| Project/Area Number |
15K10373
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Neurosurgery
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| Research Institution | Nihon University |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
山本 隆充 日本大学, 医学部, 客員教授 (50158284)
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| Project Period (FY) |
2015-04-01 – 2019-03-31
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| Project Status |
Completed (Fiscal Year 2018)
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| Budget Amount *help |
¥3,900,000 (Direct Cost: ¥3,000,000、Indirect Cost: ¥900,000)
Fiscal Year 2018: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2017: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2016: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2015: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
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| Keywords | 脳深部刺激療法 / パーキンソン病 / 視床下核 / 罹病期間 / 発症年齢 / 認知機能 / 長期予後 / ADL / 年齢 / 日常生活動作 / 治療利益 |
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| Outline of Final Research Achievements |
Despite the recognition of the usefulness of subthalamic nucleus deep brain stimulation (STN-DBS) for the treatment of Parkinson disease (PD), preoperative predictive factors for the long-term outcome of STN-DBS are not sufficiently established. We performed this study to determine such predictive factors. The subjects were 66 patients who were classified into two groups on the basis of their activities of daily living (ADL) evaluated five years after the STN-DBS surgery: 33 patients were assigned to the independent ADL group (group I) and the remaining 33 patients to the dependent ADL group (group D). We studied the differences in the preoperative state between these two groups. As a results, the PD onset age, age at surgery, preoperative high-level ADL, cognitive function, and axial symptoms are important predictive factors for the long-term outcome of STN-DBS.
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| Academic Significance and Societal Importance of the Research Achievements |
本研究の意義は、パーキンソン病治療において脳深部刺激療法をどのような症例に、いかなる時期に用いると、最も大きな手術利益をもたらせるのかを明らかにしたことである。さらに、術後に十分な手術利益を得ることができない可能性の高い症例を事前に検出することが可能となったため、インフォームドコンセントに役立てるとともに、早期よりその対策をたてることもできる。具体的には、発症年齢と手術時年齢がともに若く、認知機能の低下していない症例に長期的にADLの自立が期待できることを明らかにした。逆に高齢で罹病期間の長い症例、認知機能が低下傾向にある症例は脳深部刺激療法後もADLが侵害されやすいことがわかった。
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