Phase I Study on Safety and Feasibility of Implanting Your Own Sural Nerve Tissue into the Brain for Parkinsons Disease or Multiple System Atrophy
Led by Craig van Horne, MD, PhD · Updated on 2026-04-01
7
Participants Needed
1
Research Sites
104 weeks
Total Duration
AI-Summary
What this Trial Is About
Researchers are evaluating the safety and feasibility of implanting a persons own peripheral nerve tissue into the substantia nigra area of the brain in people diagnosed with Parkinsons disease or Multiple System Atrophy. This phase I study involves 7 participants who are early in their diagnosis with milder symptoms. The goal is to plan future larger trials and to see if this nerve tissue grafting approach is possible and safe.
Participants will be randomly assigned to one of two groups four will receive the nerve tissue graft implanted into the brain, while three will receive a sham surgery involving nerve biopsy and scalp incisions but no brain implantation. The nerve tissue is taken from the sural nerve near the ankle and implanted bilaterally using a specialized cannula through the skull. Those in the sham group may be eligible for the graft surgery after the study ends.
During the study, participants will be followed for one year with regular assessments including neuropsychological exams, movement disorder scales, cognitive tests, quality of life questionnaires, and monitoring for adverse events. Researchers will track surgery details such as procedure duration and hospital stay. The primary goal is to meet recruitment targets and evaluate safety and feasibility through various clinical and functional measures over the 12-month period.
CONDITIONS
Brief Title
Autologous suraL nervE Grafting to the Substantia nigrA in Patients With Synuclienopathies
Research Team
J
Jaimie Hixson
G
Group Monitored Email
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This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
Factors
Nerve Graft Recipients
Placebo Group (Sham Surgery)
What it is
A surgical procedure in which a patient's own sural nerve tissue is biopsied from the ankle and implanted bilaterally into the substantia nigra area of the brain using a cannula after making scalp incisions and burr holes.
A placebo-type surgery with sural nerve biopsy and scalp incisions performed, but no burr holes into the skull and no placement of nerve tissue into the brain.
Role in trial
Investigational intervention group designed to assess safety and feasibility of nerve grafting as potential disease-modifying surgery.
Placebo control arm controlling for effects of surgery, anesthesia, and postoperative care without nerve implantation.
Primary use or main purpose
To evaluate the safety and feasibility of implanting autologous sural nerve tissue into the brain for patients with Parkinson's disease or multiple system atrophy.
To act as a control for surgical and perioperative factors in assessing the investigational procedure.
How it is performed
Sural nerve biopsy is performed on the ankle, the tissue is prepared, and then surgically implanted into the brain via burr holes and a cannula, requiring bilateral scalp incisions and craniotomy.
Sural nerve biopsy and bilateral scalp incisions are performed, but no cranial burr holes or brain cannula are used and no nerve tissue is implanted.
Evidence maturity and research status
Limited early clinical evidence suggests that autologous peripheral nerve graft implantation into the substantia nigra during deep brain stimulation surgery is feasible and can be performed safely in patients with Parkinson's disease. Maturation of clinical outcome evidence is ongoing and conclusive efficacy is not yet established.
No therapeutic benefit is expected from the sham surgical procedure. Its purpose is solely to act as a placebo control.
Important limitations
Published pilot studies are small, with limited sample sizes, short to moderate follow-up, no established improvement in clinical outcomes, and no long-term safety or efficacy data. The current trial is ongoing, and wider clinical adoption awaits more robust controlled outcome studies.
Sham procedures offer no direct clinical benefit and carry surgical risks, but are a necessary element to rigorously control for placebo effects in surgery trials.
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
Who Can Participate
Age: 40Years - 75Years
All Genders
Eligibility Criteria
You may qualify if you...
Diagnosis of clinically established or clinically probable Parkinson's disease or Multiple System Atrophy as defined by Movement Disorder Society criteria
Disease duration greater than 2 years
Age between 40 and 75 years, inclusive
Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III score between 20 and 35 points off medication for Parkinson's disease or MDS-Unified Multiple System Atrophy Rating Scale (UMSARS) score of 30 or less off medication
No MDS-UPDRS Part III score greater than 3 on specified items while off medication
Able and willing to undergo ioflupane/SPECT imaging
Able to tolerate the surgical procedure
Able to complete all planned assessments
Available sural nerve for biopsy
You will not qualify if you...
Previous Parkinson's disease surgery or any intracranial surgery
Ongoing major medical or psychiatric disorders including depression and psychosis
Current treatment with neuroleptics
Typical nonparkinsonian syndrome ioflupane/SPECT signal
Unable to undergo MRI
Obstructed path to substantia nigra for surgery
Significant microvascular disease
Use of anticoagulants other than aspirin
Female who is pregnant, breastfeeding, or of child-bearing potential not using effective birth control
Decline in consent capacity before surgery resulting in removal from study
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Surgery and Immediate Post-operative Care
Duration - Day of surgery plus hospital admission until discharge
Participants undergo surgery where either their own sural nerve cells are implanted into the substantia nigra area of the brain or receive a sham surgery with sural nerve biopsy and scalp incisions only.
1 surgical procedure with hospital admission
Post-operative Follow-up
Duration - 12 months
Participants have follow-up visits to monitor safety and assess clinical outcomes after the surgery.
Multiple visits including assessments at 4 weeks, 6 months, and 12 months
How is the study designed?
Study Type
INTERVENTIONAL
Masking
QUADRUPLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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Published Research Related To This Trial
Implantation of autologous peripheral nerve grafts into the substantia nigra of subjects with idiopathic Parkinson's disease treated with bilateral STN DBS: a report of safety and feasibility.
Craig G van Horne, Jorge E Quintero, Julie A Gurwell...
Direct delivery of an investigational cell therapy in patients with Parkinson's disease: an interim analysis of feasibility and safety of an open-label study using DBS-Plus clinical trial design.
Jorge E Quintero, John T Slevin, Julie A Gurwell...
Peripheral nerve grafts implanted into the substantia nigra in patients with Parkinson's disease during deep brain stimulation surgery: 1-year follow-up study of safety, feasibility, and clinical outcome.
Craig G van Horne, Jorge E Quintero, John T Slevin...