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Murakami Y, Kawahara D, Soyano T, Kozuka T, Takahashi Y, Miyake K, Kashihara K, Kashihara T, Kamima T, Oguchi M, Murakami Y, Yoshioka Y, Nagata Y. Dosiomics for intensity-modulated radiotherapy in patients with prostate cancer: survival analysis stratified by baseline prostate-specific antigen and Gleason grade group in a 2-institutional retrospective study. Br J Radiol 2024; 97:142-149. [PMID: 38263831 PMCID: PMC11008500 DOI: 10.1093/bjr/tqad004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 05/25/2023] [Accepted: 10/12/2023] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVE This study evaluated the prognostic impact of the quality of dose distribution using dosiomics in patients with prostate cancer, stratified by pretreatment prostate-specific antigen (PSA) levels and Gleason grade (GG) group. METHODS A total of 721 patients (Japanese Foundation for Cancer Research [JFCR] cohort: N = 489 and Tokyo Radiation Oncology Clinic [TROC] cohort: N = 232) with localized prostate cancer treated by intensity-modulated radiation therapy were enrolled. Two predictive dosiomic features for biochemical recurrence (BCR) were selected and patients were divided into certain groups stratified by pretreatment PSA levels and GG. Freedom from biochemical failure (FFBF) was estimated using the Kaplan-Meier method based on each dosiomic feature and univariate discrimination was evaluated using the log-rank test. As an exploratory analysis, a dosiomics hazard (DH) score was developed and its prognostic power for BCR was examined. RESULTS The dosiomic feature extracted from planning target volume (PTV) significantly distinguished the high- and low-risk groups in patients with PSA levels >10 ng/mL (7-year FFBF: 86.7% vs 76.1%, P < .01), GG 4 (92.2% vs 76.9%, P < .01), and GG 5 (83.1% vs 77.8%, P = .04). The DH score showed significant association with BCR (hazard score: 2.04; 95% confidence interval: 1.38-3.01; P < .001). CONCLUSION The quality of planned dose distribution on PTV may affect the prognosis of patients with poor prognostic factors, such as PSA levels >10 ng/mL and higher GGs. ADVANCES IN KNOWLEDGE The effects of planned dose distribution on prognosis differ depending on the patient's clinical background.
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Affiliation(s)
- Yu Murakami
- Department of Radiation Oncology, Graduate School of Biomedical Health Sciences, Hiroshima University,1-2-3 Kasumi, Hiroshima, 734-8551, Japan
- Department of Physics, Cancer Institute, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan
| | - Daisuke Kawahara
- Department of Radiation Oncology, Graduate School of Biomedical Health Sciences, Hiroshima University,1-2-3 Kasumi, Hiroshima, 734-8551, Japan
| | - Takashi Soyano
- Department of Radiology, Japan Self-Defense Forces Central Hospital, 1-2-24 Ikejiri, Setagaya-ku, Tokyo 154-8532, Japan
| | - Takuyo Kozuka
- Department of Radiology, University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Yuka Takahashi
- Tokyo Radiation Oncology Clinic, 3-5-7, Ariake, Koto-ku, Tokyo 135-0063, Japan
| | - Konatsu Miyake
- Tokyo Radiation Oncology Clinic, 3-5-7, Ariake, Koto-ku, Tokyo 135-0063, Japan
| | - Kenichi Kashihara
- Tokyo Radiation Oncology Clinic, 3-5-7, Ariake, Koto-ku, Tokyo 135-0063, Japan
| | - Tairo Kashihara
- Department of Radiation Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Tatsuya Kamima
- Radiation Oncology Department, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan
| | - Masahiko Oguchi
- Radiation Oncology Department, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan
| | - Yuji Murakami
- Department of Radiation Oncology, Graduate School of Biomedical Health Sciences, Hiroshima University,1-2-3 Kasumi, Hiroshima, 734-8551, Japan
| | - Yasuo Yoshioka
- Radiation Oncology Department, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan
| | - Yasushi Nagata
- Department of Radiation Oncology, Graduate School of Biomedical Health Sciences, Hiroshima University,1-2-3 Kasumi, Hiroshima, 734-8551, Japan
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Kashihara K. Cerebral Hypoperfusion Detected by Arterial Spine-Labelled MR Imaging in a Patient Presenting with Migraine and Panic Attacks. Acta Med Okayama 2023; 77:319-321. [PMID: 37357633 DOI: 10.18926/amo/65497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
I report a case of arterial spine-labelled MR imaging (ASL)-detected cerebral hypoperfusion during migraine and panic attacks. A 20-year-old woman with a history of headache for 6 years and independent panic attacks for 3 years was transferred to Okayama Kyokuto Hospital for panic attacks. On that day, she had had severe headache that was improved by taking non-steroidal anti-inflammatory drug, but panic attacks initiated. On arrival, she also complained of a mild headache. ASL revealed cerebral hypoperfusion in the right temporo-occipital region. The threshold to induce panic attacks in migraine patients could be lowered by the physiopathology underlying migraine attacks.
