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BRAIN and NERVE-神経研究の進歩61巻3号

2009年03月発行

特集 Microneurography(微小神経電図法)の臨床応用

Microneurographyの基礎と臨床応用―宇宙医学の応用まで

著者: 間野忠明1

所属機関: 1岐阜医療科学大学

ページ範囲:P.227 - P.242

文献概要

はじめに

 Microneurography(微小神経電図法)はヒトの末梢神経から金属微小電極を用いて神経インパルスをin situの状態で,直接,記録する電気生理学的方法である。本法は現段階ではヒトの遠心性および求心性の末梢神経インパルスを同定して記録することのできる唯一の方法であるため,ヒトの末梢神経機能の解析にさまざまな領域で用いられている1,2)

 ヒトの末梢神経からインパルス活動を直接記録する試みは,1960年にドイツのHenselとBoman3)によって初めて報告された。彼らは被検者の皮膚を切開して神経をある程度露出した状態で,ガラス管微小電極を用いて単一感覚神経線維のインパルスを記録したが,皮膚の切開という侵襲的な方法であったため,その後,用いられていない。その約7年後の1967年にスウェーデンの異なる2つの研究グループ(KnutssonとWiden4)およびHagbarthとVallbo5))が皮膚を切開することなく,経皮的に金属微小電極をヒトの末梢神経に刺入して感覚神経インパルス活動を記録することに成功した。前者はガラスで絶縁・被覆したプラチナ・イリジウム微小電極を,後者はエポキシ樹脂で絶縁・被覆したタングステン微小電極を用いてインパルス活動を記録した。その翌年,HagbarthとVallbo6)はヒトの交感神経活動の初めての記録を報告した。その後,タングステン微小電極を用いたHagbarthとVallboの方法が発展し,現在microneurographyと呼ばれる方法の原法となった。

 Microneurographyの発展を目的として,1988年にわが国でニューログラム研究会が発足した。この研究会はさまざまな領域の研究者を含む学際的集会であり,これまでに21回の研究会が開催され,測定法,研究成果などについての発表とともに,本法実施のためのガイドラインの作成,倫理的問題の検討など活発になされている。研究発表にはロボット工学への応用(満淵邦彦,鈴木隆文,他),人工臓器制御への応用(山家智之,他),血糖制御への応用(中村孝夫,他)など,極めてユニークな目的を持つものも含まれている。第20回ニューログラム研究会は2007年10月8日に,第5回国際自律神経科学会議(ISAN2007)のサテライトシンポジウム“Microneurography as a potent tool of autonomic testing in humans”との共催で京都で開催された。これに先立ち本法のハンズオンセミナーが開かれ,研究会のメンバー(國本雅也,岩瀬 敏,新藤和雅,長谷川 修)が国内外の研究者に新しい測定装置などを用いた記録法の実際を供覧した。

