研究者詳細 - 佐々木　達也

論文 - 佐々木　達也

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Vagus Nerve Stimulation with Mild Stimulation Intensity Exerts Anti-Inflammatory and Neuroprotective Effects in Parkinson's Disease Model Rats. 国際誌

Ittetsu Kin, Tatsuya Sasaki, Takao Yasuhara, Masahiro Kameda, Takashi Agari, Mihoko Okazaki, Kakeru Hosomoto, Yosuke Okazaki, Satoru Yabuno, Satoshi Kawauchi, Ken Kuwahara, Jun Morimoto, Kyohei Kin, Michiari Umakoshi, Yousuke Tomita, Naoki Tajiri, Cesario V Borlongan, Isao Date

Biomedicines 9 ( 7 ) 2021年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: The major surgical treatment for Parkinson's disease (PD) is deep brain stimulation (DBS), but a less invasive treatment is desired. Vagus nerve stimulation (VNS) is a relatively safe treatment without cerebral invasiveness. In this study, we developed a wireless controllable electrical stimulator to examine the efficacy of VNS on PD model rats. METHODS: Adult female Sprague-Dawley rats underwent placement of a cuff-type electrode and stimulator on the vagus nerve. Following which, 6-hydroxydopamine (6-OHDA) was administered into the left striatum to prepare a PD model. VNS was started immediately after 6-OHDA administration and continued for 14 days. We evaluated the therapeutic effects of VNS with behavioral and immunohistochemical outcome assays under different stimulation intensity (0.1, 0.25, 0.5 and 1 mA). RESULTS: VNS with 0.25-0.5 mA intensity remarkably improved behavioral impairment, preserved dopamine neurons, reduced inflammatory glial cells, and increased noradrenergic neurons. On the other hand, VNS with 0.1 mA and 1 mA intensity did not display significant therapeutic efficacy. CONCLUSIONS: VNS with 0.25-0.5 mA intensity has anti-inflammatory and neuroprotective effects on PD model rats induced by 6-OHDA administration. In addition, we were able to confirm the practicality and effectiveness of the new experimental device.

DOI： 10.3390/biomedicines9070789

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[Programing of Deep Brain Stimulation and Features of Devices].

Tatsuya Sasaki, Isao Date

No shinkei geka. Neurological surgery 49 ( 4 ) 829 - 837 2021年7月

記述言語：日本語掲載種別：研究論文（学術雑誌）

Deep brain stimulation(DBS)is an effective therapy for conditions involving drug-resistant involuntary movements, such as Parkinson's disease, tremor, and dystonia. Programming of DBS, as well as strict surgical indications, appropriate target selection, and accurate electrode placement, is one of the most important factors in the success of DBS. To obtain effective stimulation for a long period, it is important to expand the therapeutic window and reduce side effects. Recent advances in DBS devices have dramatically expanded the variety of stimulus settings. While the indication criteria of DBS and surgical techniques have been established, the details of the programming algorithm are not yet unified. In this paper, we describe the features of each device, basic programming methods, management of DBS-related side effects, and advanced stimulus methods.

DOI： 10.11477/mf.1436204461

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両側淡蒼球内節刺激術が有効であったDYT1ジストニアの一卵性双胎例

岡崎洋介, 佐々木達也, 細本翔, 亀田雅博, 安原隆雄, 秋山麻里, 秋山倫之, 小林勝弘, 伊達勲

日本定位・機能神経外科学会プログラム・抄録集 60回 110 - 110 2020年12月

Cell encapsulation enhances antidepressant effect of the mesenchymal stem cells and counteracts depressive-like behavior of treatment-resistant depressed rats. 国際誌

Kyohei Kin, Takao Yasuhara, Masahiro Kameda, Yousuke Tomita, Michiari Umakoshi, Ken Kuwahara, Ittetsu Kin, Naoya Kidani, Jun Morimoto, Mihoko Okazaki, Tatsuya Sasaki, Naoki Tajiri, Cesario V Borlongan, Isao Date

Molecular psychiatry 25 ( 6 ) 1202 - 1214 2020年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

