• Pasquale Gallina, Marco Paganini, Annibale Biggeri, Mirca Marini, Annamaria Romoli, Erica Sarchielli, Valentina Berti, Elena Ghelli, Carmela Guido, Letizia Lombardini, Benedetta Mazzanti, Paolo Simonelli, Alessandro Peri, Mario Maggi, Berardino Porfirio, Nicola Di Lorenzo, and Gabriella B Vannelli.
• Careggi University Hospital, Florence, Italy.
• Stereotact Funct Neurosurg. 2014 Jan 1; 92 (4): 211-7.

BackgroundRestoration of functions in Huntington's disease (HD) by neurotransplantation stems from the formation of a striatum-like structure capable of establishing host connections as a result of grafted striatal neuroblast maturation. For the first time, we demonstrated some developmental steps accomplished by progenitor cells in the brain of an HD patient and analysed the molecular asset of the human primordium.Case ReportSurgery involved bilateral (two sessions) stereotactic, caudate-putaminal transplantation of whole ganglionic eminence fragments from single legally aborted fetuses. MRI showed that the tissue deposits of the left hemisphere grew and joined to constitute a single tissue mass that remodelled basal ganglia anatomy and remained stable in size over time. No evidence of graft growth was observed contralaterally. PET demonstrated increased striatal and stable cortical metabolism. Unified Huntington's Disease Rating Scale assessments demonstrated improvement of motor performances, which faded over the 36-month follow-up. Cognitive performance tended to decrease at a lower rate than before transplantation.ConclusionThe striatal primordium grew into the host brain and this process was associated with metabolic change and some clinical benefit. The study suggests the plasticity and reparative potential of un-manipulated primordium in an era where promising cell-based therapies are still in their infancy.2014 S. Karger AG, Basel.

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