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Diagnosis of coma and brain death by auditory brainstem responses (ABRs) and comparison of ABRs with temporal bone pathology and neuropathology.

Research Project

Project/Area Number 05404091
Research Category

Grant-in-Aid for Scientific Research (A)

Allocation TypeSingle-year Grants
Section一般
Research Field Biomedical engineering/Biological material science
Research InstitutionUNIVERSITY OF TOKYO

Principal Investigator

KAGA Kimitaka  University of Tokyo, Dept. of Otolaryngology, Professor, 医学部・附属病院, 教授 (80082238)

Co-Investigator(Kenkyū-buntansha) NAKAMURA Masaichi  University of Tokyo, Dept. of Otolaryngology, Assistant, 医学部・附属病院, 助手 (90217894)
MUROFUSHI Toshihisa  University of Tokyo, Dept. of Otolaryngology, Lecturer, 医学部・附属病院, 講師 (30242176)
YAMASOBA Tetsuya  University of Tokyo, Dept. of Otolaryngology, Lecturer, 医学部・附属病院, 講師 (60251302)
太田 康  東京大学, 医学部(病), 助手 (40251285)
Project Period (FY) 1993 – 1996
Project Status Completed (Fiscal Year 1996)
Budget Amount *help
¥4,300,000 (Direct Cost: ¥4,300,000)
Fiscal Year 1996: ¥500,000 (Direct Cost: ¥500,000)
Fiscal Year 1995: ¥800,000 (Direct Cost: ¥800,000)
Fiscal Year 1994: ¥3,000,000 (Direct Cost: ¥3,000,000)
KeywordsAuditory brainstem responses / Brain daeath / Temporal bone pathology / Neuropathology / Red cell / Carotid artery / Basilar artery / Corti's organ / 側頭骨病理 / 蝸牛神経核 / 神経病理 / 脳血管障害 / 無酸素状態
Research Abstract

Since auditory brainstem response (ABR) was discovered by D.L.Jewett in 1970, it has been widely used in the NICU or ICU as the most important tool for making a diagnosis of coma and brainstem death. In the state of brain death, the configuration of ABR shows wave I only or no response. However, the pathological study corresponding to such ABR abnormalities has rarely reported. Then, reliability of ABR for the diagnosis will be higher if pathological evidence is collected. In order to compare ABRs with temporal bone pathology and neuropathology, we designed clinical and pathological studies and animal experiments.
Research results are discribed as follows.
I.Clinical study :
1) When ABRs of patients showed wave I only or no response because of brain death, the temporal bone pathology demonstrated mostly destruction of corti's organ and exceptionally normal corti's organ. Meantime, the neuropathology revealed that red cells in the vessels in the brainstem were ghost like cells without hemo … More globin but those in the basillar artery and its branches on the brainstem were normal. This discrepancy means that the blood flow in vessels in the brainstem is shut down but on the arteries on the brainstem is normal in spite of brain death.
2) The neuropathological study revealed entire decrease or disappearance of neurons in the cortical layr of the cerebelium and cerebrum but preservation neurons of brainstem auditory nuclei except cochlear nucleus.
II.Animal experiments.
Rats experiments were conducted as various models of coma and brain death. 1) Occlusion of bilateral carotid arteries did not change ABR configuration. 2) Occlusin of the basilar artery showed complete disappearance of ABR.
3) Total spiral anesthesia which was made by injection of lidocaine into subarachnoidal space revealed disappearance of ABR.ABR disappeared a couple of minutes after injection but recovered normally within an hour. Moreover, ABR's origin was demonstrated by whole brainstem field potentials analysis in cats. Less

Report

(5 results)
  • 1996 Annual Research Report   Final Research Report Summary
  • 1995 Annual Research Report
  • 1994 Annual Research Report
  • 1993 Annual Research Report
  • Research Products

    (30 results)

All Other

All Publications (30 results)

  • [Publications] Kaga K: "Auditory brainstem response and brain death." Practica Otolaryngologica. 86. 1217-1233 (1993)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] Kaga K,Uebo K: "Auditory and Vestibular Death Revealed Pathology in Brainstem by Auditory Brainstem Response." Acta Otolaryngol(Stockh). 503. 99-103 (1993)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] Yamada K,Kaga K: "Analysis of Auditory Brainstem Response with Lidocaine Injection into the Cerebrospinal Fluid in Rats." Annals of Otology, Rhinology & Laryngology. 103. 796-800 (1994)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] Kaga K,Uebo K: "Auditory Brainstem Response and Temporal Bone and Brainste Pathology in Brainstem Death, with Special Reference to Autolysis of Red Blood Cells" Acta Otolaryngol(Stockh). 115. 183-186 (1995)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] Kaga K,Ichimura K: "Auditory Brainstem Responses in Infants and Children with Anoxic Brain Damage Due to Near-suffocation or Near-Drowning" Pediatric Otorhinolaryngology. 36. 231-239 (1996)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] Kaga K: "Diagnostic manual of apoplexy. Neurotology of cerebrovascular accidents." Nishimura Pub.Co., 16 (1996)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] Kaga K,Uebe K: "Auditory and Vestibular Death Revealed Pathology in Brainstem by Auditory Brainstem Response." Acta Otolaryngol (Stockh). 503. 99-103 (1993)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] Yamada K,Kaga K: "Analysis of Auditory Brainstem Response with Lidocaine Injection into the Cerebrospinal Fluid in Rats." Annals of Otology, Rhinology & Larygology. 103. 796-800 (1994)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] Kaga K,Uebe K: "Auditory Brainstem Response and Temporal Bone and Brainste Pathology in Brainstem Death, with Special Reference to Autolysis of Red Blood Cells" Acta Otolaryngol (Stockh). 115. 183-186 (1995)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] Kaga K,Ichimura K.: "Auditory Brainstem Responses in Infants and Children with Anoxic Brain Damage Due to Near-suffocation or Near-Drowning." Pediatric Otorhinolaryngology. 36. 231-239 (1996)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] Kaga K.: "Auditory brainstem response and brain death." Practica Otolaryngologi. 86. 1217-1233 (1993)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] Kaga K.: Diagnostic manual of apoplexy, Neurotology of cerebrovascular accidents.Nishimura Pub. Co., 16 (1996)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] 加我君孝: "ABRと脳死-脳と側頭骨の病理組織学-" 耳鼻臨床. 86. 1217-1233 (1993)

