Faculty Profiles - OOISHI Makoto

Papers - OOISHI Makoto

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MGMT Expression Contributes to Temozolomide Resistance in H3K27M-Mutant Diffuse Midline Gliomas. International journal

Hideaki Abe, Manabu Natsumeda, Masayasu Okada, Jun Watanabe, Yoshihiro Tsukamoto, Yu Kanemaru, Junichi Yoshimura, Makoto Oishi, Rintaro Hashizume, Akiyoshi Kakita, Yukihiko Fujii

Frontiers in oncology 9 1568 - 1568 2019

Language：English Publishing type：Research paper (scientific journal)

Diffuse midline gliomas (DMGs) show resistance to many chemotherapeutic agents including temozolomide (TMZ). Histone gene mutations in DMGs trigger epigenetic changes including DNA hypomethylation, one of which is a frequent lack of O6-methyl-guanine-DNA methyltransferase (MGMT) promoter methylation, resulting in increased MGMT expression. We established the NGT16 cell line with HIST1H3B K27M and ACVR1 G328E gene mutations from a DMG patient and used this cell line and other DMG cell lines with H3F3A gene mutation (SF7761, SF8628, JHH-DIPG1) to analyze MGMT promoter methylation, MGMT protein expression, and response to TMZ. Three out of 4 DMG cell lines (NGT16, SF8628, and JHH-DIPG1) had unmethylated MGMT promoter, increased MGMT expression, and showed resistance to TMZ treatment. SF7761 cells with H3F3A gene mutation showed MGMT promoter methylation, lacked MGMT expression, and sensitivity to TMZ treatment. NGT16 line showed response to ALK2 inhibitor K02288 treatment in vitro. We confirmed in vitro that MGMT expression contributes to TMZ resistance in DMG cell lines. There is an urgent need to develop new strategies to treat TMZ-resistant DMGs.

DOI： 10.3389/fonc.2019.01568

治療に難渋しているACTH産生下垂体腺腫の1例

岡田正康, 米岡有一郎, 温城太郎, 本橋邦夫, 菊池文平, 長谷川仁, 大石誠, 藤井幸彦

新潟医学会雑誌 132 ( 11-12 ) 399 - 400 2018.12

Polysomnography as an indicator for cervicomedullary decompression to treat foramen magnum stenosis in achondroplasia. International journal

Masakazu Sano, Nao Takahashi, Keisuke Nagasaki, Makoto Oishi, Junichi Yoshimura, Yukihiko Fujii

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery 34 ( 11 ) 2275 - 2281 2018.11

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: Management of cervicomedullary compression due to foramen magnum stenosis in achondroplasia remains controversial, especially for patients with no symptoms or mild symptoms. We examined the effectiveness of polysomnography (PSG) as an indicator for cervicomedullary decompression treatment. METHODS: We retrospectively reviewed nine achondroplasia cases (mean age 1 year and 9 months) treated from 2008 to 2015. All patients were examined by PSG, magnetic resonance imaging (MRI), and otolaryngeal fibroscopy. We analyzed demographic data, clinical presentation, degree and type of respiratory impairment, severity of foramen magnum stenosis and concomitant cervicomedullary compression, treatment (conservative or surgical), and clinical outcome. RESULTS: Eight of nine patients presented with no severe symptoms in the daytime. However, MRI revealed four severe, four moderate, and one mild case of cervicomedullary compression, and PSG demonstrated severe sleep apnea in four cases and moderate sleep apnea in five cases. All sleep apnea cases were obstructive or obstructive-dominant. Fibroscopy revealed no upper airway stenosis in six cases and mild stenosis in three cases. Four patients who had severe sleep-related respiratory disturbance on PSG and severe or moderate cervicomedullary compression were treated by cervicomedullary decompression. Three of these patients demonstrated improved sleep respiration soon after surgery, while one required temporary tracheostomy due to bilateral vocal cord paralysis caused by compression during intratracheal intubation. CONCLUSION: Polysomnography can be a useful indicator for cervicomedullary decompression surgery, especially in cases of seemingly asymptomatic achondroplasia with severe foramen magnum stenosis.

