文献一覧: 竹島多賀夫 (著者)

159 0 0 0 OA 種々の症状を呈する難治性疾患における中枢神経感作の役割の解明とそれによる患者ケアの向上

著者: 平田幸一鈴木圭輔春山康夫小橋元佐伯吉規細井昌子福土審柳原万理子井上雄一西原真理西須大徳森岡周西上智彦團野大介竹島多賀夫端詰勝敬橋本和明
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.37, no.2, pp.166-179, 2020 (Released:2020-08-31)
参考文献数: 51
被引用文献数: 4

難治性の疾患における持続中枢神経感作と言われる病態の疫学,基礎・臨床的な位置付けさらには患者のケアにむけての研究をまとめた.本総説は厚生労働研究班の各員の研究結果を示したものなので,必ずしもまとまりがない点に限界があるが,今までは疾患縦断的に診断治療がおこなわれてきた難治性疾患における中枢神経感作の役割を横断的にみたという意味でもわれわれの研究の結果は一部ではあるが解明したものといえる.結果として,中枢神経感作は種々の疾患,特に難治性のもので明らかに何らかの役割を呈していることが示せた.さらにその治療法の解明には至らぬまでも,患者ケアに繋がる方略を示せたものと考えられ,今後の研究の基盤となることが望まれる.

2024-01-09 08:22:53
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8 0 0 0 OA シンポジウム17―2 片頭痛の疼痛発生とその拡大進展をめぐる最先端の分子メカニズム片頭痛はなぜ慢性化するのか? 慢性片頭痛と薬物乱用頭痛の臨床とメカニズム

著者: 竹島多賀夫
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.50, no.11, pp.990-993, 2010 (Released:2011-03-28)
参考文献数: 10
被引用文献数: 1

Chronification of migraine headaches is one of the most urgent issues. Chronic migraine (CM) and medication overuse headache (MOH) are defined in international classification of headache disorders II (ICHD-II). Appendix criteria of CM and MOH were submitted and will take over the original criteria. I described a case of CM and a case of MOH. Here I pointed out some practical issues in diagnosis of CM or MOH. 1) It is not easy to define the association of headache worsening and the beginning of medication overuse in many cases. 2) Some patients cannot discontinue the overused drugs; therefore, the diagnosis of CM nor MOH cannot be completed. 3) Some patients are not released from their headache even after the discontinuation of drug. In these cases, there are two possibilities. As a result of CM, the patient had simply overused the ineffective medications. From another point of view, MOH caused irreversible brain changes and MOH do not disappear after the detoxification. 4) In a practical management, we often prescribe preventive medications simultaneously at the beginning of detoxification. In these cases, it is unclear which one of the detoxification or the preventive medication contributes the improvement of headache. The chronification of migraine is regarded as chronification of acute mechanism of migraine, i.e., inflammation of the trigeminovascular system and sensitization of the brain. Apart from medication overuse, there have been reported some new risk factors for migraine chronification, including frequent headache, female sex, obesity, low income, low education, stress by life events, depression, snoring, sleep disorders, and past history of neck or head injury. Chronification of migraine severely disturbs the quality of patient's life. More attention should be paid and the further and extensive studies are urgently necessary.

2019-02-28 06:57:18
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6 0 0 0 OA 3. 片頭痛

著者: 中島健二竹島多賀夫
出版者: 一般社団法人日本臨床薬理学会
雑誌: 臨床薬理 (ISSN:03881601)
巻号頁・発行日: vol.36, no.6, pp.277-283, 2005-11-30 (Released:2010-06-28)
参考文献数: 24

2019-09-08 15:27:02
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3 0 0 0 OA 片頭痛治療に期待される非侵襲的神経刺激療法

著者: 竹島多賀夫
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.307-312, 2018 (Released:2018-12-25)
参考文献数: 27

Neuromodulation is focused as a new therapy for primary headache disorders.Non–invasive neuromodulation devices are free from surgical risks and those costs are practical ranges in primary care settings. It is also important most of these devices are self–applicable after the appropriate introductions.Transcutaneous supraorbital trigeminal neurostimulation (Cefaly) is widely used in Europe and United States, and clinical evidence for migraine management have been accumulated. I demonstrated our preliminary favorable results of Cefaly devices for Japanese migraine sufferers. Non–invasive vagus nerve stimulation (nVNS) has been approved in United States. Single–pulse transcranial magnetic stimulation (sTMS) is also expected to be a new device for chronic pain including migraine headache.These non–invasive neuromodulation devices will open new avenues on the management of primary headaches including migraine.

2022-01-11 19:26:18
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1 0 0 0 OA 片頭痛と睡眠

著者: 竹島多賀夫
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.39, no.4, pp.564-568, 2022 (Released:2022-12-27)
参考文献数: 18

Migraine is a highly disabling prevalent neurological disease. Cortical spreading depression/depolarization, central sensitization, and neurogenic inflammation in trigemino–vasular system involve the pathophysiology of migraine. Serotonin, dopamine, and calcitonin gene related peptides relate closely these phenomenon.The relationship between headache disorders and sleep disorders can categorize 1) headaches cause sleep disorders, 2) sleep disorders (disturbances) cause or worse headaches, 3) Somewhat common factor(s) cause both headache and sleep disorders.In this lecture, I summarized possible relation of migraine and sleep disorders including sleep apnea, somnambulism, restless legs syndrome, narcolepsy.21st century headache involves new territory and special concern to sleep hygiene are essentially important.

