研究者業績

樋口 佳則

ヒグチ ヨシノリ  (Yoshinori Higuchi)

基本情報

所属
千葉大学 大学院医学研究院中核研究部門 脳・神経治療学研究講座 教授 (博士(医学))
学位
博士(医学)(2000年3月 千葉大学)

連絡先
yhiguchifaculty.chiba-u.jp
研究者番号
00456055
ORCID ID
 https://orcid.org/0000-0001-5689-3416
J-GLOBAL ID
201901020976060837
researchmap会員ID
B000368287

学歴

 2

論文

 213
  • 芹澤 徹, 樋口 佳則, 村上 幸三, 永野 修, 青柳 京子
    肺癌 59(4) 434-435 2019年8月  
  • Yamamoto M, Aiyama H, Koiso T, Watanabe S, Kawabe T, Sato Y, Higuchi Y, Kasuya H, Barfod BE
    Journal of neuro-oncology 143(3) 613-621 2019年7月  査読有り
  • Ito S, Saegusa T, Ozawa Y, Higuchi Y, Iwadate Y, Serizawa T, Nagano O, Kageyama Y, Yamakami I
    Journal of neurological surgery. Part B, Skull base 80(3) 239-243 2019年6月  査読有り
  • Kubota M, Yamakami I, Kubota S, Higuchi Y
    NMC case report journal 6(2) 47-50 2019年4月  査読有り最終著者
  • Serizawa T, Yamamoto M, Higuchi Y, Sato Y, Shuto T, Akabane A, Jokura H, Yomo S, Nagano O, Kawagishi J, Yamanaka K
    Journal of neurosurgery 132(5) 1-10 2019年4月  査読有り
  • Yamamoto M, Aiyama H, Koiso T, Watanabe S, Kawabe T, Sato Y, Higuchi Y, Kasuya H, Barfod BE
    International journal of radiation oncology, biology, physics 103(3) 631-637 2019年3月  査読有り
  • Izumi M, Higuchi Y, Yakufujiang M, Motoshima T, Horiguchi K, Aoyagi K, Nagano O, Serizawa T, Iwadate Y, Yamakami I
    World neurosurgery 123 136-141 2019年3月  査読有り責任著者
  • Yamamoto M, Aiyama H, Koiso T, Watanabe S, Kawabe T, Sato Y, Higuchi Y, Barfod BE, Kasuya H
    Neurosurgery 49(2) 80-86 2019年2月  査読有り
  • 樋口佳則, 青柳京子, 青柳京子, 和泉允基, Yakufujiang Maidinamu, 岡原陽二, 永野修, 岩立康男
    脳神経外科ジャーナル 28(6) 2019年  査読有り招待有り筆頭著者責任著者
  • 芹澤 徹, 樋口 佳則, 山本 昌昭, 松永 成生, 永野 修, 佐藤 泰憲, 青柳 京子, 四方 聖二, 小磯 隆雄, 長谷川 俊典, 中崎 清之, 森木 章人, 近藤 威, 長友 康, 岡本 久代, 光田 幸彦, 河合 秀哉, 志藤 里香, 柴崎 徹, 尾上 信二, 祁内 博行, 井上 明, 森 久恵
    定位的放射線治療 23 25-35 2019年1月  招待有り
    腫瘍体積が10ml以上の大きな脳転移に対するガンマナイフによる三期的および二期的照射の治療成績を比較検討した。本試験参加19施設において総計1441例のガンマナイフによる段階的照射が施行され、このうち335例(三期114例、二期的照射221例)が登録された。生存期間中央値は三期群15.1ヵ月、二期群12.0ヵ月と三期群の方が長い傾向にあったが有意差を認めなかった。その他のすべての副次評価項目において両群間に有意差を認めなかった。Propensity score matchを用いて最終的に212例(両群106例)を選択し評価したところ、生存期間中央値は三期群15.9ヵ月、二期群11.7ヵ月と三期群の方が長い傾向にあったが有意差を認めなかった。1年における累積腫瘍増大発生頻度は三期群21.6%、二期群16.7%で有意差を認めなかった。その他、腫瘍再発、放射線壊死、神経死、有害事象においても両群間に有意差を認めなかった。
  • Yamakami I, Kubota S, Higuchi Y, Ito S
    World neurosurgery 121 e370-e378 2019年1月  査読有り
  • Iwadate Y, Matsutani T, Hara A, Hirono S, Ikegami S, Kobayashi M, Ito D, Kawauchi D, Horiguchi K, Tamiya A, Higuchi Y
    Journal of neuro-oncology 141(1) 205-211 2019年1月  査読有り最終著者
  • Yamamoto M, Higuchi Y, Sato Y, Aiyama H, Kasuya H, Barfod BE
    Progress in neurological surgery 34 110-124 2019年  査読有り
  • 櫻井 透, 山本 達也, 阿部 翠, 鈴木 弘子, 楠本 千尋, 山中 義崇, 平野 成樹, 村田 淳, 樋口 佳則, 桑原 聡
    臨床神経学 58(Suppl.) S288-S288 2018年12月  
  • Yamamoto T, Uchiyama T, Asahina M, Yamanaka Y, Hirano S, Higuchi Y, Kuwabara S
    Brain and behavior 8(12) e01164 2018年12月  査読有り
  • Shuto T, Akabane A, Yamamoto M, Serizawa T, Higuchi Y, Sato Y, Kawagishi J, Yamanaka K, Jokura H, Yomo S, Nagano O, Aoyama H
    Journal of neurosurgery 129(Suppl1) 86-94 2018年12月  査読有り
  • Yamamoto M, Higuchi Y, Serizawa T, Kawabe T, Nagano O, Sato Y, Koiso T, Watanabe S, Aiyama H, Kasuya H
    Journal of neurosurgery 129(Suppl1) 77-85 2018年12月  査読有り
  • Yamamoto M, Serizawa T, Higuchi Y, Nagano O, Aiyama H, Koiso T, Watanabe S, Kawabe T, Sato Y, Kasuya H
    Journal of neurosurgery 129(Suppl1) 95-102 2018年12月  査読有り
  • Aiyama H, Yamamoto M, Kawabe T, Watanabe S, Koiso T, Sato Y, Higuchi Y, Ishikawa E, Yamamoto T, Matsumura A, Kasuya H
    Journal of neurosurgery 129(Suppl1) 103-110 2018年12月  査読有り
  • Nakamura K, Yamanaka Y, Higuchi Y, Hirano S, Kuroiwa R, Abe M, Murata A, Iwadate Y, Kuwabara S, Yamamoto T
    Neurology and Clinical Neuroscience 1-6 2018年11月  査読有り
  • Aiyama H, Yamamoto M, Kawabe T, Watanabe S, Koiso T, Sato Y, Higuchi Y, Ishikawa E, Yamamoto T, Matsumura A, Kasuya H, Barfod BE
    Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology 129(2) 364-369 2018年11月  査読有り
  • Serizawa T, Higuchi Y, Yamamoto M, Matsunaga S, Nagano O, Sato Y, Aoyagi K, Yomo S, Koiso T, Hasegawa T, Nakazaki K, Moriki A, Kondoh T, Nagatomo Y, Okamoto H, Kohda Y, Kawai H, Shidoh S, Shibazaki T, Onoue S, Kenai H, Inoue A, Mori H
    Journal of neurosurgery 1-11 2018年9月  査読有り
  • Matsuda T, Horiguchi K, Higuchi Y, Hanazawa T, Okamoto Y, Iwadate Y
    The Laryngoscope 128(8) 1798-1801 2018年8月  査読有り
  • Machida T, Higuchi Y, Nakano S, Izumi M, Ishige S, Fujikawa A, Akaogi Y, Shimada J, Ono J
    Journal of neurosurgery 1-8 2018年6月  査読有り
