Late Intrathecal Cell Therapy Increases Brain Glucose Metabolism and Improves the Long-Term Established Sequelae of Cerebral Hemorrhage

The possibility of an increase in brain glucose metabolism after intrathecal administrations of autologous mesenchymal stromal cells (MSCs) has been recently reported, suggesting a role in the treatment of neurological disorders.

This 49-year-old female, right-handed, and computer engineer, with more than 20 years of formal education, suffered in 2009 from spontaneous intracerebral hemorrhage in the left frontoparietal area, open to ventricule. After spontaneous resolution of the hemorrhage, the patient has been receiving a comprehensive neurorehabilitation program of physiotherapy, occupational therapy, speech therapy and neuropsychological intervention. 8 years after brain hemorrhage, the patient requests a possible treatment of cell therapy.

Clinical examination showed residual difficulty in gait, loss of balance, instability and severe spasticity on right upper extremity, especially on hand, with no functionality. Neuropsychological assessment revealed a poor performance, mainly in attention, learning, and memory, planning, naming, verbal fluency, speech and gesture apraxia tasks.

The patient received 3 intrathecal administrations of 100 million de autologous mesenchymal stromal cells each three months, until a total dose of 300 million of MSCs. From the first administration of cell therapy, the patient reported progressively a generalized and appreciable improvement in her mobility and cognitive deficits. At the end of the treatment, a clear reduction in spasticity and improvement in her stability and gait was observed. Neuropsychological assessment confirmed cognitive improvement after cell therapy and the patient had a clear enhancement in planning, working memory and semantic fluency. These clinical improvements are maintained one year after finishing MSCs administration.

The present case demonstrates, for the first time in patients, that late intrathecal administration of cell therapy with MSCs can improve chronic sequelae due to intracerebral hemorrhage. After intrathecal administration of MSCs, a progressive increase in cerebral glucose metabolism is observed, suggesting a new mechanism for neurological improvement; It is obvious that these studies open a new door of hope in patients with lesions until now considered irreversible and a new therapeutic perspective in the field of the contemporary neurology.

Sources:

Fernández-Guinea S, Zurita M, García E, Mucientes J, López C, et al. (2018) Late Intrathecal Cell Therapy Increases Brain Glucose Metabolism and Improves the Long-Term Established Sequelae of Cerebral

Hemorrhage. Int J Stem Cell Res Ther 5:058. doi.org/10.23937/2469-570X/1410058, Retrieved March 20, 2023 from https://clinmedjournals.org/articles/ijscrt/international-journal-of-stem-cell-research-and-therapy-ijscrt-5-058.php?jid=ijscrt

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