CELLULAR TRANSPLANTATION MAY MODULATE DISEASE PROGRESSION IN SPINO-CEREBELLAR ATAXIA ? A CASE REPORT

Spino-Cerebellar Ataxia (SCA) encompasses a group of progressive disorders characterized by Neurodegeneration, specifically in the region of cerebellum, brainstem and spinal cord. The current therapies for SCA have limited potential for restoration of neuronal damage. Regenerative medicine may offer a more viable treatment option for the treatment of SCA as supported by some preclinical and clinical studies. We treated a 33 year old female with SCA with severe impairment of dynamic balance, coordination, speech, gross and fine motor control. Ambulation was dependent; requiring support from two people with an ataxic gait. Functionally she scored 86 on Functional independence measure and 62 on Ataxia rating scale. She underwent autologous BMMNCs intrathecal transplantation followed by standard rehabilitation. Six months after the transplantation there was a significant improvement in handwriting, fine motor activities, standing dynamic balance and intelligibility of speech. There was an improvement in the cerebellar signs and symptoms and outcome measures like Modified International co-operative Ataxia rating scale. SCAs lead to impaired cerebellar function secondary to the autoimmune degeneration of cerebellar neurons and impaired cerebellar perfusion. BMMNCs through various paracrine mechanisms promote neurotrophic growth factors secretion, angiogenesis and modulate immune responses. We postulate that the clinical benefits and altered progression of the disease observed in this patient may be attributed to improved cerebellar function due to enhanced perfusion and altered autoimmune responses. Singularly this case report presents the preliminary findings and suggests the need for further research to explore the potential of cellular therapy to control the progression of SCA