研究者詳細 - 田岡　俊昭

特集 "-pathy"でせまる中枢神経疾患 CNS interstitial fluidopathy ─ 膜と水動態の異常

特集 "-pathy"でせまる中枢神経疾患序説にかえて-umbrella term の意義とpenumbra

田岡俊昭

画像診断 42 巻 ( 2 ) 頁： 134 - 135 2022年1月

田岡俊昭

画像診断 42 巻 ( 2 ) 頁： 197 - 207 2022年1月

Features from MRI texture analysis associated with survival outcomes in triple-negative breast cancer patients

Kamiya, S; Satake, H; Hayashi, Y; Ishigaki, S; Ito, R; Kawamura, M; Taoka, T; Iwano, S; Naganawa, S

BREAST CANCER 29 巻 ( 1 ) 頁： 164 - 173 2022年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Breast Cancer

Purpose: The purpose of the study is to evaluate the associations between intratumoral or peritumoral textural features derived from pretreatment magnetic resonance imaging (MRI) and recurrence-free survival (RFS) in triple-negative breast cancer (TNBC) patients. Methods: Forty-three patients with TNBC who underwent preoperative MRI between February 2008 and March 2014 were included. We performed two-dimensional texture analysis on the intratumoral or peritumoral region of interest (ROI) on axial of T2-weighted image (T2WI), dynamic contrast-enhanced (DCE)-MRI and DCE-MRI subtraction images. We also analyzed histopathological data. Cox proportional hazards models were used to investigate associations with survival outcomes. Results: Twelve of the 43 patients (27.9%) had recurrence disease, at a median of 32.5 months follow-up (1.4–61.5 months). In univariate analysis, nine texture features in T2WI and DCE-MRI subtraction images were significantly associated with RFS. In multivariate analysis, intratumoral difference entropy in DCE-MRI subtraction images in the initial phase (hazard ratio 11.71; 95% confidence interval (CI) [1.41, 97.00]; p value 0.023) and, peritumoral difference variance in DCE-MRI subtraction images in the delayed phase (hazard ratio 9.60; 95% CI [1.98, 46.51]; p value 0.005), were both independently associated with RFS. Moreover, multivariate analysis revealed the presence of lymphovascular invasion as independently associated with RFS (hazard ratio 8.13; 95% CI [2.16, 30.30]; p value 0.002). Conclusions: At pretreatment MRI, an intratumoral and peritumoral quantitative approach using texture analysis has the potential to serve as a prognostic marker in patients with TNBC.

DOI： 10.1007/s12282-021-01294-1

An Investigation of Water Diffusivity Changes along the Perivascular Space in Elderly Subjects with Hypertension

Kikuta, J; Kamagata, K; Takabayashi, K; Taoka, T; Yokota, H; Andica, C; Wada, A; Someya, Y; Tamura, Y; Kawamori, R; Watada, H; Naganawa, S; Aoki, S

AMERICAN JOURNAL OF NEURORADIOLOGY 43 巻 ( 1 ) 頁： 48 - 55 2022年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：American Journal of Neuroradiology

BACKGROUND AND PURPOSE: Hypertension may be related to alterations of the glymphatic system, a waste metabolite drainage system in the brain. We aimed to investigate analysis along the perivascular space index changes in elderly subjects with hypertension. MATERIALS AND METHODS: Diffusion-weighted images were acquired from 126 subjects, including 63 subjects with hypertension (25 men and 38 women; mean age, 72.45 years) and 63 age- and sex-matched controls (25 men and 38 women; mean age, 72.16 years). We calculated the analysis along the perivascular space index as a ratio of the mean of x-axis diffusivities in the projection and association areas to the mean of y-axis diffusivity in the projection area and z-axis diffusivity in the association area. The left, right, and mean analysis along the perivascular space indices of both hemispheres were compared between the hypertension and control groups using a Mann-Whitney U test. The Spearman correlation coefficient was used to assess the correlation between the left, right, and mean ALPS indices and blood pressure and pulse pressure. RESULTS: The left (P =.011) and mean (P =.024) analysis along the perivascular space indices of the hypertension group were significantly lower than that of the control group. The left, right, and mean analysis along the perivascular space indices of all subjects were significantly negatively correlated with blood pressure values (r = -0.200 to -0.278, P =.002-0.046) and pulse pressure values (r = -0.221 to -0.245, P =.006-0.013). CONCLUSIONS: Our results are consistent with a model in which hypertension causes glymphatic dysfunction.