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Affiliation(s)
- Kenichi Kashihara
- Department of Neurology, Okayama Kyokuto Hospital
- Okayama Neurology Clinic
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Soyano T, Kozuka T, Kashihara K, Murakami Y, Yonese J, Sasamura K, Shimoyachi N, Kashihara T, Yoshioka Y, Oguchi M. Intensity-modulated radiation therapy for intermediate-risk prostate cancer: does ADT still have an impact in the dose-escalated external beam radiation therapy era? Jpn J Clin Oncol 2023:7082591. [PMID: 36946312 DOI: 10.1093/jjco/hyad019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 03/02/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND This study aimed to investigate the effect of androgen deprivation therapy (ADT) on the survival of intermediate-risk prostate cancer (IR-PCA) patients treated with dose-escalated external beam radiation therapy (DE-EBRT), and to determine the group that will benefit from ADT. METHODS We analysed 620 IR-PCA patients treated with DE-EBRT at two institutions. Variables were adjusted using the stabilised inverse probability of treatment weighting method (sIPTW) between radiation therapy (RT) and RT plus ADT groups. Biochemical relapse-free survival (bRFS) rate and overall survival (OS) rate were compared using Kaplan-Meier analysis and log-rank test. Cox proportional hazard analysis (CPH) was conducted to detect unfavorable risk factors. RESULTS This study included 405 patients; with 217 and 188 patients in the RT and RT plus ADT groups, respectively. The prescribed radiation dose was 78 Gy in 39 fractions. The median follow-up time was 82.0 months. After sIPTW-adjustment, 214.3 and 189.7 patients were assigned to the RT and RT plus ADT groups, respectively. The 7-year bRFS and OS were 89.3% and 94.6% in RT group and 92.3% and 91.0% in RT plus ADT group, respectively. Before and after sIPTW adjustment, no statistically significant differences were found in these endpoints between treatment groups. Multivariate CPH for bRFS revealed Gleason score (GS) 4 + 3 as an unfavorable risk factor, and ADT improved biochemical control of them. CONCLUSION ADT may not always be effective in all Japanese IR-PCA patients treated with DE-EBRT, but it can improve biochemical control in patients with GS 4 + 3.
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Affiliation(s)
- Takashi Soyano
- Department of Radiology, Japan Self-Defense Forces Central Hospital, 1-2-24, Ikejiri, Setagaya-ku, Tokyo 154-8532, Japan
- Department of Radiation Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-Ku, Tokyo 135-8550, Japan
| | - Takuyo Kozuka
- Department of Radiology, University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-Ku, Tokyo 113-8655, Japan
| | - Kenichi Kashihara
- Tokyo Radiation Oncology Clinic, 3-5-7, Ariake, Koto-Ku, Tokyo 135-0063, Japan
| | - Yu Murakami
- Department of Radiation Oncology, Graduate School of Biomedical Health Sciences, Hiroshima University, 1-3-2 Kagamiyama, Higashihiroshima, Hiroshima 734-8551, Japan
- Department of Physics, Cancer Institute, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-Ku, Tokyo 135-8550, Japan
| | - Junji Yonese
- Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-Ku, Tokyo 135-8550, Japan
| | - Kazuma Sasamura
- Department of Radiation Therapeutics and Oncology, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo 113-8519, Japan
| | - Nana Shimoyachi
- Department of Radiation Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-Ku, Tokyo 135-8550, Japan
| | - Tairo Kashihara
- Department of Radiation Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Yasuo Yoshioka
- Department of Radiation Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-Ku, Tokyo 135-8550, Japan
| | - Masahiko Oguchi
- Department of Radiation Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-Ku, Tokyo 135-8550, Japan
