***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Amyotrophic Lateral Sclerosis ( ALS ) is a rapidly progressive neurodegenerative disorder with fatal prognosis . Cellular therapy has been studied for ALS in various animal models and these advances have highlighted its potential to be a treatment modality . This is a retrospective controlled cohort study of total 57 patients . Out of these , 37 patients underwent autologous bone marrow mononuclear cell transplantation in addition to st and ard rehabilitation and Riluzole . Control group consisted of 20 patients who did not receive cell transplantation .  The survival duration since the onset of the disease for both the groups was computed using a Kaplan-Meier Survival analysis and compared using log-rank test . Effect of age at onset , type of onset and lithium on survival duration in the intervention group was analyzed . Mean survival duration of patients in intervention group was 87.76 months which was higher than the control group mean survival duration of 57.38 months . Survival duration was significantly ( p = 0.039 ) higher in people with the onset of the disease below 50 years of age . Limb onset and lithium also showed positive influence on the survival duration . Mean survival duration of the intervention group was also higher than the survival duration of ALS patients in previous epidemiological studies . In addition to the st and ard treatment with Riluzole , early intervention with combination of BMMNCs transplantation and Lithium may have a positive effect on the survival duration in ALS . Prospect i ve r and omized controlled studies with a larger sample size and rigorous methodology are required for conclusive findings Amyotrophic lateral sclerosis ( ALS ) is the most common adult onset motor neuron disease . The etiology and pathogenic mechanisms of the disease remain unknown , and there is no effective treatment . Here we show that intrathecal transplantation of human motor neurons derived from neural stem cells ( NSCs ) in spinal cord of the SOD1G93A mouse ALS model delayed disease onset and extended life span of the animals . When HB1.F3.Olig2 ( F3.Olig2 ) cells , stable immortalized human NSCs encoding the human Olig2 gene , were treated with sonic hedgehog ( Shh ) protein for 5–7 days , the cells expressed motor neuron cell type-specific phenotypes Hb9 , Isl-1 and choline acetyltransferase ( ChAT ) . These F3.Olig2-Shh human motor neurons were transplanted intrathecally in L5–L6 spinal cord of SOD1G93A mice , and at 4 weeks post-transplantation , transplanted F3.Olig2-Shh motor neurons expressing the neuronal phenotype markers NF , MAP2 , Hb9 , and ChAT were found in the ventral horn of the spinal cord . Onset of clinical signs in ALS mice with F3.Olig2-Shh motor neuron implants was delayed for 7 days and life span of animals was significantly extended by 20 days . Our results indicate that this treatment modality of intrathecal transplantation of human motor neurons derived from NSCs might be of value in the treatment of ALS patients without significant adverse effects OBJECTIVE To evaluate the feasibility , safety , and immunological effects of intrathecal and intravenous administration of autologous mesenchymal stem cells ( MSCs ) ( also called mesenchymal stromal cells ) in patients with multiple sclerosis ( MS ) and amyotrophic lateral sclerosis ( ALS ) . DESIGN A phase 1/2 open-safety clinical trial . Patients Fifteen patients with MS ( mean [ SD ] Exp and ed Disability Status Scale [ EDSS ] score , 6.7 [ 1.0 ] ) and 19 with ALS ( mean [ SD ] Amyotrophic Lateral Sclerosis Functional Rating Scale [ ALSFRS ] score , 20.8 [ 8.0 ] ) were enrolled . Intervention After culture , a mean ( SD ) of 63.2 × 10(6 ) ( 2.5 × 10(6 ) ) MSCs was injected intrathecally ( n = 34 ) and intravenously ( n = 14 ) . In 9 cases , MSCs were magnetically labeled with the superparamagnetic iron oxide ferumoxides ( Feridex ) . MAIN OUTCOME MEASURES The main outcome measure was the recording of side effects . Follow-up ( ≤25 months ) included adverse events evaluation , neurological disability assessment by means of the EDSS , magnetic resonance imaging to exclude unexpected pathologies and track the labeled stem cells , and immunological tests to assess the short-term immunomodulatory effects of MSC transplantation . RESULTS Twenty-one patients had injection-related adverse effects consisting of transient fever , and 15 reported headache . No major adverse effects were reported during follow-up . The mean ALSFRS score remained stable during the first 6 months of observation , whereas the mean ( SD ) EDSS score improved from 6.7 ( 1.0 ) to 5.9 ( 1.6 ) . Magnetic resonance imaging visualized the MSCs in the occipital horns of the ventricles , indicating the possible migration of ferumoxides-labeled cells in the meninges , subarachnoid space , and spinal cord . Immunological analysis revealed an increase in the proportion of CD4(+)CD25(+ ) regulatory T cells , a decrease in the proliferative responses of lymphocytes , and the expression of CD40(+ ) , CD83(+ ) , CD86(+ ) , and HLA-DR on myeloid dendritic cells at 24 hours after MSC transplantation . CONCLUSION Transplantation of MSCs in patients with MS and ALS is a clinical ly feasible and relatively safe procedure and induces immediate immunomodulatory effects . Trial Registration clinical trials.gov Identifier : NCT00781872 BACKGROUND The first US Food and Drug Administration approved clinical trial for a stem cell-based treatment of amyotrophic lateral sclerosis has now been completed . OBJECTIVE Primary aims assessed the safety of a direct microinjection-based technique and the toxicity of neural stem cell transplantation to the ventral horn of the cervical and thoracolumbar spinal cord . Results from thoracolumbar-only microinjection groups have been previously published . Cervical and cervical plus thoracolumbar microinjection group perioperative morbidity results are presented . METHODS Eighteen microinjection procedures ( n = 12 thoracolumbar [ T10/11 ] , n = 6 cervical [ C3 - 5 ] ) delivered NSI-566RSC ( Neuralstem , Inc ) , a human neural stem cell , to 15 patients in 5 cohorts . Each injection series comprised 5 injections of 10 μL at 4-mm intervals . The patients in group A ( n = 6 ) were nonambulatory and received unilateral ( n = 3 ) or bilateral ( n = 3 ) thoracolumbar microinjections . The patients in groups B to E were ambulatory and received either unilateral ( group B , n = 3 ) or bilateral ( group C , n = 3 ) thoracolumbar microinjection . Group D and E patients received unilateral cervical ( group D , n = 3 ) or cervical plus bilateral thoracolumbar microinjection ( group E , n = 3 ) . RESULTS Unilateral cervical ( group D , n = 3 ) and cervical plus thoracolumbar ( group E , n = 3 ) microinjections to the ventral horn have been completed in ambulatory patients . One patient developed a postoperative kyphotic deformity prompting completion of a laminoplasty in subsequent patients . Another required reoperation for wound dehiscence and infection . The solitary patient with bulbar amyotrophic lateral sclerosis required perioperative reintubation . CONCLUSION Delivery of a cellular payload to the cervical or thoracolumbar spinal cord was well tolerated by the spinal cord in this vulnerable population . This encouraging finding supports consideration of this delivery approach for neurodegenerative , oncologic , and traumatic spinal cord afflictions Advances in stem cell biology have generated intense interest in the prospect of transplanting stem cells into the nervous system for the treatment of neurodegenerative diseases . Here , we report the results of an ongoing phase I trial of intraspinal injections of fetal-derived neural stems cells in patients with amyotrophic lateral sclerosis ( ALS ) . This is a first-in-human clinical trial with the goal of assessing the safety and tolerability of the surgical procedure , the introduction of stem cells into the spinal cord , and the use of immunosuppressant drugs in this patient population . Twelve patients received either five unilateral or five bilateral ( 10 total ) injections into the lumbar spinal cord at a dose of 100,000 cells per injection . All patients tolerated the treatment without any long-term complications related to either the surgical procedure or the implantation of stem cells . Clinical assessment s ranging from 6 to 18 months after transplantation demonstrated no evidence of acceleration of disease progression due to the intervention . One patient has shown improvement in his clinical status , although these data must be interpreted with caution since this trial was neither design ed nor powered to measure treatment efficacy . These results allow us to report success in achieving the phase I goal of demonstrating safety of this therapeutic approach . Based on these positive results , we can now advance this trial by testing intraspinal injections into the cervical spinal cord , with the goal of protecting motor neuron pools affecting respiratory function , which may prolong life for patients with ALS BACKGROUND AIMS Mesenchymal stem cells/marrow stromal cells ( MSC ) represent a promising tool for stem cell-based clinical trials in amyotrophic lateral sclerosis ( ALS ) . We present the results of long-term monitoring of 19 ALS patients enrolled in two phase I clinical trials of autologous MSC transplantation .  