DOI： 10.3174/ajnr.A7334

The Glymphatic System: A Review of the Challenges in Visualizing its Structure and Function with MR Imaging

Naganawa, S; Taoka, T

MAGNETIC RESONANCE IN MEDICAL SCIENCES 21 巻 ( 1 ) 頁： 182 - 194 2022年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Magnetic Resonance in Medical Sciences

Thecentralnervoussystem(CNS)waspreviouslythoughttobetheonlyorgansystemlackinglymphatic vessels to remove waste products from the interstitial space. Recently, based on the results from animal experiments, the glymphatic system was hypothesized. In this hypothesis, cerebrospinal fluid (CSF) enters the periarterial spaces, enters the interstitial space of the brain parenchyma via aquaporin-4 (AQP4) channels in the astrocyte end feet, and then exits through the perivenous space, thereby clearing waste products. From the perivenous space, the interstitial fluid drains into the subarachnoid space and meningeal lymphatics of the parasagittal dura. It has been reported that the glymphatic system is particularly active during sleep. Impairment of glymphatic system function might be a cause of various neurodegenerative diseases such as Alzheimer’s disease, normal pressure hydrocephalus, glaucoma, and others. Meningeal lymphatics regulate immunity in the CNS. Many researchers have attempted to visualize the function and structure of the glymphatic system and meningeal lymphatics in vivo using MR imaging. In this review, we aim to summarize these in vivo MR imaging studies and discuss the significance, current limitations, and future directions. We also discuss the significance of the perivenous cyst formation along the superior sagittal sinus, which is recently discovered in the downstream of the glymphatic system.

DOI： 10.2463/mrms.rev.2020-0122

MR Imaging of Endolymphatic Hydrops in Five Minutes

Naganawa, S; Ito, R; Kawai, H; Kawamura, M; Taoka, T; Sakai, M; Ichikawa, K; Yoshida, T; Sone, M

MAGNETIC RESONANCE IN MEDICAL SCIENCES 21 巻 ( 3 ) 頁： 401 - 405 2022年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Magnetic Resonance in Medical Sciences

In this study, we present images acquired by a fast-imaging method for the evaluation of endolymphatic hydrops after intravenous administration of a single dose of gadolinium-based contrast agent. We utilized the hybrid of reversed image of MR cisternography and a positive perilymph signal by heavily T2-weighted 3D-fluid attenuated inversion recovery-multiplied by T2 (HYDROPS2-Mi2) method combined with deep learning reconstruction denoising. The scan time for the fast protocol was approximately 5 mins, which is far shorter than previously reported scan times. The fast acquisition provides similar image quality and less motion artifacts compared to the longer method.

DOI： 10.2463/mrms.ici.2021-0022

Cross-sectional Area of the Superior Petrosal Sinus is Reduced in Patients with Significant Endolymphatic Hydrops

Naganawa, S; Ito, R; Kawai, H; Kawamura, M; Taoka, T; Yoshida, T; Sone, M

MAGNETIC RESONANCE IN MEDICAL SCIENCES 21 巻 ( 3 ) 頁： 459 - 467 2022年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Magnetic Resonance in Medical Sciences

Purpose: To evaluate the relationship between the size of the venous structures related to the inner ear and the degree of endolymphatic hydrops (EH). Methods: Thirty-four patients with a suspicion of EH underwent whole brain MR imaging including the inner ear. Images were obtained pre-and post-administration, and at 4 and 24 hours after the intravenous administration of a gadolinium-based contrast agent (IV-GBCA). The cross-sectional areas (CSA) of the internal jugular vein (IJV), superior petrosal sinus (SPS), and inferior petrosal sinus (IPS) were measured on the magnetization prepared rapid acquisition of gradient echo (MPRAGE) images obtained immediately after the IV-GBCA. The grade of EH was determined on the hybrid of reversed image of positive endolymph signal and native image of positive perilymph signal (HYDROPS) images obtained at 4 hours after IV-GBCA as no, mild, and significant EH according to the previously proposed grading system for the cochlea and vestibule, respectively. The ipsilateral CSA was compared between groups with each level of EH grade. P < 0.05 was considered statistically significant. Results: There were no statistically significant differences between EH grades for the CSA of the IJV or that of the IPS in either the cochlea or the vestibule. The CSA of the SPS in the groups with significant EH was significantly smaller than that in the group with no EH, for both the cochlea (P < 0.01) and the vestibule (P < 0.05). In an ROC analysis to predict significant EH, the cut-off CSA value in the SPS was 3.905 mm2 for the cochlea (AUC: 0.8762, 95% confidence interval [CI]: 0.7952‒0.9572) and 3.805 mm2 for the vestibule (AUC: 0.7727, 95% CI: 0.6539‒0.8916). Conclusion: In the ears with significant EH in the cochlea or vestibule, the CSA of the ipsilateral SPS was smaller than in the ears without EH.

