Microvascular decompression of the rostral ventrolateral medulla for drug-resistant neurogenic hypertension
| Project/Area Number |
16K10789
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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 | Kumamoto University |
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Principal Investigator |
Hamasaki Tadashi 熊本大学, 大学院生命科学研究部(医), 准教授 (60433033)
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| Co-Investigator(Kenkyū-buntansha) |
山田 和慶 熊本大学, 病院, 特任教授 (00398215)
藤原 幸一 名古屋大学, 工学研究科, 准教授 (10642514)
長谷川 雄 熊本大学, 大学院生命科学研究部(医), 講師 (40599114)
山川 俊貴 熊本大学, 大学院先端科学研究部(工), 准教授 (60510419)
中川 隆志 熊本大学, 医学部附属病院, 特任助教 (80773358)
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| Project Period (FY) |
2016-04-01 – 2020-03-31
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| Project Status |
Completed (Fiscal Year 2019)
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| Budget Amount *help |
¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000)
Fiscal Year 2018: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2017: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2016: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
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| Keywords | Autonomic nervous system / Brain stem / Heart rate variability / Hypertension / autonomic nervous system / brain stem / heart rate variability / intraoperative / neurosurgery / monitoring / cerebello-pontine angle / RVLM / hypertension / 脳神経外科学 / 高血圧症 / 自律神経 |
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| Outline of Final Research Achievements |
Advances in our understanding of human brain physiology have expanded application of neuromodulation therapy to treat disease symptoms. We constructed an in-house system to investigate whether there is a specific area in the human brain where neurosurgical manipulation may exert an effect on autonomic activities and thereby cause changes in systemic circulation. Forty-one surgeries were recorded and analyzed. Statistical analysis demonstrated sympathetic hyperactivity, hypertension, and tachycardia when the area of the lateral aspect of the ponto-medullary junction in the human brain stem was continuously electrically stimulated for the purpose of monitoring a cranial nerve function during tumor removal. These findings provided physiological evidence showing that there is an autonomic center in the lower brain stem of the human brain. We suggest that the area is a possible target of neuromodulation for disorders with autonomic imbalance including drug-resistant hypertension.
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| Academic Significance and Societal Importance of the Research Achievements |
片側顔面けいれんに対する微小血管減圧術後に、高血圧の改善がみられる症例がある。手術によって動脈性圧迫から解放される下位脳幹に重要な自律神経中枢が存在することが示唆されるが、ヒトにおける確実な生理学的証拠はこれまで報告されていなかった。本研究で得られた上記の成果は、ヒトの下位脳幹に重要な自律神経中枢が存在する重要な生理学的証拠であり、薬剤抵抗性神経原性高血圧症など、自律神経活動異常が関与する疾患に対する外科的治療開発の基盤となる重要な知見と考えられる。
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Report
(5 results)
Research Products
(2 results)