参考文献

1) Vallbo ÅB, Hagbarth K-E, Torebjok HE, Wallin BG: Somatosensory, proprioceptive, and sympathetic activity in human peripheral nerves. Physiol Rev 59: 919-957, 1979
2) Mano T, Iwase S, Toma S: Microneurography as a tool in clinical neurophysiology to investigate peripheral neural traffic in humans. Clin Neurophysiol 117: 2357-2384, 2006
3) Hensel H, Boman KK: Afferent impulses in cutaneous sensory nerves in human subjects. J Neurophysiol 23: 564-578, 1960
4) Knutsson E, Widen L: Impulses from single nerve fibers recorded in man using microelectrodes. Nature 213: 606-607, 1967
5) Hagbarth KE, Vallbo ÅB: Mechanoreceptor activity recorded percutaneously with semi-microelectrodes in human peripheral nerves. Acta Physiol Scand 69: 121-122, 1967
6) Hagbarth KE, Vallbo ÅB: Pulse and respiratory grouping of sympathetic impulses in human muscle nerves. Acta Physiol Scand 74: 96-108, 1968
7) Kakuda N, Nagaoka M, Tanaka R: Conduction velocities of α-motor fibers innervating human thenar muscles and order of recruitment upon voluntary contraction. Muscle Nerve 15: 332-343, 1992
8) Ribot E, Roll JP, Vedel JP: Efferent discharges recorded from single skeletomotor and fusimotor fibres in man. J Physiol 375: 251-268, 1986
9) Hallin RG, Wu G: Protocol for microneurography with concentric needle electrodes. Brain Res Brain Res Protoc 2: 120-132, 1998
10) 間野忠明: Microneurography. No To Shinkei 34: 205-215, 1982
11) 大藤 均, 國本雅也:超音波ガイドによるマイクロニューログラフィの新しい手法. 医学のあゆみ182: 205-206, 1997
12) Tsukahara R, Mano T: The recruitment pattern of single vasoconstrictor neurons in humans. J Auton Nerv Syst 66: 26-34, 1997
13) Torebjork E, Hallin RG: Identification of afferent C units in intact human skin nerves. Brain Res 67: 387-403, 1974
14) Fagius J, Wallin BG: Sympathetic reflex latencies and conduction velocities in normal man. J Neurol Sci 47: 433-448, 1980
15) Kondo M, Iwase S, Mano T, Kuzuhara S: Direct measurement of human sympathetic nerve conduction velocity. Muscle Nerve 29: 128-133, 2004
16) Vallbo ÅB, Olsson KA, Westberg KG, Clark FJ: Microstimulation of single tactile afferents from the human hand: Sensory attributes related to unit type and properties of receptive fields. Brain 107: 727- 749, 1984
17) 國本雅也, 井上聖啓: C-fiberをirregular impulseで微小電気刺激した際に誘発される感覚. 第5回痒みシンポジウム, メディカル・ジャーナル社, 大阪, 1995, pp45-57
18) Kunimoto M, Kirno K, Elam M, Wallin BG: Neuroeffector characteristics of sweat glands in the human hand activated by regular neural stimuli. J Physiol 442: 391-411, 1991
19) McNulty PA, Macefield VG: Intraneural microstimulation of motor axons in the study of human single motor units. Muscle Nerve 32: 119-139, 2005
20) Wallin BG: New aspects of sympathetic functions in man. In: Stålberg E, Young RR, editors. Butterworth International Medical Reviews, Neurology 1, Clinical Neurophysiology. Butterworth, London, 1981, pp145-167
21) Wallin BG: Intraneural recording and autonomic function in man. In: Bannister R, editor. Autonomic failure. A textbook of clinical disorders of the autonomic nervous system. Oxford University Press, Oxford, 1983, pp36-51
22) Wallin G: Functional organization of sympathetic outflow in man. In: Christensen NJ, Henriksen O, Lassen NA, editors. The Sympatho-adrenal System. Munksgaard, Copenhagen, 1986, pp52-61