Despite the advances in pharmacological therapies, only the half of depressed patients respond to currently available treatment. Thus, the need for further investigation and development of effective therapies, especially those designed for treatment-resistant depression, has been sorely needed. Although antidepressant effects of mesenchymal stem cells (MSCs) have been reported, the potential benefit of this cell therapy on treatment-resistant depression is unknown. Cell encapsulation may enhance the survival rate of grafted cells, but the therapeutic effects and mechanisms mediating encapsulation of MSCs remain unexplored. Here, we showed that encapsulation enhanced the antidepressant effects of MSCs by attenuating depressive-like behavior of Wistar Kyoto (WKY) rats, which are considered as a promising animal model of treatment-resistant depression. The implantation of encapsulated MSCs (eMSCs) into the lateral ventricle counteracted depressive-like behavior and enhanced the endogenous neurogenesis in the subventricular zone (SVZ) and the dentate gyrus (DG) of the hippocampus, whereas the implantation of MSCs without encapsulation or the implantation of eMSCs into the striatum did not show such ameliorative effects. eMSCs displayed robust and stable secretion of vascular endothelial growth factor (VEGF), brain-derived neurotrophic factor, fibroblast growth factor-2, and ciliary neurotrophic factor (CNTF), and the implantation of eMSCs into the lateral ventricle activated relevant pathways associated with these growth factors. Additionally, eMSCs upregulated intrinsic expression of VEGF and CNTF and their receptors. This study suggests that the implantation of eMSCs into the lateral ventricle exerted antidepressant effects likely acting via neurogenic pathways, supporting their utility for depression treatment.

DOI： 10.1038/s41380-018-0208-0

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Cell therapy for central nervous system disorders: Current obstacles to progress. 国際誌

Takao Yasuhara, Satoshi Kawauchi, Kyohei Kin, Jun Morimoto, Masahiro Kameda, Tatsuya Sasaki, Brooke Bonsack, Chase Kingsbury, Naoki Tajiri, Cesario V Borlongan, Isao Date

CNS neuroscience & therapeutics 26 ( 6 ) 595 - 602 2020年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

Cell therapy for disorders of the central nervous system has progressed to a new level of clinical application. Various clinical studies are underway for Parkinson's disease, stroke, traumatic brain injury, and various other neurological diseases. Recent biotechnological developments in cell therapy have taken advantage of the technology of induced pluripotent stem (iPS) cells. The advent of iPS cells has provided a robust stem cell donor source for neurorestoration via transplantation. Additionally, iPS cells have served as a platform for the discovery of therapeutics drugs, allowing breakthroughs in our understanding of the pathology and treatment of neurological diseases. Despite these recent advances in iPS, adult tissue-derived mesenchymal stem cells remain the widely used donor for cell transplantation. Mesenchymal stem cells are easily isolated and amplified toward the cells' unique trophic factor-secretion property. In this review article, the milestone achievements of cell therapy for central nervous system disorders, with equal consideration on the present translational obstacles for clinic application, are described.

DOI： 10.1111/cns.13247

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脊髄電気刺激は神経保護効果を有するか─パーキンソン病の再生医療─ 査読

安原隆雄、守本純、金恭平、佐々木達也、伊達勲

脊髄外科 SPINAL SURGERY 34 ( 1 ) 90 - 91 2020年4月

Study protocol of a Phase I/IIa clinical trial of Ad-SGE-REIC for treatment of recurrent malignant glioma. 国際誌

Kazuhiko Kurozumi, Kentaro Fujii, Yosuke Shimazu, Yusuke Tomita, Tatsuya Sasaki, Takao Yasuhara, Tomohito Hishikawa, Masahiro Kameda, Hiromi Kumon, Isao Date

Future oncology (London, England) 16 ( 6 ) 151 - 159 2020年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

Malignant glioma is one of the most common brain cancers in humans, which is very devastating. The expression of reduced expression in immortalized cells/Dickkopf-3 (REIC/Dkk-3) is decreased in various human cancers. Lately, we have developed a novel second-generation adenoviral vector that expresses REIC/Dkk-3 (Ad-SGE-REIC) and revealed its antiglioma efficacy. The present investigator-initiated clinical trial is a single-arm, prospective, nonrandomized, noncomparative, open-label, single-center trial performed at Okayama University Hospital, Okayama, Japan. The primary end points are dose-limiting toxicities and the incidence of adverse events. The secondary end points are the objective response rate and immunological assessment. Use of Ad-SGE-REIC will help to improve the prognosis of patients with malignant brain tumors.

