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2018 Fiscal Year Research-status Report

頚動脈内膜剥離術を用いた脳循環不全性認知症とアルツハイマー病の関連の解明

Research Project

Project/Area Number 18K09002
Research InstitutionIwate Medical University

Principal Investigator

小笠原 邦昭  岩手医科大学, 医学部, 教授 (00305989)

Project Period (FY) 2018-04-01 – 2021-03-31
Keywordsアミロイド / 頚動脈狭窄 / 血行再建 / 脳循環
Outline of Annual Research Achievements

一側性内頸動脈閉塞狭窄性病変による同側大脳半球の脳循環低下症例5例に対し18F-Florbetapir PETを施行した。5例とも脳循環低下側大脳半球と対側大脳半球とはRI集積の程度は同等であった。血行再建術後には5例とも病側大脳半球脳循環は改善していた。術後に18F-Florbetapir PETを施行しえた4例中、2例では手術側大脳半球のRI集積は対側に比し、明らかに低下していた。また、神経心理学的検査では、手術側大脳半球のRI集積が低下していた2例では認知機能の改善を認めたが、RI集積の術後変化がなかった残り2例では、認知機能に変化がなかった。
現時点の結論としては、「慢性脳循環状態では、アミロイドの集積が促進される」は証明できなかったが、「頚動脈狭窄を除去することによる脳循環不全の改善により、アミロイドの排出が促され、認知機能が改善する」ことが強く示唆された。

Current Status of Research Progress
Current Status of Research Progress

2: Research has progressed on the whole more than it was originally planned.

Reason

症例数も予想通りであり、結果も仮説を証明するものとなっている。現在、preliminaryな結果、「頚動脈狭窄を除去することによる脳循環不全の改善により、アミロイドの排出が促される」ことのみを論文化している最中である。

Strategy for Future Research Activity

さらに症例を増やし、術前後に施行した神経心理検査(WAIS-R, WMS, Rey test)から術後認知機能改善の有無を判定する。アミロイドPETの術前後のデータからアミロイドの排出の程度を定量化する。これら2つを比較し、、「頚動脈狭窄を除去することによる脳循環不全の改善により、アミロイドの排出が促されると認知機能が改善される」という仮説を証明する。

Causes of Carryover

RIトレーサの値段が交渉の上、当初より少し安価になったため。残額については、引き続きアミロイドトレーサの購入費用に充てる。

  • Research Products

    (14 results)

All 2019 2018

All Journal Article (14 results) (of which Int'l Joint Research: 14 results,  Peer Reviewed: 14 results,  Open Access: 4 results)

  • [Journal Article] Reduced Hypoxic Tissue and Cognitive Improvement after Revascularization Surgery for Chronic Cerebral Ischemia2019

    • Author(s)
      Shimada Yasuyoshi、Kobayashi Masakazu、Yoshida Kenji、Terasaki Kazunori、Fujiwara Shunrou、Kubo Yoshitaka、Beppu Takaaki、Ogasawara Kuniaki
    • Journal Title

      Cerebrovascular Diseases

      Volume: 47 Pages: 57~64

    • DOI

      10.1159/000497244

    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Cilostazol may improve cognition better than clopidogrel in non-surgical adult patients with ischemic moyamoya disease: subanalysis of a prospective cohort2019

    • Author(s)
      Ando Satoshi、Tsutsui Shouta、Miyoshi Kenya、Sato Shinpei、Yanagihara Wataru、Setta Kengo、Chiba Takayuki、Fujiwara Shunrou、Kobayashi Masakazu、Yoshida Kenji、Kubo Yoshitaka、Ogasawara Kuniaki
    • Journal Title

      Neurological Research

      Volume: 41 Pages: 480~487

    • DOI

      10.1080/01616412.2019.1580455

    • Peer Reviewed / Int'l Joint Research
  • [Journal Article] Resolution of Hypoxic Tissue in Cerebellar Hemispheres After Arterial Bypass Surgery in a Patient With Symptomatic Bilateral Vertebral Artery Occlusion2019

