Abstract

This talk is part of the Cambridge Clinical Neuroscience and Mental Health Symposium, 29th – 30th September 2009 at West Road Concert Hall. This event is free to attend for cambridge neuroscientists although registration is required. To register, and for further information, please visit: http://www.neuroscience.cam.ac.uk/cnmhs/

Abstract: Parkinson’s disease (PD) is a chronic neurodegenerative conditions of the brain that presents with a range of anormalities including a combination of a movement disorder with cognitive deficits. The aetiology of PD is unknown in the vast majority of cases, but the pathology targets the nigrostriatal dopaminergc neurons with the formation of alpha synuclein positive Lewy bodies. As such the disease offers an attractive target for cell based therapies, with the primary aim (in most cases) being to replace these lost cells through the implantation of exogenously derived dopaminergic neurons. This was originally undertaken in the 1980s using allografted cells derived from the developing midbrain and the open label clinical studies that evolved out of this work in the 1990s demonstrated that this approach could produce striking long term clinical benefits in some individuals. This clinical improvement correlated with evidence of dopaminergic cell survival using functional imaging with PET as well as in some post-mortem studies. However over the last ten years, two NIH supported double blind placebo controlled trials have failed to replicate these benefits and also reported significant side-effects- most notably the development of dyskinesias relating to the grafts. Whilst the basis for these dyskinesias has been debated, as has the failure of these studies to show benefits, the growth of stem cell sources for brain repair has evolved and with this an expectation that they will translate into treating patients with PD. In this talk I will re-examine the reasons as to why the clinical trials using fetal dopaminergic cells have failed to produce consistent robust benefits and what this will mean for the translation of stem cell based therapies to the clinic for PD.

Biography: Dr Roger A. Barker is a University Reader in Clinical Neuroscience and Honorary Consultant in Neurology at the Addenbrooke’s Hospital. He trained at Oxford and London and has been in his current position for nine years having completed an MRC Clinician Scientist Fellowship just prior to this. His main interests are in the neurodegenerative disorders of the nervous system in particular Parkinson’s disease and Huntington’s disease. He combines basic research looking at cell therapies to treat these conditions with clinically based work on defining the natural history and heterogeneity of both Huntington’s disease and Parkinson’s disease. He is a member of PDS Research Advisory Panel, the MRC Stem cell Liaison Committee and is co-editor in chief of the journals ACNR and the Journal of Neurology.