2023-08-21 13:42:00
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1 0 0 0 OA 成熟したトリプタン治療も新規急性期治療薬の登場で変わるのか

著者: 菊井祥二竹島多賀夫
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.37, no.4, pp.680-684, 2020 (Released:2021-05-27)
参考文献数: 33

The appearance of sumatriptan in the 1990s was an epoch–making event. Since 2000, five types of triptans have become available for use in Japan. As a result, medical treatment for headaches has become more active and the quality of medical care has dramatically improved. Increasing experience with the use of triptan for the last 20 years has allowed medical professionals to overcome various problems such as the existence of nonresponders and adverse effects of triptan, and triptan treatment has thus matured. However, some patients with migraine do not benefit from the vasoconstrictive effect of triptan stimulated by the 5–hydroxytriptamine 1B receptor. The clinical application of selective 5–hydroxytriptamine 1F receptor agonists (ditans) and calcitonin gene–related peptide receptor antagonists (gepants) that can compensate for the shortcomings of triptan is now progressing, and we hope that such drugs will become the first–choice treatment among many patients with migraine.

2023-04-02 20:23:27
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1 0 0 0 OA Susceptibility-weighted imagingで一過性の皮質静脈拡張を認め前兆のある片頭痛発作が示唆された1例

著者: 和田晋一津崎光司杉山華子菊井祥二竹島多賀夫濱野利明
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.61, no.7, pp.482-485, 2021 (Released:2021-07-30)
参考文献数: 17

症例は41歳男性,35歳時より月1回の頻度で前兆のない片頭痛を経験していた.2020年10月某日に突然同僚の名前を想起できなくなり,その後徐々に側頭部痛と悪心を自覚し当院受診となった.来院時,左側頭部の拍動性頭痛と人の名前を想起できない症状に加えて,失算,左右失認を認めた.発症3時間後の脳MRIではsusceptibility-weighted imaging(SWI)で左大脳半球に皮質静脈の拡張を認めた.発症42時間後までに頭痛を含めた神経症状は経時的に改善し,SWIで皮質静脈の拡張は改善した.本症例ではSWI所見の推移から,前兆のある片頭痛の初発発作が示唆された.

2023-03-24 21:25:51
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1 0 0 0 OA 中枢神経感作と慢性痛 ─特に片頭痛を中心に─

著者: 平田幸一團野大介菊井祥二鈴木圭輔竹島多賀夫
出版者: 日本疼痛学会
雑誌: PAIN RESEARCH (ISSN:09158588)
巻号頁・発行日: vol.35, no.2, pp.73-79, 2020-06-30 (Released:2020-08-03)
参考文献数: 11

Refractory chronic headaches greatly impair the quality of life of migraine patients and also reduce social productivity. To elucidate the pathophysiology of the supersensitive brain state of refractory migraine attacks, and to discover the treatment and prophylaxis for the refractory chronic migraine, we analyzed a brain electric field under the light stimulation–induced brain supersensitivity. As a result, we found suppression of the cortical hyperexcitation only in patients with migraine without aura. This result suggested that the suppression of the cortical hyperexcitation by cortical spreading depression may have a role for inhibition of excitation in limbic system, vestibular system and the vomiting center. Next, cranial autonomic symptoms in patients with migraine have recently received attention. We showed that central sensitization, assessed by central sensitization inventory questionnaire, was more prevalent in migraine patients with cranial autonomic symptoms compared with those without cranial autonomic symptoms, suggesting a possible role of central sensitization in comorbid autonomic symptoms in migraine. Central sensitization is postulated to participate in not only severe pain but also in various symptoms such as fatigue, sleep disturbances, anxiety and depression in chronic pain syndrome. We believe our study results from migraine patients shed some light on the role of central sensitization in pathophysiology of chronic pain syndrome, but the elucidation of these relationships require further studies.

2020-08-30 07:27:04
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1 0 0 0 OA 低用量インドメタシンとプレガバリンの併用が有用であった持続性片側頭痛の1例

著者: 菊井祥二宮原淳一柏谷嘉宏竹島多賀夫
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.54, no.10, pp.824-826, 2014-10-01 (Released:2014-10-24)
参考文献数: 10

症例は51歳男性である.約3週前より左眼窩から前頭部への頭痛が持続し,頭痛増強時に眼充血,流涙をともなった.神経学的所見,脳MRIは異常なく,インドメタシン(75 mg/日)で頭痛が完全に抑制され,国際頭痛分類第2版から持続性片側頭痛(hemicrania continua; HC)と診断した.インドメタシン減量で頭痛が再燃したので,プレガバリン(150 mg/日)を併用したところ,インドメタシンは25 mg/日まで減量可能で,忍容性も良好であった.HCはインドメタシン反応性頭痛の一つであるが,インドメタシンの連用により,胃腸障害などの副作用で,忍容性が低下し,減量や中止が余儀なくされることがあり,インドメタシンに代わりうる薬剤療法が必要である.