    • Author(s)
      Oikawa Kohki、Kobayashi Masakazu、Beppu Takaaki、Terasaki Kazunori、Ogasawara Kuniaki
    • Journal Title

      Clinical Nuclear Medicine

      Volume: 44 Pages: 295~296

    • DOI

      10.1097/RLU.0000000000002469

    • Peer Reviewed / Int'l Joint Research
  • [Journal Article] Impact of external carotid artery occlusion at declamping of the external and common carotid arteries during carotid endarterectomy on development of new postoperative ischemic cerebral lesions2019

    • Author(s)
      Kobayashi Masakazu、Yoshida Kenji、Kojima Daigo、Oshida Sotaro、Fujiwara Shunrou、Kubo Yoshitada、Ogasawara Kuniaki
    • Journal Title

      Journal of Vascular Surgery

      Volume: 69 Pages: 454~461

    • DOI

      10.1016/j.jvs.2018.03.437

    • Peer Reviewed / Int'l Joint Research
  • [Journal Article] Response by Oshida et al to Letter Regarding Article, “Wall Shear Stress and T1 Contrast Ratio Are Associated With Embolic Signals During Carotid Exposure in Endarterectomy”2018

    • Author(s)
      Oshida Sotaro、Mori Futoshi、Ogasawara Kuniaki
    • Journal Title

      Stroke

      Volume: 49 Pages: e342-e342

    • DOI

      10.1161/STROKEAHA.118.023441

    • Peer Reviewed / Int'l Joint Research
  • [Journal Article] Impact of cerebral blood flow changes due to arterial bypass surgery on cognitive function in adult patients with symptomatic ischemic moyamoya disease2018

    • Author(s)
      Yanagihara Wataru、Chida Kohei、Kobayashi Masakazu、Kubo Yoshitaka、Yoshida Kenji、Terasaki Kazunori、Ogasawara Kuniaki
    • Journal Title

      Journal of Neurosurgery

      Volume: 2019 Pages: 1~9

    • DOI

      10.3171/2018.7.JNS18149

    • Peer Reviewed / Int'l Joint Research
  • [Journal Article] Transient Symptomatic Downregulation of Cortical Neurotransmitter Receptor Function Due to Cerebral Hyperperfusion after Arterial Bypass Surgery for a Patient with Ischemic Moyamoya Disease2018

    • Author(s)
      SHIMADA Yasuyoshi、KOJIMA Daigo、YOSHIDA Jun、KOBAYASHI Masakazu、YOSHIDA Kenji、FUJIWARA Shunrou、OGASAWARA Kuniaki
    • Journal Title

      Neurologia medico-chirurgica

      Volume: 58 Pages: 481~484

    • DOI

      10.2176/nmc.cr.2018-0143

    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Wall Shear Stress and T1 Contrast Ratio Are Associated With Embolic Signals During Carotid Exposure in Endarterectomy2018

    • Author(s)
      Oshida Sotaro、Mori Futoshi、Sasaki Makoto、Sato Yuiko、Kobayshi Masakazu、Yoshida Kenji、Fujiwara Shunrou、Ogasawara Kuniaki
    • Journal Title

      Stroke

      Volume: 49 Pages: 2061~2066

    • DOI

      10.1161/STROKEAHA.118.022322

    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Comparison of Effects between Clopidogrel and Cilostazol on Cerebral Perfusion in Nonsurgical Adult Patients with Symptomatically Ischemic Moyamoya Disease: Subanalysis of a Prospective Cohort2018

    • Author(s)
      Chiba Takayuki、Setta Kengo、Shimada Yasuyoshi、Yoshida Jun、Fujimoto Kentaro、Tsutsui Shouta、Yoshida Kenji、Kobayashi Masakazu、Kubo Yoshitaka、Fujiwara Shunrou、Terasaki Kazunori、Ogasawara Kuniaki
    • Journal Title

