Microdialysis study of amino acid neurotransmitters in the spinal dorsal horn of patients undergoing microsurgical dorsal root entry zone lesioning

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Patrick MertensLaboratories of Anatomy, and Neuropharmacology and Neurochemistry (INSERM-U 512), and Departments of Neurosurgery, Anesthesiology, and Biology (Neurochemistry Unit), Federative Institute for Neuroscience, Claude Bernard University and Neurological Hospital (Hospices Civils de Lyon) Lyon, France

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Chantal GhaemmaghamiLaboratories of Anatomy, and Neuropharmacology and Neurochemistry (INSERM-U 512), and Departments of Neurosurgery, Anesthesiology, and Biology (Neurochemistry Unit), Federative Institute for Neuroscience, Claude Bernard University and Neurological Hospital (Hospices Civils de Lyon) Lyon, France

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Lionel BertLaboratories of Anatomy, and Neuropharmacology and Neurochemistry (INSERM-U 512), and Departments of Neurosurgery, Anesthesiology, and Biology (Neurochemistry Unit), Federative Institute for Neuroscience, Claude Bernard University and Neurological Hospital (Hospices Civils de Lyon) Lyon, France

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Armand Perret-LiaudetLaboratories of Anatomy, and Neuropharmacology and Neurochemistry (INSERM-U 512), and Departments of Neurosurgery, Anesthesiology, and Biology (Neurochemistry Unit), Federative Institute for Neuroscience, Claude Bernard University and Neurological Hospital (Hospices Civils de Lyon) Lyon, France

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Marc GuenotLaboratories of Anatomy, and Neuropharmacology and Neurochemistry (INSERM-U 512), and Departments of Neurosurgery, Anesthesiology, and Biology (Neurochemistry Unit), Federative Institute for Neuroscience, Claude Bernard University and Neurological Hospital (Hospices Civils de Lyon) Lyon, France

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Hussein NaousLaboratories of Anatomy, and Neuropharmacology and Neurochemistry (INSERM-U 512), and Departments of Neurosurgery, Anesthesiology, and Biology (Neurochemistry Unit), Federative Institute for Neuroscience, Claude Bernard University and Neurological Hospital (Hospices Civils de Lyon) Lyon, France

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Laurent LaganierLaboratories of Anatomy, and Neuropharmacology and Neurochemistry (INSERM-U 512), and Departments of Neurosurgery, Anesthesiology, and Biology (Neurochemistry Unit), Federative Institute for Neuroscience, Claude Bernard University and Neurological Hospital (Hospices Civils de Lyon) Lyon, France

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Roger LaterLaboratories of Anatomy, and Neuropharmacology and Neurochemistry (INSERM-U 512), and Departments of Neurosurgery, Anesthesiology, and Biology (Neurochemistry Unit), Federative Institute for Neuroscience, Claude Bernard University and Neurological Hospital (Hospices Civils de Lyon) Lyon, France

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Marc SindouLaboratories of Anatomy, and Neuropharmacology and Neurochemistry (INSERM-U 512), and Departments of Neurosurgery, Anesthesiology, and Biology (Neurochemistry Unit), Federative Institute for Neuroscience, Claude Bernard University and Neurological Hospital (Hospices Civils de Lyon) Lyon, France

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Bernard RenaudLaboratories of Anatomy, and Neuropharmacology and Neurochemistry (INSERM-U 512), and Departments of Neurosurgery, Anesthesiology, and Biology (Neurochemistry Unit), Federative Institute for Neuroscience, Claude Bernard University and Neurological Hospital (Hospices Civils de Lyon) Lyon, France

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✓ The aim of this study was to develop, for the first time in the human spinal dorsal horn (DH), an in vivo method for the study of amino acids (AAs).

A microdialysis technique was used to sample AAs in the extracellular fluid of the DH apex in eight patients in whom surgery in the dorsal root entry zone (DREZ) was performed. Before making microsurgical lesions, specific concentric-type microdialysis probes were implanted over a 60-minute period in the DREZ and directed to the DH apex (10 implantations). The AA concentrations in the dialysates were determined using high-performance liquid chromatography with fluorescence detection. The concentrations of excitatory AAs (glutamate and aspartate) and inhibitory AAs (γ-aminobutyric acid and glycine) decreased and were stabilized by 45 minutes after probe implantation, whereas the levels of nonneurotransmitter AAs (alanine and threonine) were not stabilized at 60 minutes. The ability of the probe to track the changes of extracellular AAs was demonstrated. Neither intra- nor postoperative microdialysis-related complications were observed (with a follow up of 18 months).

The present study demonstrates that microdialysis can be performed safely in the human DH during DREZ lesioning. Despite technical and analytical limitations related to the intraoperative conditions, this technique offers new possibilities for clinical research on neurotransmitters involved in some relevant pathological states, especially in chronic pain and spasticity.

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