DOI： 10.2217/fon-2019-0743

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Long-Term Continuous Cervical Spinal Cord Stimulation Exerts Neuroprotective Effects in Experimental Parkinson's Disease. 国際誌

Ken Kuwahara, Tatsuya Sasaki, Takao Yasuhara, Masahiro Kameda, Yosuke Okazaki, Kakeru Hosomoto, Ittetsu Kin, Mihoko Okazaki, Satoru Yabuno, Satoshi Kawauchi, Yousuke Tomita, Michiari Umakoshi, Kyohei Kin, Jun Morimoto, Jea-Young Lee, Naoki Tajiri, Cesar V Borlongan, Isao Date

Frontiers in aging neuroscience 12 164 - 164 2020年

記述言語：英語掲載種別：研究論文（学術雑誌）

Background: Spinal cord stimulation (SCS) exerts neuroprotective effects in animal models of Parkinson's disease (PD). Conventional stimulation techniques entail limited stimulation time and restricted movement of animals, warranting the need for optimizing the SCS regimen to address the progressive nature of the disease and to improve its clinical translation to PD patients. Objective: Recognizing the limitations of conventional stimulation, we now investigated the effects of continuous SCS in freely moving parkinsonian rats. Methods: We developed a small device that could deliver continuous SCS. At the start of the experiment, thirty female Sprague-Dawley rats received the dopamine (DA)-depleting neurotoxin, 6-hydroxydopamine, into the right striatum. The SCS device was fixed below the shoulder area of the back of the animal, and a line from this device was passed under the skin to an electrode that was then implanted epidurally over the dorsal column. The rats were divided into three groups: control, 8-h stimulation, and 24-h stimulation, and behaviorally tested then euthanized for immunohistochemical analysis. Results: The 8- and 24-h stimulation groups displayed significant behavioral improvement compared to the control group. Both SCS-stimulated groups exhibited significantly preserved tyrosine hydroxylase (TH)-positive fibers and neurons in the striatum and substantia nigra pars compacta (SNc), respectively, compared to the control group. Notably, the 24-h stimulation group showed significantly pronounced preservation of the striatal TH-positive fibers compared to the 8-h stimulation group. Moreover, the 24-h group demonstrated significantly reduced number of microglia in the striatum and SNc and increased laminin-positive area of the cerebral cortex compared to the control group. Conclusions: This study demonstrated the behavioral and histological benefits of continuous SCS in a time-dependent manner in freely moving PD animals, possibly mediated by anti-inflammatory and angiogenic mechanisms.

DOI： 10.3389/fnagi.2020.00164

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パーキンソン病モデルラットに対する持続脊髄電気刺激療法の有用性査読

桑原研、佐々木達也、岡崎洋介、細本翔、金一徹、藪野諭、河内哲、冨田陽介、馬越通有、亀田雅博、安原隆雄、伊達勲

機能的脳神経外科 58 45 - 51 2019年12月

Identification of Somatotopic Organization and Optimal Stimulation Site Within the Subthalamic Nucleus for Parkinson's Disease. 国際誌

Tatsuya Sasaki, Ken Kuwahara, Ittetsu Kin, Mihoko Okazaki, Susumu Sasada, Aiko Shinko, Masahiro Kameda, Takao Yasuhara, Takashi Agari, Isao Date

Operative neurosurgery (Hagerstown, Md.) 17 ( 3 ) 239 - 246 2019年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Details of the somatotopy within the subthalamic nucleus (STN) are still poorly understood; however, the STN is a common target of deep brain stimulation (DBS) for Parkinson disease. OBJECTIVE: To examine somatotopic organization within the STN and identify optimal stimulation sites from 77 surgical cases with microelectrode recording. METHODS: STN-DBS was performed for 77 patients with Parkinson disease between 2010 and 2014. We performed passive movements of each joint and captured single neuronal activities to identify movement-related cells (MRCs). The sites of MRCs and active contacts were determined by measuring their distances from the first contact of DBS electrode. Their positional correlations were directly and indirectly analyzed. RESULTS: The number of obtained MRCs was 264, of which 151 responded to multiple joints. The average x-, y-, and z-coordinates of the cells of the upper and lower limbs from the midcommisural point were 13.1 ± 1.1 and 12.7 ± 1.2, 0.22 ± 1.3 and -0.45 ± 1.5, and -2.5 ± 1.1 and -3.0 ± 1.4 mm, respectively. Most MRCs were distributed in the upper third of the STN, in its superior, lateral, and posterior regions, along the DBS electrode routes. Active contacts were observed to lie slightly inferior, medial, and posterior to the average MRC position. CONCLUSION: Somatotopic organization of the STN was easier to observe in the present study than in previous studies. Optimal stimulation sites were located inferior, medial, and posterior to the average MRC location. The sites may correspond to associative or motor parts through which fibers from the supplementary motor area pass.

