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      Open microsurgical autograft of adrenal medulla to the right caudate nucleus in two patients with intractable Parkinson's disease.

      The New England journal of medicine
      Adrenal Medulla, transplantation, Adult, Caudate Nucleus, surgery, Chromaffin System, physiology, Humans, Male, Methods, Microsurgery, Parkinson Disease, physiopathology, Transplantation, Autologous

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          Abstract

          Recent experimental studies and one clinical case have suggested that grafting tissue from the adrenal medulla into the brain may ameliorate the signs of Parkinson's disease. We describe the treatment of two young patients (35 and 39 years old) with intractable and incapacitating Parkinson's disease, in whom fragments of the adrenal medulla were autotransplanted to the right caudate nucleus. Clinical improvement was noted in both patients at 15 and 6 days (respectively) after implantation and has continued in both. Rigidity and akinesia had virtually disappeared in the first patient at 10 months after surgery, and his tremor was greatly reduced. A similar degree of improvement was present in the second patient at three months. We conclude that autografting of the adrenal medulla to the right caudate nucleus was associated with a marked improvement in the signs of Parkinson's disease in two patients, but our results are preliminary and further work is necessary to see whether this procedure will be applicable over the long term in other types of patients with Parkinson's disease.

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