研究者詳細 - 齋藤　竜太

論文 - 齋藤　竜太

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Involvement of the Thalamus, Hippocampus, and Brainstem in Hypsarrhythmia of West Syndrome: Simultaneous Recordings of Electroencephalography and fMRI Study 査読有り国際誌 Open Access

Maki, Y; Natsume, J; Ito, Y; Okai, Y; Bagarinao, E; Yamamoto, H; Ogaya, S; Takeuchi, T; Fukasawa, T; Sawamura, F; Mitsumatsu, T; Maesawa, S; Saito, R; Takahashi, Y; Kidokoro, H

AMERICAN JOURNAL OF NEURORADIOLOGY 43 巻 ( 10 ) 頁： 1502 - 1507 2022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：American Journal of Neuroradiology

BACKGROUND AND PURPOSE: West syndrome is a developmental and epileptic encephalopathy characterized by epileptic spasms, neurodevelopmental regression, and a specific EEG pattern called hypsarrhythmia. Our aim was to investigate the brain activities related to hypsarrhythmia at onset and focal epileptiform discharges in the remote period in children with West syndrome using simultaneous electroencephalography and fMRI recordings. MATERIALS AND METHODS: Fourteen children with West syndrome underwent simultaneous electroencephalography and fMRI at the onset of West syndrome. Statistically significant blood oxygen level-dependent responses related to hypsarrhythmia were analyzed using an event-related design of 4 hemodynamic response functions with peaks at 3, 5, 7, and 9 seconds after the onset of each event. Six of 14 children had focal epileptiform discharges after treatment and underwent simultaneous electroencephalography and fMRI from 12 to 25 months of age. RESULTS: At onset, positive blood oxygen level-dependent responses were seen in the brainstem (14/14 patients), thalami (13/14), basal ganglia (13/14), and hippocampi (13/14), in addition to multiple cerebral cortices. Group analysis using hemodynamic response functions with peaks at 3, 5, and 7 seconds showed positive blood oxygen level-dependent responses in the brainstem, thalamus, and hippocampus, while positive blood oxygen level-dependent responses in multiple cerebral cortices were seen using hemodynamic response functions with peaks at 5 and 7 seconds. In the remote period, 3 of 6 children had focal epileptiform discharge- related positive blood oxygen level-dependent responses in the thalamus, hippocampus, and brainstem. CONCLUSIONS: Positive blood oxygen level-dependent responses with hypsarrhythmia appeared in the brainstem, thalamus, and hippocampus on earlier hemodynamic response functions than the cerebral cortices, suggesting the propagation of epileptogenic activities from the deep brain structures to the neocortices. Activation of the hippocampus, thalamus, and brainstem was still seen in half of the patients with focal epileptiform discharges after adrenocorticotropic hormone therapy.

DOI： 10.3174/ajnr.A7646

小児脳幹部神経膠腫に対する脳内広範囲薬剤送達技術を用いた塩酸ニムスチン局所投与多施設共同第II相医師主導治験

齋藤竜太, 金森政之, 峰晴陽平, 荒川芳輝, 千葉謙太郎, 藍原康雄, 柴原一陽, 隈部俊宏, 松田憲一朗, 園田順彦, 高橋史朗, 冨永悌二

日本癌治療学会学術集会抄録集 60回巻頁： EN6 - 4 2022年10月

小児脳幹部神経膠腫に対する脳内広範囲薬剤送達技術を用いた塩酸ニムスチン局所投与多施設共同第II相医師主導治験

齋藤竜太, 金森政之, 峰晴陽平, 荒川芳輝, 千葉謙太郎, 藍原康雄, 柴原一陽, 隈部俊宏, 松田憲一朗, 園田順彦, 高橋史朗, 冨永悌二

日本癌治療学会学術集会抄録集 60回巻頁： EN6 - 4 2022年10月

機能的脳神経外科治療が検討された振戦性疾患の診断と治療方針

坪井崇, 鈴木将史, 佐藤茉紀, 平賀経太, 佐竹勇紀, 服部誠, 原一洋, 鳥居潤, 中坪大輔, 前澤聡, 斎藤竜太, 勝野雅央

臨床神経学 62 巻 ( Suppl. ) 頁： S256 - S256 2022年10月

機能的脳神経外科治療が検討された振戦性疾患の診断と治療方針

坪井崇, 鈴木将史, 佐藤茉紀, 平賀経太, 佐竹勇紀, 服部誠, 原一洋, 鳥居潤, 中坪大輔, 前澤聡, 斎藤竜太, 勝野雅央

臨床神経学 62 巻 ( Suppl. ) 頁： S256 - S256 2022年10月

The usefulness and safety of dexmedetomidine for postoperative sedation in pediatric patients with moyamoya disease 国際誌