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Mishima T, Chiu SW, Saiki H, Yamaguchi T, Shimo Y, Maeda T, Watanabe H, Kashihara K, Nomoto M, Hattori N, Tsuboi Y. Risk factors for developing dyskinesia among Parkinson's disease patients with wearing-off: J-FIRST. J Neurol Sci 2023; 448:120619. [PMID: 37023638 DOI: 10.1016/j.jns.2023.120619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/08/2023] [Accepted: 03/20/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Dyskinesia frequently occurs during long-term treatment with levodopa in patients with Parkinson's disease (PD) and impacts quality of life. Few studies have examined risk factors for developing dyskinesia in PD patients exhibiting wearing-off. Therefore, we investigated the risk factors and impact of dyskinesia in PD patients exhibiting wearing-off. METHODS We investigated the risk factors and impact of dyskinesia in a 1-year observational study of Japanese PD patients exhibiting wearing-off (J-FIRST). Risk factors were assessed by logistic regression analyses in patients without dyskinesia at study entry. Mixed-effect models were used to evaluate the impact of dyskinesia on changes in Movement Disorder Society-Unified PD Rating Scale (MDS-UPDRS) Part I and PD Questionnaire (PDQ)-8 scores from one timepoint before dyskinesia was observed. RESULTS Of 996 patients analyzed, 450 had dyskinesia at baseline, 133 developed dyskinesia within 1 year, and 413 did not develop dyskinesia. Female sex (odds ratio [95% confidence interval]: 2.636 [1.645-4.223]) and administration of a dopamine agonist (1.840 [1.083-3.126]), a catechol-O-methyltransferase inhibitor (2.044 [1.285-3.250]), or zonisamide (1.869 [1.184-2.950]) were independent risk factors for dyskinesia onset. MDS-UPDRS Part I and PDQ-8 scores increased significantly after the onset of dyskinesia (least-squares mean change [standard error] at 52 weeks: 1.11 [0.52], P = 0.0336; 1.53 [0.48], P = 0.0014; respectively). CONCLUSION Female sex and administration of a dopamine agonist, a catechol-O-methyltransferase inhibitor, or zonisamide were risk factors for dyskinesia onset within 1 year in PD patients exhibiting wearing-off. Nonmotor symptoms and quality of life deteriorated after dyskinesia onset.
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Kashihara K, Kitayama M. Time Taken for and Causes of a Decline to Hoehn and Yahr Stage 5 in Patients with Parkinson's Disease. Intern Med 2023; 62:711-716. [PMID: 35945019 PMCID: PMC10037007 DOI: 10.2169/internalmedicine.8922-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective Prediction of time until and causes of becoming bedridden may help patients with Parkinson's disease (PD) plan their productive lives. This study assessed the relationship between the age at the PD onset and time taken to reach Hoehn and Yahr stage (HY) 5 as well as the causes of motor decline to HY5 in Japanese patients with PD. Patients We enrolled patients with PD who visited our institute between April 2015 and December 2020, met the UK brain bank criteria, had medical records from the early PD stage, and had had HY5 for over three months. The relationship between the age at the PD onset and the disease duration was evaluated. Data on the possible causes of motor decline to HY5 were obtained from patients, caregivers or medical records. Results In total, 123 patients with PD (mean age at the PD onset was 69.3 years old; 80 women and 43 men) were included. The age at the PD onset was significantly and negatively correlated with the time until the decline to HY5. Among the 123 patients, 49 reported that the natural course of PD caused the decline to HY5. Possible events that accelerated the motor decline to HY5 included traumatic injury, pneumonia, and other medical or social conditions that might have resulted in reduced daily activities. Conclusion The time until the decline to HY5 can be estimated based on the age at the PD onset. In addition to natural PD progression, medical or social conditions that reduce physical activity may accelerate motor decline to HY5.
