神経薬理の立場からみためまい治療

概要

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The mechanism of action of antivertigo drugs was reviewed in the light of our neuropharmacological studies, with special reference to neurotransmitters and neuromodulators such as bioactive amines, amino acids and peptides. It was concluded that acetylcholine is a neurotransmitter candidate from the vestibular nerve to the lateral vestibular nucleus neurons and that the vestibular nucleus neurons are not regulated by noradrenaline and dopamine. Diphenhydramine, an antihistamine, interfered with synaptic transmission in the medial vestibular nucleus neurons much more effectively than in the lateral vestibular nucleus neurons. Betahistine, which is chemically related to histamine, produced more pronounced inhibition of polysynaptic neurons than monosynaptic neurons in the lateral vestibular nucleus. Central vasodilators such as cinnarizine and ATP increased the responsiveness of the vestibular nucleus neurons, probably due to an indirect effect resulting from increased cerebral blood flow. In contrast, ethanol predominantly inhibited synaptic transmission of the monosynaptic neurons in the lateral vestibular nucleus with much less effect on the polysynaptic neurons as well as the medial vestibular nucleus neurons. These results indicate that the selection of durgs for the treatment of vertigo should take into account the mechanism of action of the drugs and the etiology of the symptoms.
耳鼻咽喉科臨床学会の論文