Kanamori, F; Araki, Y; Yokoyama, K; Uda, K; Kurimoto, M; Shiba, Y; Mamiya, T; Takayanagi, K; Ishii, K; Nishihori, M; Izumi, T; Okamoto, S; Saito, R

JOURNAL OF NEUROSURGERY-PEDIATRICS 30 巻 ( 3 ) 頁： 301 - 307 2022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：Journal of Neurosurgery: Pediatrics

OBJECTIVE After revascularization surgery in pediatric patients with moyamoya disease (MMD), resting and avoiding crying is important. However, this inaction is often difficult because of pain or anxiety. Dexmedetomidine (DEX), which has sedative and analgesic properties, may be useful in reducing those uncomfortable conditions; however, its common side effects include bradycardia and hypotension, which have a risk of decreasing the cerebral blood flow. The aim of this study was to investigate the efficacy and safety of using DEX for pediatric patients with MMD in the acute period after revascularization surgery. METHODS This retrospective study included pediatric patients with MMD who underwent revascularization surgery. Based on whether DEX was used for light sedation during postoperative days (PODs) 0–1 after extubation, the patients were divided into DEX or control groups. For neurological outcomes, the incidence of symptomatic cerebral infarction and transient neurological events (TNEs) during PODs 0–1 and the entire hospitalization were investigated. In addition, the Richmond Agitation-Sedation Scale (RASS) was used to assess the effect of DEX, and bradycardia and hypotension were evaluated as side effects. RESULTS A total of 84 surgical procedures were included in this study (27 in the DEX group and 57 in the control group). During PODs 0–1, symptomatic infarction was not observed in either group. The incidence of TNEs was almost the same in both groups: 2 (7.4%) of the 27 procedures in the DEX group and 4 (7.0%) of the 57 procedures in the control group (p > 0.99). Moreover, the incidences of symptomatic infarction and TNEs during the entire hospitalization did not differ significantly (symptomatic infarction, p > 0.99; TNEs, p = 0.20). Regarding the DEX effect, the median RASS scores during PODs 0–1 were −1.0 (drowsy) in the DEX group and +1.0 (restless) in the control group, showing a significant difference (p < 0.01). Regarding side effects, bradycardia was observed only in 3 (11.1%) of the 27 procedures in the DEX group (p = 0.03), and hypotension was not observed in any of the cases. CONCLUSIONS In pediatric patients with MMD who are extubated after revascularization surgery, DEX produced appropriate light sedation and analgesia. The risk for symptomatic infarction is almost the same in cases in which DEX is used and those in which it is not; however, neurosurgeons should be cautious of bradycardia and TNEs as potential side effects.

DOI： 10.3171/2022.6.PEDS2241

ゲノムおよびトランスクリプトーム解析による膠芽腫の分子的多様性の解明(Dissecting the molecular complexity underlying glioblastoma by genomic and transcriptome profiling)

中島拓真, 舟越勇介, 南部翔平, 畝田篤仁, 片山琴絵, 花谷亮典, 井元清哉, 田中將太, 齋藤竜太, 吉本幸司, 成田善孝, 鈴木啓道

日本癌学会総会記事 81回巻頁： E - 1040 2022年9月

星細胞腫IDH変異型の全ゲノムシークエンスと包括的な分子学的解析(Whole-genome sequencing and comprehensive molecular profiling of Astrocytoma, IDH-mutant)

舟越勇介, 中島拓真, 南部翔平, 畝田篤仁, 片山琴絵, 井元清哉, 花谷亮典, 田中將太, 齋藤竜太, 吉本幸司, 成田善孝, 鈴木啓道

日本癌学会総会記事 81回巻頁： E - 1038 2022年9月

Oligodendroglioma,IDH-mutant and 1p/19q-codeletedのマルチオミクス解析による全ゲノム解析の全貌(Whole genome multi-omics landscape of Oligodenderoglioma, IDH-mutant and 1p/19q-codeleted)

