2018 Fiscal Year Final Research Report

Evaluation of Deep Brain Stimulation as Therapeutic Approach for Orthostatic Hypotension

Research Project

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Project/Area Number	16K01361
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Research Field	Biomedical engineering/Biomaterial science and engineering
Research Institution	Kochi University
Principal Investigator	HIROTA Takayoshi 高知大学, 教育研究部医療学系臨床医学部門, 助教 (10437741)
Co-Investigator(Kenkyū-buntansha)	山崎文靖高知大学, 医学部附属病院, 特任教授 (10243841)
Research Collaborator	SATO Takayuki MORITA Yukari SEIKE Masahito TOYONAGA Shinichi
Project Period (FY)	2016-04-01 – 2019-03-31
Keywords	深部脳刺激 / 起立性低血圧 / 生体制御・治療 / パーキンソン病 / 医用生体工学
Outline of Final Research Achievements	We developed an artificial feedback system for treatment of orthostatic hypotension due to autonomic failure in Parkinson disease with deep brain stimulation (DBS). (1) We confirmed HUT-induced systolic AP drop was suppressed by DBS in 36% of patients (40±22 versus 15+-26 mmHg, a total of 33 PD patients). (2) The frequency responses of AP to random DBS were identifiable in 13 in 25 trials. On the basis of these results, the proportional correction factor was set at 50, and the integral correction factor was set at 10. The computer simulation study revealed that the system could quickly and effectively attenuate a sudden AP drop induced by external disturbance such as head-up tilting. The artificial baroreflex system with DBS could be a novel therapeutic approach for orthostatic hypotension.
Free Research Field	人間医工学
Academic Significance and Societal Importance of the Research Achievements	深部脳刺激を組み込んだ人工動脈圧反射システムは起立性低血圧の新しい治療法になり得ることを見出した。パーキンソン病における起立性低血圧の治療法として、脳内刺激による血圧サーボシステムを開発するという着想そのものが極めて画期的で、新しいデバイスを開発できる可能性がある。本装置を上市すれば、パーキンソン病以外の神経疾患にも適応できる可能性があり、起立性低血圧のために寝たきりを余儀なくされていた患者に新しい治療を提供する道が開ける。また、「人工機能装置に生体本来のnativeなダイナミクスを移植する」という枠組みは、他の機能代行装置の開発（人工心臓等）に重要な示唆を与えるものと思われる。