Homopantothenic acid （HOPA）の臨床試用経験

CLINICAL EXPERIENCE WITH HOMOPANTOTHENIC ACID (HOPA)

I．はじめに

　γ—amino-butyric acid （GABA）およびその関連物質の脳内における代謝調整効果について，近年とみに関心が高まり^1）〜3），α—oxy GABA, n-carbobenzoxy-GABA，α—mercapto-GABA，γ—amino—β—hydroxy-butyric acid（GABOB），γ—aminocrotonic acid （GACA）ε—aminocap—ronic acid （EACA） homocarnoxinなど数多くの化合物がとりあげられている。しかし，経口的あるいは血行内に投与されたこれら物質の血脳関門通過については実験的・臨床的観点から疑問視する向きも少なくない^4）〜10）。

　われわれの教室においても，1961年以来斎藤ら^{11）〜13）}がGABAやGABOBの急性および慢性投与実験を試みているが，そのうちGABOBの痙攣抑制効果は，経口投与より髄腔内投与が勝るようで，この点より同物質の脳組織内移行に関して疑問を抱いている。

A study of HOPA was conducted in 40 selected patients with epilepsy, EEG abnormalities and sequelae of head injury. The effects of HOPA were evaluated from clinical and electroencephalographic view-points.

Clinically, it was noted that HOPA influenced scar-cely on petit mal and focal rcortical seizures while partial control of convulsive incidences was obtained in 73 per cent of the patients. Besides, HOPA exert-ed a noticeable effect on humoral or mental syndro-mes (moodiness, restlessness, clumsiness, etc.) due to cerebral dysfunctions of epileptic or organic nature.

As to EEG, the basic activity was satisfactorily improved and the change in frequency was found to be converging into alpha-band at 10 cps in the aid of frequency analyser. Namely, HOPA normalizes cereb-ral currents. On the other hand, the paroxysmal pat-terns, such as random spike, sharp wave and spike wave complex, were not so remarkably improved as high voltage slow wave burst.

As the side effect, mild gastrointestinal disturbances were seen in 2 patients who received a relatively lar-ge dose of HOPA though withdrawal of the drug was not required.