23) Mano T: Muscular and cutaneous sympathetic nerve activity. In: Apenzeller O, editor. The autonomic nervous system (I), Handbook of clinical neurology 74, Elsevier Science BV, Amsterdam, 1999, pp649-665
24) 間野忠明, 岩瀬 敏: 筋交感神経活動. 神経進歩33: 346-356, 1989
25) Mark AL, Victor RG, Nerhed C, Wallin BG: Microneurographic studies of the mechanisms of sympathetic nerve responses to static exercise in humans. Circ Res 57: 461-469, 1985
26) Saito M, Mano T, Iwase S, Koga K, Abe H, et al: Responses in muscle sympathetic activity to acute hypoxia in humans. J Appl Physiol 65: 1548-1552, 1988
27) Okada H, Iwase S, Mano T, Sugiyama Y, Watanabe T: Changes in muscle sympathetic nerve activity during sleep in humans. Neurology 41: 1961-1966, 1991
28) Iwase S, Mano T, Watanabe Y, Saito M, Kobayashi F: Age-related changes of sympathetic outflow to muscles in humans. J Gerontol 46: M1-5, 1991
29) Matsukawa T, Sugiyama Y, Watanabe T, Kobayashi F, Mano T: Gender difference in age-related changes in muscle sympathetic nerve activity in healthy subjects. Am J Physiol 275: R1600-R1604, 1998
30) Scherrer U, Randin D, Tappy L, Vollenweider P, Jequier E, et al: Body fat and sympathetic nerve activity in healthy subjects. Circulation 89: 2634-2640, 1994
31) Macfeild VG, Wallin BG, Vallbo ÅB: The discharge behaviour of single vasoconstrictor motoneurones in human muscle nerves. J Physiol 481: 799-809, 1994
32) Murai H, Takata S, Maruyama M, Nakano M, Kobayashi D, et al: The activity of a single muscle sympathetic vasoconstrictor nerve unit is affected by physiological stress in humans. Am J Physiol Heart Circ Physiol 290: H853-H860, 2005
33) Bini G, Hagbarth KE, Hyninen P, Wallin BG: Thermoregulatory and rhythm generating mechanisms governing the sudomotor and vasoconstrictor outflow in human cutaneous nerves. J Physiol 306: 537-552, 1980
34) Blumberg H, Wallin BG: Direct evidence of neurally mediated vasodilatation in hairy skin of the human foot. J Physiol 382: 105-121, 1987
35) Sugenoya J, Iwase S, Mano T, Sugiyama Y, Ogawa T, et al: Vasodilator component in sympathetic nerve activity destined for the skin of the dorsal foot of mildly heated humans. J Physiol 507: 603-610, 1998
36) Macefield VG, Wallin BG: The discharge behaviour of single sympathetic neurones supplying human sweat glands. J Auton Nerv Syst 61: 277-286, 1996
37) 間野忠明: 筋紡錘の病態生理. 神経進歩25: 444-455, 1981
38) 間野忠明, 宮岡 徹: 単一神経線維の生理. 神経進歩26: 248-257, 1982
39) Vallbo ÅB, Olausson H, Wessberg J: Unmyelinated afferents constitute a second system coding tactile stimuli of the human hairy skin. J Neurophysiol 81: 2753-2763, 1999
40) Olausson H, Lamarre Y, Backlund H, Morin C, Wallin BG, et al: Unmyelinated tactile afferents signal touch and project to insular cortex. Nat Neurosci 5: 900-904, 2002
41) Marchettini P, Simone DA, Caputi G, Ochoa JL. Pain from excitation of identified muscle nociceptors in humans. Brain Res 740: 109-116, 1996
42) 後藤和廣, 桜井運雄, 鹿児島 裕, 三上真弘, 相川貞男: ヒト皮膚侵害受容器からのC・Aδ求心性神経活動. 臨床脳波34: 81-85, 1992
43) Schmeltz M, Michael K, Weidner C, Schmidt R, Torebjork HE, et al: Which nerve fibers mediate the axon reflex flare in human skin? Neuroreport 11: 645-648, 2000
44) Macefield VG, Sverrisdottir YB, Wallin BG: Resting discharge of human muscle spindles is not modulated by increases in sympathetic drive. J Physiol 551: 1005-1011, 2003
45) Elam M, Macefield VG: Does sympathetic nerve discharge affect the firing of myelinated cutaneous afferent in human? Auton Neurosci 111: 116-126, 2004
