Clinical CNS microdialysis of glutamate with a special methodological focus on human spinal cord

Abstract

Glutamate has a paramount role in central nervous system since it is the main excitatory neurotransmitter in both the brain and the spinal cord. In clinical studies, the monitoring of glutamate has revealed tight links between the variations of its interstitial concentration and those of other metabolic biomarkers and partial pressure in oxygen within tissue. The use of microdialysis has allowed to monitor glutamate over several days in patients with brain injury, epilepsy, or Parkinson’s disease. We describe here a neurochemical method carried out in the spinal cord of patients suffering from chronic pain compared to patients suffering from spasticity, with a stress on peculiarities on such a monitoring. We provide also a detailed discussion on the significant usefulness of microdialysis and its technical and methodological limits in the specific field of clinical research.