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Radiosurgery as Neuromodulation Therapy!

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Gamma Knife Neurosurgery in the Management of Intracranial Disorders

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 116))

Abstract

Radiosurgery is commonly considered to be effective through a destructive physical mechanism acting on neural tissue. However, the results of modern neurophysiological, radiological, and histological studies are providing a basis on which to question this assumption. There are now multiple pieces of evidence pointing to a nonlesional mechanism of the radiosurgical action. It appears that tissue destruction is absent or minimal and in almost all cases insufficient to explain the clinical effects produced. There is a real possibility that radiosurgery induces changes in the functioning of neural tissue by differential effects on various neuronal populations and remodeling the glial environment, leading to modulation of function while preserving basic processing. Hence, the majority of radiosurgical procedures induce the desired biological effect without histological destruction of tissue. These findings may result in a major paradigm shift in the treatment of functional brain disorders.

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Conflict of Interest

The Author is recipient of the research grant from Elekta Instruments AB and Meetings’ sponsorships from Accuray, BrainLab, Elekta Instruments AB, and Varian, none of which is related to the present study.

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Authors and Affiliations

  1. Department of Stereotactic and Functional Neurosurgery, Aix Marseille University, Timone University Hospital, and INSERM U751, 264 rue Saint Pierre, Marseille, 13385, Cedex 05, France

    Jean Régis

  2. Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering and Science, Tokyo Women’s Medical University, Tokyo, Japan

    Jean Régis

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  1. Jean Régis
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Correspondence to Jean Régis .

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Editors and Affiliations

  1. , Fac. of Adv. Techno-Surgery, Tokyo Women's Medical University, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Mikhail F. Chernov

  2. , Dept. of Neurosurgery, Tokyo Women's Medical University, Kawada-cho, Shinjuku-ku 8-1, Tokyo, 162-8666, Japan

    Motohiro Hayashi

  3. Oysteinsgate 16, Bergen, 5007, Norway

    Jeremy C. Ganz

  4. Kawada-cho, Shinjuku-ku 8-1, JP-162 8666 TOKYO, Japan

    Kintomo Takakura

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Régis, J. (2013). Radiosurgery as Neuromodulation Therapy!. In: Chernov, M., Hayashi, M., Ganz, J., Takakura, K. (eds) Gamma Knife Neurosurgery in the Management of Intracranial Disorders. Acta Neurochirurgica Supplement, vol 116. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1376-9_19

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  • DOI: https://doi.org/10.1007/978-3-7091-1376-9_19

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