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2014年2月15日

5175 論文「薬剤性眼瞼痙攣の脳グルコース代謝」:neuroscience誌;が掲載されました

論文「薬剤性眼瞼痙攣の脳グルコース代謝」:neuroscience誌;が掲載されました
S03064522
私たちの研究グループが長年提唱してきた「眼瞼痙攣はGABA-ベンゾジアゼピン系の異常が原因で起こる」という眼瞼痙攣の成因を解き明かす仮説が漸く認められようとしています。

この論文の共著者の若倉先生(井上眼科病院名誉院長)がデパスが眼瞼痙攣の原因となることがあるということを提唱され、それをこの研究では核医学神経画像を用いて証明しようとしたのですが、如何にも斬新すぎる仮説であったため、なかなか核医学雑誌の査読者達には受け入れていただけませんでした。

私たちの研究グループのいくつかの関連論文はすでに出版できておりましたが、今回の論文掲載で一流雑誌に大きな柱が立ちましたので、まずはひと段落というところでしょうか。ニューロサイエンス誌(neuroscience)のインパクトファクターは3.122です。

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Glucose hypermetabolism in the thalamus of patients with drug-induced blepharospasm ☆
Y. Suzuki,M. Kiyosawa, M. Wakakura, M. Mochizuki, K. Ishiwata, K. Oda, K. Ishii
⇒サイエンスダイレクトへ リンクhttp://dx.doi.org/10.1016/j.neuroscience.2014.01.024
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1-s2_0-S0306452214000360-gr2

Highlights
薬剤性眼瞼痙攣では視床の糖代謝が亢進している
原発性眼瞼痙攣と薬剤性眼瞼痙攣の糖代謝の変化は同様である
長期にわたるベンゾジアゼピンの使用が基底核-皮質回路の活性化を起こす。
GABAに関連する脳内の回路の変化は原発性および薬剤性眼瞼痙攣の両方のグループの成因に関連しているかもしれない。
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翻訳を準備中ですが、その英文の要約は以下の通りです。
Abstract

We examined the difference in cerebral function alterations between drug-induced blepharospasm patients and essential blepharospasm (EB) patients by using positron emission tomography with 18F-fluorodeoxyglucose. Cerebral glucose metabolism was examined in 21 patients with drug-induced blepharospasm (5 men and 16 women; mean age, 53.1 [range, 29–78] years), 21 essential EB patients (5 men and 16 women; mean age, 53.0 [range, 33–72] years) and 24 healthy subjects (6 men and 18 women; mean age, 57.9 [range, 22–78] years) with long-term history of benzodiazepines use (drug healthy subjects). Drug-induced blepharospasm patients developed symptoms while taking benzodiazepines or thienodiazepines. Sixty-three normal volunteers (15 men and 48 women; mean age, 53.6 [range, 20–70] years) were examined as controls. Differences between the patient groups and control group were examined by statistical parametric mapping. Additionally, we defined regions of interests on both sides of the thalamus, caudate nucleus, anterior putamen, posterior putamen and primary somatosensory area. The differences between groups were tested using two-sample t-tests with Bonferroni correction for multiple comparisons. Cerebral glucose hypermetabolism on both side of the thalamus was detected in drug-induced blepharospasm, EB patients and drug healthy subjects by statistical parametric mapping. In the analysis of regions of interest, glucose metabolism in both sides of the thalamus in the drug-induced blepharospasm group was significantly lower than that in the EB group. Moreover, we observed glucose hypermetabolism in the anterior and posterior putamen bilaterally in EB group but not in drug-induced blepharospasm group and drug healthy subjects. Long-term regimens of benzodiazepines or thienodiazepines may cause down-regulation of benzodiazepine receptors in the brain. We suggest that the functional brain alteration in drug-induced blepharospasm patients is similar to that in EB patients, and that alteration of the GABAergic system might be related to the pathology of both blepharospasm types.

Abbreviations
BoNT, botulinum neurotoxin type A;
DBS, Deep-brain stimulation;
EB, essential blepharospasm;
FWE, family-wise error;
FDG, 18F-fluorodeoxyglucose;
GP, globus pallidus;
GPe, globus pallidus externa;
GPi, globus pallidus interna;
JRS, Jankovic Rating Scale;
MRI, magnetic resonance imaging;
PET, positron emission tomography;
PSA, primary somatosensory area;
ROI, region of interest;
SPM, statistical parametric mapping;
SNr, substantia nigra reticulate;
STN, subthalamic nucleus

Categorised in: 眼瞼痙攣