DOI： 10.1093/ons/opy351

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Lithium counteracts depressive behavior and augments the treatment effect of selective serotonin reuptake inhibitor in treatment-resistant depressed rats. 国際誌

Kyohei Kin, Takao Yasuhara, Satoshi Kawauchi, Masahiro Kameda, Kakeru Hosomoto, Yousuke Tomita, Michiari Umakoshi, Ken Kuwahara, Ittetsu Kin, Naoya Kidani, Jun Morimoto, Tatsuya Sasaki, Isao Date

Brain research 1717 52 - 59 2019年8月

記述言語：英語掲載種別：研究論文（学術雑誌）

Wistar Kyoto (WKY) rats are a useful animal model of treatment-resistant depression. Lithium is effective for treating recurrent mood disorders or treatment-resistant depression, and lithium augmentation treatment is also useful for treatment-resistant depression. However, the treatment effect of lithium on the depressive behavior of WKY rats remains poorly understood, and whether lithium augments the treatment effect of antidepressants in WKY rats is also unknown. In this study, we evaluated the treatment effect of lithium in WKY rats. We also sought to determine if lithium treatment augments the treatment effect of fluoxetine. Lithium was administered for 15 consecutive days and fluoxetine was administered 23.5, 5, and 1 h before the forced swim test (FST) day 2, based on previous studies. Lithium treatment counteracted depressive behavior in the FST and increased hippocampal neurogenesis. Additionally, co-administration of lithium and fluoxetine augmented the treatment effect observed in the FST and in hippocampal neurogenesis in WKY rats, although fluoxetine monotherapy showed no treatment effect. Lithium prevented an increase in body weight, similar to its effect in human patients. These results are consistent with those of lithium augmentation treatment for human patients with treatment-resistant depression. They suggest that WKY rats are a promising animal model for treatment-resistant depression. However, lithium treatment has various side effects. A new treatment with the same anti-depressive effect as fluoxetine + lithium treatment and fewer side effects compared with lithium would be desirable for patients with treatment-resistant depression.

DOI： 10.1016/j.brainres.2019.04.001

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Characteristics and prognostic factors of Parkinson's disease patients with abnormal postures subjected to subthalamic nucleus deep brain stimulation. 国際誌

Mihoko Okazaki, Tatsuya Sasaki, Takao Yasuhara, Masahiro Kameda, Takashi Agari, Ittetsu Kin, Ken Kuwahara, Jun Morimoto, Kyohei Kin, Michiari Umakoshi, Yousuke Tomita, Cesario V Borlongan, Isao Date

Parkinsonism & related disorders 57 44 - 49 2018年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVE: In Parkinson's disease (PD), abnormal postures are often accompanied, which interfere with rehabilitation and subsequent functional recovery. This study investigated the relationship between clinical characteristics and improvement in abnormal postures of PD patients who received subthalamic nucleus deep brain stimulation (STN-DBS). METHODS: Seventy-four PD patients were included in this study. Clinical data were analyzed using the patients' functional status at pre- and post-STN-DBS, including anteflexion vs. non-anteflexion, scoliosis vs. non-scoliosis, improved anteflexion vs. non-improved anteflexion, and improved scoliosis vs. non-improved scoliosis. RESULTS: In patients with anteflexion, UPDRS III motor score at off medication was worse than that of patients with non-anteflexion. Patients with scoliosis presented with more comorbid spinal deformity and longer disease duration than those without scoliosis. Cobb angle of patients with asymmetrical psoas major and erector spinal muscles was more than that of patients without the asymmetry. Patients with improved anteflexion after STN-DBS had thicker abdominal oblique muscle and transverse abdominal muscle than those of patients without improved anteflexion. Patients with improved scoliosis were significantly younger at PD onset than those without improvement. CONCLUSIONS: There were only a few prognostic factors recognized in patients with improved postures. The thick abdominal muscle for anteflexion and younger PD onset for scoliosis were significant factors for improvement by STN-DBS. Rehabilitation designed to maintain muscle for correct postures may contribute to the amelioration of abnormal postures by STN-DBS, although multicenter trials are needed.