  • Kyoko Aoyagi, Yoshinori Higuchi, Yoji Okahara, Maidinamu Yakufujiang, Takuma Matsuda, Yoshitaka Yamanaka, Tatsuya Yamamoto, Shigeki Hirano, Yasuo Iwadate
    Acta Neurochirurgica 160(2) 393-395 2018年2月1日  査読有り責任著者
    A 41-year-old man was diagnosed with chronic pulmonary thromboembolism and underwent pulmonary thromboendarterectomy (PTE) with deep hypothermia and circulatory arrest. Five days after the operation, chorea emerged in the lower extremities. The patient was referred to our hospital for disabling chorea 16 years after PTE. Neurological examination revealed choreatic movements in the four extremities. Brain magnetic resonance images indicated atrophy in the bilateral head of the caudate nuclei. The patient underwent deep brain stimulation (DBS) of the bilateral globus pallidus interna (GPi). Continuous GPi-DBS diminished the choreatic movements. GPi-DBS may be a treatment option for sustained choreatic movements after PTE.
  • Yakufujiang Maidinamu, 樋口佳則, 岡原陽二, 青柳京子, 和泉允基, 山本達也, 阿部翠, 村田淳, 岩立康男
    機能的神経外科 57 52-56 2018年  
  • 青柳京子, 樋口佳則, 岡原陽二, 和泉允基, Maidinamu, Yakufujiang, 永野修, 山本達也, 椎名明大, 村田淳, 岩立康男
    機能的神経外科 57 46-51 2018年  
    【目的】パーキンソン病(PD)に対する視床下核脳深部刺激療法(STN-DBS)による運動症状の改善は明らかではあるが、経時的な体幹症状・高次脳機能の変化は議論の余地が残り、時に包括的な管理が必要となる。当施設では神経内科・リハビリテーション科・精神科とともに術前適応判断から術後評価まで行っており、その評価結果および自宅療養が困難となるまでの期間とその原因を検討した。【方法】DBSを目的に紹介されたPD 141例を対象とし、術前適応判断および術後評価結果を検討した。またSTN-DBS術後自宅での療養が不可能となるまでの期間を競合リスク解析により評価した。【結果】術前評価により手術適応とされた症例は65例であり、適応とならなかった理由は薬物治療再調整が最も多かった。このうち57例でSTN-DBSが施行された。DBS術後症例の経過観察期間中央値は58.1(IQR31〜86)ヵ月で、術後5年で29.2%が自宅での療養が困難となっていた。PD発症が55歳以上あるいは65歳超でDBSを施行した例で施設入所または長期入院までの期間が有意に短く、その原因は認知機能障害、体幹症状の進行などであった。【結語】PDに対するDBSにおいては多科による包括的な評価と管理が重要である。また、対象患者の高齢化により術後比較的早期に自宅での療養が困難となることが想定され、地域医療も含めた多職種連携が必要と考えられる。(著者抄録)
  • 樋口佳則
    脳神経外科ジャーナル 27(Supplement) 342-351 2018年  査読有り筆頭著者責任著者
  • 芹澤 徹, 樋口 佳則, 小澤 由季子, 村上 幸三, 永野 修, 青柳 京子, 松田 信二, 平井 達夫, 竹本 真也, 芝本 雄太, 岩立 康男
    定位的放射線治療 22 63-74 2018年1月  招待有り
    ガンマナイフ治療(GKS)を施行した脳転移患者における神経死(ND)および全身死(SD)のリスクを評価する新しいツールND・SDリスクアセスメントを提案し、その有用性について検討した。GKSを施行した脳転移患者連続3436例を対象とした。449例(13.1%)の生存、2987例(86.9%)の死亡を確認した。死亡2987例中、NDは480例(16.1%)、SDは2507例(83.9%)と判定された。GKS後1〜5年における累積発生率はNDで8.7%、12.6%、14.1%、14.9%、15.5%、SDで53.4%、68.7%、74.7%、77.8%、79.3%であった。多変量解析の結果、NDに対する頭蓋内予後影響因子として、頭蓋内総腫瘍体積、造影MRIの限局性髄液播種所見、腫瘍最大径が独立して有意であった。一方、SDに対する頭蓋外予後影響因子は、性別、初診時KPS score、原病巣制御、頭蓋外転移、遺伝子変異が独立して有意であった。
  • 青柳 京子, 永野 修, 樋口 佳則, 村上 幸三, 芹澤 徹, 岩立 康男
    定位的放射線治療 22 75-82 2018年1月  招待有り
    ガンマナイフ治療を施行した乳癌脳転移症例のうちGenetic Phenotype(GP)の情報の得られた394例を対象に、全生存、全身死、神経死、神経機能低下について検討した。Basal(HER2/ER/PRともに陰性)88例、Luminal A(HER2陰性、ERまたはPR陽性)105例、Luminal B(HER2陽性、ERまたはPR陽性)95例、HER2(HER2陽性、ER/PRともに陰性)106例であり、4群間の患者背景に有意差を認めなかった。102例(25.9%)の生存、292例(74.1%)の死亡を確認し、全生存中央値はBasal 7.4ヵ月、Luminal A 12.6ヵ月、HER2 14.5ヵ月、Luminal B 22.3ヵ月で4群間に有意差を認めた。全身死について神経死を競合リスクとしてGP別に評価したところ、ガンマナイフ治療後3年での累積発生頻度はBasal 74.4%、Luminal A 74.2%、HER2 55.2%、Luminal B 51.4%であり、4群間に有意差を認め、特にHER2陽性群では有意に発生頻度が低かった。さらに、神経死について全身死を競合リスクとしてGP別に評価したところ、ホルモン受容体陽性群で有意に発生頻度が低かった。
  • Toshio Machida, Yoshinori Higuchi, Shigeki Nakano, Satoshi Ishige, Junichiro Shimada, Koichi Honma
    World Neurosurgery 109 204-208 2018年1月1日  査読有り
    Background Hypotension is a significant risk factor for the development of ischemic complication following revascularization surgery for moyamoya disease (MMD). However, it is currently unknown whether autonomic dysfunction also plays a role. Case Description Here we report a case of MMD in which hypotension due to autonomic dysfunction caused postoperative cerebral ischemia. A 30-year-old female patient with MMD had a history of transient right hemiparesis following laughter. Single-photon emission computed tomography showed impaired cerebral blood flow (CBF) in both cerebral hemispheres, so she underwent revascularization surgery in her left cerebral hemisphere. She awoke from anesthesia uneventfully however, 1 hour after the surgery her blood pressure suddenly dropped to 90/40 mm Hg and she became comatose. A perfusion computed tomography scan demonstrated a widespread reduction in CBF in the left hemisphere. Bezold-Jarisch reflex was thought to be the cause of the hypotension. Following treatment with a vasopressor agent, her BP increased and her consciousness rapidly recovered. The reduced CBF had almost completely recovered the next day. Head-up tilt test conducted 2 weeks after surgery demonstrated latent vasopressor-type autonomic dysfunction, which was possibly another cause of the hypotension. She was discharged from the hospital, and the laughter-induced hemiparesis gradually resolved. Conclusion Situational neurologic deterioration in patients with MMD suggests latent autonomic dysfunction, which may be a risk factor for postoperative ischemic complications.