DOI： 10.2463/mrms.mp.2021-0010

特集撮った,読んだ,わかった! 認知症画像診断認知症画像のカッティングエッジ2:Glymphaticシステム,CNS interstitial fluidopathyの概念

田岡俊昭

画像診断 41 巻 ( 14 ) 頁： 1543 - 1553 2021年11月

FLUID study: study protocol for an open-label, single-centre pilot study to investigate the efFect of Lemborexant on sleep management in Japanese sUbjects aged 50 years and older with Insomnia Disorder 国際誌

Okada, I; Iwamoto, K; Miyata, S; Fujimoto, A; Tanaka, M; Amano, M; Matsuyama, N; Taoka, T; Naganawa, S; Ozaki, N

BMJ OPEN 11 巻 ( 11 ) 頁： e054885 2021年11月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：BMJ Open

Introduction Bidirectional associations have been reported between sleep disturbance and both cognitive impairment, including Alzheimer’s disease and amyloid beta-peptide (Aβ) accumulation. These relationships can be explained by the glymphatic system, which acts as a garbage drainage system in the brain. As interstitial fluid dynamics are suggested to increase during sleep, clearance of Aβ can be influenced by sleep disturbance or deprivation. We hypothesised that using lemborexant, an orexin receptor antagonist, to improve sleep quality would also improve the function of the glymphatic system. We plan to examine the effect of lemborexant on sleep quality and the glymphatic system among patients with insomnia disorder. Methods and analysis This pilot study is designed as an open-label, single-arm, single-centre trial. Thirty patients aged 50 years and over with insomnia will be recruited. The participants will take lemborexant (5 mg) at bedtime for 12 weeks and undergo a home-based sleep study at baseline and weeks 4 and 12, as well as MRI examinations to evaluate the glymphatic system at baseline and week 12. The primary outcome will be changes in objective sleep parameters as evaluated using a sleep monitoring system. The secondary outcomes will be changes in subjective sleep parameters. The relationships between changes in sleep parameters and the glymphatic system will be evaluated using diffusion tensor image analysis along the perivascular space, which is called the ALPS-index. Sleep parameters and the ALPS-index will be analysed using a paired t-test or Pearson’s correlation coefficient. Ethics and dissemination The study protocol was approved by Nagoya University Certified Review Board. The findings from this research will be published in peer-reviewed journals and be presented at local, national and international conferences.

DOI： 10.1136/bmjopen-2021-054885

Magnetic resonance cisternography imaging findings related to the leakage of Gadolinium into the subarachnoid space

Nakamichi, R; Taoka, T; Kawai, H; Yoshida, T; Sone, M; Naganawa, S

JAPANESE JOURNAL OF RADIOLOGY 39 巻 ( 10 ) 頁： 927 - 937 2021年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Japanese Journal of Radiology

Purpose: To identify magnetic resonance cisternography (MRC) imaging findings related to Gadolinium-based contrast agent (GBCA) leakage into the subarachnoid space. Materials and methods: The number of voxels of GBCA leakage (V-leak) on 3D-real inversion recovery images was measured in 56 patients scanned 4 h post-intravenous GBCA injection. Bridging veins (BVs) were identified on MRC. The numbers of BVs with surrounding cystic structures (BV-cyst), with arachnoid granulations protruding into the superior sagittal sinus (BV-AG-SSS) and the skull (BV-AG-skull), and including any of these factors (BV-incl) were recorded. Correlations between these variables and V-leak were examined based on the Spearman’s rank correlation coefficient. Receiver-operating characteristic (ROC) curves were generated to investigate the predictive performance of GBCA leakage. Results: V-leak and the number of BV-incl were strongly correlated (r = 0.609, p < 0.0001). The numbers of BV-cyst and BV-AG-skull had weaker correlations with V-leak (r = 0.364, p = 0.006; r = 0.311, p = 0.020, respectively). The number of BV-AG-SSS was not correlated with V-leak. The ROC curve for contrast leakage exceeding 1000 voxels and the number of BV-incl had moderate accuracy, with an area under the curve of 0.871. Conclusion: The number of BV-incl may be a predictor of GBCA leakage and a biomarker for waste drainage function without using GBCA.

