Elucidation of cerebral blood flow autoregulation mechanism by analysis of internal jugular vein blood vascular hormone dynamics during cerebral ischemia and reperfusion

2022 Fiscal Year Final Research Report

• Project/Area Number: 18K08979
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 56010:Neurosurgery-related
• Research Institution: Iwate Medical University
• Principal Investigator: Yoshida Kenji 岩手医科大学, 医学部, 特任准教授 (10316367)
• Co-Investigator(Kenkyū-buntansha): 小笠原 邦昭 岩手医科大学, 医学部, 教授 (00305989)
• Project Period (FY): 2018-04-01 – 2023-03-31
• Keywords: 脳血管反応性 / 過灌流 / 脳虚血再灌流

Outline of Final Research Achievements

Comprehensive array analysis was performed on changes in microRNA in the jugular vein as candidates for intraoperative vascular hormones in patients with ischemic events associated with cervical carotid endarterectomy and patients with hyperperfusion. It was confirmed that some microRNAs on miRBase show significant changes immediately after the event.
It is still unclear why hyperperfusion after revascularization also causes higher brain dysfunction. This time, in a prospective study, we found that new microhemorrhages occurred in the brain in patients who showed hyperperfusion after revascularization. It was found to be significantly involved in functional impairment.

Free Research Field

虚血性脳血管障害

Academic Significance and Societal Importance of the Research Achievements

慢性的な虚血性脳血管障害に対して、外科的血行再建術の有意性が証明さているが、脳循環予備能が著しく障害された症例では、術後に過灌流を発生し、新たな認知機能障害や機能・清明予後に関わる重篤な合併症を来すことが大きな問題点であり、過灌流のメカニズムは未だ不明のままであった。今回我々は、術後過灌流メカニズムの解明に寄与するmicroRNAの動態を明らかにした。また、過灌流がなぜ高次脳機能障害をももたらすかについて、脳内に微少出血が発生していること、新規脳内微小出血が、術後認知機能障害に有意に関与していることを明らかにし、過灌流症候群の新たな知見を獲得した。