46) Elam M, Olausson B, Skarphedinsson JO, Wallin BG: Does sympathetic nerve discharge affect the firing of polymodal C-fibre afferents in humans? Brain 122: 2237-2244, 1999
47) Watanabe M, Toma S, Murakami M, Shimoyama I, Nakajima Y, et al: Assessment of mechanical and thermal thresholds of human C nociceptors during increases in skin sympathetic nerve activity. Clin Neurophysiol 113: 1485-1490, 2002
48) Mano T, Iwase S: Sympathetic nerve activity in hypotension and orthostatic intolerance. Acta Physiol Scand 177: 359-365, 2003
49) Kachi T, Iwase S, Mano T, Saito M, Kunimoto M, et al: Effect of L-threo-3, 4-dihydroxyphenylserine on muscle sympathetic nerve activities in Shy-Drager syndrome. Neurology 38: 1091-1094, 1988
50) Iwase S, Mano T, Kamiya A, Niimi Y, Fu Q, et al: Syncopal attack alters the burst properties of muscle sympathetic nerve activity in human. Auton Neurosci 95: 141-145, 2002
51) Hakusui S, Sugiyama Y, Iwase, S Hasegawa Y, Koike Y, et al: Postprandial hypotension: Microneurographic analysis and treatment with vasopressin. Neurology 41: 712-715, 1991
52) Matsukawa T, Mano T, Gotoh E, Ishii M: Elevated sympathetic nerve activity in patients with accelerated essential hypertension. J Clin Invest 92: 25-28, 1993
53) Watanabe T, Mano T, Iwase S, Sugiyama Y, Okada H, et al: Enhanced muscle sympathetic nerve activity during sleep apnea in the elderly. J Auton Nerv Syst 37: 223-226, 1992
54) Iwase S, Ikeda T, Kitazawa H, Hakusui S, Sugenoya J, et al: Altered response in cutaneous sympathetic outflow to mental and thermal stimuli in primary palmoplantar hyperhidrosis. J Auton Nerv Syst 64: 65-73, 1997
55) Yamamoto K, Sobue G, Iwase S: Skin sympathetic nerve activity in Guillain-Barre syndrome: a microneurographic study. J Neurol Neurosurg Psychiatry 63: 537-541, 1997
56) Yamamoto K, Sobue G, Iwase S, Kumazawa K, Mitsuma T, et al: Possible mechanism of anhidrosis in a symptomatic female carrier of Fabry's disease: an assessment by skin sympathetic nerve activity and sympathetic skin response. Clin Auton Res 6: 107-110, 1996
57) Murakami K, Sobue G, Iwase S, Mitsuma T, Mano T: Skin sympathetic nerve activity in acquired idiopathic generalized anhidrosis. Neurology 43: 1137-1140, 1993
58) Fagius J: Microneurographic findings in diabetic polyneuropathy with special reference to sympathetic nerve activity. Diabetologia 23: 415-420, 1982
59) Shindo K, Tsunoda S, Shiozawa Z: Increased sympathetic outflow to muscles in patients with amyotrophic lateral sclerosis: a comparison with other neuromuscular patients. J Neurol Sci 134: 57-60, 1995
60) Shindo K, Watanabe H, Tanaka H, Ohashi K, Nagasaka T, et al: Age and duration related changes in muscle sympathetic nerve activity in Parkinson's disease. J Neurol Neurosurg Psychiatry 74: 1407-1411, 2003
61) Shindo K, Kaneko E, Watanabe H, Sugimoto T, Ohta E, et al: Analysis of the relationship between muscle sympathetic nerve activity and cardiac (123) I-metaiodobenzylguanidine uptake in patients with Parkinson's disease. Mov Disord 20: 1419-1424, 2005
62) 長谷川 修, 小宮山 純: 微小神経電図法を用いた糖尿病性ニューロパチーの電気生理学的評価. 臨床神経33: 365-368, 1993
63)Kuwabara S, Nagase H, Arai K, Hattori T: Slowly conducting, low-threshold components of sensory nerve potentials in peripheral neuropathy: a microneurographic study. Muscle Nerve 20: 961-968, 1997
