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Electrical stimulation therapy for residual proximal upper limb tremor after thalamotomy

Research Project

Project/Area Number 21K09099
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 56010:Neurosurgery-related
Research InstitutionOsaka University

Principal Investigator

Oshino Satoru  大阪大学, 大学院医学系研究科, 准教授 (40403050)

Co-Investigator(Kenkyū-buntansha) 谷 直樹  大阪大学, 大学院医学系研究科, 助教 (20598370)
藤田 祐也  大阪大学, 大学院医学系研究科, 招へい教員 (20839097)
何 馨  大阪大学, 大学院医学系研究科, 特任研究員 (40895273)
三浦 慎平  大阪大学, 医学部附属病院, 医員 (50869716)
細見 晃一  大阪大学, 大学院医学系研究科, 招へい教員 (70533800)
江村 拓人  大阪大学, 医学部附属病院, 医員 (70891505)
木本 優希  大阪大学, 医学部附属病院, 医員 (10889645)
小野田 祐司  大阪大学, 医学部附属病院, 医員 (10945348)
Project Period (FY) 2021-04-01 – 2024-03-31
Project Status Completed (Fiscal Year 2023)
Budget Amount *help
¥4,030,000 (Direct Cost: ¥3,100,000、Indirect Cost: ¥930,000)
Fiscal Year 2023: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2022: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2021: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
Keywords振戦 / 機能神経外科 / 電気刺激療法 / 不随意運動
Outline of Research at the Start

本研究は、肩や上腕の筋肉(近位筋)を電気刺激することで手の震え(振戦)を抑える治療法の開発を目指すものです。振戦には外科治療が著効しますが、近位筋の振戦は抑制され難い傾向があります。一方、近位筋の振戦は腕の位置により変化し、特定の肢位で軽減する現象があります。本研究ではまず肢位に関わる筋の緊張状態との振戦との関連をビデオや脳磁図で解析し、その結果から近位筋の電気刺激で振戦を抑制できるかを試みます。

Outline of Final Research Achievements

We investigated the pathophysiology and the potential effect of electrical stimulation to recurrent tremor. The rotational motion power of the hand, forearm, and upper arm during tremor was calculated using with small accelerometers and the changes in power of the upper arm during postural tremor, and in the forearm during writing tremor correlated with rating scale of tremor. We also found decreased frequency and prolonged contraction period on electromyography in recurrent tremor. For electrical stimulation, some patients subjectively felt improvement of tremor with decreased the above-mentioned power during the stimulation on brachial radius or other muscles above the contraction threshold, suggesting the effectiveness of stimulation to support keeping the limb position. Because of COVID-19 pandemic, magnetoencephalography could be measured in a few cases, but some changes were suggested in the motor or sensory related magnetic fields between treated and non-treated hand movement.

Academic Significance and Societal Importance of the Research Achievements

振戦は頻度の高い不随意運動で、進行すると日常生活動作まで障害される。近年集束超音波治療等の外科治療の効果が再認識されているが、高齢者を中心に再燃例が一定数存在する。本研究ではそれらの病態評価と補助療法として電気刺激の可能性を検討した。当初想定した近位筋の電気刺激のみでは効果はなかったが、肢位支持筋の収縮を補助する刺激で自覚的にも回転運動パワーにおいても振戦が改善する例がみられた。また再燃例の筋電図解析で、筋の持続収縮維持能の低下が示唆される所見も得られた。これらの成果から次の科研では、治療による筋特性の変化と肢位を支持する電気刺激の効果を検証し、低侵襲かつ有効な補助療法の開発を目指したい。

Report

(4 results)
  • 2023 Annual Research Report   Final Research Report ( PDF )
  • 2022 Research-status Report
  • 2021 Research-status Report
  • Research Products

    (22 results)

All 2024 2023 2022 2021

All Journal Article (7 results) (of which Int'l Joint Research: 1 results,  Peer Reviewed: 7 results,  Open Access: 6 results) Presentation (14 results) (of which Int'l Joint Research: 2 results,  Invited: 3 results) Book (1 results)

  • [Journal Article] Characteristics of Changes in Intrathecal Baclofen Dosage over Time due to Causative Disease2023

    • Author(s)
      KIMOTO Yuki、OSHINO Satoru、TANI Naoki、HOSOMI Koichi、KHOO Hui Ming、FUJITA Yuya、MIURA Shimpei、IWATA Takamitsu、EMURA Takuto、MATSUHASHI Takahiro、ONODA Yuji、ISHIUCHI Takamasa、YANAGISAWA Takufumi、HIRATA Masayuki、KISHIMA Haruhiko
    • Journal Title