DOI： 10.1007/s00381-018-3880-0

Absolute risk and predictors of the growth of acute spontaneous intracerebral haemorrhage: a systematic review and meta-analysis of individual patient data. International journal

Rustam Al-Shahi Salman, Joseph Frantzias, Robert J Lee, Patrick D Lyden, Thomas W K Battey, Alison M Ayres, Joshua N Goldstein, Stephan A Mayer, Thorsten Steiner, Xia Wang, Hisatomi Arima, Hitoshi Hasegawa, Makoto Oishi, Daniel A Godoy, Luca Masotti, Dar Dowlatshahi, David Rodriguez-Luna, Carlos A Molina, Dong-Kyu Jang, Antonio Davalos, José Castillo, Xiaoying Yao, Jan Claassen, Bastian Volbers, Seiji Kazui, Yasushi Okada, Shigeru Fujimoto, Kazunori Toyoda, Qi Li, Jane Khoury, Pilar Delgado, José Álvarez Sabín, Mar Hernández-Guillamon, Luis Prats-Sánchez, Chunyan Cai, Mahesh P Kate, Rebecca McCourt, Chitra Venkatasubramanian, Michael N Diringer, Yukio Ikeda, Hans Worthmann, Wendy C Ziai, Christopher D d'Esterre, Richard I Aviv, Peter Raab, Yasuo Murai, Allyson R Zazulia, Kenneth S Butcher, Seyed Mohammad Seyedsaadat, James C Grotta, Joan Martí-Fàbregas, Joan Montaner, Joseph Broderick, Haruko Yamamoto, Dimitre Staykov, E Sander Connolly, Magdy Selim, Rogelio Leira, Byung Hoo Moon, Andrew M Demchuk, Mario Di Napoli, Yukihiko Fujii, Craig S Anderson, Jonathan Rosand

The Lancet. Neurology 17 ( 10 ) 885 - 894 2018.10

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Intracerebral haemorrhage growth is associated with poor clinical outcome and is a therapeutic target for improving outcome. We aimed to determine the absolute risk and predictors of intracerebral haemorrhage growth, develop and validate prediction models, and evaluate the added value of CT angiography. METHODS: In a systematic review of OVID MEDLINE-with additional hand-searching of relevant studies' bibliographies- from Jan 1, 1970, to Dec 31, 2015, we identified observational cohorts and randomised trials with repeat scanning protocols that included at least ten patients with acute intracerebral haemorrhage. We sought individual patient-level data from corresponding authors for patients aged 18 years or older with data available from brain imaging initially done 0·5-24 h and repeated fewer than 6 days after symptom onset, who had baseline intracerebral haemorrhage volume of less than 150 mL, and did not undergo acute treatment that might reduce intracerebral haemorrhage volume. We estimated the absolute risk and predictors of the primary outcome of intracerebral haemorrhage growth (defined as >6 mL increase in intracerebral haemorrhage volume on repeat imaging) using multivariable logistic regression models in development and validation cohorts in four subgroups of patients, using a hierarchical approach: patients not taking anticoagulant therapy at intracerebral haemorrhage onset (who constituted the largest subgroup), patients taking anticoagulant therapy at intracerebral haemorrhage onset, patients from cohorts that included at least some patients taking anticoagulant therapy at intracerebral haemorrhage onset, and patients for whom both information about anticoagulant therapy at intracerebral haemorrhage onset and spot sign on acute CT angiography were known. FINDINGS: Of 4191 studies identified, 77 were eligible for inclusion. Overall, 36 (47%) cohorts provided data on 5435 eligible patients. 5076 of these patients were not taking anticoagulant therapy at symptom onset (median age 67 years, IQR 56-76), of whom 1009 (20%) had intracerebral haemorrhage growth. Multivariable models of patients with data on antiplatelet therapy use, data on anticoagulant therapy use, and assessment of CT angiography spot sign at symptom onset showed that time from symptom onset to baseline imaging (odds ratio 0·50, 95% CI 0·36-0·70; p<0·0001), intracerebral haemorrhage volume on baseline imaging (7·18, 4·46-11·60; p<0·0001), antiplatelet use (1·68, 1·06-2·66; p=0·026), and anticoagulant use (3·48, 1·96-6·16; p<0·0001) were independent predictors of intracerebral haemorrhage growth (C-index 0·78, 95% CI 0·75-0·82). Addition of CT angiography spot sign (odds ratio 4·46, 95% CI 2·95-6·75; p<0·0001) to the model increased the C-index by 0·05 (95% CI 0·03-0·07). INTERPRETATION: In this large patient-level meta-analysis, models using four or five predictors had acceptable to good discrimination. These models could inform the location and frequency of observations on patients in clinical practice, explain treatment effects in prior randomised trials, and guide the design of future trials. FUNDING: UK Medical Research Council and British Heart Foundation.

