HEALING THE BRAIN

Easy-reading first-person account of research into the effectiveness of using fetal dopamine cells to treat Parkinson’s disease, a venture that aroused controversy not just for its use of cells from human embryos but because the double-blind study called for half the patients to undergo sham brain surgery.

Freed, director of the neuroscience and neurotransplant center at the Univ. of Chicago, is aided in this narrative of medical derring-do by LeVay, a neurobiologist with a talent for explaining science to Everyman (The Sexual Brain, 1993, etc.). Background information includes one articulate patient’s description of his illness; the 19th-century observations of James Parkinson, for whom the disease is named; and the story of the 1960s discovery of L-dopa’s uses and limitations. The authors recount the advances that made study of primates’ brains possible, and then in 1988, Freed’s first implantation of fetal dopamine cells into the brain of a human patient. Details of the procedure and of the refinements made in subsequent operations make for fascinating reading. When the Clinton administration made federal funding for fetal cell research available in 1992, Freed and his colleagues were ready with a proposal for an elaborate double-blind study involving 40 patients, half of whom were randomly assigned to receive transplants of fetal dopamine cells and half placed in a control group. In fairness, those in the control group, who underwent fake surgeries, could later opt for the real thing. The politics and the logistics of getting the study underway are made clear, and the authors add human interest by including profiles of six typical participants. Especially interesting is the description of how the sham surgeries were made realistic—even the anesthesiologists were kept in the dark. One-year follow-ups revealed beneficial effects in the younger patients; study of the long-term effects is continuing today. Despite the limitations placed on stem-cell research by the current administration, the authors conclude on an optimistic note with a brief look at future avenues of research.

A revealing look at the ins and outs of scientific research—and the ups and downs of collaboration and competition among scientists.