脳磁図の臨床応用に関する文献レビュー(第1報) : てんかん  [in Japanese] Bibliographic survey on the clinical application of magnetoencephalography (I) : epilepsy  [in Japanese]

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Abstract

脳磁図は2004年に保険適用検査となったが, 科学的エビデンスは必ずしも明らかでない。本研究では文献検索にもとづきてんかんの脳磁図臨床研究の動向を調べた。MEDLINE にてepilepsy AND (MEG OR magnetoencephalography OR (magnetic source imaging)) を検索, 2010年7月までで961論文が検索された。これをエビデンスレベル, 抄録内容にもとづいて65論文に絞りこみ内容を調べた。エビデンスレベルはグレード1: 0編, 2: 3編, 3: 20編, 4: 22編, 5: 14編, 6: 6編であった。総じて有用性を報告したものが多く, 特に診断・治療方針の決定に関してはエビデンスレベルの高い論文もあり, てんかん焦点源検索や頭蓋内電極留置部位決定に関して頭皮脳波より優れていると考えられた。現在, 脳磁図の保険適用は手術適応例に対する術前検査であるが, 手術適応評価法としての位置づけがむしろ適切と考えられる。

Magnetoencephalography (MEG) was approved as an examination covered by health insurance in 2004, but the scientific evidence is not necessarily clear. In this study, we reviewed clinical MEG studies regarding epilepsy based on a website bibliographic survey. We searched epilepsy papers before July 2010 using MEDLINE by keywords: epilepsy AND (MEG OR magnetoencephalography OR (magnetic source imaging)). Nine hundred sixty-one papers were retrieved. We further narrowed the search to 65 papers based on levels of evidence and abstract contents. The levels of evidences were classified as grade 1: no paper, 2: 3 papers, 3: 20 papers, 4: 22 papers, 5: 14 papers, 6: 6 papers, respectively. Most of the papers reported clinical usefulness of MEG. Several papers certified the high levels of evidences that MEG is superior to scalp electroencephalography to estimate epileptic foci and to decide the placement site and area of intracranial electrodes. Although the present indication of health insurance for MEG is restricted to presurgical evaluation for the surgical cases, it should cover usefulness of the MEG evaluation for surgical indication.

Journal

  • Japanese Journal of Clinical Neurophysiology

    Japanese Journal of Clinical Neurophysiology 40(3), 140-146, 2012-06-01

    Japanese Society of Clinical Neurophysiology

References:  31

Codes

  • NII Article ID (NAID)
    10031159670
  • NII NACSIS-CAT ID (NCID)
    AA11410258
  • Text Lang
    JPN
  • Article Type
    REV
  • ISSN
    13457101
  • Data Source
    CJP  J-STAGE 
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