Dyskinesia after fetal cell transplantation for parkinsonism: a PET study.
Persistent dyskinesias in the absence of or with only minimal amounts of dopaminergic medication have been reported after dopamine cell implantation for Parkinson's disease. In this study, we used [(18)F]fluorodopa (FDOPA) and positron emission tomography to determine whether this complication resulted from specific alterations in dopamine function after transplantation. Caudate and putamen FDOPA uptake values in these patients (DYS+, n = 5) were compared with those obtained in a cohort of age- and disease duration-matched transplant recipients who did not develop this complication (DYS-, n = 12). PET signal for both groups was compared at baseline and at 12 and 24 months after transplantation. We found that putamen FDOPA uptake was significantly increased (p < 0.005) in DYS+ transplant recipients. These increases were predominantly localized to two zones within the left putamen. In addition to the posterodorsal zone in which a prominent reduction in FDOPA uptake was present at baseline, the DYS+ group also displayed a relative increase ventrally, in which preoperative dopaminergic input was relatively preserved. Postoperative FDOPA uptake did not reach supranormal values over the 24-month follow-up period. These findings suggest that unbalanced increases in dopaminergic function can complicate the outcome of neuronal transplantation for parkinsonism.
Ma
Yilong
Y
Center for Neurosciences, North Shore Long Island Jewish Research Institute and Department of Neurology, North Shore University Hospital, 350 Community Drive, Manhasset, NY 11030, USA.
Feigin
Andrew
A
Dhawan
Vijay
V
Fukuda
Masafumi
M
Shi
Qiuhu
Q
Greene
Paul
P
Breeze
Robert
R
Fahn
Stanley
S
Freed
Curt
C
Eidelberg
David
D
D000328:Adult; D001921:Brain / Q000196:embryology; D002421:Caudate Nucleus / Q000000981:diagnostic imaging / Q000378:metabolism; D015331:Cohort Studies; D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D004311:Double-Blind Method; D020820:Dyskinesias / Q000209:etiology*; D016332:Fetal Tissue Transplantation / Q000009:adverse effects*; D005462:Fluorine Radioisotopes / Q000493:pharmacokinetics; D006801:Humans; D008875:Middle Aged; D020734:Parkinsonian Disorders / Q000000981:diagnostic imaging* / Q000601:surgery*; D011699:Putamen / Q000000981:diagnostic imaging / Q000378:metabolism; D014055:Tomography, Emission-Computed
D005462:Fluorine Radioisotopes; C043437:fluorodopa F 18; D004295:Dihydroxyphenylalanine