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Affiliation(s)
- Kenichi Kashihara
- Department of Neurology, Okayama Kyokuto Hospital, Japan
- Okayama Neurology Clinic, Japan
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Shimabuku M, Taguchi J, Zay Yar Myint K, Kaneda M, Kashihara K, Kusano T, Horio R, Shimizu Y, Hirokawa K. [Ⅳ. Dendritic Cell Immunotherapy as Pancreatic Cancer Treatment]. Gan To Kagaku Ryoho 2022; 49:1070-1075. [PMID: 36281598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Masamori Shimabuku
- Center for Advanced Medical Science and Technology, Tokyo Midtown Medical Center
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Nishiwaki H, Ito M, Hamaguchi T, Maeda T, Kashihara K, Tsuboi Y, Ueyama J, Yoshida T, Hanada H, Takeuchi I, Katsuno M, Hirayama M, Ohno K. Short chain fatty acids-producing and mucin-degrading intestinal bacteria predict the progression of early Parkinson's disease. NPJ Parkinsons Dis 2022; 8:65. [PMID: 35650236 PMCID: PMC9160257 DOI: 10.1038/s41531-022-00328-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 05/05/2022] [Indexed: 01/07/2023] Open
Abstract
To elucidate the relevance of gut dysbiosis in Parkinson’s disease (PD) in disease progression, we made random forest models to predict the progression of PD in two years by gut microbiota in 165 PD patients. The area under the receiver operating characteristic curves (AUROCs) of gut microbiota-based models for Hoehn & Yahr (HY) stages 1 and 2 were 0.799 and 0.705, respectively. Similarly, gut microbiota predicted the progression of Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) III scores in an early stage of PD with AUROC = 0.728. Decreases of short-chain fatty acid-producing genera, Fusicatenibacter, Faecalibacterium, and Blautia, as well as an increase of mucin-degrading genus Akkermansia, predicted accelerated disease progression. The four genera remained unchanged in two years in PD, indicating that the taxonomic changes were not the consequences of disease progression. PD patients with marked gut dysbiosis may thus be destined to progress faster than those without gut dysbiosis.
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Affiliation(s)
- Hiroshi Nishiwaki
- Division of Neurogenetics, Center for Neurological Diseases and Cancer, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mikako Ito
- Division of Neurogenetics, Center for Neurological Diseases and Cancer, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomonari Hamaguchi
- Division of Neurogenetics, Center for Neurological Diseases and Cancer, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tetsuya Maeda
- Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Iwate, Japan
| | | | - Yoshio Tsuboi
- Department of Neurology, Fukuoka University, Fukuoka, Japan
| | - Jun Ueyama
- Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takumi Yoshida
- Department of Computer Science, Nagoya Institute of Technology, Nagoya, Japan
| | - Hiroyuki Hanada
- Center for Advanced Intelligence Project, RIKEN, Tokyo, Japan
| | - Ichiro Takeuchi
- Department of Computer Science, Nagoya Institute of Technology, Nagoya, Japan.,Center for Advanced Intelligence Project, RIKEN, Tokyo, Japan
| | - Masahisa Katsuno
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masaaki Hirayama
- Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Kinji Ohno
- Division of Neurogenetics, Center for Neurological Diseases and Cancer, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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Kashihara K, Maeda T, Yoshida K. Safety and tolerability of aripiprazole in patients with psychosis associated with Parkinson's disease-Results of a multicenter open trial. Neuropsychopharmacol Rep 2022; 42:135-141. [PMID: 35226404 PMCID: PMC9216359 DOI: 10.1002/npr2.12235] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 12/27/2021] [Accepted: 01/11/2022] [Indexed: 11/08/2022] Open
Abstract
Aim To evaluate the effect of aripiprazole on psychosis and motor function in Japanese Parkinson's disease patients. Methods Patients with Parkinson's disease and hallucinations and/or delusions were enrolled. They were administered aripiprazole 3 mg/day, with dosage increased or reduced as needed. Patients were evaluated using the Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression‐Severity (CGI‐S) scale, and Clinical Global Impression‐Improvement scale for psychiatric response; Hoehn & Yahr staging and Unified Parkinson's Disease Rating Scale (UPDRS) part III for motor response; Mini‐Mental State Examination (MMSE) and Frontal Assessment Battery (FAB) for cognitive response; and Schwab and England Activities of Daily Living scale for daily activities of patients, before and at 2, 4, and 12 weeks after initiation of open‐label aripiprazole administration. This study was registered at the University Hospital Medical Information Network Center (registration number: UMIN000007711). Results Nine of the 24 enrolled patients discontinued the study. Among them, eight patients discontinued the trial on account of their worsening parkinsonian symptoms. There were no differences in age, disease duration, disease severity, and MMSE and FAB scores at baseline