  • Higuchi Y, Yamamoto M, Serizawa T, Aiyama H, Sato Y, Barfod BE
    Cancer management and research 10 1889-1899 2018年  査読有り筆頭著者
  • Toru Serizawa, Yoshinori Higuchi, Osamu Nagano, Shinji Matsuda, Kyoko Aoyagi, Junichi Ono, Naokatsu Saeki, Yasuo Iwadate, Tatsuo Hirai, Shinya Takemoto, Yuta Shibamoto
    JOURNAL OF NEUROSURGERY 127(5) 1000-1006 2017年11月  査読有り
    OBJECTIVE The neurological prognostic score (NPS) was recently proposed as a means for predicting neurological outcomes, such as the preservation of neurological function and the prevention of neurological death, in brain metastasis patients treated with Gamma Knife radiosurgery (GKRS). NPS consists of 2 groups: Group A patients were expected to have better neurological outcomes, and Group B patients were expected to have poorer outcomes. NPS robustness was tested in various situations. METHODS In total, 3040 patients with brain metastases that were treated with GKRS were analyzed. The cumulative incidence of the loss of neurological function independence (i.e., neurological deterioration) was estimated using competing risk analysis, and NPS was compared between Groups A and B by employing Gray's model. NPS was tested to determine if it can be applied to 5 cancer categories-non-small cell lung cancer, small cell lung cancer, gastrointestinal tract cancer, breast cancer, and other cancers-as well as if it can be incorporated into the 5 major grading systems: recursive partitioning analysis (RPA), score index for stereotactic radiosurgery (SIR), basic score for brain metastases (BSBM), graded prognostic assessment (GPA), and modified-RPA (M-RPA). RESULTS There were 2263 patients in NPS Group A and 777 patients in Group B. Neurological deterioration was observed in 586 patients (19.2%). The cumulative incidences of neurological deterioration were 9.5% versus 21.0%, 14.1% versus 25.4%, and 17.6% versus 27.8% in NPS Groups A and B at 1, 2, and 5 years, respectively. Significant differences were detected between the NPS groups in all cancer categories. There were significant differences between NPS Groups A and B for all classes in terms of the BSBM, GPA, and M-RPA systems, but the differences failed to reach statistical significance in terms of RPA Class I and SIR Class 0 to 3. CONCLUSIONS The NPS was verified as being highly applicable to all cancer categories and almost all classes for the 5 grading systems in terms of neurological function independence. This NPS system appears to be quite robust in various situations for brain metastasis patients treated with GKRS.
  • Masaaki Yamamoto, Toru Serizawa, Yoshinori Higuchi, Yasunori Sato, Jun Kawagishi, Kazuhiro Yamanaka, Takashi Shuto, Atsuya Akabane, Hidefumi Jokura, Shoji Yomo, Osamu Nagano, Hidefumi Aoyama
    INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 99(1) 31-40 2017年9月  査読有り
    Purpose: The JLGK0901 study showed the noninferiority of stereotactic radiosurgery (SRS) alone as initial treatment of 5 to 10 brain metastases (BMs) compared with 2 to 4 BMs in terms of overall survival and most secondary endpoints (Lancet Oncol 2014; 15: 387-95). However, observation periods were not long enough to allow confirmation of the long-term safety of SRS alone in patients with 5 to 10 BMs. Methods and Materials: This was a prospective observational study of Gamma Knife SRS-treated patients with 1 to 10 newly diagnosed BMs enrolled at 23 facilities between March 1, 2009, and February 15, 2012. Results: The 1194 eligible patients were categorized into the following groups: group A, 1 tumor (n=455); group B, 2 to 4 tumors (n=531); and group C, 5 to 10 tumors (n=208). Cumulative rates of Mini-Mental State Examination (MMSE) score maintenance (MMSE score decrease <3 from baseline) determined with a competing risk analysis of groups A, B, and C were 93%, 91%, and 92%, respectively, at the 12th month after SRS; 91%, 89%, and 91%, respectively, at the 24th month; 89%, 88%, and 89%, respectively, at the 36th month; and 87%, 86%, and 89%, respectively, at the 48th month (hazard ratio [HR] of group A vs group B, 0.719; 95% confidence interval [CI], 0.437-1.172; PZ. 18; HR of group B vs group C, 1.280; 95% CI, 0.696-2.508; PZ. 43). During observations ranging from 0.3 to 67.5 months (median, 12.0 months; interquartile range, 5.826.5 months), as of December 2014, 145 patients (12.1%) had SRS-induced complications. Cumulative complication incidences by competing risk analysis for groups A, B, and C were 7%, 8%, and 6%, respectively, at the 12th month after SRS; 10%, 11%, and 11%, respectively, at the 24th month; 11%, 11%, and 12%, respectively, at the 36th month; and 12%, 12%, and 13%, respectively, at the 48th month (HR of group A vs group B, 0.850; 95% CI, 0.592-1.220; P=. 