著者

永田 栄一郎

出版者

日本神経学会

雑誌

臨床神経学 (ISSN:0009918X)

巻号頁・発行日

vol.60, no.1, pp.20-26, 2020 (Released:2020-01-30)

参考文献数

43

被引用文献数

3

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片頭痛病態に関する研究は,脳血管が原因で起こるとする血管説,皮質性拡延性抑制現象(cortical spreading depression; CSD)を中心とした神経説が提唱され,その後三叉神経節を中心とした血管や神経原性炎症を起源とする三叉神経血管説が提唱され,現在まで広く受け入れられている.近年,画像検査の進歩により片頭痛発生時期を前兆期より前の予兆期にすでに視床下部での活動性が上昇していることがfunctional MRIやPETなどで明らかとなった.また,光過敏症に関しては内因性網膜神経節細胞(intrinsically photosensitive retinal ganglion cells; ipRGCs)が発症に関与していることも明らかとなった.近年の分子生物学および画像診断の目覚ましい進歩により,過去に提唱されていた病態仮説が次第に明らかとなりつつある.

著者

永田 栄一郎

出版者

日本神経治療学会

雑誌

神経治療学 (ISSN:09168443)

巻号頁・発行日

vol.35, no.3, pp.303-306, 2018 (Released:2018-12-25)

参考文献数

3

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Migraine is a chronic, disabling, and recurrent neurological disorder. The guideline published by Japanese Headache Society, based on evidence–based medicine data, is a useful source of guidance, especially for acute and preventive therapies of migraine (Japanese Clinical Practice Guideline for Chronic Headache 2013). At present, migraine therapy can be classed as acute therapy and preventive therapy. In acute therapy, we give migraineurs NSAIDs or triptans for abortive medicines. We have five triptans (sumatriptan, zolmitriptan, eletriptan, rizatriptan, and naratriptan) in Japan. Notably, sumatripotan has three dosage forms (oral tablet, inhalant, and injection). They are used appropriately by the type of migraine attacks. In general, we firstly give an oral tablet. However, when patients have nausea and vomiting, they cannot take oral medicines. At that time, we use inhalant or injection, especially using injection for a severe attack. It's best timing to take a triptan just after the attack to get the most effective treatment. On the other hand, we usually use calcium blockers, anti–epileptic drugs, anti–depressants, and β–blockers for preventive therapy. Among them, lomerizine, verapamil, valproic acid, amitriptyrine, and propranolol have insurance adaptation in Japan. In preventive therapy, you should not change another preventive drug at least two months. Moreover, you should choose appropriate preventive drug with individual patients. As for the trick of acute treatment, we sometimes give a migraineur both triptan and NSAIDs when a migarineur has a severe attack.

著者

永田 栄一郎

出版者

一般社団法人 日本頭痛学会

雑誌

日本頭痛学会誌 (ISSN:13456547)

巻号頁・発行日

vol.48, no.3, pp.520-523, 2022 (Released:2022-04-28)

参考文献数

16

著者

永田 栄一郎

出版者

日本神経学会

雑誌

臨床神経学 (ISSN:0009918X)

巻号頁・発行日

vol.52, no.11, pp.1014-1017, 2012 (Released:2012-11-29)

参考文献数

7

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The diagnosis of migraine can be difficult, even for headache specialists, because some patients do not necessarily fulfill the International Headache Society criteria for migraine. Hence, reliable disease markers of migraine are required for accurate migraine diagnosis. We performed "Omics" analysis such as transcriptomics, proteomics, and genomics utilizing the lymphoblast cell lines and serum obtained from migraineurs. We verified that αfodrin, which was among the identified 15 genes that were differentially expressed in lymphoblasts originating from patients with migraine, increased after cortical spreading depression in an animal model. We also investigated the alterations of protein expressions induced by migraine attacks using proteomics analysis. Notably, in two migraineurs, the level of apolipoprotein E protein expression during attacks was significantly higher than pre-attack levels. Recently, we have found a novel family lineage with migraine. They also exhibit severe myalgia with arms and legs. GC binding protein which binds to vitamin D was identified as the product of the causative gene in this family. Our omics approach will contribute to a better understanding of migraine pathophysiology.

著者

永田 栄一郎

出版者

日本臨床生理学会

雑誌

日本臨床生理学会雑誌 (ISSN:02867052)

巻号頁・発行日

vol.49, no.5, pp.155-160, 2019-12-01 (Released:2020-03-06)

参考文献数

8

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神経免疫疾患は,重症筋無力症,多発性硬化症,ギラン・バレー症候群,慢性炎症性脱髄性多発神経炎(CIDP),自己免疫性脳炎,多発性筋炎など自己免疫の異常を起こし,中枢神経系および末梢神経に障害を起こす疾患で,その症状は多彩である.中でも末梢神経障害,筋疾患に関しては診断,治療の評価に対して筋電図検査は有用である.ギラン・バレー症候群,CIDP などの末梢神経障害を起こす疾患では,神経伝導速度検査が有用である.CIDP では,運動神経伝導速度では,遠位潜時の延長,伝導速度の遅延,時間的分散や伝導ブロックなどの異常が認められる.また,針筋電図などでも神経原性変化が認められる.多発性筋炎や皮膚筋炎などの筋疾患では針筋電図において筋原性変化を認める.さらに,重症筋無力症は反復刺激試験においてwaning 現象を認め診断の一助となる.神経免疫疾患において,特に電気生理学的検査は診断・治療の上で重要である.

著者

永田 栄一郎

出版者

日本生理人類学会

雑誌

日本生理人類学会誌 (ISSN:13423215)

巻号頁・発行日

vol.25, no.2, pp.15-22, 2020-05-25 (Released:2020-05-25)

参考文献数

21

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We always diagnose migraine using the International Classification of Headache Disorders criteria (version 3). However, since this criteria depends on clinical symptoms and the pathophysiology of migraine is not fully understood, diagnosis sometimes differs between doctors. Hence, we investigate for an appropriate diagnostic biomarker of migraine using the omics approach—a comprehensive analysis of transcriptome, proteome, and genome. Dysfunctions of α-fodrin, apolipoprotein E, and GC-binding protein were found to be candidate biomarkers through proteome, transcriptome, and genome analyses, respectively. Although currently we cannot narrow down to one candidate biomarker, this can be subsequently achieved by evaluating a larger number of patients.