1986 Fiscal Year Final Research Report Summary
Effects of neurosimulation on reversibility of neuronal function --Experience of treatment for vegetative status--
| Project/Area Number |
60570682
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Cerebral neurosurgery
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| Research Institution | Fujita-Gakuen Health University |
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Principal Investigator |
KANNO Tetsuo Fujita-Gakuen Health University,School of Medicine Dept. of Neurosurgery, Professor, 医学部, 教授 (90084540)
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| Co-Investigator(Kenkyū-buntansha) |
KAJIHARA Toshio Fujita-Gakuen Health University,School of Medicine Rehabilitation service, Assis, 医学部リハビリテーション, 講師 (40118930)
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| Project Period (FY) |
1985 – 1986
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| Keywords | Neurostimulation / Dorsal column stimulation vegetative status / <gamma> -CBF / Catecholamine / カテコールアミン代謝 |
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| Research Abstract |
Developements in the diagnostic procedures, microsurgical techniques, intensive care, and the social rescue system have lowered the mortality in cerebrovascular diseases, head injuries and other emergencies of neurology and neurosurgery. However, this decreased mortality has given rise to a new social and medical problem i.e. vegetative status, which is an increase in the number of poeple who live on with mild or severe residual neurological deficits. During the last two years, we have used dorsal column stimulation (DCS) for improving spasicity of hemiplegics. While doing so, we incidentally found an improvement in the EEG in some of the cases. This led us to use dorsal column stimulation in cases of vegetative status. In this paper, we have described methodology and our experience with ten cases of vegetative status. All cases satisfied the defenition of "vegetative status" and had received medical treatment for more than 3 months prior to DCS without showing any clinical improvement
… More
. A neurostimulator made by "Medtronic Neuro" was used. The neurostimulator was implanted in epidural space, in midline, at C-2 level under general anaesthesia. Video recording of clinical conditions, EEG, <gamma> -CBF and catecholamine metabolism in CSF at regular intervals were monitored to see the efficacy of this treatment. 1)There was an improvement in the EEG in nine cases out of ten cases after neurostimulation. This was in the form of appearance of more wide spread <alpha> waves, and was noticed between 3 to 14 days after starting the neurostimulation. 2)Four of these cases showed good clinical improvement. In the other four cases there was slight clinical improvement. They improved to the extent of following verbal orders within four months while the another patient started opening eyes two weeks after starting the neurostimulation. 3)CT findings of all cases did not show any correlation with the amount of clinical improvement. However, we have not performed this stimulation for cases of which CT showed large diffuse low density area in cortex or brainstem. 4)Neurostimulation increased <gamma> -CBF by 20 - 40% at any parts of brain in cases of vegetative status. It increased not only in cerebrum, but also in cerebellum and brainstem. 5)Neurostimulation enhanced the metabolism of catecholamine in CSF. NE, DA, DOPAC, HVA, and 5HIAA increased, but 3MT and 5HT decreased in CSF. In conclusion, DCS increases <gamma> -CBF, enhances the metabolism of catecholamine and improves EEG. These facts bring the clinical improvement of cases in vegetative status. Less
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Research Products
(7 results)