    • Related Report
      1996 Annual Research Report
  • [Publications] Kaga K,Uebo K,: "Auditory and Vestibular Death Revealed Pathology in Brainstem by Auditory Brainstem Response." Acta Otolaryngol(Stockh). 503. 99-103 (1993)

    • Related Report
      1996 Annual Research Report
  • [Publications] Yamada K,Kaga K,: "Analysis of Auditory Brainstem Response with Lidocaine Injection into the Cerebrospinal Fluid in Rats." Annals of Otology,Rhinology & Laryngology. 103. 796-800 (1994)

    • Related Report
      1996 Annual Research Report
  • [Publications] Kaga K,Uebo K: "Auditory Brainstem Response and Temporal Bone and Brainstem Pathology in Brainstem Death,with Special Reference to Autolysis of Red Blood Cells" Acta Otolaryngol(Stockh). 115. 183-186 (1995)

    • Related Report
      1996 Annual Research Report
  • [Publications] Kaga K,Ichimura K: "Auditory Brainstem Responses in Infants and Children with Anoxic Brain Damage Due to Near suffocation or Near-Drowning." Pediatric Otorhinolaryngology. 36. 231-239 (1996)

    • Related Report
      1996 Annual Research Report
  • [Publications] 加我君孝: "脳卒中診断学(脳血管障害の神経耳科学的検査-聴覚誘発電位を中心に-)" 西村書店, 16 (1996)

    • Related Report
      1996 Annual Research Report
  • [Publications] Kaga K et: "Auditory brainstem response and temporcl bow and brainstem Pathology in brainstem death,wothauatays:soyred blood cell" Acta Otolarynpol(Stockhl). 115. 183-186 (1995)

    • Related Report
      1995 Annual Research Report
  • [Publications] Kaga K et: "Auditory brainstem responses in Children with Corelia de Lange Syndrome." Int J Pecl Otolaryng. 31. 137-146 (1995)

    • Related Report
      1995 Annual Research Report
  • [Publications] Kaga K et al: "Auditory air-bow conduction brainstem responses and dainped rolatiu tert for young Children with bilat atresio" Int J Pecl Otolaryng. 32. 13-21 (1995)

    • Related Report
      1995 Annual Research Report
  • [Publications] Yamasoba T et al: "Magnet.Rescnanu Ansiographic Ft.mclings in Uatigiuas Patients with clow blood flow" Acta Otolarynpol Swppl. 520. 153-156 (1995)

    • Related Report
      1995 Annual Research Report
  • [Publications] Kaga,K: "Temporal Bone Pathology in Patients without Caloric Response" Acta Otolaryngol(Stockh). 114. 586-594 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] Kaga,K: "ANALYSIS OF AUDITORY BRAIN STEM RESPONSE WITH LIDOCAINE INJECTION INTO THE CEREBROSPINAL FLUID IN RATS" Ann Otol Rhinol Laryngol. 103. 796-800 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] Kaga,K: "Chronological changes of auditory brainstem responses in Cockayne's syndrome" International Journal of Pediatric Otorhinolaryngology. 30. 211-221 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] Murofushi: "Temporary latency shifts in auditory evoked potentials by injection of lidocaine in the rat" HEARING RESEARCH. (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] Kaga,K: "Temporal Bone Pathology of Leukemia and Malignant Lymphoma with Middle Ear Effusion" Auris・Nasus・Larynx(Tokyo). 21. 1-7 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] Kaga,K: "Auditory and vestibular patholosy in brainstem death revealed by auditory brainstem response." Acta Otolaryngologica.503. 99-103 (1993)

    • Related Report
      1993 Annual Research Report
  • [Publications] 加我君孝: "ABRと脳死-脳と側頭骨の病理組織学-" 耳鼻臨床. 86. 1217-1233 (1993)

    • Related Report
      1993 Annual Research Report
  • [Publications] Tatsuya Yamasoba: "An electrocochleographic study of acute low-tone sensorineural hearing loss." Eur Arch Otorhinolaryngol. 250. 418-422 (1993)

    • Related Report
      1993 Annual Research Report

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Published: 1994-04-01   Modified: 2016-04-21  

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