| Project/Area Number |
19K07980
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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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| Review Section |
Basic Section 52020:Neurology-related
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| Research Institution | Kyorin University |
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Principal Investigator |
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| Project Period (FY) |
2019-04-01 – 2024-03-31
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| Project Status |
Completed (Fiscal Year 2023)
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| Budget Amount *help |
¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000)
Fiscal Year 2021: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2020: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2019: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
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| Keywords | 急性期脳梗塞 / 虚血コア / ミスマッチ / 機能局在 / 灌流画像 / 脳梗塞 / 急性期治療 / 血栓回収療法 / 再灌流療法 / 血行再建療法 / 脳梗塞画像診断 / 急性血行再建療法 |
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| Outline of Research at the Start |
本研究の目的は、日本の医療事情に即した実践的な虚血コア判定法を作成することである。重症度と虚血コアサイズのミスマッチを示す用語である Clinical-Core Mismatch（CCM） を深化させ、脳の機能局在と臨床症状にも配慮した Clinical symptom - Core location Mismatch（Cs-Cl M）という概念の確立と普及を目指す。
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| Outline of Final Research Achievements |
The association between ischemic core determination by perfusion imaging and early ischemic lesions by ASPECTS was investigated in 133 consecutive patients (2019~2023) who underwent mechanical thrombectomy at the Kyorin University Stroke Center. The ASPECTS corresponding to an ischemic core size of 70 mL was 5. The combined volume of ischemic core and penumbra was associated with stroke severity as assessed by NIHSS. Good outcome (mRS 0-2 or recovery to pre-morbid mRS level) after mechanical therobectomy was associated with M3 and M5 regions among the ASPECTS assessment sites. In particular, when the M5 region, including the primary motor cortex, is included in the ischaemic extent, obtaining reperfusion in this region has a significant impact on improving outcome.
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| Academic Significance and Societal Importance of the Research Achievements |
急性期脳梗塞に対する脳画像所見に基づく治療、すなわち tissue-based therapyにおいて重要となる、実践的な虚血コアサイズの評価法を提唱した。脳の機能局在を考慮することで、より適切な治療方針の決定、ならびに転帰改善に重要とされる一次運動野への血流再開に重きを置くべきことを明らかにした。Clinical symptom-Core location Mismatchという概念を提唱することで簡便かつ迅速な治療選択が可能となった。
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