In the first experiment, single doses of 20 or 40 Gy (but not 10 Gy) reduced substantially, and in some cases eliminated, behaviorally and electrographically recognized seizures. Significant reductions in both the frequency and duration of spontaneous seizures were observed during a follow-up period of up to 10 months postradiation. Histological examination of the targeted region did not reveal signs of necrosis. These findings indicate that single-dose focal ionizing beam irradiation at subnecrotic dosages reduces or eliminates repetitive spontaneous seizures in a rat model of temporal lobe epilepsy. In the second experiment, synaptically driven neuronal firing was shown to be intact in hippocampal neurons subjected to 40-Gy doses. However, the susceptibility to penicillin-induced epileptiform activity was reduced in the brain slices of animals receiving 40-Gy doses, compared with those from control rats that were not irradiated. The results provide rational support for the utility of subnecrotic gamma irradiation as a therapeutic strategy for treating epilepsy. These findings also provide evidence that a functional increase in the seizure threshold of hippocampal neurons contributes to the anticonvulsant influence of subnecrotic gamma irradiation.
Radiation-induced changes in the parietal cortex of Wistar rats were observed at various time points after gamma surgery. Maximum dosages of 50, 75, and 120 Gy were given at the iso-center of the radiation using a 4-mm collimator. Conventional histochemical and immunocytochemical analyses, and computer-assisted videomicroscopy were utilized to examine perfusion-fixed brain tissue. Irradiation at a dosage of 50 Gy elicited morphological changes of astrocytes in the parietal cortex at 3 months. Vasodilatation became obvious at 12 months; fibrin deposition was observed in the dilated capillary wall. Neither leakage of Evans Blue from the vasculature into the tissue nor necrosis was observed across the 12 month observation period. Irradiation at a dosage of 75 Gy resulted in morphological changes of astrocytes within 1 month. Dilatation of vessels and capillary thickening were observed at 3 months. Evans Blue leakage and necrosis were observed at 4 months after 75 Gy irradiation. At this time, the walls of arterioles became thickened by subintimal accumulation of fibrin and hyaline substance; this sometimes resulted in occlusion of the lumen. Significant hemispheric swelling was observed at 4 months. Irradiation at a dosage of 120 Gy elicited changes in astrocytic morphology within 3 days. Evans Blue leakage into the tissue was observed by 3 weeks. Vasodilation became marked at this time point and rarefaction was observed in the irradiated cortex. Necrosis was observed at 4 weeks, however, no significant swelling was observed. Taken together, these findings demonstrate time-dependent and dosage-dependent changes in normal cerebral tissue after Gamma Knife irradiation. These results provide a basis for gauging the impact of gamma surgery in regions of eloquent tissue. An enhanced understanding of the cellular responses to radiosurgery will contribute to developing and evaluating future applications for gamma surgery.
The necrotic response to intermediate doses of focused-beam irradiation appears after a considerable latency period and then progresses rapidly. This contrasts with previously reported responses to fractionated whole-brain irradiation, in which damage occurs slowly and gradually. Alterations in the microvascular basement membrane precede overt cellular changes in neuronal and vascular cells and provide an early index of cerebrovascular dysfunction in regions destined to undergo necrosis.
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