Thursday, December 4, 2008 - 3:58PM EST

Treatment Options for Parkinson's Disease

Surgical Therapy for Parkinson's Disease

  • Better control of symptoms because placement of the electrode is more accurate
  • Less risk of stroke or hemorrhage

Fetal Tissue Transplantation

Fetal tissue transplantation is an experimental procedure in which fetal brain cells that are rich in dopamine are implanted in the corpus striatum area of the brain. The corpus striatum is involved in motor control and is easier and safer to locate than the substantia nigra which is smaller and deeper in the brain. This procedure is performed to restore dopamine levels in the brain and thus restore the patient to a less advanced stage of Parkinson's disease.

Several hundred fetal cell transplants have been performed with variable outcomes, ranging from no response to significant improvement. The agreed upon aspects of limited improvement include better motor control during "on" and "off" periods, an increase of "on" time, as well as a reduction of rigidity and bradykinesia. Results have been tracked from 6 months to several years. A reduction in the dose of dopamine may follow the surgery.

Fetal tissue transplantation is usually performed bilaterally, either in stages or simultaneously. Since not all fetal cells take effect with the procedure, an oversupply of fetal cells must be transplanted in order to hopefully reach a critical mass of cells that will restore dopamine production. Benefits from the surgery are usually not seen for several months because the cells need time to propagate.

Trials show that the greatest benefit of fetal cell transplantation is in younger Parkinson's disease patients. Because of the risk of rejection of the foreign fetal cells, the patient may be given immunosuppressive drugs indefinitely. The surgery is still considered experimental and the source of fetal cells is controversial for many doctors and patients.

In some patients, fetal tissue transplantation resulted in disabling dyskinesia. The risk of stroke or hemorrhage is approximately 1-3%.

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