Régis Jean
Department of Stereotactic and Functional Neurosurgery, Aix Marseille University, Timone University Hospital, and INSERM U751, 264 rue Saint Pierre, Marseille, 13385, Cedex 05, France.
Acta Neurochir Suppl. 2013;116:121-6. doi: 10.1007/978-3-7091-1376-9_19.
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.
放射外科通常被认为是通过作用于神经组织的破坏性物理机制发挥作用。然而，现代神经生理学、放射学和组织学研究结果正为质疑这一假设提供依据。现在有多项证据指向放射外科作用的非损伤性机制。似乎组织破坏不存在或很轻微，几乎在所有情况下都不足以解释所产生的临床效果。放射外科很有可能通过对不同神经元群体的差异作用和重塑胶质环境来诱导神经组织功能变化，从而在保留基本加工过程的同时调节功能。因此，大多数放射外科手术在不造成组织组织学破坏的情况下诱导出所需的生物学效应。这些发现可能会导致功能性脑部疾病治疗的重大范式转变。