DOI： 10.1016/S1474-4422(18)30253-9

MGMT Expression Contributes to Temozolomide Resistance in H3K27M-Mutant Diffuse Midline Gliomas and MGMT Silencing to Temozolomide Sensitivity in IDH-Mutant Gliomas.

Hideaki Abe, Manabu Natsumeda, Yu Kanemaru, Jun Watanabe, Yoshihiro Tsukamoto, Masayasu Okada, Junichi Yoshimura, Makoto Oishi, Yukihiko Fujii

Neurologia medico-chirurgica 58 ( 7 ) 290 - 295 2018.7

Language：English Publishing type：Research paper (scientific journal)

Histone H3 mutations are frequently found in diffuse midline gliomas (DMGs), which include diffuse intrinsic pontine gliomas and thalamic gliomas. These tumors have dismal prognoses. Recent evidence suggests that one reason for the poor prognoses is that O6-methylguanine-DNA methyltransferase (MGMT) promoter frequently lacks methylation in DMGs. This review compares the epigenetic changes brought about by histone mutations to those by isocitrate dehydrogenase-mutant gliomas, which frequently have methylated MGMT promoters and are known to be sensitive to temozolomide.

DOI： 10.2176/nmc.ra.2018-0044

High Incidence of Deep Vein Thrombosis in the Perioperative Period of Neurosurgical Patients. International journal

Manabu Natsumeda, Takeo Uzuka, Jun Watanabe, Masafumi Fukuda, Yasuhisa Akaiwa, Kazuhiko Hanzawa, Masahiko Okada, Makoto Oishi, Yukihiko Fujii

World neurosurgery 112 e103-e112 2018.4

Language：English Publishing type：Research paper (scientific journal)

INTRODUCTION: A prospective study was designed to elucidate incidence and predictors of deep venous thrombosis (DVT) in patients undergoing craniotomies. MATERIALS AND METHODS: Ninety-two patients who underwent craniotomies received pre- and postoperative venous ultrasonography and/or contrast-enhanced spiral computed tomography for diagnosis of DVT. The primary endpoint was DVT occurrence. Serial levels of serum D-dimer, soluble fibrin, and thrombin-antithrombin complex (TAT) were analyzed. RESULTS: Twenty-four of 92 patients (26.1%) had DVT, of whom 10 (41.7%) were diagnosed preoperatively. In patients with preoperative DVT, age, incidence of decreased performance status and leg paresis, levels of D-dimer, soluble fibrin, and TAT were significantly greater. In patients with postoperative DVT, length of surgery, incidence of decreased postoperative performance status, levels of D-dimer on postoperative days (POD) 3, 7, and 14, and TAT on POD7 were significantly greater. Patients with postoperative DVT had elevated D-dimer levels on POD 7 compared with POD 3. The D-dimer cutoff of 2.65 μg/mL at POD 7 could be used to identify DVT with 85.7% sensitivity and 72.3% specificity. A cutoff of 5.25 μg/mL at POD 7 yielded a specificity of 96.9%. Decreased performance status and elevated D-dimer were independent predictors for preoperative DVT, prolonged operation time, and elevated D-dimer on POD 7 for postoperative DVT. CONCLUSIONS: DVT frequently was observed in patients before and after undergoing craniotomies. Patients with decreased performance status should be preoperatively screened for DVT by checking D-dimer levels. Elevated D-dimer levels on POD 7 compared with POD 3 and D-dimer levels greater than 2.65 μg/mL at POD7 suggest the presence of DVT.

