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To confirm the usefulness of N18 and other SEP components of medullary origin for the diagnosis of brain death

Research Project

Project/Area Number 09670669
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Neurology
Research InstitutionTeikyo University

Principal Investigator

SONOO Masahiro  School of Medicine, Teikyo University, Assistant Professor, 医学部, 講師 (40231386)

Co-Investigator(Kenkyū-buntansha) MOCHIZUKI Atsuko  School of Medicine, Teikyo University, Lecturer, 医学部, 助手 (50286994)
FUKUDA Hiroyuki  School of Medicine, Teikyo University, Lecturer, 医学部, 助手 (60286961)
SHOZAWA Yasunobu  School of Medicine, Teikyo University, Lecturer, 医学部, 助手 (30256052)
HATANAKA Yuuki  School of Medicine, Teikyo University, Lecturer, 医学部, 助手
Project Period (FY) 1997 – 1999
Project Status Completed (Fiscal Year 1999)
Budget Amount *help
¥3,100,000 (Direct Cost: ¥3,100,000)
Fiscal Year 1999: ¥1,200,000 (Direct Cost: ¥1,200,000)
Fiscal Year 1998: ¥700,000 (Direct Cost: ¥700,000)
Fiscal Year 1997: ¥1,200,000 (Direct Cost: ¥1,200,000)
Keywordssomatosensory evoked potentials (SEPs) / median nerve / brain death / criteria to diagnose brain death / N18 / auditory brainstem responses (ABRs) / brainstem function / cuneate nucleus in medulla oblongata / 脳幹機能 / P13 / 14電位 / P9電位
Research Abstract

1. We collected around 140 recordings of SEP and ABR together with clinical signs from around 100 brain-dead or comatous patients during the 3 years we accepted the grants. As a result, N18 in median SEPs was lost in all the brain-dead recordings whereas it was preserved in nearly 90% of comatous but not brain-dead recordings. Namely, N18 had perfect specificity and very high sensitivity (higher than ABR which was preserved for about 80% of comatous recordings) for detecting the remaining brainstem function.
2. We managed to follow the course progressing from coma to brain-death in 8 patients having brain herniation. Signs reflecting midbrain function such as light reflex and oculocephalic reflex were first lost, those reflecting pontine function such as corneal reflex and wave III in ABR followed. Lastly, loss of cough reflex and pharyngeal reflex, cease of spontaneous respiration, sudden fall of blood pressure and loss of N18 occurred within a short time and brain-death was judged to be established. The fact that N18 disappeared concomitantly with these signs reflecting medullary functions further supported our opinion that N18 is generated by the cuneate nucleus located in the medulla oblongata.
3. There has been no neurophysiological or other method which can objectively evaluate the function of medulla oblongata which plays the most important role for maintaining the vital functions. ABR can evaluate only pontine and midbrain functions. The present investigation established N18 as the first objective indicator for the medullary function. Wide clinical application of N18 must increase the reliablity of the diagnose is of brain death.
4. Other related researches performed include: the origin of the P13-like potential which remains after brain death (by Sonoo), the origin of P9 (by Mochizuki and Sonoo) and the best method to determine the stimulus intensity in median SEPs (by Fukuda and Sonoo).

Report

(4 results)
  • 1999 Annual Research Report   Final Research Report Summary
  • 1998 Annual Research Report
  • 1997 Annual Research Report
  • Research Products

    (30 results)

All Other

All Publications (30 results)

