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Improvement of bilateral motor functions in patients with Parkinson disease through the unilateral intraputaminal infusion of glial cell line-derived neurotrophic factor

SLEVIN, John T ; GERHARDT, Greg A ; SMITH, Charles D ; GASH, Don M ; KRYSCIO, Richard ; YOUNG, Byron

Journal of neurosurgery, 2005-02, Vol.102 (2), p.216-222 [Periódico revisado por pares]

Park Ridge, IL: American Association of Neurological Surgeons

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Título:
Improvement of bilateral motor functions in patients with Parkinson disease through the unilateral intraputaminal infusion of glial cell line-derived neurotrophic factor
Autor: SLEVIN, John T ; GERHARDT, Greg A ; SMITH, Charles D ; GASH, Don M ; KRYSCIO, Richard ; YOUNG, Byron
Assuntos: Aged ; Antiparkinson Agents - administration & dosage ; Biological and medical sciences ; Dominance, Cerebral - drug effects ; Dominance, Cerebral - physiology ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Female ; Gait - drug effects ; Gait - physiology ; Glial Cell Line-Derived Neurotrophic Factor ; Humans ; Infusion Pumps, Implantable ; Male ; Medical sciences ; Middle Aged ; Motor Activity - drug effects ; Motor Activity - physiology ; Nerve Growth Factors - administration & dosage ; Neurosurgery ; Parkinson Disease - diagnosis ; Parkinson Disease - drug therapy ; Parkinson Disease - physiopathology ; Postural Balance - drug effects ; Postural Balance - physiology ; Psychomotor Performance - drug effects ; Psychomotor Performance - physiology ; Putamen - drug effects ; Putamen - physiopathology ; Reaction Time - drug effects ; Reaction Time - physiology ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Treatment Outcome
É parte de: Journal of neurosurgery, 2005-02, Vol.102 (2), p.216-222
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SourceType-Scholarly Journals-1
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Descrição: Glial cell line-derived neurotrophic factor (GDNF) has demonstrated significant antiparkinsonian actions in several animal models and in a recent pilot study in England in which four of five patients received bilateral putaminal delivery. In the present study the authors report on a 6-month unilateral intraputaminal GDNF infusion in 10 patients with advanced Parkinson disease (PD). Patients with PD in a functionally defined on and off state were evaluated 1 week before and 1 and 4 weeks after intraputaminal catheter implantation in the side contralateral to the most affected side. Each patient was placed on a dose-escalation regimen of GDNF: 3, 10, and 30 microg/day at successive 8-week intervals, followed by a 1-month wash-out period. The Unified Parkinson's Disease Rating Scale (UPDRS) total scores in the on and off states significantly improved 34 and 33%, respectively, at 24 weeks compared with baseline scores (95% confidence interval [CI] 18-47% for off scores and 16-51% for on scores). In addition, UPDRS motor scores in both the on and off states significantly improved by 30% at 24 weeks compared with baseline scores (95% CI 15-48% for off scores and 5-61% for on scores). Improvements occurred bilaterally, as measured by balance and gait and increased speed of hand movements. All significant improvements of motor function continued through the wash-out period. The only observed side effects were transient Lhermitte symptoms in two patients. Analysis of the data in this open-label study demonstrates the safety and potential efficacy of unilateral intraputaminal GDNF infusion. Unilateral administration of the protein resulted in significant, sustained bilateral effects.
Editor: Park Ridge, IL: American Association of Neurological Surgeons
Idioma: Inglês

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Improvement of bilateral motor functions in patients with Parkinson disease through the unilateral intraputaminal infusion of glial cell line-derived neurotrophic factor

SLEVIN, John T ; GERHARDT, Greg A ; SMITH, Charles D ; GASH, Don M ; KRYSCIO, Richard ; YOUNG, Byron

Park Ridge, IL: American Association of Neurological Surgeons

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