トランプの「神経衰弱」実施時における高次脳機能障害者の脳血流の特徴―NIRSを用いた健常者との比較─

Cerebral blood flow characteristics of higher brain dysfunction during the card game “concentration”: An NIRS-based comparative study

要旨：「神経衰弱」実施による脳機能の精神生理学的評価および治療効果の検証へと繋げるため，高次脳機能障害（患者）群と健常群を対象に，前頭極部，前頭葉背外側部，頭頂葉前中部の酸素化ヘモグロビン変動量を近赤外分光法を用い検討した．結果は，患者群は健常群と比較し有意な低下（前頭極部，前頭葉背外側部，頭頂葉前中部いずれもp＜0.001）を認めた．また酸素化ヘモグロビンは，健常群では時間経過に伴う増加や左前頭葉背外側部と右頭頂葉前中部で対側と比較し増加を認めたが，患者群では時間経過に伴う増加や左右差を認めなかった．患者群は「神経衰弱」の遂行に関与するワーキングメモリーを司る部位が十分に賦活されていないことが確認された．

　Changes in the oxy-hemoglobin levels in the front polar region, the dorsolateral region of the frontal lobe, and the anterior-middle region of the parietal lobe during a game of concentration were compared by near-infrared spectroscopy in patients with higher brain dysfunction and healthy individuals to evaluate the possibility of psychophysiological assessments of brain functions and subsequent therapeutic effects. The oxy-hemoglobin levels in the patients were significantly lower than in the healthy individuals (p＜0.001 in all 3 regions). Also, the levels increased with time and were higher in the dorsolateral region of the left frontal lobe and anterior-middle region of the right parietal lobe compared with the opposite sides in the healthy subjects. However, the levels did not indicate time-associated increases or lateral differences in the patients. The areas of working memory involved in concentration were confirmed not to be sufficiently activated in the patients.