Evaluation of the higher brain dysfunction disorder after subarachnoid hemorrhage using flumazenil PET/MRI

• Project/Area Number: 16K20000
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Neurosurgery
• Research Institution: University of Fukui
• Principal Investigator: Higashino Yoshifumi 福井大学, 学術研究院医学系部門, 助教 (80554542)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000); Fiscal Year 2018: ¥390,000 (Direct Cost: ¥300,000、Indirect Cost: ¥90,000); Fiscal Year 2017: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000); Fiscal Year 2016: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
• Keywords: higher brain dysfunction / subarachnoid hemorrhage / くも膜下出血 / 高次脳機能障害 / フルマゼニル / PET/MRI

Outline of Final Research Achievements

During this investigation period, 64cases of patient with a episode of subarachnoid hemorrhage were admitted our institute. We performed MMSE, FAB, SDS for 31 cases after treatment(clip or coil embolization) soon. The average age of this group was 65.5+-16 years old, WFNS grade(expressed severity of disease) at the onset g1-18 cases, g2-5 cases, g3-4 cases, g4-3 cases, g5-1 cases. Modified RS 0-2(means good recovery) at the time of discharge were 21 cases. Average of MMSE, FAB, SDS is 23.2+-6.8, 12.6+-4.8, 41.7+-9.1, respectively. These test was performed after 11.2+-6.4 days from surgical procedure. Subarachnoid hemorrhage cause not only the impairment of short-term memory but also the frontal lobe dysfunction.

Academic Significance and Societal Importance of the Research Achievements

くも膜下出血は発症早期の死亡率が高く、治療により生存できても長期に及ぶ高次脳機能障害を残す症例が多い。我々はくも膜下出血の治療後、早期に高次脳機能障害について評価した（慢性期には水頭症の影響が出るため）。発症後1－２週間目に脳血管攣縮が起こる。この期間（平均11日目）に測定した。意識障害が重度やコミュニケーションが取れず評価できない症例を除いた31例中、退院時のADL良好群が21/31例を占めていた。対象を絞っても、短期機能障害だけでなく前頭葉機能の低下を認めることが明らかになった。