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- Lindvall, O, et al.
(författare)
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Human fetal dopamine neurons grafted into the striatum in two patients with severe Parkinson's disease. A detailed account of methodology and a 6-month follow-up
- 1989
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Ingår i: Archives of Neurology. - : American Medical Association (AMA). - 0003-9942. ; 46:6, s. 31-615
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Tidskriftsartikel (refereegranskat)abstract
- By using stereotaxic surgical techniques, ventral mesencephalic tissues from aborted human fetuses of 8 to 10 weeks' gestational age were implanted unilaterally into the striata in two patients with advanced Parkinson's disease. The patients were treated with a cyclosporine, azathioprine, and steroid regimen to minimize the risk for graft rejection. They were examined for 6 months preoperatively and 6 months postoperatively and continued to receive the same doses of antiparkinsonian medication. There were no significant postoperative complications. No major therapeutic effect from the operation was observed. However, in the clinical tests, both patients showed small but significant increases of movement speed for repeated pronation-supination, fist clenching, and foot lifting. The rate of walking also increased in the one patient tested. For both patients, there was an initial worsening postoperatively, followed by improvement vs preoperative performance at 1 to 3 months. Both patients also showed significant improvement in the magnitude of response to a single dose of levodopa (L-dopa), but there was no increase in the duration of drug action. The motor readiness potential increased in both patients postoperatively, primarily over the operated hemisphere. Neurophysiological measurements also showed a more rapid performance of simple and complex arm and hand movements on the side contralateral to transplantation in one patient at 5 months postoperatively. Positron emission tomography demonstrated no increased uptake of 6-L-(18F)-fluorodopa in the transplanted striatum at 5 and 6 months. Taken together, these results suggest that the fetal nigral implants may have provided a modest improvement in motor function, consistent with the presence of small surviving grafts. Although our results support further scientific experimentation with transplantation in Parkinson's disease, widespread clinical trials with this procedure are probably not warranted at this time.
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- Lindvall, O, et al.
(författare)
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In reply : Fetal brain grafts and Parkinson's disease
- 1990
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Ingår i: Science (New York, N.Y.). - : American Association for the Advancement of Science (AAAS). - 0036-8075 .- 1095-9203. ; 250:4986, s. 1435-1435
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Tidskriftsartikel (refereegranskat)
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- Sawle, G V, et al.
(författare)
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Transplantation of fetal dopamine neurons in Parkinson's disease : PET [18F]6-L-fluorodopa studies in two patients with putaminal implants
- 1992
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Ingår i: Annals of Neurology. - : Wiley. - 0364-5134 .- 1531-8249. ; 31:2, s. 73-166
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Tidskriftsartikel (refereegranskat)abstract
- Two patients with Parkinson's disease who underwent implantation of fetal mesencephalic tissue into the putamen were serially studied using positron emission tomography and [18F]6-L-fluorodopa ([18F]dopa). The uptake of [18F]dopa is related to the functional integrity of the presynaptic dopaminergic system. Preoperative studies revealed a marked decrease in putamen [18F]dopa uptake, with lesser involvement of the caudate. Two and 4 months, respectively, after operation, both patients demonstrated functional improvement, as described elsewhere. One patient was scanned 5, 8, and 13 months after the operation and the other was scanned 7 and 12 months after the operation. In both patients, [18F]dopa uptake increased within the operated putamen despite a progressive decrease in tracer uptake in the unoperated striatal structures. We believe that this increased uptake of [18F]dopa at the implantation site represents functional integrity within a surviving neural graft. While there has been little further clinical improvement beyond the fifth postoperative month, the uptake of [18F]dopa at the operation site in both patients has progressively increased. The kinetic data provide evidence of disease progression in the unoperated striatum, which, balanced against increasing graft function, may explain why clinical improvement reached a plateau within months after surgery.
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- Stephens, A. N., et al.
(författare)
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Too close for comfort : A mixed methods study to understand self-reported tailgating using the theory of planned behaviour
- 2023
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Ingår i: Transportation Research Part F. - : Elsevier. - 1369-8478 .- 1873-5517. ; 93, s. 11-22
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Tidskriftsartikel (refereegranskat)abstract
- Background: Tailgating (following a lead vehicle too closely) is a key contributor to crashes and injury. While vehicle technology has the potential to reduce the trauma resulting from tailgating, full market penetration of these technologies is some time away. In the meantime, efforts to improve road safety can focus on supporting safer driver behaviour by targeting motivations for this behaviour.Method: A mixed methods design was used to understand reasons why drivers tailgate and potential countermeasures to reduce this behaviour. Qualitative data from 247 drivers (males = 29 %; mean age = 39.86; SD = 14.39) were sought to understand circumstances when drivers are tailgated and when they report tailgating. In a second study, 736 drivers (males = 41 %; mean age = 37.69; SD = 14.27) responded to questions developed from the qualitative findings to quantify the frequency of tailgating and reasons behind it. The theory of planned behaviour (TPB) was applied to understand whether self-reported intention to tailgate could be predicted by attitudes, perceived social acceptance of the behaviour, perceived behavioural control, and past tailgating behaviour.Results: Tailgating was a common behaviour. All drivers in the first study had experienced being tailgated by other drivers, while 77% had tailgated other vehicles; albeit 55% reported this was rare. Tailgating was unintentional (due to dense traffic; or lack of knowledge of safe following distance recommendations) or intentional (due to pressure from other drivers, anger or to change others’ behaviour). Structural equation modelling showed that TPB constructs of attitude, social norms, perceived behavioural control and past tailgating behaviour predicted intention to tailgate, accounting for 66% of the variance.Conclusion: TPB is a useful framework for explaining tailgating behaviour, or at least the intention to tailgate, and to develop interventions. These could focus on education of the risks of tailgating, the recommended safe following distances as well as strategies to support drivers maintaining safe following distances across different speed zones
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