NEW YORK (Reuters Health) - Continuous intraputamenal infusion of glial cell line-derived neurotrophic factor (GDNF) improves clinical outcomes and quality of life measures in patients with idiopathic Parkinson’s disease (PD), according to a report in the February Annals of Neurology.
Previous studies of the intracerebroventricular administration of GDNF yielded no clinical benefit, the authors explain, and the clinical effects of 12 months of continuous intraputamenal infusion of GDNF were reported earlier (see Reuters Health report April 18, 2002).
Dr. Steven S. Gill from Frenchay Hospital, Bristol, UK and colleagues now report the effects after 2 years of continuous intraputamenal infusion of GDNF at the rate of 28.8 micrograms/putamen/day during the last 6 months in 5 patients with idiopathic PD (except in 1 patient who reverted back to 14.4 micrograms/putamen/day at month 20).
At 24 months, the authors report, there were 57% and 63% improvements in off-medication motor and functional performance, respectively, and 48% and 58% improvements in on-medication motor and functional performance, respectively.
Periods of akinesia remained completely eliminated, the report indicates, leaving only mild dyskinesias (reduced in duration by 73%) during the on-period.
All domains on the SF-36 quality of life measure were improved at both 12 and 24 months, the researchers note.
Most measures of neuropsychological function remained unchanged at both 12 and 24 months, the results indicate, whereas a parallel control group experienced significant declines on several measures.
GDNF was tolerated well, the report indicates, though all patients experienced intermittent Lhermitte’s phenomenon (electric shock-like sensations that extend down the spine and shoot into the limbs upon flexing the neck).
“Our results indicate GDNF’s potential as a therapeutic agent in PD, from its ability not only to provide symptomatic relief, but also to possibly modify the disease state, distinct from other current therapeutic strategies,” the authors conclude. “However, continuing dopamine replacement was required.”
“The progressive and sustained improvement in symptomatology, and increased 18F-dopa uptake throughout the putamen at 24 months, is suggestive of reduced disease progression,” the investigators add.
Source: Ann Neurol 2005;57:298-302. [ Google search on this article ]
MeSH Headings:Injections, IntraventricularCopyright © 2002 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