38; HR of group B vs group C, 1.052; 95% CI, 0.666-1.662, P=. 83). Leukoencephalopathy occurred in 12 of the 1074 patients (1.1%) with follow-up magnetic resonance imaging and was detected after salvage whole-brain radiation therapy in 11 of these 12 patients. In these 11 patients, leukoencephalopathy was detected by magnetic resonance imaging 5.2 to 21.2 months (median, 11.0 months; interquartile range, 7.0-14.4 months) after whole-brain radiation therapy. Conclusions: Neither MMSE score maintenance nor post-SRS complication incidence differed among groups A, B, and C. This longer-term follow-up study further supports the already-reported noninferiority hypothesis of SRS alone for patients with 5 to 10 BMs versus 2 to 4 BMs. (C) 2017 Elsevier Inc. All rights reserved.
  • 足立 明彦, 堀口 健太郎, 樋口 佳則, 松谷 智郎, 原 彩佳, 久保田 真彰, 菊地 浩, 岩立 康男, 神戸 美千代, 長谷川 安都佐, 小藤 昌志, 伊原 史英, 大熊 雄介, 堅田 浩司, 花澤 豊行, 岡本 美孝
    千葉医学雑誌 93(4) 151-156 2017年8月  
    【目的・背景】重粒子線治療は本邦が実運用に成功した技術である。我々は重粒子線治療後に誘発された二次性腫瘍の初の臨床2症例を経験し一昨年および昨年,国際学会にて発表した。本研究では,その臨床検体を用いた解析から染色体構造の変化を捉え得たので報告する。【症例報告】症例1:外耳道癌に対する重粒子線照射の4年後,片麻痺・失語・てんかん発作で発症した側頭葉病変で,摘出した腫瘤の病理は原疾患(扁平上皮がん)と全く異なる,海綿状血管腫であった。周囲脳には硝子化など放射線誘発性変化を伴っており,これら複数所見より重粒子線により発生した腫瘍であることが示された。症例2:上顎洞未分化癌への重粒子線照射の13年後,歯痛・頬腫脹・てんかん発作で発症した,眼窩から中頭蓋窩(側頭葉先端)まで拡がる腫瘍で,生検により重粒子線による二次性の骨肉腫と病理診断された。腫瘍は広範に浸潤しており,耳鼻咽喉科および脳外科による合同手術を行った。【結果】G-band染色ならびに腫瘍CGH+SNPアレイによる分析を行ったところ,欠失・逆位・転座を含む複数の染色体構造異常を見出だすことができた。【考察・今後の計画】以上より,X線・ガンマ線照射後に報告のある誘発腫瘍が,重粒子線治療後にも起こりうることを証明した。また,重粒子線誘発腫瘍においてgeneticな変化が起きている可能性を示した。但し同一腫瘍検体内に複数の個別の変異が含まれていることからは,構造変化を伴わず現時点で検出できていない共通する遺伝子異常が存在している可能性も示唆され,今後は塩基配列決定などにて,詳細な変異部位,更には腫瘍関連遺伝子の同定を目指す。(著者抄録)
  • Tatsuya Yamamoto, Tomoyuki Uchiyama, Yoshinori Higuchi, Masato Asahina, Shigeki Hirano, Yoshitaka Yamanaka, Liu Weibing, Satoshi Kuwabara
    JOURNAL OF THE NEUROLOGICAL SCIENCES 379 18-21 2017年8月  査読有り
    Introduction: We aimed to examine temporal changes in health-related quality of life (HRQOL) and its relationship with motor and cognitive functions in patients with Parkinson's disease (PD) after subthalamic nucleus deep brain stimulation (STN-DBS). Methods: In total, 31 patients with PD were enrolled in this study (mean age: 66.7 +/- 0.9 years; mean disease duration: 11.6 +/- 3.7 years). Participants completed the Unified Parkinson's Disease Rating Scale and the Parkinson's Disease Questionnaire-39. Cognitive function was assessed using the Mini Mental State Examination, the Frontal Assessment Battery, and the Montreal Cognitive Assessment. Postoperative evaluation was performed at three months, one year, three years, and five years after surgery; temporal changes in the correlation between HRQOL and motor and cognitive functions were evaluated at all follow-up periods. Results: All patients completed postoperative clinical evaluations after three months, after one year. Of the 31 participants, twelve completed postoperative clinical evaluations after three years and seven after five years. Motor functions showed significant improvement over the five-year follow-up period. The mobility subdomain of the HRQOL worsened whereas the total score did not change significantly over years. Cognitive functions were not significantly impaired during follow-up periods. HRQOL was basically not significantly correlated with motor and cognitive functions during the follow-up period. Conclusions: The mobility subdomain of the HRQOL worsened after surgery, and the improvement in motor functions was basically not correlated with HRQOL after STN-DBS in patients with PD. Cognitive functions were not significantly impaired during follow-up periods. (C) 2017 Published by Elsevier B.V.
  • Toshio Machida, Yoshinori Higuchi, Shigeki Nakano, Satoshi Ishige, Atsushi Fujikawa, Yuichi Akaogi, Junichiro Shimada, Yoichi Yoshida, Sigenori Maru, Junichi Ono
    STROKE 48(6) 1665-+ 2017年6月  査読有り
