トライジェミナル・オートノミック・セファラジーにおける神経調節: 迷走神経の非侵襲的な刺激の11年間の経験
Catarina S Fernandes1,2, Usman Ashraf1, Peter J Goadsby1
1NIHR King's Clinical Research Facility and SLaM Biomedical Research Centre, King's College, London, UK.
Cephalalgia : an international journal of headache
|September 1, 2025
まとめ
非侵襲的迷走神経刺激 (nVNS) は,トライジェミナル自律性頭痛 (TAC) の患者にとって,特に予防的な治療として有効性と耐受性を示しています. 大半の患者はnVNSが有用であると認め,有害事象はほとんど報告されなかった.
科学分野:
- 神経科学
- 頭痛 薬
- 神経刺激
背景:
- トライジェミナル自律性頭痛 (TAC) は,衰弱性頭痛障害の一種である.
- 非侵襲的迷走神経刺激 (nVNS) は,様々な神経学的状態に対する新興の治療方法である.
研究 の 目的:
- TACと診断された患者のコホートでnVNSの有効性と耐性を評価する.
- nVNSは TACの急性治療と予防治療の両方として有用性を評価する.
主な方法:
- 遡及的なサービス評価には,様々なTAC (クラスター頭痛,偏頭痛,偏頭痛継続,SUNCT/ SUNA) を有する108人の患者が含まれていた.
- nVNSを使用した患者の臨床書簡から2014年1月から2025年2月の間にデータを収集した.
- 記述的統計と非パラメトリックテストがデータ分析に使用された.
主要な成果:
- 108人の患者のうち70人がnVNSを有効と認め,使用期間の中央値は47ヶ月でした.
- 23人の患者が副作用を報告したが,治療に関連した重篤な副作用は発生しなかった.
- nVNSは,すべてのTACの予防治療においてより効果的であり,クラスター頭痛およびSUNCT/SUNAの急性治療においても有用であると考えられた.
結論:
- 非侵襲的迷走神経刺激 (nVNS) は,クラスター頭痛を含むトライジェミナル自律性頭痛 (TAC) の管理に有効であり,よく耐える.
- この発見は,nVNSを TACの予防療法として使用することを支持し,特定の亜型の急性治療においてさらに有用である.
- この研究は,TAC管理におけるnVNSのエビデンスベースに追加され,治療の選択肢としてその可能性を強調しています.
関連する概念動画
Excitatory and Inhibitory Effects of Neurotransmitters
When an action potential reaches the presynaptic axon terminal, it releases neurotransmitters from the neuron into the synaptic cleft at a chemical synapse. The released neurotransmitter can be excitatory or inhibitory. The critical criteria commonly used to determine whether a molecule is a neurotransmitter at a chemical synapse are the molecule's presence in the presynaptic neuron. Second, its release is in response to strong presynaptic depolarization. And lastly, the presence of specific...
Ligand-Gated Ion Channel Receptor: Gating Mechanism
Ligand-gated ion channels are transmembrane proteins that play a vital role in intercellular communication and functions of the nervous system. They allow the influx of ions across the membrane once the neurotransmitter binds, allowing the subsequent transmission of electrical excitation across the neurons. Other ligand-gated ion channels, like the γ-aminobutyric acid (GABA) receptor, permit anions like chloride into the cells on the binding of the GABA molecule. Their entry into the cell...
Neuromuscular Junction And Blockade
The site of chemical communication between a motor neuron and a muscle fiber is called the neuromuscular junction (NMJ). The end of the motor neuron at the NMJ divides into a cluster of synaptic end bulbs. The cytoplasm of these bulbs consists of synaptic vesicles enclosing acetylcholine molecules, the principal neurotransmitter released at the NMJ. The region opposite the synaptic bulb that ends in the muscle fiber is called the motor end plate, which has acetylcholine receptors. Within the...
Spinal Cord: Information Processing
The spinal cord is an integral hub for motor and sensory information that enables the brain to communicate with the peripheral nervous system (PNS). This communication consists of relaying sensory data and transmission of motor commands.
Sensory Information Processing
Sensory information processing begins at the sensory receptors located in the skin and other tissues, which detect somatic sensory stimuli such as touch, temperature, or pain. These receptors function as catalysts, initiating...
Sensory Information Processing
Sensory information processing begins at the sensory receptors located in the skin and other tissues, which detect somatic sensory stimuli such as touch, temperature, or pain. These receptors function as catalysts, initiating...
Major Somatic Sensory Pathways
Sensory impulses related to touch, pressure, vibration, and proprioception from various body parts, such as the limbs, trunk, neck, and posterior head, travel to the cerebral cortex through the posterior column-medial lemniscus pathway. The pathway’s name derives from the two white-matter tracts that convey the impulses: the spinal cord's posterior column and the brainstem's medial lemniscus. First-order sensory neurons extend their axons into the spinal cord, forming the posterior columns...
Enteric Nervous System: Regulation of GI Motor Activity
The Enteric Nervous System (ENS) plays a pivotal role in regulating gastrointestinal or GI motor activity. This complex network of nerves, deeply embedded within the gut wall, responds to changes in the gut environment and receives input from both the autonomic nervous system and the central nervous system. By doing so, the ENS operates various programs tailored to the body's nutritional status and needs.
During periods of fasting, the ENS initiates the migrating myoelectric complex, a program...
During periods of fasting, the ENS initiates the migrating myoelectric complex, a program...


