グリアと神経細胞のクロストーク；てんかん焦点の広域周波数帯域脳波と画像解析

2013 Fiscal Year Annual Research Report

• Project/Area Number: 23591275
• Research Institution: Kyoto University
• Principal Investigator: 池田 昭夫 京都大学, 医学(系)研究科(研究院), 教授 (90212761)
• Co-Investigator(Kenkyū-buntansha): 宮本 享 京都大学, 医学(系)研究科(研究院), 教授 (70239440) ; 松本 理器 京都大学, 医学(系)研究科(研究院), 准教授 (00378754) ; 澤本 伸克 京都大学, 医学(系)研究科(研究院), 講師 (90397547) ; 松橋 眞生 京都大学, 学内共同利用施設等, 准教授 (40456885)
• Keywords: 発作時DC電位 / 高周波数律動 / グリア細胞 / 神経細胞 / てんかん焦点 / 広域周波数脳波解析 / てんかん外科 / 神経膠腫

Research Abstract

目的：てんかん発作時のDC電位、HFOに焦点を絞ってその発現様式の特徴を抽出し、病理学的な所見と統合的に解析しててんかん原性におけるグリアと神経細胞の密接な関連を明らかにすることを目的とした。
方法：難治部分てんかん患者のうち、てんかん手術のために脳内電極を留置した患者。1）広域周波数脳波解析＝脳表面にてんかん焦点検索を目的として留置した硬膜下電極から、標本化周波数1000-2000 Hz、高周波フィルター300-500 Hz、時定数10秒で皮質脳波を計測した。てんかん焦点における通常の発作時の脳波所見、DC電位、HFOの解析を行い、出現様式の特徴を明らかにした。2）病理標本との対比解析＝切除された病理所見と焦点におけるDC電位、HFOの出現様式との関連を検討した。
成果：1）DC電位、HFOの発現様式＝発作時DC電位、HFOを16例中それぞれ12例(75%)、8例(50%)で認めた。DC電位を認めた12例では、解析された全てのてんかん発作108回のうち、72%にDC電位を認め、HFOは同様に46.3%であった。発作時DC電位、HFO、通常の発作時脳波所見の３者を全て認めた6例では、DC電位、HFOが通常の発作時脳波開始点に対して、それぞれ6.2±11.0秒、3.5±9.1秒で先行した。通常の発作時脳波所見およびDC電位、HFOのいずれかを認めた12例のうち発作時DC電位は8例(66.7%)で、HFOは3例(25.0%)で通常脳波より限局した範囲に認められた。1例で焦点近傍の白質内の深部電極から発作時DC電位が記録されたが、HFOは認めなかった。2）病理所見との関連＝発作時DC電位は病理所見毎に①神経膠腫75.0%、②皮質異形成77.8%、③海馬硬化50.0%で認めた。一方HFOは同様に①50.0%、②44.4%、③50.0%で認めた。特に①のうち皮質異形成を伴う2症例で発作時DC電位、HFOを90-100％で認めた。
総括：発作時DC電位がHFOに先行して出現することから、グリアの積極的な関与が示唆された。さらに病理組織別にDC電位、HFO発現が異なることを示した。