    Background and Purpose-Venous oxygen saturation (SO2) is measured in medical fields to assess tissue circulation insufficiency. This study aimed to elucidate the use of a cortical venous redness measurement to evaluate hemodynamic changes during revascularization surgery for patients with moyamoya disease. Methods-In this retrospective case-series analysis, we first quantitatively measured and correlated SO2 and R intensity of 24-bit color digital red-green-blue pictures of blood samples from 3 volunteers. Subsequently, based on intraoperative digital pictures of 29 patients with moyamoya disease, we measured the R intensities of a cortical vein near the anastomosis site before and after anastomosis. Cerebral blood flow (CBF) at the site was measured using a single-photon emission computed tomography before and 1 to 3 days after surgery. Venous R intensity and CBF were measured twice by 4 raters, and their correlations were examined using generalized linear mixed effect model and linear regression analysis. Results-A strong linear correlation was found between blood R intensity and its SO2 (coefficients, 0.522; 95% confidence interval, 0.364-0.680, using generalized linear mixed effect model). Venous R intensity before the anastomosis was not correlated with preoperative CBF (coefficients, 0.000352; 95% confidence interval, -0.000369 to 0.00107, by generalized linear mixed effect); however, the increases in venous R intensity after anastomosis were correlated with postoperative increases in CBF (R-2, 0.367; 95% confidence interval, 0.116-0.618 to 0.548; 95% confidence interval, 0.331-0.764, by linear regression analysis). Conclusions-Cortical venous redness represented impaired CBF and could be a useful parameter for assessing hemodynamic changes during revascularization surgery.
  • 樋口佳則, 廣野誠一郎, 堀口健太郎, 山上岩男, 岩立康男
    脳神経外科ジャーナル 24(4) 263-272 2017年4月  査読有り筆頭著者責任著者
  • Yoshinori Higuchi, Shinji Matsuda, Toru Serizawa
    MOVEMENT DISORDERS 32(1) 28-35 2017年1月  査読有り筆頭著者責任著者
    Functional radiosurgery has advanced steadily during the past half century since the development of the gamma knife technique for treating intractable cancer pain. Applications of radiosurgery for intracranial diseases have increased with a focus on understanding radiobiology. Currently, the use of gamma knife radiosurgery to ablate deep brain structures is not widespread because visualization of the functional targets remains difficult despite the increased availability of advanced neuroimaging technology. Moreover, most existing reports have a small sample size or are retrospective. However, increased experience with intraoperative neurophysiological evaluations in radiofrequency thalamotomy and deep brain stimulation supports anatomical and neurophysiological approaches to the ventralis intermedius nucleus. Two recent prospective studies have promoted the clinical application of functional radiosurgery for movement disorders. For example, unilateral gamma knife thalamotomy is a potential alternative to radiofrequency thalamotomy and deep brain stimulation techniques for intractable tremor patients with contraindications for surgery. Despite the promising efficacy of gamma knife thalamotomy, however, these studies did not include sufficient follow-up to confirm long-term effects. Herein, we review the radiobiology literature, various techniques, and the treatment efficacy of gamma knife radiosurgery for patients with movement disorders. Future research should focus on randomized controlled studies and long-term effects. (C) 2016 International Parkinson and Movement Disorder Society
  • Takao Koiso, Masaaki Yamamoto, Takuya Kawabe, Shinya Watanabe, Yasunori Sato, Yoshinori Higuchi, Tetsuya Yamamoto, Akira Matsumura, Hidetoshi Kasuya, Bierta E. Barfod
    JOURNAL OF NEURO-ONCOLOGY 130(3) 581-590 2016年12月  査読有り
    We aimed to reappraise whether post-stereotactic radiosurgery (SRS) results for brain metastases differ between patients with and without neurological symptoms. This was an institutional review board-approved, retrospective cohort study using our prospectively accumulated database including 2825 consecutive BM patients undergoing gamma knife SRS alone during the 15-year period since July 1998. The 2825 patients were divided into two groups; neurologically asymptomatic [group A, 1374 patients (48.6 %)] and neurologically symptomatic [group B, 1451 (51.4 %)]. Because there was considerable bias in pre-SRS clinical factors between groups A and B, a case-matched study was conducted. Ultimately, 1644 patients (822 in each group) were selected. The standard Kaplan-Meier method was used to determine post-SRS survival. Competing risk