between patients who continued and discontinued the study. However, in patients who continued aripiprazole administration at 3 mg/day or less significantly improved BPRS, CGI‐S scale, and UPDRS parts I and III scores. Conclusion Significant improvements in hallucinations and delusions can be expected, although aripiprazole may aggravate parkinsonism in Parkinson's disease patients. Low‐dose use of aripiprazole may be useful for managing Parkinson's disease patients with psychosis, but only with close observation of extrapyramidal symptoms. We conducted a multicenter clinical study to determine the efficacy of aripiprazole to relieve psychosis in Parkinson's disease. We found that aripiprazole reduced psychotic symptoms without cognitive impairment (based on BPRS and CGI‐S scores), and motor symptoms also improved (based on UPDRS scores). We believe that our study makes a significant contribution to the literature because the results suggest aripiprazole may be a better alternative to the drugs that are currently being prescribed for Parkinson disease‐associated psychosis.![]()
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Affiliation(s)
- Kenichi Kashihara
- Department of Neurology, Okayama Kyokuto Hospital, Okayama, Japan.,Okayama Neurology Clinic, Okayama, Japan
| | - Tetsuya Maeda
- Department of Neurology and Movement Disorder Research, Research Institute for Brain and Blood Vessels-Akita, Akita, Japan.,Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Kazuto Yoshida
- Department of Neurology, Asahikawa Red Cross Hospital, Asahikawa, Japan.,Department of Neurology, Kashiwaba Neurosurgical Hospital, Sapporo, Japan
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Takahashi K, Nishiwaki H, Ito M, Iwaoka K, Takahashi K, Suzuki Y, Taguchi K, Yamahara K, Tsuboi Y, Kashihara K, Hirayama M, Ohno K, Maeda T. Altered gut microbiota in Parkinson's disease patients with motor complications. Parkinsonism Relat Disord 2021; 95:11-17. [PMID: 34954497 DOI: 10.1016/j.parkreldis.2021.12.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/15/2021] [Accepted: 12/19/2021] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Parkinson's disease (PD) is associated with gut dysbiosis. However, whether gut dysbiosis can cause motor complications is unclear. METHODS Subjects were enrolled from four independent movement disorder centers in Japan. We performed 16S ribosomal RNA gene sequence analysis of gut microbiota. Relative abundance of gut microbiota and relationships between them and clinical characteristics were statistically analyzed. Analysis of co-variance (ANCOVA) was used to assess altered gut microbiota associated with wearing-off or dyskinesia. RESULTS We enrolled 223 patients with PD. Wearing-off was noted in 47.5% of patients and dyskinesia in 21.9%. We detected 98 genera of bacteria. Some changes in the gut microbiota were observed in patients with PD and motor complications. After Bonferroni correction, patients with wearing-off showed decreased relative abundance of Lachnospiraceae Blautia (p < 0.0001) and increased relative abundance of Lactobacillaceae Lactobacillus (p < 0.0001), but patients with dyskinesia no longer showed significant changes in the gut microbiota. Adjustment with two models of confounding factors followed by ANCOVA revealed that age (p < 0.0001), disease duration (p = 0.01), and wearing-off (p = 0.0004) were independent risks for the decreased relative abundance of Lachnospiraceae Blautia, and wearing-off (p = 0.009) was the only independent risk factor for the increased relative abundance of Lachnospiraceae Lactobacillus. CONCLUSION Relative abundance of Lachnospiraceae Blautia and Lactobacillaceae Lactobacillus was significantly decreased and increased, respectively, in the gut microbiota of PD patients with motor complications. This indicates that an altered gut microbiota is associated with the development of motor complications in patients with advanced PD.
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Affiliation(s)
- Kai Takahashi
- Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Hiroshi Nishiwaki
- Division of Neurogenetics, Center for Neurological Disease and Cancer, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mikako Ito
- Division of Neurogenetics, Center for Neurological Disease and Cancer, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuhiro Iwaoka
- Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Kenta Takahashi
- Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Yoshio Suzuki
- Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Keita Taguchi
- Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Kanako Yamahara
- Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Yoshio Tsuboi
- Department of Neurology, Fukuoka University, Fukuoka, Japan
| | - Kenichi Kashihara
- Department of Neurology, Okayama Kyokuto Hospital, Okayama, Japan; Okayama Neurology Clinic, Okayama, Japan
| | - Masaaki Hirayama
- Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kinji Ohno
- Division of Neurogenetics, Center for Neurological Disease and Cancer, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tetsuya Maeda
- Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Iwate, Japan.
