In vivo imaging of the integration and function of nigral grafts in clinical trials

Marios Politis*, Paola Piccini

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

18 Citations (Scopus)

Abstract

In vivo functional imaging has provided objective evidence for the integration and function of nigral grafts in the brains of patients with Parkinson's disease. Clinical trials with the use of positron emission tomography have shown that transplants of human dopamine-rich fetal ventral mesencephalic tissue can survive, grow, and release dopamine providing motor symptom relief, and also that they can restore brain activation related to movement. Positron emission tomography has aided in the elucidation of the pathophysiology of serious adverse effects, so-called graft-induced dyskinesias. With the use of newly established radioligands, positron emission tomography and single-photon emission computed tomography could help to improve Parkinson's patient selection in future clinical trials by selecting those with better predicted outcomes. Moreover, positron emission tomography could help monitoring postoperational inflammatory processes around the grafted tissue and the effect of immunosuppression. Recent evidence from positron emission tomography has provided insight of how ongoing extrastriatal serotonergic denervation may have relevance to nonmotor symptoms in transplanted Parkinson's disease patients indicating new cell therapy targets for a more complete relief of symptoms. Functional and structural magnetic resonance imaging techniques could help to better assess the integration of nigral graft with the host brain by assessing the restoration of brain activation during movement and of functional and structural connectivity. This knowledge should lead to the development of new, optimized in vivo imaging protocols that could help to better schedule, monitor, and modify the clinical outcomes of future human trials assessing the efficacy of fetal or stem cell therapy in Parkinson's disease.

Original languageEnglish
Title of host publicationFunctional Neural Transplantation III
Subtitle of host publicationPrimary and Stem Cell Therapies for Brain Repair, Part I
EditorsSB Dunnett, A Bjorklund
PublisherELSEVIER SCIENCE BV
Pages199-220
Number of pages22
ISBN (Print)9780444595751
DOIs
Publication statusPublished - 2012

Publication series

NameProgress in Brain Research
PublisherELSEVIER SCIENCE BV
Volume200
ISSN (Print)0079-6123

Keywords

  • MRI
  • neural grafts
  • Parkinson's disease
  • PET
  • SPECT
  • POSITRON-EMISSION-TOMOGRAPHY
  • FETAL CELL TRANSPLANTATION
  • SUPPLEMENTARY MOTOR AREA
  • LONG-TERM SURVIVAL
  • PARKINSONS-DISEASE
  • DOPAMINERGIC GRAFTS
  • SEROTONERGIC DYSFUNCTION
  • NEURAL TRANSPLANTATION
  • NEUROLOGICAL DISORDERS
  • MESENCEPHALIC TISSUE

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