Structural Microtubule Collapse: A Proposed Mechanism for mtND4-Linked Neurotoxicity in Venezuelan Populations

This paper explores the 2026 clinical crisis involving the mtND4 m.11232T>C mutation found in patients of Venezuelan ancestry. Following catastrophic neurological outcomes during routine anesthesia, evidence suggests that volatile gases (such as Sevoflurane) trigger an immediate structural collapse of the neuronal cytoskeleton. The research suggests that the immediate injury observed, irreversible brain damage within minutes is caused by a "structural crash" rather than simple metabolic exhaustion. When ATP production is inhibited, the protective "cap" of microtubules is lost, triggering "Catastrophic Depolymerization" where the tubes physically unzip.