Research Products

• [Journal Article] A novel SCN1A mutation at a cytoplasmic loop in intractable juvenile myoclonic epilepsy without febrile seizures: a case report. (2014)
  • Author(s): Jingami N, Matsumoto, Ito H, Ishii A, Ihara Y, Hirose S, Ikeda A, Takahashi R.
  • Journal Title: Epil Disord Volume: 印刷中 Pages: in press
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• [Journal Article] Temporal lobe epilepsy with amygdala enlargement: a morphologic and functional study. (2014)
  • Author(s): Takaya S, Ikeda A, Mitsueda-Ono T, Matsumoto R, Inouchi M, Namiki C, Oishi N, Mikuni N, Ishizu K, Takahashi R, Fukuyama H.
  • Journal Title: J Neuroimaging Volume: 24 Pages: 54-62
  • DOI: 10.1111/j.1552-6569.2011.00694.x.
  • Peer Reviewed
• [Journal Article] Automatic reference selection for quantitative EEG interpretation: Identification of diffuse/localised activity and the active earlobe reference, iterative detection of the distribution of EEG rhythms. (2014)
  • Author(s): Wang B, Wang X, Ikeda A, Nagamine T, Shibasaki H, Nakamura M.
  • Journal Title: Med Eng Phys Volume: 36 Pages: 88-95
  • DOI: 10.1016/j.medengphy.2013.10.002.
  • Peer Reviewed
• [Journal Article] Automatic interpretation and writing a report of the adult waking electroencephalogram. (2014)
  • Author(s): Shibasaki H, Nakamura M, Sugi T, Nishida S, Nagamine T, Ikeda A
  • Journal Title: Clin Neurophysiol Volume: 印刷中 Pages: in press
  • DOI: 10.1016/j.clinph.2013.12.114.
  • Peer Reviewed
• [Journal Article] Intraoperative dorsal language network mapping by using single-pulse electrical stimulation. (2014)
  • Author(s): Yamao Y, Matsumoto R, Kunieda T, Arakawa Y, Kobayashi K, Usami K, Shibata S, Kikuchi T, Sawamoto N, Mikuni N, Ikeda A, Fukuyama H Miyamoto S.
  • Journal Title: Human Brain Mapping Volume: 印刷中 Pages: in press
  • DOI: 10.1002/hbm.22479.
  • Peer Reviewed
• [Journal Article] Evaluation of seizure foci and genes in the Lgi1L385R/+ mutant rat. (2014)
  • Author(s): Fumoto N, Mashimo T, Masui A, Ishida S, Mizuguchi Y, Minamimoto S, Ikeda A, Takahashi R, Serikawa T, Yukihiro Ohno Y.
  • Journal Title: Neurosci Res Volume: 印刷中 Pages: in press
  • DOI: 10.1016/j.neures.2013.12.008.
  • Peer Reviewed
• [Journal Article] Persistent, very frequent subclinical seizures could impair memory even after clinical remission in smoldering limbic encephalitis. (2014)
  • Author(s): Kanazawa K, Matsumoto R, Shimotake A, Kinoshita M, Otsuka A, Watanabe A, Tanaka K, Ryosuke Takahashi R, Ikeda A.
  • Journal Title: Epil Disord Volume: 印刷中 Pages: in press
  • Peer Reviewed
• [Journal Article] 急性無菌性髄膜脳炎の経過中に局所性皮質反射性ミオクローヌスを呈し抗グルタミン酸受容体抗体が検出された2例. (2014)
  • Author(s): 戸島麻耶、人見健文、陣上直人、谷岡洸介、山門穂高、松本理器、高橋幸利、池田昭夫、髙橋良輔.
  • Journal Title: 臨床神経学 Volume: 印刷中 Pages: in press
  • Peer Reviewed
• [Journal Article] Bereitschaftspotential augmentation by neuro-feedback training in Parkinson’s disease. (2013)
  • Author(s): Fumuro T, Matsuhashi M, Mitsueda T, Inouchi M, Hitomi T, Nakagawa T, Matsumoto R, Kawamata J, Inoue H, Mima M, Takahashi R, Ikeda A.
  • Journal Title: Clin Neurophysiol Volume: 124 Pages: 1398-405
  • DOI: 10.1016/j.clinph.2013.01.026.
  • Peer Reviewed
• [Journal Article] Internal structural change in the hippocampus observed on 3-tesla MRI in patients with mesial temporal lobe epilepsy. (2013)
  • Author(s): Mitsueda T, Ikeda A, Sawamoto N, Aso T, Hanakawa T, Kinoshita M, Matsumoto R, Mikuni N, Amano S, Fukuyama H Takahashi R.
  • Journal Title: Int Med Volume: 52 Pages: 877-85
  • Peer Reviewed
• [Journal Article] Anterior temporal lobe white matter abnormal signal (ATLAS) as an indicator for laterality of seizure focus in temporal lobe epilepsy: comparison among double inversion recovery, FLAIR and T2W Imaging. (2013)
  • Author(s): Morimoto E, Kanagaki M, Okada T, Yamamoto A, Mori N, Matsumoto R, Ikeda A, Mikuni N, Paul D, Miyamoto S, Takahashi R, Togashi K.
  • Journal Title: Eur Radiol Volume: 23 Pages: 3-11
  • DOI: 10.1007/s00330-012-2565-4.
  • Peer Reviewed
• [Journal Article] Prolonged ictal monoparesis with parietal PLEDs. (2013)
