The thing that has concerned me the most about Ntcell is not whether or not it works, because there is overwhelming evidence that it does, but that the phase II trial will be able to conclusively demonstrate its efficacy.
The problem that has surfaced in the past with Parkinsons is that when the disease is too far advanced, structural changes have occurred in the brain which no therapy can undo. This is not related to age, but solely to the severity and duration of the disease. One dopamine implantation trial which selected younger patients spectacularly failed because those patients almost certainly had permament damage as shown by their poor response to L-dopa before the trial began. The significance of this was not realised until after the trial.
However LCT is aware of the problem and I believe the design of the protocol for NTcell has taken into account all the relevant factors. One could wish for more placebo controls, but the trial is expensive and if they can achieve the result with 18 patients, then we should be very happy about reducing the cost. I believe that LCT has taken on board all the lessons from the past trials on embryological dopamine implants, and Dr Snow's experience in this field is an enormous advantage.
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