著者

Mari Matsumoto Manabu Sakaguchi Shuhei Okazaki Kazuo Hashikawa Tsutomu Takahashi Masayasu Matsumoto Toshiho Ohtsuki Takeshi Shimazu Toshiki Yoshimine Hideki Mochizuki Kazuo Kitagawa

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-16-0707, (Released:2017-01-31)

参考文献数

18

被引用文献数

1 7

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Background:In Japan, warfarin treatment at prothrombin time-international normalized ratio (PT-INR) of 1.60–2.60 is recommended for elderly patients with nonvalvular atrial fibrillation (NVAF). But it remains unknown whether PT-INR 1.60–1.99 has a similar effect on stroke severity as a value >2.0. The purpose of this study was to clarify the association between infarct volume and PT-INR levels.Methods and Results:The 180 patients (mean age, 76 years [SD, 10 years], 53% male) selected from 429 consecutive ischemic stroke patients admitted within 48 h of onset between 2004 and 2014 with NVAF were included. We classified them into 4 groups according to their PT-INR values on admission: no warfarin (NW), 129 patients; PT-INR <1.60 (poor control: PC), 29 patients; PT-INR 1.60–1.99 (low-intensity control: LC), 14 patients; and PT-INR ≥2.00 (high-intensity control: HC), 8 patients. Median (interquartile range: IQR) of infarct volume was 55 mL (IQR 14–175) in the NW, 42 mL (IQR 27–170) in the PC, 36 mL (IQR 6–130) in the LC, and 11 mL (IQR 0–39) in the HC groups. The infarct volume of the HC group was significantly smaller than in the other 3 groups, but no difference existed between the LC and PC groups or the LC and NW groups.Conclusions:Warfarin control at PT-INR of 1.60–1.99 is not effective for reducing the severity of ischemic stroke in NVAF patients.

著者

Takufumi YANAGISAWA Ryohei FUKUMA Ben SEYMOUR Koichi HOSOMI Haruhiko KISHIMA Takeshi SHIMIZU Hiroshi YOKOI Masayuki HIRATA Toshiki YOSHIMINE Yukiyasu KAMITANI Youichi SAITOH

出版者

The Japan Neurosurgical Society

雑誌

Neurologia medico-chirurgica (ISSN:04708105)

巻号頁・発行日

pp.st.2018-0099, (Released:2018-07-12)

参考文献数

41

被引用文献数

6

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A brachial plexus root avulsion (BPRA) causes intractable pain in the insensible affected hands. Such pain is partly due to phantom limb pain, which is neuropathic pain occurring after the amputation of a limb and partial or complete deafferentation. Previous studies suggested that the pain was attributable to maladaptive plasticity of the sensorimotor cortex. However, there is little evidence to demonstrate the causal links between the pain and the cortical representation, and how much cortical factors affect the pain. Here, we applied lesioning of the dorsal root entry zone (DREZotomy) and training with a brain–machine interface (BMI) based on real-time magnetoencephalography signals to reconstruct affected hand movements with a robotic hand. The DREZotomy successfully reduced the shooting pain after BPRA, but a part of the pain remained. The BMI training successfully induced some plastic changes in the sensorimotor representation of the phantom hand movements and helped control the remaining pain. When the patient tried to control the robotic hand by moving their phantom hand through association with the representation of the intact hand, this especially decreased the pain while decreasing the classification accuracy of the phantom hand movements. These results strongly suggested that pain after the BPRA was partly attributable to cortical representation of phantom hand movements and that the BMI training controlled the pain by inducing appropriate cortical reorganization. For the treatment of chronic pain, we need to know how to modulate the cortical representation by novel methods.

著者

Masayuki HIRATA Kojiro MATSUSHITA Takafumi SUZUKI Takeshi YOSHIDA Fumihiro SATO Shayne MORRIS Takufumi YANAGISAWA Tetsu GOTO Mitsuo KAWATO Toshiki YOSHIMINE

出版者

The Institute of Electronics, Information and Communication Engineers

雑誌

IEICE TRANSACTIONS on Communications (ISSN:09168516)

巻号頁・発行日

vol.E94-B, no.9, pp.2448-2453, 2011-09-01

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The brain-machine interface (BMI) is a new method for man-machine interface, which enables us to control machines and to communicate with others, without input devices but directly using brain signals. Previously, we successfully developed a real time control system for operating a robot arm using brain-machine interfaces based on the brain surface electrodes, with the purpose of restoring motor and communication functions in severely disabled people such as amyotrophic lateral sclerosis patients. A fully-implantable wireless system is indispensable for the clinical application of invasive BMI in order to reduce the risk of infection. This system includes many new technologies such as two 64-channel integrated analog amplifier chips, a Bluetooth wireless data transfer circuit, a wirelessly rechargeable battery, 3 dimensional tissue-fitting high density electrodes, a titanium head casing, and a fluorine polymer body casing. This paper describes key features of the first prototype of the BMI system for clinical application.