舟越勇介, 南部翔平, 中島拓真, 畝田篤仁, 片山琴絵, 井元清哉, 花谷亮典, 田中將太, 齋藤竜太, 吉本幸司, 成田善孝, 鈴木啓道

日本癌学会総会記事 81回巻頁： E - 1041 2022年9月

True Angina Pectoris Immediately After Cervical Disc Herniation Surgery for Preoperative Cervical Angina Symptoms: A Case Report 国際誌

Abe, T; Tanei, T; Nishimura, Y; Saito, R

CUREUS JOURNAL OF MEDICAL SCIENCE 14 巻 ( 8 ) 頁： e28313 2022年8月

経鼻頭蓋底術後髄液漏の検討

竹内和人, 永田雄一, 佐々木博勇, 水野晃宏, 齋藤竜太

日本内分泌学会雑誌 98 巻 ( S.HPT ) 頁： 25 - 27 2022年8月

ラトケ嚢胞に類似した所見を示した頭蓋咽頭腫の一例

原田英幸, 竹内和人, 永田雄一, 棚橋邦明, 佐々木博勇, 水野晃宏, 井下尚子, 齋藤竜太

日本内分泌学会雑誌 98 巻 ( S.HPT ) 頁： 72 - 73 2022年8月

Primary central nervous system malignant lymphoma in a patient with rheumatoid arthritis receiving tocilizumab: illustrative case. 国際誌 Open Access

Ohno M, Kuramitsu S, Iwakoshi A, Yamaguchi J, Ohka F, Saito R

Journal of neurosurgery. Case lessons 4 巻 ( 6 ) 2022年8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：Journal of Neurosurgery: Case Lessons

BACKGROUND Although the risk of developing malignant lymphoma is higher in patients with rheumatoid arthritis (RA) than in the general population, primary central nervous system lymphoma (PCNSL) in patients with RA is extremely rare. In recent years, there has been concern that biological disease-modifying antirheumatic drugs (bDMARDs), widely administered to patients with RA, might increase the risk of cancer development. The authors report the first case of PCNSL in a patient with RA receiving the bDMARD tocilizumab. OBSERVATIONS A 70-year-old man who was diagnosed with RA in 2010 was treated with low-dose methotrexate (MTX) from 2010 to 2015. Tocilizumab was commenced in 2012. In 2018, he developed gait disturbances, and gadolinium-enhanced magnetic resonance imaging showed multiple contrast-enhanced lesions in the basal ganglia and brain stem. Stereotactic brain biopsy led to the diagnosis of diffuse large B-cell lymphoma, and finally PCNSL was diagnosed. He was treated with five courses of MTX 3.5 g/m2, and his disease has been in remission for 34 months. LESSONS Low-dose MTX and bDMARDs are associated with the concern of increased cancer risk in patients with RA. Because tocilizumab has been in use for a relatively short time, further accumulation of cases and careful follow-up are necessary. https://thejns.org/doi/abs/10.3171/CASE22256.

DOI： 10.3171/CASE22256

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Spontaneous regression of asymptomatic tumefactive perivascular spaces in the anterior temporal lobe

Hashida, M; Nagashima, Y; Nishimura, Y; Eguchi, K; Taoka, T; Kawai, H; Saito, R

NAGOYA JOURNAL OF MEDICAL SCIENCE 84 巻 ( 3 ) 頁： 678 - 685 2022年8月

記述言語：英語出版者・発行元：Nagoya Journal of Medical Science

Perivascular spaces are fluid-filled spaces that surround the perforating vessels of the brain and are normal findings on brain imaging. These are usually asymptomatic and are considered a manifestation of aging. Perivascular spaces occasionally undergo significant enlargement and are referred to as tumefactive perivascular spaces, which are often indistinguishable from neoplastic lesions. Spontaneous regression of tumefactive perivascular spaces during follow-up is rare. We report the imaging findings and clinical course of a patient who showed spontaneous regression of tumefactive perivascular spaces in the anterior temporal lobe, together with a literature review and discussion regarding the characteristics and pathogenesis of spontaneous regression of tumefactive perivascular spaces. Most studies in the available literature report tumefactive perivascular spaces in the anterior temporal lobe; in our view, the characteristics of anterior temporal lobe tumefactive perivascular spaces may differ from those of tumefactive perivascular spaces that occur at other locations.

