Evaluation of instability plaque in the patient with acute ischemic stroke with intracranial artery stenosis and investigation of related factors to persistent plaque instability.

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K07429
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 52020:Neurology-related
• Research Institution: Kawasaki Medical School
• Principal Investigator: Yagita Yoshiki 川崎医科大学, 医学部, 教授 (20403066)
• Co-Investigator(Kenkyū-buntansha): 大山 直紀 川崎医科大学, 医学部, 准教授 (90622895)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: 脳梗塞 / 頭蓋内脳動脈狭窄

Outline of Final Research Achievements

Ischemic stroke caused by intracranial cerebral artery stenosis has high risk of recurrence. Because atherosclerotic plaque instability is related to a high risk of recurrent stroke, plaque characterization is important for optimal therapy to prevent stroke recurrence. In this study, we investigated the time course of plaque stabilization using enhancement rate of high-resolution magnetic resonance vessel wall imaging (HR-VWI). The results showed that plaque can be stabilized in the course of clinical phase after acute ischemic stroke with medical therapy including lipid-lowering therapy. The more potent the lipid-lowering therapy could achieve earlier plaque stabilization. Our results indicate that HR-VWI is useful in the therapeutic efficacy evaluation of plaque stabilization after acute ischemic stroke caused by intracranial cerebral artery stenosis.

Free Research Field

神経内科

Academic Significance and Societal Importance of the Research Achievements

本研究の成果により頭蓋内脳動脈のプラーク安定化の経時変化をHR-VWIで評価しうることが示された。この成果によりこれまで容易ではなかった頭蓋内脳動脈の不安定プラークの病態や不安定性に影響を与える因子の研究が格段に進むことが期待できる。またHR-VWIを指標にすることにより、頭蓋内脳動脈のプラーク安定化の治療効果が評価できる。本研究では発症時のプラーク不安定化因子よりも治療介入によってそれらをどれだけ抑制できたかがプラーク安定化に寄与することが示された。このように、より効果的な治療レジメを考えるうえで臨床的にも有用な検査法であるといえる。