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Randomized, double-blind trial of glial cell line-derived neurotrophic factor (GDNF) in PD

Nutt, J.G., Burchiel, K.J., Comella, C.L., Jankovic, J., Lang, A.E., Laws, E.R., Lozano, A.M., Penn, R.D., Simpson, R.K., Stacy, M., Wooten, G.F., the ICV GDNF Study Group*·2003·Neurology

Abstract

OBJECTIVE: To assess the safety, tolerability, and biological activity of glial cell line-derived neurotrophic factor (GDNF) administered by an implanted intracerebroventricular (ICV) catheter and access port in advanced PD. BACKGROUND: GDNF is a peptide that promotes survival of dopamine neurons. It improved 6-OHDA- or MPTP-induced behavioral deficits in rodents and monkeys. METHODS: A multicenter, randomized, double-blind, placebo-controlled, sequential cohort study compared the effects of monthly ICV administration of placebo and 25, 75, 150, 300, and 500 to 4,000 microg of GDNF in 50 subjects with PD for 8 months. An open-label study extended exposure up to an additional 20 months and maximum single doses of up to 4,000 microg in 16 subjects. Laboratory testing, adverse events (AE), and Unified Parkinson's Disease Rating Scale (UPDRS) scoring were obtained at 1- to 4-week intervals throughout the studies. RESULTS: Twelve subjects received placebo and seven or eight subjects were assigned to each of the other GDNF dose groups. "On" and "off" total and motor UPDRS scores were not improved by GDNF at any dose. Nausea, anorexia, and vomiting were common hours to several days after injections of GDNF. Weight loss occurred in the majority of subjects receiving 75 microg or larger doses of GDNF. Paresthesias, often described as electric shocks (Lhermitte sign), were common in GDNF-treated subjects, were not dose related, and resolved on discontinuation of GDNF. Asymptomatic hyponatremia occurred in over half of subjects receiving 75 microg or larger doses of GDNF; it was symptomatic in several subjects. The open-label extension study had similar AE and lack of therapeutic efficacy. CONCLUSIONS: GDNF administered by ICV injection is biologically active as evidenced by the spectrum of AE encountered in this study. GDNF did not improve parkinsonism, possibly because GDNF did not reach the target tissues--putamen and substantia nigra.

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Research works printed but not linked: 14

  1. Gash DM, Zhang Z, Gerhardt GA. Neuroprotective and neurorestortative properties of GDNF. Ann Neurol . 1998; 44 (suppl 1): S121–S125.
  2. 10.1006/nbdi.1997.0151 · DOI · Paper page
  3. Zhang Z, Miyoshi Y, Lapchak PA, et al. Dose response to intraventricular glial cell line-derived neurotrophic factor administration in parkinsonian monkeys. J Pharmacol Exp Ther . 1997; 282: 1396–1401. · DOI
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  5. 10.1002/1531-8249(199909)46:3<419::AID-ANA21>3.0.CO;2-Q · doi:10.1002/1531-8249(199909)46:3<419::aid-ana21>3.0.co;2-q
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  12. 10.1006/exnr.1999.7175 · DOI
  13. Gill SS, Patel NK, O’Sullivan K, et al. Intra-parenchymal putaminal administration of glial-derived neurotrophic factor in the treatment of advanced Parkinson’s disease. Neurology . 2002; 58 (suppl 3): A241.Abstract.
  14. 10.1126/science.290.5492.767 · DOI · Paper page

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Metadata

Authors
Nutt, J. G., Burchiel, K. J., Comella, C. L., Jankovic, J., Lang, A. E., Laws, E. R., Lozano, A. M., Penn, R. D., Simpson, R. K., Stacy, M., Wooten, G. F., & the ICV GDNF Study Group*
Venue
Neurology
Published
2003-01-14
Volume
60
Issue
1
Pages
69-73
ISSN
  • 0028-3878 (ISSN-L)
  • 1526-632X
OpenAlex
W2165526364
Cited by
824
References
2
FWCI
33.13
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Randomized, double-blind trial of glial cell line-derived neurotrophic factor (GDNF) in PD. https://app.cochat.ai/papers/10.1212/wnl.60.1.69
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Nutt, J. G., Burchiel, K. J., Comella, C. L., Jankovic, J., Lang, A. E., Laws, E. R., Lozano, A. M., Penn, R. D., Simpson, R. K., Stacy, M., Wooten, G. F., & the ICV GDNF Study Group*. (2003). Randomized, double-blind trial of glial cell line-derived neurotrophic factor (GDNF) in PD. Neurology. https://doi.org/10.1212/wnl.60.1.69

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.