analysis was applied to estimate cumulative incidences of neurological death, neurological deterioration, local recurrence, re-SRS for new lesions and SRS-induced complications. Post-SRS median survival times (MSTs) did not differ between the two groups; 7.8 months in group A versus 7.4 months in group B patients (HR 1.064, 95 % CI 0.963-1.177, p = 0.22). However, cumulative incidences of neurological death (HR 1.637, 95 % CI 1.174-2.281, p = 0.0036) and neurological deterioration (HR 1.425, 95 % CI 1.073-1.894, p = 0.014) were significantly lower in the group A than in the group B patients. Neurologically asymptomatic patients undergoing SRS for BM had better results than symptomatic patients in terms of both maintenance of good neurological state and prolonged neurological survival. Thus, we conclude that screening computed tomography/magnetic resonance imaging is highly beneficial for managing cancer patients.
  • Mine Seiichiro, Higuchi Yoshinori, Horiguchi Kentaro, Saeki Naokatu
    JOURNAL OF NEUROLOGICAL SURGERY PART B-SKULL BASE 77(6) 473-478 2016年12月  査読有り
    ObjectivesThis study aims to compare the surgical and functional outcomes of superolateral orbitotomy (group A) and conventional superior orbitotomy (group B) for benign orbital tumors. DesignA retrospective review of 31 consecutive orbital tumor surgeries with the fronto-orbital approach was conducted. SettingProcedures were performed at two institutions by a single surgeon. ParticipantsA total of 31 orbital tumor patients participated in this study. Overall, 11 intraconal and 2 extraconal tumors in group A and 11 intraconal and 7 extraconal tumors in group B were resected by superolateral orbitotomy, respectively. Main Outcome MeasuresDemographic information, pre- and postoperative neurological findings and neuroimaging data, and pathological data were collected. Surgical and functional outcomes were compared and statistically analyzed between the two different surgical procedures. ResultsThe surgical outcomes were not significantly different between the two groups. In patients with intraconal tumors, the functional outcome was significantly better in group A than in group B. ConclusionSuperolateral orbitotomy provides better functional outcomes.
  • Takao Koiso, Masaaki Yamamoto, Takuya Kawabe, Shinya Watanabe, Yasunori Sato, Yoshinori Higuchi, Tetsuya Yamamoto, Akira Matsumura, Hidetoshi Kasuya
    JOURNAL OF NEUROSURGERY 125(Suppl 1) 2-10 2016年12月  査読有り
    OBJECTIVE Stereotactic radiosurgery (SRS) without upfront whole-brain radiotherapy (WBRT) has influenced recent treatment recommendations for brain metastasis patients. However, in brain metastasis patients who undergo SRS alone, new brain metastases inevitably appear with relatively high incidences during post-SRS follow-up. However, little is known about the second SRS results. The treatment results of second SRS were retrospectively reviewed, mainly for newly developed or, uncommonly, for recurrent brain metastases in order to reappraise the efficacy of this treatment strategy with a special focus on the maintenance of neurological status and safety. METHODS This was an institutional review board approved, retrospective cohort study that used a prospectively accumulated database, including 3102 consecutive patients with brain metastases who underwent SRS between July 1998 and June 2015. Among these 3102 patients, 859 (376 female patients; median age 64 years; range 21-88 years) who underwent a second SRS without WBRT were studied with a focus on overall survival, neurological death, neurological deterioration, local recurrence, salvage SRS, and SRS-induced complications after the second SRS. Before the second SRS., the authors also investigated the clinical factors and radiosurgical parameters likely to influence these clinical outcomes. For the statistical analysis, the standard Kaplan-Meier method was used to determine post second SRS survival and neurological death. A competing risk analysis was applied to estimate post second SRS cumulative incidences of local recurrence, neurological deterioration, salvage SRS, and SRS-induced complications. RESULTS The post second SRS median survival time was 7.4 months (95% CI 7.0-8.2 months). The actuarial survival rates were 58.2% and 34.7% at 6 and 12 months after the second SRS, respectively. Among 789 deceased patients, the causes of death could not be determined in 24 patients, but were confirmed in the remaining 765 patients to be nonbrain diseases in 654 (85.5%) patients and brain diseases in 111 (14.5%) patients. The actuarial neurological death free survival rates were 94.4% and 86.6% at 6 and 12 months following the second SRS. Multivariable analysis revealed female sex, Karnofsky Performance Scale score of 80% or greater, better modified recursive partitioning analysis class, smaller tumor numbers, and higher peripheral dose to be significant predictive factors for longer survival. The cumulative incidences of local recurrence were 11.2% and 14.9% at 12 and 24 months after the second SRS. The crude incidence of neurological deterioration was 7.1%, and the respective cumulative incidences were 4.5%, 5.8%, 6.7%, 7.2%, and 7.5% at 12, 24, 36, 48, and 60 months after the second SRS. SRS-induced complications occurred in 25 patients (2.9%) after a median post second SRS period of 16.8 months (range 0.6-95.0 months; interquartile range 5.6-29.3 months). The cumulative incidences of complications were 1.4%, 2.0%, 2.4%, 3.0%, and 3.0% at 12, 24, 36, 48, and 60 months after the second SRS, respectively. CONCLUSIONS Carefully selected patients with recurrent tumors either new or locally recurrent are favorable candidates for a second SRS, particularly in terms of neurological status maintenance and the safety of this treatment strategy.
  • 原 彩佳, 樋口 佳則, 堀口 健太郎, 杉本 晃, 岡本 美孝, 佐伯 直勝
    脳神経外科ジャーナル 25(11) 938-942 2016年11月  査読有り責任著者
  • 藤田 真祐子, 白鳥 恵理佳, 鈴木 亮介, 池原 甫, 塩浜 直, 藤井 克則, 砂岡 宏和, 樋口 佳則, 村井 尚之, 下条 直樹
    日本小児科学会雑誌 120(9) 1379-1379 2016年9月  
  • 樋口佳則, 岡原陽二, 和泉允基, 青柳京子, 永野 修, 山本達也, 中山義崇, 内山智之, 佐伯直勝
    機能的神経外科 55 17-21 2016年  招待有り
  • Tatsuya Yamamoto, Tomoyuki Uchiyama, Yoshinori Higuchi, Masato Asahina, Shigeki Hirano, Yoshitaka Yamanaka, Satoshi Kuwabara
    PLOS ONE 10(9) e0138462 2015年9月  査読有り
    Aims Although subthalamic nucleus deep brain stimulation (STN-DBS) is effective in patients with advanced Parkinson's disease (PD), its physiological mechanisms remain unclear. Because STN-DBS is effective in patients with PD whose motor symptoms are dramatically alleviated by L-3,4-dihydroxyphenylalanine (L-DOPA) treatment, the higher preoperative catecholamine levels might be related to the better clinical outcome after surgery. We aimed to examine the correlation between the preoperative catecholamine levels and postoperative clinical outcome after subthalamic nucleus deep brain stimulation. The effectiveness of STN-DBS in the patient who responded well to dopaminergic medication suggest the causal link between the dopaminergic system and STN-DBS. We also examined how catecholamine levels were modulated after subthalamic stimulation. Methods In total 25 patients with PD were enrolled (Mean age 66.2 +/- 6.7 years, mean disease duration 11.6 +/- 3.7 years). Mean levodopa equivalent doses were 1032 +/- 34.6 mg before surgery. Cerebrospinal fluid and plasma catecholamine levels were measured an hour after oral administration of antiparkinsonian drugs before surgery. The mean Unified Parkinson's Disease Rating Scale scores (UPDRS) and the Parkinson's disease Questionnaire-39 (PDQ-39) were obtained before and after surgery. Of the 25 patients, postoperative cerebrospinal fluid and plasma were collected an hour after oral administration of antiparkinsonian drugs during on stimulation at follow up in 11 patients. Results Mean levodopa equivalent doses significantly decreased after surgery with improvement in motor functions and quality of life. The preoperative catecholamine levels had basically negative correlations with postoperative motor scores and quality of life, suggesting that higher preoperative catecholamine levels were related to better outcome after STN-DBS. The preoperative plasma levels of L-DOPA had significantly negative correlations with postoperative UPDRS-III score in off phase three months after STN-DBS. The preoperative cerebrospinal fluid (CSF) 3,4-dihydroxyphenylacetic acid (DOPAC) and 5-hydroxytryptamine (5-HT) levels had significantly negative correlations with postoperative UPDRS-III score in off phase one year after STN-DBS and the preoperative CSF homovanilic acid (HVA) levels had significant negative correlations with postoperative UPDRS-III score in on phase three months after STN-DBS. In PDQ-39 SI (summary index), preoperative plasma dopamine (DA) level had significantly negative correlations with postoperative PDQ-39 SI one year after STN-DBS suggesting that higher preoperative plasma DA level resulted in better quality of life (QOL) one year after STN-DBS. The stepwise