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Endogenous analgesia and brain function correlates of postoperative pain and quality of life after breast reconstruction surgery / Prospective observational study

Research Project

Project/Area Number 19K18287
Research Category

Grant-in-Aid for Early-Career Scientists

Allocation TypeMulti-year Fund
Review Section Basic Section 55050:Anesthesiology-related
Research InstitutionGunma University

Principal Investigator

Kumakura Minami  群馬大学, 医学部附属病院, 医員 (20827571)

Project Period (FY) 2019-04-01 – 2024-03-31
Project Status Completed (Fiscal Year 2023)
Budget Amount *help
¥2,470,000 (Direct Cost: ¥1,900,000、Indirect Cost: ¥570,000)
Fiscal Year 2020: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2019: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Keywords乳房再建術 / 術後痛 / 生活の質 / 内因性鎮痛 / 脳機能相関 / 乳癌 / 手術 / 痛み / 脳イメージング / 鎮痛 / 脳機能
Outline of Research at the Start

乳房再建術は乳癌患者数の増加とともに世界的に急速に増加しているがその半数以上に術後痛が発生し、患者の生活の質を落とし、社会復帰への支障になっている。本研究は従来の患者申告の主観的アンケート調査(生活の質と術後痛)に加え、客観的評価(術前の内因性鎮痛と術前後の機能的脳画像解析)を加えることで、術後痛発生因子を確立することを目的としている。2つの仮説(1。内因性鎮痛の術前低値と術後痛発生が相関する 2。 脳機能画像解析において前頭葉と辺縁系の連絡性脆弱が関わっている)を検証し、術後痛の詳細な部位別調査も加える。本研究は術後痛発生の重要なリスクを予想し、鎮痛方法を考慮する上で重要な情報となる。

Outline of Final Research Achievements

Breast reconstruction surgery causes postoperative pain in more than half of patients, reducing their quality of life (QOL) and hindering their return to society. In this study, in order to reevaluate the social significance of breast reconstruction, we placed importance on the subjective evaluation of patients, using the short form-36 health survey (SF-36) as a measure of quality of life (Mental Component Score: MCS) and Physical Component Score PCS). The results showed that the entire striatum was analyzed as a region of interest (ROI) in the brain (Ogino et al., Frontiers in Human Neuroscience. 2019). The results showed that the azygos (part of the striatum) was correlated with MCS (p = 0.04) and PCS (p = 0.009), although the results were not significant when the entire striatum was used as the ROI. The significance of this study is that the striatum of the brain was identified as the site of correlation between cranial neural adaptability and quality of life (QOL).

Academic Significance and Societal Importance of the Research Achievements

生活の質(QOL: quality of life)指標としてthe short form-36 health survey (SF-36)を用い(Ogino et al. Frontiers in Human Neuroscience. 2019)脳の線条体を中心としたROI [Region of interest](関心領域解析)による二次解析(閾値uncorrected p < 0.001)を行った。線条体、特に淡蒼球が生活の質の精神と身体の両面から関係があることが示唆された。脳神経適応性(学習や環境にあわせて形態と機能を柔軟に変化する性質)とQOLの相関部位として、線条体が挙げられる。

Report

(6 results)
  • 2023 Annual Research Report   Final Research Report ( PDF )
  • 2022 Research-status Report
  • 2021 Research-status Report
  • 2020 Research-status Report
  • 2019 Research-status Report

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Published: 2019-04-18   Modified: 2025-01-30  

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