64) 作田 学, 島田康夫, 豊倉康夫, 中西孝雄: Microneurogramによる知覚異常の解析(1)知覚受容野の変化について. 神経内科13: 472-474, 1980
65) 荒崎圭介, 中西孝雄: 多発神経炎における単一神経線維の受容野. 臨床神経24: 72-76, 1984
66) Ochoa JL, Torebjork HE: Paraesthesiae from ectopic impulse generation in human sensory nerves. Brain 103: 835-853, 1980
67) Cline MA, Ochoa J, Torebjork HE: Chronic hyperalgesia and skin warming caused by sensitized C nociceptors. Brain 112: 621-647, 1989
68) Campero M, Serra J, Ochoa JL: C-polymodal nociceptors activated by noxious low temperature in human skin. J Physiol 497: 565-572, 1996
69) Ørstavik K, Weidner C, Schmidt R, Schmelz M, Hilliges M, et al: Pathological C-fibres in patients with a chronic painful condition. Brain 126: 567-578, 2003
70) Ochoa JL, Campero M, Serra J, Bostock H: Hyperexcitable polymodal and insensitive nociceptors in painful human neuropathy. Muscle Nerve 32: 459-472, 2005
71) Bostock H, Campero M, Serra J, Ochoa H: Temperature-dependent double spikes in C-nociceptors of neuropathic pain patients. Brain 128: 2154-2163, 2005
72) Schmelz M, Hilliges M, Schmidt R, ørstavik K, Vahlquist C, et al: Active "itch fibers" in chronic pruritus. Neurology 61: 564-566, 2003
73) Schmelz M, Schmidt R, Weidner C, Hillinges M, Torebjork HE, et al: Chemical response pattern of different classes of C-nociceptors to pruritogens and algogens. J Neurophysiol 89: 2441-2448, 2003
74) Mano T, Yamazaki Y, Mitarai G, Iwase S: Somatosensory vestibular interactions and autonomic nervous activities in man under weightlessness simulated by water immersion. In: Mitarai G (ed), Sensory Motor Functions under Weightlessness and Space Motion Sickness, The University of Nagoya Press, Nagoya, 1985, pp1-12
75) Mano T, Iwase S, Yamazaki Y, Saito M: Sympathetic nervous adjustments in man to simulated weightlessness induced by water immersion. J UOEH 7 (suppl): 15-28, 1985
76) Iwase S, Mano T, Cui J, Kitazawa A, Kamiya, et al: Sympathetic outflow to muscle in humans during short periods of microgravity produced by parabolic flight. Am J Physiol 277: R419-426, 1999
77) Kamiya A, Iwase S, Kitazawa H, Mano T, Vinogradova OL, et al: Baroreflex control of muscle sympathetic nerve activity after 120 days of 6°head-down bed rest. Am J Physiol Regul Integr Comp Physiol 278: R445-452, 2000
78) Iwase S, Sugiyama S, Miwa C, Kamiya A, Mano T, et al: Effects of three days of dry immersion on muscle sympathetic nerve activity and arterial blood pressure in humans. J Auton Nerv Syst 79: 156-164, 2000
79) Cox JF, Tahvanainen KU, Kuusela TA, Levine BD, Cooke WH, et al: Influence of microgravity on astronauts' sympathetic and vagal responses to Valsalva's manoeuvre. J Physiol 538: 309-320, 2002
80) Ertl AC, Dietrich A, Biaggioni I, Leine BD, Robertson RM,et al: Human muscle sympathetic nerve activity and plasma noradrenaline kinetics in space. J Physiol 538: 321-329, 2002
81) Fu Q, Levine BD, Pawelczyk JA, Ertl AC, Diedrich A, et al: Cardiovascular and sympathetic neural responses to handgrip and cold pressor stimuli in humans before, during and after spaceflight. J Physiol 544: 653-664, 2002
82) Levine BD, Pawelczyk JA, Ertl AC, Cox JF, Zuckerman JH, et al: Human muscle sympathetic neural and haemodynamic responses to tilt following spaceflight. J Physiol 538: 331-340, 2002

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