title: [Neuroprotective subthalamotomy in Parkinson's disease. The role of magnetic resonance-guided focused ultrasound in early surgery].
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.
authors.affiliation: Servicio de Neurocirugía Clínica, Universidad de Navarra, Pamplona, España. Electronic address: jguridi@unav.es.
authors.forename: Jorge
authors.initials: J
authors.lastname: Guridi
authors.affiliation: Servicio de Neurocirugía Clínica, Universidad de Navarra, Pamplona, España.
authors.forename: Miguel
authors.initials: M
authors.lastname: Marigil
authors.affiliation: Servicio de Neurocirugía Clínica, Universidad de Navarra, Pamplona, España.
authors.forename: Victoria
authors.initials: V
authors.lastname: Becerra
authors.affiliation: Servicio de Neurocirugía Clínica, Universidad de Navarra, Pamplona, España.
authors.forename: Olga
authors.initials: O
authors.lastname: Parras
mesh_terms: D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D009474:Neurons; D010300:Parkinson Disease / Q000601:surgery*; D020531:Subthalamic Nucleus / Q000601:surgery*; D018084:Ultrasonography, Interventional
keywords: Enfermedad de Parkinson; Magnetic resonance-guided focused ultrasound; Neuroprotección; Neuroprotection; Neurotoxicidad; Neurotoxicity; Núcleo subtalámico; Parkinson's disease; Subthalamic nucleus; Ultrasonidos focalizados por resonancia