DOI： 10.1016/j.parkreldis.2018.07.014

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A new approach for implantation of a cardiac resynchronization therapy-defibrillator in a patient with bilateral pectoral neurostimulation devices. 国際誌

Saori Tsukuda, Nobuhiro Nishii, Yoshiaki Inoue, Tatsuya Sasaki, Hiroshi Morita, Hiroshi Ito

HeartRhythm case reports 4 ( 10 ) 444 - 446 2018年10月

[Devices and Practices for Improving the Accuracy of Deep Brain Stimulation].

Tatsuya Sasaki, Takashi Agari, Isao Date

No shinkei geka. Neurological surgery 46 ( 9 ) 751 - 762 2018年9月

乳児脳室外上衣下巨細胞性星細胞腫の一例

坪井伸成, 黒住和彦, 佐々木達也, 柳井広之, 伊達勲

Brain Tumor Pathology 35 ( Suppl. ) 166 - 166 2018年9月

Hemodynamic features of offending vessels at neurovascular contact in patients with trigeminal neuralgia and hemifacial spasm. 国際誌

Toru Satoh, Takanobu Yagi, Keisuke Onoda, Masahiro Kameda, Tatsuya Sasaki, Tomotsugu Ichikawa, Isao Date

Journal of neurosurgery 1 - 7 2018年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVEOffending vessels at the site of neurovascular contact (NVC) in patients with trigeminal neuralgia (TN) and hemifacial spasm (HFS) may have specific hemodynamic features. The purpose of this study was to investigate the wall shear stress (WSS) of offending vessels at NVCs by conducting a computational fluid dynamics (CFD) analysis.METHODSThe authors retrospectively analyzed the cases of 20 patients (10 with TN and 10 with HFS) evaluated by 3D CT angiography and used the imaging findings for analysis of the hemodynamic parameters. The 3D CFD images were directly compared with the NVCs determined by simulated multifusion images of CT angiogram and MR cisternogram, and operative photos. The magnitudes of the WSS (WSSm) at the proximal (WSSm-p), just-beginning (WSSm-j), contact site (WSSm-s), and distal (WSSm-d) areas of each NVC were analyzed. The ratios of the WSSm-j, WSSm-s, and WSSm-d areas to the WSSm-p area were calculated individually. The direction of the WSS (WSSv) and its temporal variation (WSSvV) were depicted and morphologically compared with the NVC confirmed by simulated images and operative findings.RESULTSThe ratios of WSSm at the just-beginning and the contact site to the proximal area of the NVCs (WSSm-j/WSSm-p and WSSm-s/WSSm-p) were both significantly higher than that at the distal area (WSSm-d/WSSm-p) (p < 0.05). The WSSv and WSSvV at the NVCs showed small variation in a single cardiac cycle, especially along the areas that were in contact with the affected nerve.CONCLUSIONSAreas of relatively high WSSm and temporal variation of WSSm (WSSmV) were observed at the NVCs. Less mobility of the WSSv and WSSvV was detected along the side of the vessels in contact with the nerves. These findings may be consistent with the actual area of the NVC. Hemodynamic features of the site of NVC can be added to the preoperative simulation for MVD surgery, which may be useful for the diagnosis and treatment planning of TN and HFS.

DOI： 10.3171/2018.1.JNS172544

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Efficacy of Dural Sealant System for Preventing Brain Shift and Improving Accuracy in Deep Brain Stimulation Surgery.

Tatsuya Sasaki, Takashi Agari, Ken Kuwahara, Ittetsu Kin, Mihoko Okazaki, Susumu Sasada, Aiko Shinko, Masahiro Kameda, Takao Yasuhara, Isao Date

Neurologia medico-chirurgica 58 ( 5 ) 199 - 205 2018年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

The success of deep brain stimulation (DBS) depends heavily on surgical accuracy, and brain shift is recognized as a significant factor influencing accuracy. We investigated the factors associated with surgical accuracy and showed the effectiveness of a dural sealant system for preventing brain shift in 32 consecutive cases receiving DBS. Thirty-two patients receiving DBS between March 2014 and May 2015 were included in this study. We employed conventional burr hole techniques for the first 18 cases (Group I) and a dural sealant system (DuraSeal) for the subsequent 14 cases (Group II). We measured gaps between the actual positions of electrodes and the predetermined target positions. We then retrospectively evaluated the factors involved in surgical accuracy. The average gap between an electrode's actual and target positions was 1.55 ± 0.83 mm in all cases. Postoperative subdural air volume e, the only factor associated with surgical accuracy (r = 0.536, P < 0.0001), was significantly smaller in Group II (Group I: 43.9 ± 27.7, Group II: 12.1 ± 12.5 ml, P = 0.0006). The average electrode position gap was also significantly smaller in Group II (Group I: 1.77 ± 0.91, Group II: 1.27 ± 0.59 mm, P = 0.035). Use of a dural sealant system could significantly reduce intracranial air volume, which should improve surgical accuracy.