DOI： 10.1016/j.wneu.2017.12.139

Application of brain diffusion-weighted imaging performed using readout segmentation of long variable Echo Trains Reviewed

Go Ishida, Makoto Oishi, Ken Morii, Kenji Hasegawa, Akihiko Saito, Mitsuya Sato, Osamu Takizawa, Katsutoshi Murata, Da Porter, Hitoshi Matsuzawa, Yukihiko Fujii

Neurological Surgery 43 ( 1 ) 31 - 40 2015.1

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Igaku-Shoin Ltd

We report the preliminary use of the readout segmentation of long variable echo trains (RESOLVE) sequence, a novel magnetic resonance (MR) scanning technique based on a readout segmented echo planar imaging (EPI) strategy. RESOLVE enables high-resolution diffusion-weighted imaging (DWI) by minimizing susceptibility distortions and T2′ blurring. The software for this sequence was provided by Siemens AG, Germany. Previously, we determined appropriate sequence parameters to obtain sufficiently high-resolution images through phantom studies. Then, we applied the sequence to some clinical cases with neurological disorders and analyzed the RESOLVE-DWI data with diffusion tensor imaging (DTI) techniques. In this article, we report clinical application of the RESOLVE sequence in two cases, one with cerebellar infarction and one with an intracranial epidermoid cyst. In both cases, RESOLVE-DWI clearly exposed structures that were obscured or severely distorted by artifacts on usual single-shot EPI-DWI. DTI analyses for RESOLVE-DWI data provided detailed information about fiber tracts and cranial nerves.

DOI： 10.11477/mf.1436202942

3D Computer graphics simulation to obtain optimal surgical exposure during microvascular decompression of the glossopharyngeal nerve. International journal

Tetsuya Hiraishi, Toshio Matsushima, Masatou Kawashima, Yukiko Nakahara, Yuichi Takahashi, Hiroshi Ito, Makoto Oishi, Yukihiko Fujii

Neurosurgical review 36 ( 4 ) 629 - 35 2013.10

Language：English Publishing type：Research paper (scientific journal)

The affected artery in glossopharyngeal neuralgia (GPN) is most often the posterior inferior cerebellar artery (PICA) from the caudal side or the anterior inferior cerebellar artery (AICA) from the rostral side. This technical report describes two representative cases of GPN, one with PICA as the affected artery and the other with AICA, and demonstrates the optimal approach for each affected artery. We used 3D computer graphics (3D CG) simulation to consider the ideal transposition of the affected artery in any position and approach. Subsequently, we performed microvascular decompression (MVD) surgery based on this simulation. For PICA, we used the transcondylar fossa approach in the lateral recumbent position, very close to the prone position, with the patient's head tilted anteriorly for caudal transposition of PICA. In contrast, for AICA, we adopted a lateral suboccipital approach with opening of the lateral cerebellomedullary fissure, to visualize better the root entry zone of the glossopharyngeal nerve and to obtain a wide working space in the cerebellomedullary cistern, for rostral transposition of AICA. Both procedures were performed successfully. The best surgical approach for MVD in patients with GPN is contingent on the affected artery--PICA or AICA. 3D CG simulation provides tailored approach for MVD of the glossopharyngeal nerve, thereby ensuring optimal surgical exposure.

DOI： 10.1007/s10143-013-0479-5

Glioneuonal tumorの周囲脳組織のイメージング解析と病理組織学的所見の検討

福多真史, 北浦弘樹, 大石誠, 高尾哲郎, 平石哲也, 澁木克栄, 柿田明美, 藤井幸彦

てんかん研究 31 ( 2 ) 405 - 405 2013.9

Interactive presurgical simulation applying advanced 3D imaging and modeling techniques for skull base and deep tumors. International journal

Makoto Oishi, Masafumi Fukuda, Naoki Yajima, Kenzo Yoshida, Machiko Takahashi, Tetsuya Hiraishi, Tetsuro Takao, Akihiko Saito, Yukihiko Fujii

Journal of neurosurgery 119 ( 1 ) 94 - 105 2013.7

Language：English Publishing type：Research paper (scientific journal)

