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Int. J. Mol. Sci. 2017, 18(10), 2190;

Neuroprotective Surgical Strategies in Parkinson’s Disease: Role of Preclinical Data

University Grenoble Alpes, CEA, LETI, CLINATEC, MINATEC Campus, 38000 Grenoble, France
Department of Anatomy, University of Sydney; Sydney Medical School, Sydney NSW 2006, Australia
Author to whom correspondence should be addressed.
Received: 19 September 2017 / Revised: 10 October 2017 / Accepted: 13 October 2017 / Published: 20 October 2017
(This article belongs to the Special Issue Neuroprotective Strategies 2017)
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Although there have been many pharmacological agents considered to be neuroprotective therapy in Parkinson’s disease (PD) patients, neurosurgical approaches aimed to neuroprotect or restore the degenerative nigrostriatal system have rarely been the focus of in depth reviews. Here, we explore the neuroprotective strategies involving invasive surgical approaches (NSI) using neurotoxic models 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) and 6-hydroxydopamine (6-OHDA), which have led to clinical trials. We focus on several NSI approaches, namely deep brain stimulation of the subthalamic nucleus, glial neurotrophic derived factor (GDNF) administration and cell grafting methods. Although most of these interventions have produced positive results in preclinical animal models, either from behavioral or histological studies, they have generally failed to pass randomized clinical trials to validate each approach. We argue that NSI are promising approaches for neurorestoration in PD, but preclinical studies should be planned carefully in order not only to detect benefits but also to detect potential adverse effects. Further, clinical trials should be designed to be able to detect and disentangle neuroprotection from symptomatic effects. In summary, our review study evaluates the pertinence of preclinical models to study NSI for PD and how this affects their efficacy when translated into clinical trials. View Full-Text
Keywords: neuroprotection; Parkinson disease; surgery; cell grafts; glial neurotrophic derived factor; deep brain stimulation neuroprotection; Parkinson disease; surgery; cell grafts; glial neurotrophic derived factor; deep brain stimulation

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Torres, N.; Molet, J.; Moro, C.; Mitrofanis, J.; Benabid, A.L. Neuroprotective Surgical Strategies in Parkinson’s Disease: Role of Preclinical Data. Int. J. Mol. Sci. 2017, 18, 2190.

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