METHODS Nineteen patients ( 11 male and eightfemale ) with ALS were enrolled in two consecutive phase I clinical trials . The patients were followed-up for 6 - 9 months and then treated with autologous MSC isolated from bone marrow and implanted into the dorsal spinal cord with a surgical procedure . The patients were monitored regularly before and after transplantation with clinical , psychological and neuroradiologic assessment s every 3 months , at the tertiary referral ALS center in Novara ( Italy ) , until death . RESULTS Follow-up brain magnetic resonance imaging ( MRI ) revealed no structural changes ( including tumor formation ) relative to the baseline throughout the follow-up . There was no deterioration in the psychosocial status and all patients coped well . No clear clinical benefits were detected in these patients but the recruitment and selection of appropriate patients into larger trials will be needed to test the efficacy of the treatment . CONCLUSIONS This study is the first to show the safety of MSC transplantation in the central nervous system during a follow-up of nearly 9 years , and is in support of applying MSC-based cellular clinical trials to neurodegenerative disorders BACKGROUND AIMS Amyotrophic lateral sclerosis ( ALS ) is characterized by the selective death of motor neurons . CD133(+ ) stem cells are known to have the capacity to differentiate into neural lineages . Stem cells may provide an alternative treatment for ALS and other neurodegenerative diseases . METHODS Five men and five women ( aged 38 - 62 years ) with confirmed ALS were included in this study . Our institutional ethics and research committees approved the protocol . After informed consent was obtained , patients underwent Hidrogen-Magnetic Resonance Imaging ( H-MRI ) spectroscopy  and were given scores according to an ALS functional rating scale , Medical Research Council power muscle scale and daily living activities . Bone marrow was stimulated with 300 microg filgrastim subcutaneously daily for 3 days . Peripheral blood mononuclear cells were obtained after admission by leukapheresis . The cell suspension was conjugated with anti-human CD133 superparamagnetic microbeads , and linked cells were isolated in a magnetic field . The isolated cells ( 2.5 - 7.5x10(5 ) ) were resuspended in 300 microL of the patient 's cerebrospinal fluid , and implanted in motor cortexes using a Hamilton syringe . Ten patients with confirmed ALS without transplantation were used as a control group . Patients were followed up for a period of 1 year . RESULTS The autologous transplantation of CD133(+ ) stem cells into the frontal motor cortex is a safe and well-tolerated procedure in ALS patients . The survival of treated patients was statistically higher ( P=0.01 ) than untreated control patients . CONCLUSIONS Stem-cell transplantation in the motor cortex delays ALS progression and improves quality of life BACKGROUND Amyotrophic lateral sclerosis ( ALS ) is a fatal neurodegenerative disorder characterized by progressive loss of spinal cord and cortical motoneurons . Despite improved underst and ing of the mechanisms underlying ALS , in clinical practice the management of ALS remains essentially supportive and focused on symptom relief . However , over the past few years stem cell research has exp and ed greatly as a tool for developing potential new therapies for treating incurable neurodegenerative diseases . METHODS Thirteen patients with sporadic amyotrophic lateral sclerosis ( SALS ) were included in this study , and bone marrow (BM)-derived hematopoietic progenitor stem cells were used . We selected patients with bulbar involvement and severe loss of movement . Our aim was to put the stem cells into the end of the brain stem and at the beginning of the spinal cord because the blood-brain barrier is intact in ALS and this region was the most 
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In contrast , the number of clinical studies is still insufficient to assess their effectiveness , and these studies only demonstrate the absence of serious adverse events .