OBJECT: In this paper, the authors' goal was to report their novel presurgical simulation method applying interactive virtual simulation (IVS) using 3D computer graphics (CG) data and microscopic observation of color-printed plaster models based on these CG data in surgery for skull base and deep tumors. METHODS: For 25 operations in 23 patients with skull base or deep intracranial tumors (meningiomas, schwannomas, epidermoid tumors, chordomas, and others), the authors carried out presurgical simulation based on 3D CG data created by image analysis for radiological data. Interactive virtual simulation was performed by modifying the 3D CG data to imitate various surgical procedures, such as bone drilling, brain retraction, and tumor removal, with manipulation of a haptic device. The authors also produced color-printed plaster models of modified 3D CG data by a selective laser sintering method and observed them under the operative microscope. RESULTS: In all patients, IVS provided detailed and realistic surgical perspectives of sufficient quality, thereby allowing surgeons to determine an appropriate and feasible surgical approach. Surgeons agreed that in 44% of the 25 operations IVS showed high utility (as indicated by a rating of "prominent") in comprehending 3D microsurgical anatomies for which reconstruction using only 2D images was complicated. Microscopic observation of color-printed plaster models in 12 patients provided further utility in confirming realistic surgical anatomies. CONCLUSIONS: The authors' presurgical simulation method applying advanced 3D imaging and modeling techniques provided a realistic environment for practicing microsurgical procedures virtually and enabled the authors to ascertain complex microsurgical anatomy, to determine the optimal surgical strategies, and also to efficiently educate neurosurgical trainees, especially during surgery for skull base and deep tumors.

DOI： 10.3171/2013.3.JNS121109

Ictal near-infrared spectroscopy and electrocorticography study of supplementary motor area seizures. International journal

Yosuke Sato, Masafumi Fukuda, Makoto Oishi, Atsushi Shirasawa, Yukihiko Fujii

Journal of biomedical optics 18 ( 7 ) 76022 - 76022 2013.7

Language：English Publishing type：Research paper (scientific journal)

The seizure onset zone (SOZ) and propagation pathways in supplementary motor area (SMA) seizures are difficult to identify because of the short duration and swift propagations of this seizure type. Herein, we studied ictal cerebral blood flow changes, seizure electrical activities, and clinical signs employing simultaneous near-infrared spectroscopy (NIRS) and electrocorticography (ECoG) recordings in a brain tumor patient with SMA seizures. Increased cerebral blood flow was observed from the SOZ in the ipsilateral SMA and spread to the ipsilateral premotor cortex, ipsilateral sensorimotor cortex, and also the contralateral hemisphere. These propagation patterns were concordant with ictal ECoG seizure activities and clinical signs. Removal of the SOZ and surrounding areas, where the higher blood flow and higher frequency oscillations had been identified, achieved a good outcome for this patient. Our ictal NIRS-ECoG technique is robust and useful for detecting the SOZ and seizure propagations.

DOI： 10.1117/1.JBO.18.7.076022

Significance of horizontal propagation of synchronized activities in human epileptic neocortex investigated by optical imaging and immunohistological study. International journal

Tetsuya Hiraishi, Hiroki Kitaura, Makoto Oishi, Masafumi Fukuda, Shigeki Kameyama, Hitoshi Takahashi, Akiyoshi Kakita, Yukihiko Fujii

Epilepsy research 104 ( 1-2 ) 59 - 67 2013.3

Language：English Publishing type：Research paper (scientific journal)

To characterize the physiological condition of human epileptic neocortex, we employed flavoprotein fluorescence imaging (FFI), an optical imaging method which detects intrinsic signals accompanying neural activation, and immunohistologically studied human cortical specimens. The experimented materials were cortical tissues surrounding various intracerebral lesions obtained from 5 patients with epilepsy (epileptic patients: EPs) and 5 without epilepsy (non-epileptic patients: NEPs). These tissues were immersed in oxygenated artificial cerebrospinal fluid immediately after removal in the operating room. Signal changes of FFI in the cortical layers subjected to electrical stimulation were observed under bicuculline methiodide perfusion. Immunohistological staining for parvalbumin (PV), calbindin, and calretinin were performed on the same specimens to evaluate expressions of calcium-binding protein positive cells. The FFI study showed the characteristic cortical propagation pattern of elicited activities horizontally along the cortical layers in EPs but not in NEPs. The propagated area with more than 0.5% signal changes was significantly larger in EPs than in NEPs (p=0.008). Only the expression of PV positive neurons was significantly lower in EPs than in NEPs (p=0.006). The propagated area on FFI and the decrease in PV positive neurons correlated significantly (R=-0.78, p=0.04). The present study visualized the unique horizontal propagation of signal changes on FFI and demonstrated a correlation of this propagation with immunohistological decreases in PV positive neurons in human epileptic cortex. Further investigations may elucidate the mechanism of hyper-excitability and hyper-synchronization in epileptic cortical tissue itself.

