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Taku Ochiai

Publications and source records attributed to Taku Ochiai.

9 recordsLinked to original sources

"Sulcal root" generic model: a hypothesis to overcome the variability of the human cortex folding patterns.

The great variability of cerebral cortical folding patterns raises major problems for the systematic study of functional-structural relationships. This paper describes a novel perspective for explaining this variability, a perspective that relies on gyri buried in the depth of the sulci. From this perspective we propose a generic model of folding, based on indivisible units, called sulcal roots, which correspond to the first folding locations during antenatal life. These units are organized according to a basic scheme allowing us to describe the cortical surface using a system of meridians and parallels. This scheme is thought to be stable across individuals at the fetal stage, and may be related to the protomap model. Variability at the adult stage is thought to result from the chaotic behavior of the folding process: inter-individual differences in cortical areas can lead to qualitatively different folding patterns. We have tested the capacity of this model to match actual cortical anatomy with a database of magnetic resonance images of 20 normal subjects, using new three-dimensional visualization tools giving access to shapes buried in the cortex.

Adult↗

Long-term complications after gamma knife surgery for arteriovenous malformations.

OBJECT: The authors analyzed of the long-term complications that occur 2 or more years after gamma knife surgery (GKS) for intracranial arteriovenous malformations (AVMs). METHODS: Patients with previously untreated intracranial AVMs that were managed by GKS and followed for at least 2 years after treatment were selected for analysis (237 cases). Complete AVM obliteration was attained in 130 cases (54.9%), and incomplete obliteration in 107 cases (45.1%). Long-term complications were observed in 22 patients (9.3%). These complications included hemorrhage (eight cases), delayed cyst formation (eight cases), increase of seizure frequency (four cases), and middle cerebral artery stenosis and increased white matter signal intensity on T2-weighted magnetic resonance imaging (one case of each). The long-term complications were associated with larger nidus volume (p < 0.001) and a lobar location of the AVM (p < 0.01). Delayed hemorrhage was associated only with incomplete obliteration of the nidus (p < 0.05). Partial obliteration conveyed no benefit. Delayed cyst formation was associated with a higher maximal GKS dose (p < 0.001), larger nidus volume (p < 0.001), complete nidus obliteration (p < 0.01), and a lobar location of the AVM (p < 0.05). CONCLUSIONS: Incomplete obliteration of the nidus is the most important factor associated with delayed hemorrhagic complications. Partial obliteration does not seem to reduce the risk of hemorrhage. Complete obliteration can be complicated by delayed cyst formation, especially if high maximal treatment doses have been administered.

Adolescent↗

Gamma knife surgery of the pituitary: new treatment for thalamic pain syndrome.

OBJECT: Although reports in the literature indicate that thalamic pain syndrome can be controlled with chemical hypophysectomy, this procedure is associated with transient diabetes insipidus. It was considered reasonable to attempt gamma knife surgery (GKS) to the pituitary gland to control thalamic pain. METHODS: Inclusion criteria in this study were poststroke thalamic pain, failure of all other treatments, intolerance to general anesthetic, and the main complaint of pain and not numbness. Seventeen patients met these criteria and were treated with GKS to the pituitary. The target was the pituitary gland together with the border between the pituitary stalk and the gland. The maximum dose was 140 to 180 Gy. All patients were followed for more than 3 months. CONCLUSIONS: An initial significant pain reduction was observed in 13 (76.5%) of 17 patients. Some patients experienced pain reduction within 48 hours of treatment. Persistent pain relief for more than 1 year was observed in five (38.5%) of 13 patients. Rapid recurrence of pain in fewer than 3 months was observed in four (30.8%) of 13 patients. The only complication was transient diabetes insipidus in one patient. It would seem that GKS of the pituitary might have a role to play in thalamic pain arising after a stroke.

Aged↗

Sulcal pattern and morphology of the superior temporal sulcus.

The superior temporal sulcus (STs) is the main sulcal landmark of the external temporal cortex and is very important for functional (posterior language areas on the left) mapping and surgery. The methodology we use is based on the extraction of the 3D shape of sulci and their separation into subunits called sulcal roots. Seventeen normal brains (male: 11, female: 6, age: 22-60) were systematically analyzed. Additionally, parameters generated by visual observation were recorded. Non-parametric statistics were performed to evaluate the variation of the STs and influence of side, handedness and sex. We found that the 3D architecture of the STs was consistent with our generic model in four sulcal roots and four "plis de passage" (PP) and significant differences between right and left hemispheres. These morphological differences may be related to the language-relevant cortical areas difference and are pertinent for defining the limits of morphometric variability of the STs in "normal humans".

Adult↗

[Three dimensional stereotactic functional neurosurgical planning].

In order to arrive the small area in the deep brain with minimum invasion, stereotactic technique is useful. Subthalamic nucleus stimulation with this technique has been common for Parkinson disease. Recently some papers reported the cognitive performance change after implantation and there were some discussion about the electrode trajectory. Though we didn't have the answer until now, three-dimensional target included the trajectory seems to be important. Another way, stereotactic technique was used the epilepsy evaluation. The point of this procedure was based on the clinical aspect, the well-known neural network and the anatomical understanding for each patient. Three-dimensional anatomical target provides us the best treatment for stereotactic neurosurgery.

Electric Stimulation Therapy↗

Subtemporal amygdalohippocampectomy prevents verbal memory impairment in the language-dominant hemisphere.

BACKGROUND: In this report, we show the operative and neuropsychological results for 20 patients with medically intractable nonlesional temporal lobe epilepsy treated surgically by subtemporal amygdalohippocampectomy whose mean postoperative follow-up period was more than 6 years. METHODS: Pre- and postoperative Wechsler Adult Intelligence Scale-Revised (WAIS/-R) scores, including verbal intelligence quotient (VIQ), performance IQ (PIQ) and full-scale IQ (FIQ) scores, were determined in the 19 adults. The revised Wechsler Intelligent Scale for Children was used in a 9-year-old boy. The verbal paired associates learning test was performed pre- and postoperatively in 15 patients. These data were compared pre- and postoperatively in 10 patients in whom the language-dominant hemisphere side was operated on, and in 5 patients in whom the language-non-dominant side was operated on. RESULTS: Seizure control was achieved in 80% of patients, with improvement into Engel categories I and II without definite permanent complications except for postoperative memory impairment in one patient. VIQ improved after 2 years, and PIQ and FIQ improved after both 2 months and 2 years postoperatively. CONCLUSION: There was no significant decline in the postoperative verbal memory scores in those patients whose medial temporal structure of the language-dominant side had been removed.

Adolescent↗