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Hirayama M, Nishiwaki H, Hamaguchi T, Ito M, Ueyama J, Maeda T, Kashihara K, Tsuboi Y, Ohno K. Intestinal Collinsella may mitigate infection and exacerbation of COVID-19 by producing ursodeoxycholate. PLoS One 2021; 16:e0260451. [PMID: 34813629 PMCID: PMC8610263 DOI: 10.1371/journal.pone.0260451] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 11/09/2021] [Indexed: 12/12/2022] Open
Abstract
The mortality rates of COVID-19 vary widely across countries, but the underlying mechanisms remain unelucidated. We aimed at the elucidation of relationship between gut microbiota and the mortality rates of COVID-19 across countries. Raw sequencing data of 16S rRNA V3-V5 regions of gut microbiota in 953 healthy subjects in ten countries were obtained from the public database. We made a generalized linear model (GLM) to predict the COVID-19 mortality rates using gut microbiota. GLM revealed that low genus Collinsella predicted high COVID-19 mortality rates with a markedly low p-value. Unsupervised clustering of gut microbiota in 953 subjects yielded five enterotypes. The mortality rates were increased from enterotypes 1 to 5, whereas the abundances of Collinsella were decreased from enterotypes 1 to 5 except for enterotype 2. Collinsella produces ursodeoxycholate. Ursodeoxycholate was previously reported to inhibit binding of SARS-CoV-2 to angiotensin-converting enzyme 2; suppress pro-inflammatory cytokines like TNF-α, IL-1β, IL-2, IL-4, and IL-6; have antioxidant and anti-apoptotic effects; and increase alveolar fluid clearance in acute respiratory distress syndrome. Ursodeoxycholate produced by Collinsella may prevent COVID-19 infection and ameliorate acute respiratory distress syndrome in COVID-19 by suppressing cytokine storm syndrome.
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Affiliation(s)
- Masaaki Hirayama
- Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
- * E-mail: (MH); (KO)
| | - Hiroshi Nishiwaki
- Division of Neurogenetics, Center for Neurological Diseases and Cancer, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomonari Hamaguchi
- Division of Neurogenetics, Center for Neurological Diseases and Cancer, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mikako Ito
- Division of Neurogenetics, Center for Neurological Diseases and Cancer, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Jun Ueyama
- Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tetsuya Maeda
- Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Iwate, Japan
| | | | - Yoshio Tsuboi
- Department of Neurology, Fukuoka University, Fukuoka, Japan
| | - Kinji Ohno
- Division of Neurogenetics, Center for Neurological Diseases and Cancer, Nagoya University Graduate School of Medicine, Nagoya, Japan
- * E-mail: (MH); (KO)
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Kashihara T, Kashihara K. Radiotherapy with genomic-adjusted radiation dose. Lancet Oncol 2021; 22:e468. [PMID: 34735810 DOI: 10.1016/s1470-2045(21)00541-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 09/07/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Tairo Kashihara
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo 1040045, Japan.
| | - Kenichi Kashihara
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo 1040045, Japan; Tokyo Radiation Oncology Clinic, Tokyo, Japan
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Shimo Y, Maeda T, Chiu SW, Yamaguchi T, Kashihara K, Tsuboi Y, Nomoto M, Hattori N, Watanabe H, Saiki H. Influence of istradefylline on non-motor symptoms of Parkinson's disease: A subanalysis of a 1-year observational study in Japan (J-FIRST). Parkinsonism Relat Disord 2021; 91:115-120. [PMID: 34583302 DOI: 10.1016/j.parkreldis.2021.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 08/26/2021] [Accepted: 09/19/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The non-motor symptoms (NMSs) of Parkinson's disease (PD) significantly impact the patient's health-related quality of life. This subanalysis of the J-FIRST study evaluated the effect of istradefylline, a selective adenosine A2A receptor antagonist, on NMSs in istradefylline-naïve Japanese patients with PD. METHODS Patients with PD and ≥1 NMS and 'wearing-off' with their current antiparkinsonian treatment were observed for up to 52 weeks. The effect of istradefylline on NMSs was measured in terms of changes in the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part 1 total, individual sub-items scores and the 8 item PD questionnaire (PDQ-8) estimated by the marginal structural model. RESULTS Overall, 732 patients were istradefylline-naïve prior to the study, of whom 171 were treated with istradefylline for ≥8 weeks during the observation period (istradefylline-treated patients). At baseline, istradefylline-treated patients were more likely to have a dyskinesia (49.7% vs 40.8%) and received a significantly higher daily dose of levodopa (462.8 mg vs 413.0 mg) than those who did not receive istradefylline (n = 561). MDS-UPDRS Part 1 total score at the end of the 52-week observational period slightly increased in patients who received istradefylline and those who did not (0.49 ± 0.41 vs 0.07 ± 0.20; P = 0.36). There were no statistically significant differences between the two groups of patients in terms of changes in the MDS-UPDRS Part 1 total score or any sub-items, or in the PDQ-8 total score. CONCLUSION NMSs remained generally controlled in istradefylline-treated Japanese patients with PD who exhibited wearing-off with their current antiparkinsonian treatment. Istradefylline could be a feasible treatment option for patients with advanced PD, without worsening existing NMSs.