DOI： 10.1016/j.eplepsyres.2012.09.014

[Intraoperative monitoring of motor evoked potentials during glioma removal].

Masafumi Fukuda, Makoto Oishi, Tetsuro Takao, Tetsuya Hiraishi, Tsutomu Kobayashi, Hiroshi Aoki, Ryosuke Ogura, Akihiko Saito, Yukihiko Fujii

No shinkei geka. Neurological surgery 41 ( 3 ) 219 - 27 2013.3

Language：Japanese Publishing type：Research paper (scientific journal)

OBJECTIVE: To determine whether motor evoked potentials(MEPs)provide reliable monitoring of the motor system during resection of gliomas in or adjacent to the motor cortex or pyramidal tract. MATERIALS AND METHODS: MEP recording was performed during 64 operations in 55 patients harboring gliomas. Intraoperative MEP findings were classified into 3 groups:Group A was defined as having no significant MEP changes, Group B as having reversible MEP changes(?50% amplitude decrease or loss), and Group C as having irreversible changes. Postoperative motor function was evaluated according to the presence/absence of deterioration immediately after surgery and 1 month later, as compared to preoperative motor status RESULTS: Immediately after surgery, 13 of 39(33%)patients in Group A, 6 of 17(35%)in Group B, and 7 of 8(88%)in Group C experienced deterioration of motor function. One month after surgery, 4 of 39(10%)patients in Group A, 3 of 17(18%)in Group B, and 4 of 8(50%)showed deterioration of motor function. Both immediately(χ2=8.3, p<0.05)and 1 month(χ2=6.9, p<0.05)after surgery, MEP alterations correlated significantly with postoperative deterioration of motor function. Despite MEPs being stable throughout surgery(Group A), there were some patients with deterioration of motor function initially appearing to represent false negative monitoring. However, these deteriorations were confirmed to have been caused by secondary hemorrhage, venous return dysfunction, postoperative convulsion, or resection of the supplementary motor area. CONCLUSIONS: MEP monitoring provides reliable information on the motor system during glioma surgery. Although false negative MEP results may exist in some patients, most data were not influenced by intraoperative manipulation but rather were attributable to secondary postoperative events.

グリオーマ摘出術中の運動誘発電位モニタリングの有用性と限界

福多真史, 大石誠, 高尾哲郎, 平石哲也, 小林勉, 青木洋, 小倉良介, 斉藤明彦, 藤井幸彦

Neurological Surgery 41 ( 3 ) 219 - 227 2013.3

Language：Japanese Publisher：(株)医学書院

運動野および錐体路近傍のグリオーマ摘出術55例64回(男34例、女21例、平均43.5歳)を対象に、術中皮質刺激による運動誘発電位(MEP)モニタリングの有用性について検討した。術中MEPの振幅低下を認めなかったのは39例(A群)、一時的に振幅低下や反応消失を認め、最終的に回復したのは17例(B群)、回復なしが8例(C群)であった。術翌日に上肢の運動機能が術前に比較して悪化していたのはA群13例(33%)、B群6例(35%)、C群7例(88%)で、3群間に有意差が認められた。A群悪化例のうち、補足運動野症候群を呈したのが6例、術直後のけいれん発作、静脈灌流障害、術直後の出血による悪化が各1例であった。C群で悪化を認めなかった1例は、MEPが最終的に50%以下となった症例であった。術後1ヵ月目の悪化はA群4例、B群3例、C群4例と減少し、A群の内訳は補足運動野症候群の回復過程、術後の頻回なけいれん発作、腫瘍の再増大、照射中の浮腫増強であった。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2013&ichushi_jid=J01228&link_issn=&doc_id=20130311040004&doc_link_id=10.11477%2Fmf.1436101949&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1436101949&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Facial nerve dysfunction after drainage of cerebrospinal fluid during vestibular schwannoma surgery. International journal

Tetsuya Hiraishi, Masafumi Fukuda, Makoto Oishi, Yukihiko Fujii

Clinical neurology and neurosurgery 115 ( 1 ) 102 - 5 2013.1

Hemodynamic and electrophysiological connectivity in the language system: simultaneous near-infrared spectroscopy and electrocorticography recordings during cortical stimulation. International journal

Yosuke Sato, Makoto Oishi, Masafumi Fukuda, Yukihiko Fujii

Brain and language 123 ( 1 ) 64 - 7 2012.10

Language：English Publishing type：Research paper (scientific journal)