      Neurologia medico-chirurgica

      Volume: 63 Issue: 12 Pages: 535-541

    • DOI

      10.2176/jns-nmc.2022-0359

    • ISSN
      0470-8105, 1349-8029
    • Year and Date
      2023-12-15
    • Related Report
      2023 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Clinical Factors Related to Outcomes in Pediatric Epilepsy Surgery: Insight into Predictors of Poor Surgical Outcome2023

    • Author(s)
      OSHINO Satoru、TANI Naoki、KHOO Hui Ming、KAGITANI-SHIMONO Kuriko、NABATAME Shin、TOMINAGA Koji、YANAGISAWA Takufumi、HIRATA Masayuki、KISHIMA Haruhiko
    • Journal Title

      Neurologia medico-chirurgica

      Volume: 63 Issue: 5 Pages: 173-178

    • DOI

      10.2176/jns-nmc.2022-0300

    • ISSN
      0470-8105, 1349-8029
    • Year and Date
      2023-05-15
    • Related Report
      2023 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Characteristics of Pain During MRI-Guided Focused Ultrasound Thalamotomy2023

    • Author(s)
      He Xin、Oshino Satoru、Hosomi Koichi、Kanemoto Manabu、Tani Naoki、Kishima Haruhiko
    • Journal Title

      Neurosurgery

      Volume: 93 Issue: 2 Pages: 358-365

    • DOI

      10.1227/neu.0000000000002420

    • Related Report
      2023 Annual Research Report 2022 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Utilization of three-dimensional fusion images with high-resolution computed tomography angiography for preoperative evaluation of microvascular decompression: patient series2023

    • Author(s)
      Iwata Takamitsu、Hosomi Koichi、Tani Naoki、Khoo Hui Ming、Oshino Satoru、Kishima Haruhiko
    • Journal Title

      Journal of Neurosurgery: Case Lessons

      Volume: 6 Issue: 9

    • DOI

      10.3171/case23330

    • Related Report
      2023 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Altered Thalamic Connectivity Due to Focused Ultrasound Thalamotomy in Patients with Essential Tremor2022

    • Author(s)
      Tani Naoki、Oshino Satoru、Hosomi Koichi、Hattori Noriaki、Mihara Masahito、Yanagisawa Takufumi、Khoo Hui Ming、Kanemoto Manabu、Watanabe Yoshiyuki、Mochizuki Hideki、Kishima Haruhiko
    • Journal Title

      World Neurosurgery

      Volume: 164 Pages: e1103-e1110

    • DOI

      10.1016/j.wneu.2022.05.113

    • Related Report
      2022 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] 特集 定位・機能神経外科の基礎と臨床 Ⅱ 定位・機能神経外科手術の対象となる主な疾患 振戦に対する定位的外科治療2021

    • Author(s)
      谷 直樹、押野 悟、細見 晃一、Khoo Hui Ming、貴島 晴彦
    • Journal Title

      Neurological Surgery 脳神経外科

      Volume: 49 Issue: 4 Pages: 760-768

    • DOI

      10.11477/mf.1436204454

    • ISSN
      0301-2603, 1882-1251
    • Year and Date
      2021-07-10
    • Related Report
      2021 Research-status Report
    • Peer Reviewed
  • [Journal Article] Indication of MR Image-guided Focused Ultrasound2021

    • Author(s)
      Kishima Haruhiko、Oshino Satoru、Tani Naoki、Hosomi Koichi
    • Journal Title

      Japanese Journal of Neurosurgery

      Volume: 30 Issue: 7 Pages: 519-526

    • DOI

      10.7887/jcns.30.519

    • NAID

      130008067538

    • ISSN
      0917-950X, 2187-3100
    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access
  • [Presentation] 振戦に対するMRガイド下集束超音波治療の基本手技2024

    • Author(s)
      押野悟、鐘本学、谷直樹、細見晃一、何馨、松橋崇寛、江村拓人、貴島晴彦
    • Organizer
      第63回日本定位・機能神経外科学会
    • Related Report
      2023 Annual Research Report
    • Invited
  • [Presentation] 振戦の客観的評価指標としての加速度センサーの有用性2024

    • Author(s)
      三浦慎平、押野悟、江村拓人、松橋崇寛、木本優希、Khoo Hui Ming、細見晃一、谷直樹、貴島晴彦
    • Organizer
      第63回日本定位・機能神経外科学会
    • Related Report
      2023 Annual Research Report
  • [Presentation] 視床腹側中間核凝固術後の振戦再発例での筋電図の変化2024