DOI： 10.18999/nagjms.84.3.678

Radiological Analysis of Minimally Invasive Microscopic Laminectomy for Lumbar Canal Stenosis with a Focus on Multilevel Stenosis and Spondylolisthesis 国際誌 Open Access

Awaya, T; Nishimura, Y; Eguchi, K; Nagashima, Y; Ando, R; Akahori, S; Yoshikawa, S; Haimoto, S; Hara, M; Takayasu, M; Saito, R

WORLD NEUROSURGERY 164 巻頁： E224 - E234 2022年8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：World Neurosurgery

Objective: We retrospectively compared the radiological and clinical outcomes of two different surgical techniques (lumbar spinous process splitting laminectomy [LSPSL] and unilateral laminotomy for bilateral decompression [ULBD]) to treat lumbar spinal canal stenosis (LCS). Methods: We performed a retrospective comparative study of 141 consecutive patients with an average age of 70.8 ± 9.4 years who had undergone LSPSL or ULBD for LCS between April 2015 and April 2019. None of the patients had developed remote fractures of the spinous processes using either technique. These cases were divided into 2 groups: group L, 73 patients who had undergone LSPSL from April 2015 to April 2017; and group U, 68 patients who had undergone ULBD from May 2017 to April 2019. The clinical and radiological outcomes and surgical complications at the 1-year postoperative follow-up period were evaluated. Results: We found no significant differences in the operative time between the 2 groups. However, group U had had significantly less blood loss than group L. The facet joints were significantly well preserved in group U. We examined the multilevel and spondylolisthesis cases separately and found that both surgical procedures were equally effective and that the visual analog scale scores for back or leg pain and Japanese Orthopaedic Association scores had significantly improved postoperatively in each group. Group U showed better outcomes in terms of LCS recurrence, with 3 patients in the group L requiring repeat surgery. Conclusions: We found both ULBD and LSPSL to be safe and effective techniques for LCS, even for patients with spondylolisthesis and multilevel disease. ULBD was superior in terms of recurrence prevention, preservation of the facet joints, and less blood loss.

DOI： 10.1016/j.wneu.2022.04.079

Role of the parietooccipital fissure and its implications in the pathophysiology of posterior medial temporal gliomas 国際誌

Shibahara, I; Saito, R; Kanamori, M; Sonoda, Y; Sato, S; Hide, T; Tominaga, T; Kumabe, T

JOURNAL OF NEUROSURGERY 137 巻 ( 2 ) 頁： 505 - 514 2022年8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：Journal of Neurosurgery

OBJECTIVE The parietooccipital fissure is an anatomical landmark that divides the temporal, occipital, and parietal lobes. More than 40% of gliomas are located in these three lobes, and the temporal lobe is the most common location. The parietooccipital fissure is located just posterior to the medial temporal lobe, but little is known about the clinical significance of this fissure in gliomas. The authors investigated the anatomical correlations between the parietooccipital fissure and posterior medial temporal gliomas to reveal the radiological features and unique invasion patterns of these gliomas. METHODS The authors retrospectively reviewed records of all posterior medial temporal glioma patients treated at their institutions and examined the parietooccipital fissure. To clarify how the surrounding structures were invaded in each case, the authors categorized tumor invasion as being toward the parietal lobe, occipital lobe, isthmus of the cingulate gyrus, insula/basal ganglia, or splenium of the corpus callosum. DSI Studio was used to visualize the fiber tractography running through the posterior medial temporal lobe. RESULTS Twenty-four patients with posterior medial temporal gliomas were identified. All patients presented with a parietooccipital fissure as an uninterrupted straight sulcus and as the posterior border of the tumor. Invasion direction was toward the parietal lobe in 13 patients, the occipital lobe in 4 patients, the isthmus of the cingulate gyrus in 19 patients, the insula/basal ganglia in 3 patients, and the splenium of the corpus callosum in 8 patients. Although the isthmus of the cingulate gyrus and the occipital lobe are located just posterior to the posterior medial temporal lobe, there was a significantly greater preponderance of invasion toward the isthmus of the cingulate gyrus than toward the occipital lobe (p = 0.00030, McNemar test). Based on Schramm's classification for the medial temporal tumors, 4 patients had type A and 20 patients had type D tumors. The parietooccipital fissure determined the posterior border of the tumors, resulting in a unique and identical radiological feature. Diffusion spectrum imaging (DSI) tractography indicated that the fibers running through the posterior medial temporal lobe toward the occipital lobe had to detour laterally around the bottom of the parietooccipital fissure. CONCLUSIONS Posterior medial temporal gliomas present identical invasion patterns, resulting in unique radiological features that are strongly affected by the parietooccipital fissure. The parietooccipital fissure is a key anatomical landmark for understanding the complex infiltrating architecture of posterior medial temporal gliomas.