DOI： 10.1007/s11604-021-01137-1

その他リンク： https://link.springer.com/article/10.1007/s11604-021-01137-1/fulltext.html

Changes in Vessel Wall Enhancement Related to the Recent Neurological Symptoms in Patients with Moyamoya Disease 査読有り

Muraoka, S; Taoka, T; Kawai, H; Okamoto, S; Uda, K; Naganawa, S; Araki, Y

NEUROLOGIA MEDICO-CHIRURGICA 61 巻 ( 9 ) 頁： 515 - 520 2021年9月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Neurologia Medico-Chirurgica

Moyamoya disease (MMD) causes intracranial arterial stenosis progression. The progression of intracranial arterial stenosis will increase the risk of ischemic cerebrovascular events. This study aims to investigate the relationship between intracranial arterial stenosis progression, vessel wall enhancement (VWE), and the recent neurological symptoms. A total of 39 MMD patients (12 male 37.6 ± 18.0 years old) were registered in this study analysis between April 2016 and July 2018. All patients received MRI at registration and 6, 12, and 24 months post-registration. The incidence of ischemic cerebrovascular events (transit ischemic attacks or cerebral infarction) was checked until December 2018. We evaluated the relationship between the intensity of VWE, intracranial arterial stenosis, and the recent neurological symptoms. During the mean follow-up period of 13.8 ± 5.5 months, the changes in VWE were observed in 33 hemispheres (42.3%), stenosis progression was observed in 21 hemispheres (26.9%), and recent neurological symptoms occurred in 10 hemispheres (12.8%). Stenosis progression was observed in 11 hemispheres (33.3%) in the VWE(+) group and ten hemispheres (22.2%) in the VWE(-) group (p = 0.310). The recent neurological symptoms were observed in eight hemispheres (21.2%) in the VWE(+) group and two hemispheres (4.44%) in the VWE(-) group (odds ratio 6.88, 95% confidence interval 1.35-34.98, p = 0.015). The intensity of VWE sometimes changes. The changes in VWE were significantly associated with the recent neurological symptoms but not with stenosis progression.

DOI： 10.2176/nmc.oa.2021-0058

Neu rofluid as Assessed by Diffusion-Weighted Imaging 国際誌

Taoka, T

MAGNETIC RESONANCE IMAGING CLINICS OF NORTH AMERICA 29 巻 ( 2 ) 頁： 243 - 251 2021年5月

Associations among Cognitive Functions, Plasma DNA, and Diffusion Tensor Image along the Perivascular Space (DTI-ALPS) in Patients with Parkinson's Disease 国際共著国際誌

Chen, HL; Chen, PC; Lu, CH; Tsai, NW; Yu, CC; Chou, KH; Lai, YR; Taoka, T; Lin, WC

OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021 巻頁： 4034509 - 4034509 2021年2月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Oxidative Medicine and Cellular Longevity

Background. Parkinson's disease (PD) is a common neurodegenerative disease associated with accumulation of misfolding proteins and increased neuroinflammation, which may further impair the glymphatic system. The purpose of this study was to utilize diffusion tensor image analysis along the perivascular space (DTI-ALPS) to evaluate glymphatic system activity and its relationship with systemic oxidative stress status in PD patients. Methods. Magnetic resonance imaging and neuropsychological tests were conducted on 25 PD patients with normal cognition (PDN), 25 PD patients with mild cognitive impairment (PD-MCI), 38 PD patients with dementia (PDD), and 47 normal controls (NC). Oxidative stress status was assessed by plasma DNA level. Differences in ALPS-index among the subgroups were assessed and further correlated with cognitive functions and plasma DNA levels. Results. The PD-MCI and PDD groups showed significantly lower ALPS-index compared to normal controls. The ALPS-index was inversely correlated with plasma nuclear DNA, mitochondrial DNA levels, and cognitive scores. Conclusions. Lower diffusivity along the perivascular space, represented by lower ALPS-index, indicates impairment of the glymphatic system in PD patients. The correlation between elevated plasma nuclear DNA levels and lower ALPS-index supports the notion that PD patients may exhibit increased oxidative stress associated with glymphatic system microstructural alterations.

DOI： 10.1155/2021/4034509