    • Author(s)
      藤永貴大、押野悟、江村拓人、松橋崇寛、木本優希、三浦慎平、Khoo Hui Ming、細見晃一、谷直樹、貴島晴彦
    • Organizer
      第63回日本定位・機能神経外科学会
    • Related Report
      2023 Annual Research Report
  • [Presentation] 不随意運動障害の治療 現在~未来2024

    • Author(s)
      押野悟
    • Organizer
      回復期リハビリテーション病棟協会第43回研究大会in熊本
    • Related Report
      2023 Annual Research Report
    • Invited
  • [Presentation] Clinical outcome of focused ultrasound and radiofrequency thalamotomy for tremor2023

    • Author(s)
      Oshino S,Tani N,Hosomi K, Xin HE,Kanemoto M,Emura T,Matsuhashi T,Miura S,Kimoto Y, Hui Ming KHOO,Kishima H
    • Organizer
      AASSFN2023
    • Related Report
      2023 Annual Research Report
    • Int'l Joint Research
  • [Presentation] 振戦の外科的治療におけるBrainLab Elementsを用いた後方視的評価2023

    • Author(s)
      三浦慎平、押野悟、江村拓人、木本優希、松橋崇寛、藤永貴大、Khoo Hui Ming、細見晃一、谷直樹、貴島晴彦
    • Organizer
      第82回日本脳神経外科学会総会
    • Related Report
      2023 Annual Research Report
  • [Presentation] 視床腹側中間核凝固術後の振戦再発例での筋電図の変化2023

    • Author(s)
      藤永貴大、押野悟、江村拓人、松橋崇寛、木本優希、三浦慎平、Khoo Hui Ming、細見晃一、谷直樹、貴島晴彦
    • Organizer
      第82回日本脳神経外科学会総会
    • Related Report
      2023 Annual Research Report
  • [Presentation] ふるえに対する外科的治療の進歩2023

    • Author(s)
      押野悟
    • Organizer
      第62回日本定位機能神経外科学会
    • Related Report
      2022 Research-status Report
    • Invited
  • [Presentation] MRガイド下集束超音波治療の実際と工夫点2022

    • Author(s)
      押野悟、鐘本学、何馨、江村拓人、松橋崇寛、細見晃一、谷直樹、貴島晴彦
    • Organizer
      第5回日本経頭蓋MRガイド下集束超音波治療研究会
    • Related Report
      2022 Research-status Report
  • [Presentation] 集束超音波治療における頭痛の特徴2022

    • Author(s)
      何馨、押野悟、鐘本学、細見晃一、谷直樹、望月秀樹、貴島晴彦
    • Organizer
      第81回日本脳神経外科学会学術集会
    • Related Report
      2022 Research-status Report
  • [Presentation] Characteristics of Pain during MRI-Guided Focused Ultrasound Thalamotomy2022

    • Author(s)
      XIN HE ,Satoru Oshino, Koichi Hosomi, Manabu Kanemoto, Naoki Tani, Haruhiko Kishima
    • Organizer
      WSSFN 2023 World Society for Stereotactic and Functional Neurosurgery
    • Related Report
      2022 Research-status Report
    • Int'l Joint Research
  • [Presentation] ふるえに対する外科的治療2021

    • Author(s)
      押野悟
    • Organizer
      第41回日本脳神経外科コングレス総会
    • Related Report
      2021 Research-status Report
  • [Presentation] 振戦に対する凝固術の再興と課題2021

    • Author(s)
      押野悟、谷直樹、細見晃一、何馨、鐘本学、Khoo Hui Ming、藤田祐也、三浦慎平、江村拓人、木本優希、松橋崇寛、岩田貴光、柳澤琢史、貴島晴彦
    • Organizer
      第80回日本脳神経外科学会学術総会
    • Related Report
      2021 Research-status Report
  • [Presentation] 集束超音波治療中の痛みの特徴2021

    • Author(s)
      何馨、押野悟、細見晃一、谷直樹、鐘本学、貴島晴彦
    • Organizer
      第80回日本脳神経外科学会学術総会
    • Related Report
      2021 Research-status Report
  • [Book] 16章 機能脳神経外科, 1 てんかん2021

    • Author(s)
      押野悟、貴島晴彦
    • Total Pages
      52
    • Publisher
      金芳堂
    • Related Report
      2021 Research-status Report

URL: 

Published: 2021-04-28   Modified: 2025-01-30  

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