      Journal of Stroke and Cerebrovascular Diseases

      Volume: 27 Pages: 3373~3379

    • DOI

      10.1016/j.jstrokecerebrovasdis.2018.07.041

    • Peer Reviewed / Int'l Joint Research
  • [Journal Article] Accuracy of brain perfusion single-photon emission computed tomography for detecting misery perfusion in adult patients with symptomatic ischemic moyamoya disease2018

    • Author(s)
      Setta Kengo、Kojima Daigo、Shimada Yasuyoshi、Yoshida Jun、Oshida Sotaro、Fujimoto Kentaro、Tsutsui Shouta、Chiba Takayuki、Fujiwara Shunrou、Terasaki Kazunori、Ogasawara Kuniaki
    • Journal Title

      Annals of Nuclear Medicine

      Volume: 32 Pages: 611~619

    • DOI

      10.1007/s12149-018-1283-7

    • Peer Reviewed / Int'l Joint Research
  • [Journal Article] Two-Year Clinical, Cerebral Hemodynamic, and Cognitive Outcomes of Adult Patients Undergoing Medication Alone for Symptomatically Ischemic Moyamoya Disease Without Cerebral Misery Perfusion: A Prospective Cohort Study2018

    • Author(s)
      Miyoshi Kenya、Chida Kohei、Kobayashi Masakazu、Kubo Yoshitaka、Yoshida Kenji、Terasaki Kazunori、Ogasawara Kuniaki
    • Journal Title

      Neurosurgery

      Volume: 2019 Pages: 1-7

    • DOI

      10.1093/neuros/nyy234

    • Peer Reviewed / Int'l Joint Research
  • [Journal Article] Preoperative brain temperature imaging on proton magnetic resonance spectroscopy predicts hemispheric ischemia during carotid endarterectomy for unilateral carotid stenosis with inadequate collateral blood flow2018

    • Author(s)
      Tsutsui Shouta、Nanba Takamasa、Yoshioka Yoshichika、Sasaki Makoto、Fujiwara Shunrou、Kobayashi Masakazu、Yoshida Kenji、Miyoshi Kenya、Sato Shinpei、Ogasawara Kuniaki
    • Journal Title

      Neurological Research

      Volume: 40 Pages: 1~7

    • DOI

      10.1080/01616412.2018.1457130

    • Peer Reviewed / Int'l Joint Research
  • [Journal Article] Crossed Cerebellar Tracer Uptake on Acute-Stage 123I-Iomazenil SPECT Imaging Predicts 3-Month Functional Outcome in Patients With Nonfatal Hypertensive Putaminal or Thalamic Hemorrhage2018

    • Author(s)
      Kojima Daigo、Komoribayashi Nobukazu、Omama Shinichi、Oikawa Kohki、Fujiwara Shunrou、Kobayashi Masakazu、Kubo Yoshitaka、Terasaki Kazunori、Ogasawara Kuniaki
    • Journal Title

      Clinical Nuclear Medicine

      Volume: 43 Pages: 1~1

    • DOI

      10.1097/RLU.0000000000002068

    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Preoperatively reduced cerebrovascular contractile reactivity to hypocapnia by hyperventilation is associated with cerebral hyperperfusion syndrome after arterial bypass surgery for adult patients with cerebral misery perfusion due to ischemic moyamoya disease2018

    • Author(s)
      Sato Shinpei、Kojima Daigo、Shimada Yasuyoshi、Yoshida Jun、Fujimato Kentaro、Fujiwara Shunrou、Kobayashi Masakazu、Kubo Yoshitaka、Yoshida Kenji、Terasaki Kazunori、Tsutsui Shouta、Miyoshi Kenya、Ogasawara Kuniaki
    • Journal Title

      Journal of Cerebral Blood Flow & Metabolism

      Volume: 38 Pages: 1021~1031

    • DOI

      10.1177/0271678X18757621

    • Peer Reviewed / Int'l Joint Research

URL: 

Published: 2019-12-27  

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