Journal Information
Vol. 27. Issue 6.
Pages 285-290 (November - December 2016)
Share
Share
Download PDF
More article options
Vol. 27. Issue 6.
Pages 285-290 (November - December 2016)
Artículo de revisión
Subtalamotomía como neuroprotección en la enfermedad de Parkinson. El papel de los ultrasonidos guiados por resonancia como cirugía temprana
Neuroprotective subthalamotomy in Parkinson's disease. The role of magnetic resonance-guided focused ultrasound in early surgery
Jorge Guridi
Corresponding author
jguridi@unav.es

Autor para correspondencia.
, Miguel Marigil, Victoria Becerra, Olga Parras
Servicio de Neurocirugía Clínica, Universidad de Navarra, Pamplona, España
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (1)
Resumen

La hiperactividad del núcleo subtalámico en la enfermedad de Parkinson puede ser un fenómeno temprano. El comienzo de la misma no se conoce con exactitud pero podría ocurrir en la fase presintomática de la enfermedad. Esta hiperactividad glutamatérgica puede ser tóxica para las neuronas dopaminérgicas de la sustancia negra compacta. Si esto fuera así, el neurotransmisor excitador, ácido glutámico, afectaría a las neuronas que se encuentran con un turnover elevado como mecanismo compensador. ¿Podría una lesión en el núcleo subtalámico reducir esta hiperactividad y ser un mecanismo neuroprotector para dichas neuronas? Los autores hipotetizan sobre la posibilidad de realizar una cirugía sobre la lesión en el núcleo subtalámico en una fase muy temprana para evitar el efecto neurotóxico del ácido glutámico sobre las neuronas dopaminérgicas y ser una cirugía neuroprotectora que pudiera alterar la historia natural de la enfermedad en sus primeras fases motoras. En este sentido, los ultrasonidos guiados por resonancia abren una nueva ventana en el arsenal estereotáctico.

Palabras clave:
Enfermedad de Parkinson
Neurotoxicidad
Neuroprotección
Ultrasonidos focalizados por resonancia
Núcleo subtalámico
Abstract

Subthalamic nucleus hyperactivity in Parkinson's disease may be a very early phenomenon. Its start is not well known, and it may occur during the pre-symptomatic disease stage. Glutamatergic hyperactivity may be neurotoxic over the substantia nigra compacta dopaminergic neurons. If this occurred, the excitatory neurotransmitter, glutamate, should affect the neurons that maintain a high turnover as a compensatory mechanism. Would a subthalamic nucleus lesion decrease this hyperactivity and thus be considered as a neuroprotective mechanism for dopaminergic neurons? The authors hypothesise about the possibility to perform surgery on a subthalamic nucleus lesion at a very early stage in order to avoid the neurotoxic glutamatergic effect over the dopaminergic neurons, and therefore be considered as a neuroprotective surgery able to alter the progress of the disease during early motor symptoms. In this regard, magnetic resonance-guided focused ultrasound techniques open a new window in the stereotactic armamentarium.

Keywords:
Parkinson's disease
Neurotoxicity
Neuroprotection
Magnetic resonance-guided focused ultrasound
Subthalamic nucleus

Article

These are the options to access the full texts of the publication Neurocirugía (English edition)
Member
Member of the Sociedad Española de Neurocirugía

If it is the first time you have accessed you can obtain your credentials by contacting Elsevier Spain in suscripciones@elsevier.com or by calling our Customer Service at902 88 87 40 if you are calling from Spain or at +34 932 418 800 (from 9 to 18h., GMT + 1) if you are calling outside of Spain.

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option ¿I have forgotten my password¿.

Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Neurocirugía (English edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Email
Idiomas
Neurocirugía (English edition)
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?