We applied near-infrared spectroscopy (NIRS) and electrocorticography (ECoG) recordings during cortical stimulation to a temporal lobe epilepsy patient who underwent subdural electrode implantation. Using NIRS, changes in blood concentrations of oxyhemoglobin (HbO(2)) and deoxyhemoglobin (HbR) during cortical stimulation of the left language areas were measured in each hemisphere. NIRS revealed that 2 Hz stimulation with 5 mA produced no significant hemodynamic changes in either hemisphere. By contrast, 50 Hz stimulation elicited significant increases in both HbO(2) and HbR at the stimulation site. Furthermore, with 50 Hz stimulation of the left superior temporal gyrus, the increases in HbO(2) and HbR were observed not only at the stimulation site but also concurrently at the left inferior frontal gyrus. This suggests the existence of functional connectivity in the language system. The present study demonstrates that simultaneous NIRS and ECoG studies during cortical stimulation allow a novel analysis of cerebral connectivity.

DOI： 10.1016/j.bandl.2012.07.006

Interactive virtual simulation using a 3D computer graphics model for microvascular decompression surgery. International journal

Makoto Oishi, Masafumi Fukuda, Tetsuya Hiraishi, Naoki Yajima, Yosuke Sato, Yukihiko Fujii

Journal of neurosurgery 117 ( 3 ) 555 - 65 2012.9

Language：English Publishing type：Research paper (scientific journal)

OBJECT: The purpose of this paper is to report on the authors' advanced presurgical interactive virtual simulation technique using a 3D computer graphics model for microvascular decompression (MVD) surgery. METHODS: The authors performed interactive virtual simulation prior to surgery in 26 patients with trigeminal neuralgia or hemifacial spasm. The 3D computer graphics models for interactive virtual simulation were composed of the brainstem, cerebellum, cranial nerves, vessels, and skull individually created by the image analysis, including segmentation, surface rendering, and data fusion for data collected by 3-T MRI and 64-row multidetector CT systems. Interactive virtual simulation was performed by employing novel computer-aided design software with manipulation of a haptic device to imitate the surgical procedures of bone drilling and retraction of the cerebellum. The findings were compared with intraoperative findings. RESULTS: In all patients, interactive virtual simulation provided detailed and realistic surgical perspectives, of sufficient quality, representing the lateral suboccipital route. The causes of trigeminal neuralgia or hemifacial spasm determined by observing 3D computer graphics models were concordant with those identified intraoperatively in 25 (96%) of 26 patients, which was a significantly higher rate than the 73% concordance rate (concordance in 19 of 26 patients) obtained by review of 2D images only (p < 0.05). Surgeons evaluated interactive virtual simulation as having "prominent" utility for carrying out the entire surgical procedure in 50% of cases. It was evaluated as moderately useful or "supportive" in the other 50% of cases. There were no cases in which it was evaluated as having no utility. The utilities of interactive virtual simulation were associated with atypical or complex forms of neurovascular compression and structural restrictions in the surgical window. Finally, MVD procedures were performed as simulated in 23 (88%) of the 26 patients . CONCLUSIONS: Our interactive virtual simulation using a 3D computer graphics model provided a realistic environment for performing virtual simulations prior to MVD surgery and enabled us to ascertain complex microsurgical anatomy.

DOI： 10.3171/2012.5.JNS112334

Movement-related cortical activation with voluntary pinch task: simultaneous monitoring of near-infrared spectroscopy signals and movement-related cortical potentials. International journal

Yosuke Sato, Masafumi Fukuda, Makoto Oishi, Yukihiko Fujii

Journal of biomedical optics 17 ( 7 ) 076011 - 076011 2012.7

Language：English Publishing type：Research paper (scientific journal)

