Abstract

Since approximately two thirds of epileptic patients are non-eligible for surgery, local axonal fiber transections might be of particular interest for them. Micrometer to millimeter wide synchrotron-generated X-ray beamlets produced by spatial fractionation of the main beam could generate such fiber disruptions non-invasively. The aim of this work was to optimize irradiation parameters for the induction of fiber transections in the rat brain white matter by exposure to such beamlets. For this purpose, we irradiated cortex and external capsule of normal rats in the antero-posterior direction with a 4 mm×4 mm array of 25 to 1000 µm wide beamlets and entrance doses of 150 Gy to 500 Gy. Axonal fiber responses were assessed with diffusion tensor imaging and fiber tractography; myelin fibers were examined histopathologically. Our study suggests that high radiation doses (500 Gy) are required to interrupt axons and myelin sheaths. However, a radiation dose of 500 Gy delivered by wide minibeams (1000 µm) induced macroscopic brain damage, depicted by a massive loss of matter in fiber tractography maps. With the same radiation dose, the damage induced by thinner microbeams (50 to 100 µm) was limited to their paths. No macroscopic necrosis was observed in the irradiated target while overt transections of myelin were detected histopathologically. Diffusivity values were found to be significantly reduced. A radiation dose ≤ 500 Gy associated with a beamlet size of < 50 µm did not cause visible transections, neither on diffusion maps nor on sections stained for myelin. We conclude that a peak dose of 500 Gy combined with a microbeam width of 100 µm optimally induced axonal transections in the white matter of the brain.

Highlights

  • Microbeam radiation therapy (MRT), an alternative form of brain radiosurgery, is under development since about two decades, and since 15 years [1] at the European Synchrotron Radiation Facility (ESRF) in Grenoble, France

  • No neurological changes were observed during the whole experiment (2 months) in rats which survived after the first week; the results did not depend on microbeam width and radiation dose

  • The results of the present study show that high dose delivery through synchrotron-generated X-rays might be used as a nonsurgical alternative of multiple subpial transections for the treatment of epilepsy

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Summary

Introduction

Microbeam radiation therapy (MRT), an alternative form of brain radiosurgery, is under development since about two decades, and since 15 years [1] at the European Synchrotron Radiation Facility (ESRF) in Grenoble, France. It uses spatially fractionated synchrotron-generated X-rays in the form of arrays of quasiparallel, lamellar microbeams, tens of micron wide, and spaced hundreds of microns on-center [2]. The quasi-null divergence and the high flux of synchrotron light allows deposition of very high radiation dose (hundreds of Gy) in the brain, ablating selectively neurons, astrocytes and oligodendrocytes in tissue microslices [3]. Dilmanian et al briefly discussed oligodendrocyte repopulation in the spinal cord 3 months after MRT [12] but the irradiation parameters and biological responses were not extensively described

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