  • Author(s): Murahara T, Kinoshita M, Matsui M, Yamashita K, Ikeda A, Takahashi R.
  • Journal Title: Epi Disord Volume: 15 Pages: 197-202
  • DOI: 10.1684/epd.2013.0567.
  • Peer Reviewed
• [Journal Article] Pre-SMA actively engages in conflict processing in human: a combined study of epicortical ERPs and direct cortical stimulation. (2013)
  • Author(s): Usami K, Matsumoto R, Kunieda T, Shimotake A, Matsuhashi M, Miyamoto S, Fukuyama H, Takahashi R, Ikeda A.
  • Journal Title: Neuropsychologia Volume: 51 Pages: 1011-7
  • DOI: 10.1016/j.neuropsychologia.2013.02.002.
  • Peer Reviewed
• [Journal Article] Role of posterior parietal cortex in reaching movements in humans. Clinical implication for ‘optic ataxia’. (2013)
  • Author(s): Inouchi M, Matsumoto R, Taki J, Kikuchi T, Mitsueda-Ono T, Nobuhiro Mikuni N, Wheaton L, Hallett M, Fukuyama H, Shibasaki H, Takahashi R, Ikeda A.
  • Journal Title: Clin Neurophysiol Volume: 124 Pages: 2230-4
  • DOI: 10.1016/j.clinph.2013.05.011.
  • Peer Reviewed
• [Journal Article] Higher degree of clinical anticipation in maternal transmission in benign adult familial myoclonus epilepsy in Japan. (2013)
  • Author(s): Hitomi T, Kobayashi K, Jingami N, Nakagawa T Imamura H, Matsumoto R, Kondo T, Chin K, Takahashi R, Ikeda A
  • Journal Title: Epi Disord Volume: 15 Pages: 428-32
  • DOI: 10.1684/epd.2013.0608.
  • Peer Reviewed
• [Journal Article] Long-term seizure outcome following resective surgery for epilepsy: to be or not to be completely cured? (2013)
  • Author(s): Kunieda T, Mikuni N, Shibata S, Inano R, Yamao Y, Kikuchi T, Matsumoto R, Takahashi J, Ikeda A, Fukuyama H, Miyamoto S.
  • Journal Title: Neurol Med Chir Volume: 53 Pages: 805-13
  • Peer Reviewed
• [Journal Article] Evaluation of Focus Laterality in Temporal Lobe Epilepsy: A Quantitative Study Comparing Double Inversion-Recovery MR Imaging at 3T with FDG-PET. (2013)
  • Author(s): Morimoto E, Okada T, Kanagaki M, Yamamoto A, Fushimi Y, Matsumoto R, Takaya S, Ikeda A, Kunieda T, Kikuchi T, Paul D, Miyamoto S, Takahashi T, Togashi K.
  • Journal Title: Epilepsia Volume: 54 Pages: 2174-83
  • DOI: 10.1111/epi.12396.
  • Peer Reviewed
• [Journal Article] Faciobrachial dystonic seizureで初発したくすぶり型の抗leucine-rich glioma-inactivated 1 (LGI1)抗体陽性辺縁系脳炎の1例. (2013)
  • Author(s): 中奥由里子、眞木崇州、金澤恭子、松本理器、福山秀直、高橋良輔、池田昭夫.
  • Journal Title: 臨床神経学 Volume: 53 Pages: 706-11
  • Peer Reviewed
• [Presentation] グリアとてんかん病態 発作時DC脳波の発生機構：てんかん焦点のグリアの関与. (2013)
  • Author(s): 池田昭夫.
  • Organizer: 第４７回日本てんかん学会
  • Place of Presentation: 福岡県北九州市
  • Year and Date: 20131011-20131012
  • Invited
• [Presentation] Invasive EEG Recording to Define Epileptic Zone. Symposium: EEG in Diagnosis of Seizures and Epilepsy. (2013)
  • Author(s): Ikeda A.
  • Organizer: 5th Asian and Oceanian Congress of Clinical Neurophysiology
  • Place of Presentation: Bali, Indonesia
  • Year and Date: 20130828-20130831
  • Invited
• [Presentation] Localization: electrophysiology vs. metabolism. Seizures: EEG and MEG are the best. (2013)
  • Author(s): Ikeda A.
  • Organizer: 30th International Epilepsy Congress, Controversy session
  • Place of Presentation: Montreal, Canada
  • Year and Date: 20130623-20130627
  • Invited
• [Presentation] What’s new in diagnostics. The new EEG era. Recording and interpreting, DC shifts and ultra-slow activity. (2013)
  • Author(s): Ikeda A.
  • Organizer: 30th International Epilepsy Congress, Controversy session:Localization, Teaching session
  • Place of Presentation: Montreal, Canada
  • Year and Date: 20130623-20130627
  • Invited
• [Presentation] Movement disorders and epilepsy. The relationship between myoclonus and epilepsy: New insights from, neurophysiological and genetic studies in myoclonus dystonia and familial cortical tremor. (2013)
  • Author(s): Ikeda A.
  • Organizer: 17th International Congress of Parkinson’s Disease and Movement Disorders
  • Place of Presentation: Sydney, Australia
  • Year and Date: 20130616-20130620
  • Invited
• [Book] 症例から学ぶ戦略的てんかん診断・治療 (2014)
  • Author(s): 池田昭夫（編）.
  • Total Pages: 271
  • Publisher: 南山堂
• [Remarks] てんかん・運動異常生理学講座
  • URL: http://epilepsy.med.kyoto-u.ac.jp