;
- stem cells;
Despite 3 decades of basic and clinical studies, there is still no dopaminergic cell therapy for Parkinson's disease. Several arguments have been put forward why this approach, so far tested with transplantation of human fetal mesencephalic dopamine-rich tissue, will never be of clinical use and should be abandoned: (1) Lack of efficacy in 2 sham surgery-controlled trials; (2) occurrence of troublesome off-medication dyskinesias in a subgroup of grafted patients; (3) disease process destroys grafted neurons; and (4) non-motor symptoms will not be influenced by intrastriatal dopaminergic grafts. Here, the author argues that, based on recent scientific advancements, the development of a dopaminergic cell therapy for Parkinson's disease should continue. Factors influencing the outcome after transplantation have now been identified, and dopaminergic neurons can be generated in large numbers from stem cells. Mechanisms of graft-induced dyskinesias are much better understood, and patients with well functioning grafts can exhibit long-term motor recovery of therapeutic value even in the presence of non-motor symptoms. © 2013 Movement Disorder Society