Brain Transplant: An End To Parkinsonism?

3815 words - 16 pages

The Modern Day Brain Transplant:An End to Parkinsonism or the Beginning of a Greater Debate?

It sometimes begins with a feeling of lethargy, being "down in the dumps," or shakiness (1). Maybe it begins with a twitch of the pinky finger that was not there before. Speech becomes more difficult and softer to the level of a whisper; this is often accompanied by irritability. Movements become rigid, unsteady and slow (2). A tremor develops, with trembling of the hands, arms, legs, jaw, and face. Later, walking is often only accomplished through short and shuffling steps, intermixed with a loss of balance and instability (3). These symptoms usually progress until the person is incapacitated ...view middle of the document...

The standard treatment is to prescribe levodopa (L-dopa) (4), the precursor of dopamine to patients. This is given because dopamine itself does not cross the blood-brain barrier. The levodopa is converted to dopamine inside the brain and is effective in improving the severity of symptoms dramatically. Unfortunately, long-term usage of levodopa causes a myriad of side effects, such as head bobbing, grimacing, abnormal movements of the trunk and limbs (2). With time, the side effects of levodopa become more dramatic than the original Parkinson's and the thus outweigh the benefits of giving the drug. Other treatments include a brain "pacemaker," deep brain stimulation with electrodes, and pallidotomy (destroying a portion of the globus pallidus in the brain). The research on neural transplantation as a method of treating Parkinsonism has recently been at the forefront of the media (5).

These neural cell transplants are not the brain transplants of 1950s horror movies nor is cell therapy a new concept. For decades researches have been implanting fetal neural tissue as a possible answer to illnesses such as diabetes, Alzheimer's, and Huntington's diseases (2). In the 1980s, successes in reducing Parkinson's symptoms in animals by transplanting fetal cells inspired researchers to do human clinical trials (6). However, due to an eight-year ban on this type of research by Presidents Reagan and Bush, the research was suspended, but resumed in 1993 with the coming of the Clinton administration (6).

The rationale behind fetal tissue transplants is that isolating and transplanting fetal dopamine-producing neurons into the putamen and caudate nucleus will cause these neurons to establish connections with other parts of the brain and will replace the cells originally lost. In theory, these new cells would begin to produce their own dopamine and increase the level of dopamine in the system bringing it back to normal (2). The brain tissue is usually obtained from immature fetuses whose mothers have undergone elective abortion. Tissues from the appropriate region are then transplanted into the Parkinson patient. The surgery relies on the plasticity of the brain, meaning its ability to change and reconnect using the new cells. But whether this is the cure for Parkinson's disease is still debated.

The results of the most recent fetal tissue transplants for Parkinson's were recently released to the media. The first randomized, controlled, double-blind study in this field involved three neuroscience centers in the USA. Human embryonic mesencephalic tissue containing dopamine neurons, obtained from 7-8 week old aborted embryos were transplanted into the brains of 20 patients with Parkinson's. Twenty other Parkinson's patients underwent sham surgery meaning a hole was drilled through the cranium, but the dura was not penetrated and no cells were transplanted (7), (8). According to the researchers' article in the New England Journal of Medicine, "The...

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