臨床神経学

大会長講演

脳血管疾患病態の多様性と神経伝達物質機能の解明を目指して

鈴木 則宏

慶應義塾大学医学部神経内科

The concept of neurogenic control of the cerebral circulation began to develop only as recent as the middle of the 20th century, when it was elucidated that the cerebral blood vessels are supplied by a very dense plexus of adrenergic nerves innervating the vascular bed. After then, already in the course of several decades, more than ten types of neurotransimitters including acetylcholine, serotonin, substance P, and calcitonin gene-related peptide, etc., have been observed in these nerves. To determine the origins and pathways of cerebrovascular parasympathetic nerves and sensory nerves, retrograde axonal tracing with immnohistochemstry has been studied. The cerebrovascular parasympathetic nerves originated 1) in the sphenopalatine ganglion (SPG), and 2) from the internal carotid ganglion, and also 3) from the otic ganglion. While the cerebrovascular sensory nerves originated 1) in the trigeminal ganglion (TG), and 2) from the internal carotid ganglion, and also 3) from the upper cervical dorsal root ganglia. The neurogenic cerebrovascular vasodilatation was demonstrated in vivo, by the electrical stimulation of the cerebraovascular branches of TG or SPG. This vasodilatation was attenuated not by anticholinergic agents but triptans as well as anti-CGRP agents. This implicates the mechanism of pathological neurogenic inflammation and vasodilatation during the migraine attacks.
Full Text of this Article in Japanese PDF (671K)

(臨床神経, 52:819−824, 2012)
key words:脳血管の神経支配,三叉神経,副交感神経,片頭痛,皮質拡延性抑制

(受付日:2012年5月23日)