  • [Publications] Sonoo M et al: "Detailed analysis of the latencies of median nerve somatosensory evoked potential components, 2: analysis of subcomponents of the P13/14 and N20 potentials."Electroenceph. Clin. Neurophysiol,. 104. 296-311 (1997)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] 園生雅弘: "体性感覚誘発電位"臨床検査. 41. 1381-1386 (1997)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] 木村一恵他: "小児短潜時体性感覚誘発電位(SSEP)に及ぼす年齢と身長の影響-重回帰分析による検討"臨床脳波. 39. 150-154 (1997)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] 園生雅弘: "体性感覚誘発電位"Brain Medical. 10. 131-136 (1998)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] 畑中裕己他: "電気生理学的脳幹モニタリング:ABRとSEP."救急医学. 22. 761-766 (1998)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Mochizuki A et al.: "P9 in median nerve SEPs is a junctional potential generated by the change of the volume conductor size between trunk and neck"Electroenceph. Clin. Neurophysiol,. 108. 584-587 (1998)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Sonoo M et al.: "N18 in median nerve SEPs: a new indicator of the medullary function useful for the diagnosis of brain death."J. Neurol. Neurosurg. Psychiat.. 67. 374-378 (1999)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] 畑中裕己他: "脳死移行症例8症例における正中神経SEP N18成分と臨床徴候との関係"脳死・脳蘇生研究会誌. 12. 58-59 (1999)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] 園生雅弘他: "正中神経SEPのN18成分は、脳死診断に高い有用性を示す新しい延髄機能の指標となる。"脳死・脳蘇生研究会誌. 12. 60-61 (1999)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] 園生雅弘: "正中神経電気刺激による体性感覚誘発電位(SEP)。pp116-137、黒岩義之、園生雅弘編著、臨床誘発電位ハンドブック"中外医学社、東京. 340(22) (1998)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Sonoo M: "How much has been solved regarding SEP generators? pp47-51, Functional Neuroscience: Evoked Potentials and Magnetic Fields (EEG Suppl. 49). Barber C et al, eds."Elsevier Sciences B.V., Amsterdam. 330(5) (1999)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Sonoo M et al: "Detailed analysis of the latencies of median nerve somatosensory evoked potential components, 2 : analysis of subcomponents of the P13/ 14 and N20 potentials"Electroencephalograph. Clin. Neurophysiol .. 104(4). 296-311 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Sonoo M: "Somatosensory evoked potentials"Clinical testing (Tokyo). 41(11). 1381-1386 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Kimura K, Sonoo M et al: "The latencies of the somatosensory evoked potentials in children: Correlation with age and height"Clinical Electroencephalography (Tokyo). 39(3). 150-154 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Sonoo M: "Somatosensory evoked potentials"Brain Medical (Tokyo). 10(2). 131-136 (1998)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Hatanaka Y and Sonoo M: "Electrophysiological braintem monitoring: ABR and SEP"The Japanese Journal of Acute Medicine (Tokyo). 22(7). 761-766 (1998)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Mochizuki A, Sonoo M et al: "P9 in median nerve SEPs is a junctional potential generated by he change of the volume conductor size between trunk and neck"Eiectroencephalograph. Clin. Neurophysiol.. 108(6). 584-587 (1998)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Sonoo M et al.: "N 18 in median nerve SEPs: a new indicatio9 of the medullary function useful for the diagnosis of brain death"J. Neurol. Meurosurg. Psychiat.. 67(3). 374-378 (1999)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Hatanaka Y, Sonoo M et al: "The relationship between N18 in median SEPs and clinical signs in 8 patients progessing from coma to brain death"Journal of Japanese association of brain death and brain resuscitation. 12. 58-59 (1999)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Sonoo M et al: "N18 in median SEPs is a new indicator of medullary function which is useful for the diagnosis of brain death"Journal of Japanese association of brain death and brain resuscitation. 12. 60-61 (1999)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Sonoo M: "How much has been solved regarding SEP generators? Functional Neuroscience: Evoked Potentials and Magnetic Fields (EEG Suppl.49). Barber C, Celesia GC, Hashimoto I, Kakigi R eds."Elsevier Sciences B.V. Amsterdam. 47-51 (1999)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Sonoo M: "Somatosensory evoked potentials (SEP) following median nerve electrical stimulation: Clinical Handbook of evoked potentials. Kuroiwa Y and Sonoo M eds."Chu-gai Igakusya(Tokyo). 116-137 (1998)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Sonoo M et al.: "N18 in median nerve SEPs:a new indicator of the medullary function useful for the diagnosis of brain death"J.Neurol.Neurosurg.Psychiat.. 67・3. 374-378 (1999)

    • Related Report
      1999 Annual Research Report
  • [Publications] 畑中裕己他: "脳死移行8症例における正中神経SEP N18成分と臨床徴候との関係"脳死・脳蘇生研究会誌. 12. 58-59 (1999)

    • Related Report
      1999 Annual Research Report
  • [Publications] 園生雅弘他: "正中神経SEPのN18成分は,脳死診断に高い有用性を示す新しい延髄機能の指標となる"脳死・脳蘇生研究会誌. 12. 60-61 (1999)

    • Related Report
      1999 Annual Research Report
  • [Publications] Sonoo M: "How much has been solved regarding SEP generators?pp47-51,Functional Neuroscience:Evoked Potentials and Magnetic Fields(EEG Suppl.49).Barber C et al.eds."Elsevier Sciences B.V.,Amsterdam. 330 (1999)

    • Related Report
      1999 Annual Research Report
  • [Publications] Mochizuki A et al: "P9 in median nerve SEPs is a junctional potential generated by the change of the volume conductor size between trunk and neck." Electroencephalography and Clinical Neurophysiology. 108・6. 584-587 (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] 畑中裕己ら: "電気生理学的脳幹モニタリング:ABRとSEP." 救急医学. 22.7. 761-766 (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] 園生雅弘: "体性感覚誘発電位." Brain Medical. 10・2. 131-136 (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] Mochizuki A et al.: "P9 in median nerve SEPs is a junctional potential generated by the change of the volume conductor size between trunk and neck." Electroencephalography and Clinical Neurophysiology. (in press).

    • Related Report
      1997 Annual Research Report

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Published: 1997-04-01   Modified: 2016-04-21  

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