multiple linear regression study revealed that higher preoperative plasma HVA levels had negative influence on the postoperative motor symptoms (i.e., increase in the score of UPDRS), whereas higher preoperative CSF L-DOPA levels had positive influence on the postoperative motor symptoms and QOL (decrease in the score of UPDRS and PDQ-39 SI) The catecholamine levels were not significantly reduced postoperatively in 11 patients despite the significant reduction in levodopa equivalent doses. Unexpectedly, CSF HVA levels significantly increased from 0.00089 +/- 0.0003 ng/mu l to 0.002 +/- 0.0008 ng/mu l after STN-DBS. Conclusion The preoperative catecholamine levels might affect the postoperative motor symptoms and quality of life. The catecholamine levels were not significantly reduced postoperatively despite the significant reduction in levodopa equivalent doses.
  • Tohru Takarada, Tetsunosuke Asada, Yoshihisa Sumi, Yoshinori Higuchi
    Anesthesia Progress 62(3) 100-105 2015年9月1日  査読有り
    We have previously reported that a dynamic air-pressure sensor system allows respiratory status to be visually monitored for patients in minimally clothed condition. The dynamic air-pressure sensor measures vital information using changes in air pressure. To utilize this device in the field, we must clarify the influence of clothing conditions on measurement. The present study evaluated use of the dynamic airpressure sensor system as a respiratory monitor that can reliably detect change in breathing patterns irrespective of clothing. Twelve healthy volunteers reclined on a dental chair positioned horizontally with the sensor pad for measuring air-pressure signals corresponding to respiration placed on the seat back of the dental chair in the central lumbar region. Respiratory measurements were taken under 2 conditions: (a) thinly clothed (subject lying directly on the sensor pad) and (b) thickly clothed (subject lying on the sensor pad covered with a pressure-reducing sheet). Air-pressure signals were recorded and time integration values for air pressure during each expiration were calculated. This information was compared with expiratory tidal volume measured simultaneously by a respirometer connected to the subject via face mask. The dynamic air-pressure sensor was able to receive the signal corresponding to respiration regardless of clothing conditions. A strong correlation was identified between expiratory tidal volume and time integration values for air pressure during each expiration for all subjects under both clothing conditions (0.840-0.988 for the thinly clothed condition and 0.867-0.992 for the thickly clothed condition). These results show that the dynamic air-pressure sensor is useful for monitoring respiratory physiology irrespective of clothing.
  • Seiichiro Hirono, Daisuke Kawauchi, Yoshinori Higuchi, Taiki Setoguchi, Kazunori Kihara, Kentaro Horiguchi, Ken Kado, Motoki Sato, Kazumasa Fukuda, Takao Nakamura, Naokatsu Saeki, Iwao Yamakami
    Journal of neurological surgery reports 76(1) e83-6-6 2015年7月  査読有り
    Although lumbar drainage (LD) is widely used in skull base surgery (SBS), no cases with intracranial hypotension (IH) following LD-assisted SBS have been reported, and skull base surgeons lack awareness of this potentially life-threatening condition. We report two cases of IH after LD-assisted SBS, a spheno-orbital meningioma and an osteosarcoma in the orbit. Despite a minimal amount of cerebrospinal fluid (CSF) drainage and early LD removal, severe postural headache and even a deteriorating consciousness level were observed in the early postoperative course. Neuroimages demonstrated epidural fluid collections, severe midline shift, and tonsillar sag compatible with IH. Epidural blood patch (EBP) immediately and completely reversed the clinical and radiologic findings in both patients. IH should be included in the differential diagnosis of postural headache after LD-assisted SBS that can be managed successfully with EBP. Persistent leakage of CSF at the LD-inserted site leads to IH. Broad dural dissection and wide removal of bony structure may be involved in the midline shift. EBP should be performed soon after conservative management fails. Further reports will determine the risk factors for IH development following LD-assisted SBS.
  • 内山 智之, 山本 達也, 新井 英二, 新井 誠人, 樋口 佳則, 渡邊 由佳, 橋本 謙一, 門脇 太郎, 新郷 哲郎, 柴田 千晴, 加賀 勘家, 山西 友典, 榊原 隆次, 桑原 聡, 平田 幸一
    自律神経 52(2) 165-165 2015年6月  査読有り

MISC

 326

講演・口頭発表等

 33

担当経験のある科目(授業)

 5