DOI： 10.3171/2021.7.JNS21990

術中皮質脳波によるてんかん原生領域の評価に基づいたてんかん外科手術

石崎友崇, 前澤聡, 山本啓之, 鳥居潤, 武藤学, 伊藤芳記, 夏目淳, 寳珠山稔, 齋藤竜太

てんかん研究 40 巻 ( 2 ) 頁： 389 - 389 2022年8月

Medical Management of a Mural Thrombus Inducing Repeated Ischemic Strokes in a Patient with Congenital Afibrinogenemia 査読有り国際誌

Nishihori, M; Araki, Y; Suzuki, N; Tamura, S; Hattori, M; Izumi, T; Goto, S; Yokoyama, K; Uda, K; Matsushita, T; Saito, R

JOURNAL OF STROKE & CEREBROVASCULAR DISEASES 31 巻 ( 7 ) 頁： 106526 - 106526 2022年7月

記述言語：英語出版者・発行元：Journal of Stroke and Cerebrovascular Diseases

Objectives: Congenital afibrinogenemia is an autosomal recessive inherited disorder that can cause thrombotic as well as hemorrhagic events. We describe a case of repeated mild ischemic strokes due to a mural thrombus in the carotid artery and our medical treatment. Case description: A 49-year-old woman with congenital afibrinogenemia developed two minor ischemic strokes in two months. Clinical images revealed scattered fresh infarcts in the right middle cerebral artery region and mild cervical carotid artery stenosis. The risk for surgical treatment was considered to be extraordinarily high. The patient was treated with 100 mg/day of aspirin and 3 g fibrinogen infusion every two weeks. After the one-year course of medication, the mural thrombus gradually decreased, and there were no bleeding or ischemic stroke events. Conclusion: This case report highlights the successful treatment of an ischemic stroke in a patient with a congenital afibrinogenemia with an antiplatelet agent and fibrinogen replacement. There are no guidelines for managing ischemic stroke in patients with congenital afibrinogenemia, and further studies are needed.

DOI： 10.1016/j.jstrokecerebrovasdis.2022.106526

特集癒着性くも膜炎の病態と治療法を学ぼう術後に生じる癒着性くも膜炎

西村由介, 永島吉孝, 齋藤竜太

脊椎脊髄ジャーナル 35 巻 ( 2 ) 頁： 99 - 105 2022年6月

Direct intracranial invasion of eccrine spiradenocarcinoma of the scalp: a case report and literature review 国際誌 Open Access

Kibe, Y; Tanahashi, K; Ohtakara, K; Okumura, Y; Ohka, F; Takeuchi, K; Nagata, Y; Motomura, K; Akahori, S; Mizuno, A; Sasaki, H; Shimizu, H; Yamaguchi, J; Nishikawa, T; Yokota, K; Saito, R

BMC NEUROLOGY 22 巻 ( 1 ) 頁： 223 - 223 2022年6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：BMC Neurology

Background: Eccrine spiradenocarcinoma (SC), also known as malignant eccrine spiradenoma, is a rare malignant cutaneous adnexal neoplasm arising from long-standing benign eccrine spiradenoma. Malignant skin tumors rarely show direct intracranial invasion. However, once the intracranial structure is infiltrated, curative excision with sufficient margins can become extremely difficult, particularly when the venous sinuses are involved. No effective adjuvant therapies have yet been established. Here, we report an extremely rare case of scalp eccrine SC with direct intracranial invasion, which does not appear to have been reported previously. Case presentation: An 81-year-old woman presented with a large swelling on the parietal scalp 12 years after resection of spiradenoma from the same site. The tumor showed intracranial invasion with involvement of the superior sagittal sinus and repeated recurrences after four surgeries with preservation of the sinus. The histopathological diagnosis was eccrine SC. Adjuvant high-precision external beam radiotherapy (EBRT) proved effective after the third surgery, achieving remission of the residual tumor. The patient died 7 years after the first surgery for SC. Conclusions: Scalp SC with direct intracranial invasion is extremely rare. Radical resection with tumor-free margins is the mainstay of treatment, but the involvement of venous sinuses makes this unfeasible. High-precision EBRT in combination with maximal resection preserving the venous sinuses could be a treatment option for local tumor control.

DOI： 10.1186/s12883-022-02749-4

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