Technology and target group: In Parkinson’s disease, the brain cells that produce dopamine die. Approximately 15,000 patients in Sweden have Parkinson’s disease. In its early stages, the disease can often be treated successfully by drugs. However, in most patients the disease progresses after a few years to a stage with complications where drugs no longer have a sufficient effect. In patients with Parkinson’s disease, cell transplantation is intended to replace dead brain cells. A solution containing small fragments of brain tissue is injected into the patient’s brain. The results to date suggest that cell transplantation mainly benefits patients who still have a positive effect from medication but who have started to have complications. The size of this patient group in Sweden is estimated to be between 100 and 200 per year.

Patient benefit: A valuable level of symptom amelioration was achieved in three open studies of 15 patients who received cell transplantation. This outcome remained at 2-year follow-up. There are two randomized placebo-controlled trials including 74 patients with advanced disease. Patients were followed for one or two years post implantation. Small, but statistically confirmed, improvements were noted in the first trial in patients under 60 years of age and in the second study in patients with less advanced Parkinson’s disease. Survival of the transplanted dopamine neurons was, however, substantially below what had been reported in earlier studies. Stereotactic surgery, the method used in transplantation, carries a risk for cerebral hemorrhaging. Furthermore, there is a risk for immunological rejection. The results to date suggest, however, that these risks are small.

Scientific evidence: Cell transplantation in treating Parkinson’s disease is currently an experimental method under development. There is poor documentation on the effects of treatment. There is no documentation on the cost-effectiveness of the method.

Until further evidence becomes available the method should be used only within the framework of scientific studies.