This study was designed to evaluate hemodynamic and electrophysiological motor cortex responses to voluntary finger pinching in humans, with simultaneous recording of near-infrared spectroscopy (NIRS) signals and movement-related cortical potentials (MRCP). Six healthy, right-handed subjects performed 100 trials of voluntary right-thumb index-finger pinching with about a 10-second interval at their own pace. Throughout the session, 48 regions over the bilateral motor cortex were assessed by NIRS, while MRCP and electromyogram (EMG) were simultaneously monitored. MRCP started 1536 ± 58 ms before EMG onset and peaked 127 ± 24 ms after EMG onset. NIRS data showed bilateral prefrontal cortex at 0.5 ± 0.1 s before EMG onset and bilateral dorsal premotor cortex activations at 0.6 ± 0.1 s before EMG onset. The hand area of the sensorimotor cortex was activated left-dominantly, seen obviously peaked at 3.7 ± 0.2 s after EMG onset. The comparison between MRCP and NIRS results raised the possibility that the vascular response to neural activity occurs within 4 s with a voluntary pinch task. These results indicate that our technique allows detailed study of the motor control. Our method is a promising strategy for event-related motor control and neurovascular coupling studies.

DOI： 10.1117/1.JBO.17.7.076011

Periventricular nodular heterotopia functionally couples with the overlying hippocampus Reviewed

Hiroki Kitaura, Makoto Oishi, Nobuyuki Takei, Yong-Juan Fu, Tetsuya Hiraishi, Masafumi Fukuda, Hitoshi Takahashi, Katsuei Shibuki, Yukihiko Fujii, Akiyoshi Kakita

EPILEPSIA 53 ( 7 ) e127 - e131 2012.7

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

Patients with periventricular nodular heterotopia (PVNH) often have severe epilepsy. However, it is unclear how the heterotopia contributes to epileptogenesis. Recently, electrophysiologic studies using intraoperative depth electrodes have indicated that interaction between the heterotopia and overlying cortex is crucial for seizure onset. We performed an in vitro physiologic study using slices of resected brain from a 22-year-old man with PVNH, who manifested medically refractory mesial temporal lobe epilepsy. Preoperative evaluation indicated that the right mesial temporal structure and PVNH were the epileptogenic focus. The resected tissue was immediately immersed in cold artificial cerebrospinal fluid, and then slices of the brain tissue including the heterotopic nodules and overlying hippocampus were prepared. We electrically stimulated the incubated slices, and the elicited neural activities were analyzed as changes in the flavoprotein fluorescence signals. When we stimulated either the heterotopic nodule or the overlying hippocampus, clear functional coupling of neural activities between these structures was observed. The coupling response evoked by stimulation of the subiculum and developing within the heterotopic nodule was enhanced by application of bicuculline. Therefore, activities of the hippocampus and the nodule are closely correlated.

DOI： 10.1111/j.1528-1167.2012.03509.x

Epidermoid cyst involving the medial temporal lobe: surgical pathologic features of the epileptogenic lesion. International journal

Tetsuya Hiraishi, Makoto Oishi, Hiroki Kitaura, Masae Ryufuku, Yong-Juan Fu, Masafumi Fukuda, Hitoshi Takahashi, Yukihiko Fujii, Akiyoshi Kakita

Neuropathology : official journal of the Japanese Society of Neuropathology 32 ( 2 ) 196 - 201 2012.4

Language：English Publishing type：Research paper (scientific journal)

Epidermoid cysts in the middle fossa are rare and may involve the temporal lobe and lateral ventricle. Affected patients often suffer from seizures, but the pathomechanisms underlying the epileptogenic lesions have remained unclear. Here we report the surgical pathological features of the hippocampus in a 31-year-old woman with mesial temporal lobe epilepsy (mTLE), in whom an epidermoid cyst involving the right basal cistern and inferior horn of the lateral ventricle was evident. The ictal electrocorticogram indicated seizure onset at the parahippocampal gyrus. An anterior temporal lobectomy and amygdalohippocampectomy were performed. Histologically, the hippocampus showed marked atrophy with severe loss of pyramidal neurons in the cornu Ammonis subfields and granule cell loss in the dentate gyrus. At the ventricular surface of the hippocampus, there were small granulomatous lesions with spicularly anchored keratin substance. These features indicated multiple and chronic stab wounds by the cyst contents and consequent local inflammatory responses within the parenchyma. The predisposition to adhesion between the tumor and hippocampus may have caused neurons to develop abnormal irritability to certain chemical mediators present in the cyst. Epileptogenicity involving the atrophic hippocampus and medial temporal lobes nearby may have developed in association with these processes. This case appears to provide information that is useful for surgical planning in patients with mTLE and epidermoid cysts involving the medial temporal lobe.

DOI： 10.1111/j.1440-1789.2011.01243.x

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