DOI： 10.2176/nmc.oa.2017-0242

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The Factors Affecting the Difficulty of Percutaneous Cylindrical Electrode Placement for Spinal Cord Stimulation. 国際誌

Kyohei Kin, Takashi Agari, Takao Yasuhara, Yousuke Tomita, Ken Kuwahara, Ittetsu Kin, Michiari Umakoshi, Jun Morimoto, Mihoko Okazaki, Tatsuya Sasaki, Isao Date

World neurosurgery 113 e391-e398 2018年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVE: Optimal placement of electrodes is important for spinal cord stimulation. Factors affecting the difficulty of percutaneous electrode placement are not well known. In this study, we retrospectively evaluated the factors affecting the difficulty of percutaneous electrode placement. METHODS: We performed a retrospective analysis of 90 consecutive procedures of percutaneous cylindrical electrode implantation at the first author's institution. Age, sex, smoking state, body mass index, the duration of time from the beginning of pain syndrome to operation, diagnosis, the number of previous electrode placements, the previous electrode implantation period, the presence of axial low back pain, the electrode tip level, the pattern of electrode placement, and the reason for reimplantation were selected as factors associated with the success of electrode placement or the operation time of electrode placement. RESULTS: The number of previous electrode placements and the electrode tip level were independently associated with the operation time of electrode placement. According to both univariable and multivariable regression analyses, 1 previous electrode placement lengthened the operation time by approximately 15 minutes. No factors were significantly associated with the success of electrode placement. The more frequently that previous electrode placement was performed, the more difficult electrode placement tended to be. However, electrode reimplantation can be successful given extra time. CONCLUSIONS: This is the first study to evaluate factors affecting the difficulty of percutaneous electrode placement. A history of percutaneous cylindrical electrode placement did not affect the success of current placement, although it lengthened the operation time.

DOI： 10.1016/j.wneu.2018.02.040

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多様な画像所見を呈したmultifocal dysembryoplastic neuroepithelial tumorの1例

佐々木達也, 亀田雅博, 冨田陽介, 細本翔, 林裕美子, 遠藤文香, 岡牧郎, 冨田祐介, 安原隆雄, 上利崇, 小林勝弘, 伊達勲

脳神経外科ジャーナル 27 ( 4 ) 317 - 323 2018年4月

記述言語：日本語出版者・発行元：(一社)日本脳神経外科コングレス

症例は側頭葉てんかんを発症した13歳男児。頭部MRIで右側頭葉内広範囲、基底核、深部白質、側脳室内などに多発する病変を認め、さらに経時的に造影病変は変化した。Fluorodeoxyglucose-positron emission tomography(FDG-PET)で悪性を示唆する所見はなく、subtraction ictal single-photon emission computed tomography coregistered to MRI(SISCOM)と発作時脳波で右側頭葉が発作焦点であると判断し、一期的に右側頭葉切除を行った。病理学的診断はdysembryoplastic neuroepithelial tumorであった。現時点で術後半年経過したが、発作は消失し、残存病変についても増大していない。多発性DNTは非常にまれであり、変化に富む画像所見とあわせて、治療方針の決定に難渋した。本症例はてんかんの治療目的に手術を行ったが、複雑な病態であっても、治療目的を明確にし、それに応じた検査、手術を行うことが重要である。(著者抄録)

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J02632&link_issn=&doc_id=20180403310006&doc_link_id=10.7887%2Fjcns.27.317&url=https%3A%2F%2Fdoi.org%2F10.7887%2Fjcns.27.317&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

高齢者パーキンソン病に対する脳深部刺激療法─review─ 査読

佐々木達也、安原隆雄、亀田雅博、上利崇、伊達勲

Geriatric Neurosurgery 30 47 - 51 2018年3月

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