Setback spurs Parkinson's disease research

results of the first controlled trial of the technique of implanting foetal cells into the brains of Parkinson’s disease patients, published last month, which found no overall benefit and left a number of the patients with tragic side effects which cannot be undone. But many researchers are concerned that the response to this new study, which some newspapers called a ‘catastrophe’, may overshadow a large body of promising and expanding work and are keen to flag up cell transplantation as one of the best chances of new treatments for this and other neurodegenerative diseases. Gerald Fischbach, who was director of the National Institute of Neurological Disorders and Stroke, which sponsored the new study published in The New England Journal of Medicine, said that while the transplantation of foetal cells had been promoted by some neurosurgeons as miraculous, this was the first time it was rigorously evaluated. It used sham surgery as a comparison, a controversial and rarely used strategy but one the researchers felt was necessary to understand the true effects of the treatment. In the study, researchers, led by Curt Freed of the University of Colorado Health Sciences Center in Denver and Stanley Fahn of the Columbia University College of Physicians and Surgeons, recruited 40 patients between the age of 34 and 75 who had had Parkinson’s disease for an average of 14 years. The patients were randomly assigned to have substantia nigra cells from four foetuses implanted in their brains or to have sham surgery, for comparison. The surgery took place in Colorado and the patients were evaluated in New York. The fetal cell surgery involved drilling four small holes in the patient’s forehead and then inserting long needles through the holes into the brain. The sham surgery involved drilling the holes but not injecting needles into the brain. The study’s primary measure of success was whether the patients themselves noticed that they were better, as determined by a survey that they mailed in a year later but before they knew whether they had had foetal cell implants or a sham operation. The study found no difference between the two groups. Parkinson’s disease occurs when cells of the substantia nigra region in the base of the brain die, for unknown reasons. The hope is that fetal substantia nigra cells might take over for them. Most researchers welcomed the team’s effort to carry out a controlled trial to build on the experimental work that has been Magazine R285