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Intraarterial Autologous Implantation of Adult Stem Cells for Patients with Parkinson Disease

医学 萧条(经济学) 生活质量(医疗保健) 帕金森病 干细胞 四分位数 磁共振成像 外科 内科学 疾病 放射科 置信区间 遗传学 护理部 生物 经济 宏观经济学
作者
Augusto Brazzini,Raúl Cantella,Antonio De la Cruz,Jorge Yupanqui,Carlos León,Tamara Jorquiera,Mariana Brazzini,Melitón Ortega,Luis N. Saenz
出处
期刊:Journal of Vascular and Interventional Radiology [Elsevier BV]
卷期号:21 (4): 443-451 被引量:49
标识
DOI:10.1016/j.jvir.2010.01.008
摘要

Purpose To evaluate the feasibility, safety, and effectiveness of intraarterial autologous implantation of adult stem cells for Parkinson disease (PD). Materials and Methods From June 2006 to August 2008, 36 men and 14 women (mean age, 62.5 years ± 10.4; range, 38–81 y) with PD (mean duration, 9.3 years; range, 1–28 y) underwent autologous implantation of stem cells with superselective arterial catheterization. Patients were evaluated with clinical and neurologic examinations; internationally recognized scales for the evaluation of PD, disability, activities of daily living, depression, and quality of life (QOL); as well as videos, magnetic resonance (MR) imaging, and MR spectroscopy. Stem cells were implanted in the posterior region of the circle of Willis. Patients were evaluated according to clinical measures. Comparison was made versus data collected from all scales before treatment, as well as videos and spectroscopy in eight patients. Results In a mean follow-up of 7.4 months ± 4.5 (range, 1–18 months), patients showed a median improvement of 51.1% and quartile deviation (QD) of 24.8% on the Unified PD Rating Scale. They showed significant improvement in disability, activities of daily living, depression, and QOL (P < .5). No complications were observed. In eight patients, follow-up MR spectroscopy revealed mean improvements in n-acetylaspartate/creatine ratio from 1.805 to 2.07 (12.8%) and from 1.25 to 1.88 (43.56%) in right and left basal ganglia, respectively, versus preprocedural values (P < .05). Conclusions Treatment of PD with intraarterial autologous implantation of adult stem cells is feasible and safe and results in improved severity of disease and QOL. To evaluate the feasibility, safety, and effectiveness of intraarterial autologous implantation of adult stem cells for Parkinson disease (PD). From June 2006 to August 2008, 36 men and 14 women (mean age, 62.5 years ± 10.4; range, 38–81 y) with PD (mean duration, 9.3 years; range, 1–28 y) underwent autologous implantation of stem cells with superselective arterial catheterization. Patients were evaluated with clinical and neurologic examinations; internationally recognized scales for the evaluation of PD, disability, activities of daily living, depression, and quality of life (QOL); as well as videos, magnetic resonance (MR) imaging, and MR spectroscopy. Stem cells were implanted in the posterior region of the circle of Willis. Patients were evaluated according to clinical measures. Comparison was made versus data collected from all scales before treatment, as well as videos and spectroscopy in eight patients. In a mean follow-up of 7.4 months ± 4.5 (range, 1–18 months), patients showed a median improvement of 51.1% and quartile deviation (QD) of 24.8% on the Unified PD Rating Scale. They showed significant improvement in disability, activities of daily living, depression, and QOL (P < .5). No complications were observed. In eight patients, follow-up MR spectroscopy revealed mean improvements in n-acetylaspartate/creatine ratio from 1.805 to 2.07 (12.8%) and from 1.25 to 1.88 (43.56%) in right and left basal ganglia, respectively, versus preprocedural values (P < .05). Treatment of PD with intraarterial autologous implantation of adult stem cells is feasible and safe and results in improved severity of disease and QOL.

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