Authors: Lopez, William Omar Contreras | Nikkhah, Guido | Schültke, Elisabeth | Furlanetti, Luciano | Trippel, Michael
Article Type: Research Article
Abstract: Purpose: Intrastriatal neural transplantation using multiple grafts is an experimental approach to the treatment of Huntington's disease (HD). Brain atrophy makes stereotactic plans in these patients a tedious procedure with a risk of suboptimal spatial distribution of the grafts in transplantation procedures. Here we present a self-developed software to optimize the surgical stereotactic planning for bilateral neurotransplantation procedures. It allows close to symmetrical distribution of the stereotactic coordinates in relation to the mid-commissural point (MCP), proposing automatically the planning coordinates for the first transplanted hemisphere and mirrored coordinates to be used in the contra-lateral hemisphere. Methods: Twenty-two consecutive HD patients …underwent bilateral stereotactic striatal transplantation. Two caudate nucleus and four putaminal tracks were planned bilaterally. For the second, contra-lateral transplantation, the coordinates were mirrored in order to determine contralateral targets and trajectories. Intra-individual comparison between software given coordinates and finally used coordinates was performed. Results: No statistical significance was found comparing a) the differences between coordinates proposed by the software and the final coordinates and b) the distribution of the transplantation sites in relation to the midline for the right vs. left hemisphere. No intra- or postoperative transplantation-related adverse events occurred. Conclusions: The use of model-based and mirrored coordinates allowed optimal spatial distribution of the grafts. Minor changes were required comparing right to left coordinates giving proof-of principle. The initial use of the software suggests that it may be useful in experimental transplantation trials where neural cell grafts are to be implanted into predefined target sites in the human brain, whether unilateral or bilateral. Show more
Keywords: Huntington's disease, human fetal striatal transplantation, anterior commissure-posterior commissure line (AC-PC), mid-commissural point (MCP), whole ganglionic eminence (WGE), caudate nucleus, putamen
DOI: 10.3233/RNN-130340
Citation: Restorative Neurology and Neuroscience, vol. 32, no. 2, pp. 259-268, 2014
Authors: Lopez, William Omar Contreras | Nikkhah, Guido | Kahlert, Ulf D. | Maciaczyk, Donata | Bogiel, Tomasz | Moellers, Sven | Schültke, Elisabeth | Döbrössy, Máté | Maciaczyk, Jaroslaw
Article Type: Research Article
Abstract: Purpose: The concept of transplantation of neuronal cells to treat Huntington's and Parkinson's diseases is based on the proven principle that dopaminergic and GABA-ergic progenitor neurons (from the human developing ventral mesencephalon and whole ganglionic eminence) can survive, differentiate and functionally integrate into an allogenic host brain. However, several donor and host-specific variables play a major role in the safety and outcome of this procedure. In this paper, we seek to summarize an updated neural transplantation protocol, based on our institutional experience and many years of collaboration with other neurotransplantation centers. Methods: We present a detailed clinical neurotransplantation protocol for …Parkinson's (PD) and Huntington's (HD) diseases with special emphasis in understanding the anatomical relationships of the human fetal tissue that are relevant for selection of the desired cell populations. Results: Two detailed step-wise neurotransplantation protocols are presented, outlining strategies facilitating the avoidance of possible procedure-related complications. Conclusions: In this paper we delineated some crucial technical factors enabling the execution of a safe and effective neural transplantation. The protocols presented here might contribute to further development of the experimental clinical neurotransplantation towards a routine therapeutic procedure. Show more
Keywords: Human fetal neural precursor cells (hFNPCs), neural stem cells (NSC), neural transplantation, ventral mesencephalon (VM), whole ganglionic eminence (WGE), substantia nigra (SN), Parkinson's disease (PD), Huntington's disease (HD), good clinical practice (GCP)
DOI: 10.3233/RNN-130317
Citation: Restorative Neurology and Neuroscience, vol. 31, no. 5, pp. 579-595, 2013