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Affiliation(s)
- Yasushi Shimo
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan; Department of Neurology, Juntendo University Nerima Hospital, Tokyo, Japan.
| | - Tetsuya Maeda
- Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Iwate, Japan; Department of Neurology, Research Institute for Brain and Blood Vessels-Akita, Akita, Japan
| | - Shih-Wei Chiu
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kenichi Kashihara
- Okayama Kyokuto Hospital, Okayama, Japan; Okayama Neurology Clinic, Okayama, Japan
| | - Yoshio Tsuboi
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Masahiro Nomoto
- Ehime University Graduate School of Medicine, Tohon, Japan; Department of Neurology, Saiseikai Imabari Center for Health and Welfare, Imabari, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | | | - Hidemoto Saiki
- Parkinson's Disease Advanced Therapy Center, Aichi Medical University Hospital, Aichi, Japan
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13
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Daida K, Nishioka K, Li Y, Yoshino H, Shimada T, Dougu N, Nakatsuji Y, Ohara S, Hashimoto T, Okiyama R, Yokochi F, Suzuki C, Tomiyama M, Kimura K, Ueda N, Tanaka F, Yamada H, Fujioka S, Tsuboi Y, Uozumi T, Takei T, Matsuzaki S, Shibasaki M, Kashihara K, Kurisaki R, Yamashita T, Fujita N, Hirata Y, Ii Y, Wada C, Eura N, Sugie K, Higuchi Y, Kojima F, Imai H, Noda K, Shimo Y, Funayama M, Hattori N. PLA2G6 variants associated with the number of affected alleles in Parkinson's disease in Japan. Neurobiol Aging 2020; 97:147.e1-147.e9. [PMID: 32771225 DOI: 10.1016/j.neurobiolaging.2020.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/26/2020] [Accepted: 07/04/2020] [Indexed: 12/18/2022]
Abstract
This study aimed to evaluate genotype-phenotype correlations of Parkinson's disease (PD) patients with phospholipase A2 group V (PLA2G6) variants. We analyzed the DNA of 798 patients with PD, including 78 PD patients reported previously, and 336 in-house controls. We screened the exons and exon-intron boundaries of PLA2G6 using the Ion Torrent system and Sanger method. We identified 21 patients with 18 rare variants, such that 1, 9, and 11 patients were homozygous, heterozygous, and compound heterozygous, respectively, with respect to PLA2G6 variants. The allele frequency was approximately equal between patients with familial PD and those with sporadic PD. The PLA2G6 variants detected frequently were identified in the early-onset sporadic PD group. Patients who were homozygous for a variant showed more severe symptoms than those who were heterozygous for the variant. The most common variant was p.R635Q in our cohort, which was considered a risk variant for PD. Thus, the variants of PLA2G6 may play a role in familial PD and early-onset sporadic PD.
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Affiliation(s)
- Kensuke Daida
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Kenya Nishioka
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan.
| | - Yuanzhe Li
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Hiroyo Yoshino
- Research Institute for Diseases of Old Age, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Tomoyo Shimada
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Nobuhiro Dougu
- Department of Neurology, Toyama University Hospital, Toyama, Japan
| | - Yuji Nakatsuji
- Department of Neurology, Toyama University Hospital, Toyama, Japan
| | - Shinji Ohara
- Department of Neurology, Iida Hospital, Iida, Nagano, Japan
| | | | - Ryoichi Okiyama
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Fusako Yokochi
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Chieko Suzuki
- Department of Neurology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Masahiko Tomiyama
- Department of Neurology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Katsuo Kimura
- Department of Neurology, Yokohama City University Medical Center, Yokohama, Japan
| | - Naohisa Ueda
- Department of Neurology, Yokohama City University Medical Center, Yokohama, Japan
| | - Fumiaki Tanaka
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | | | - Shinsuke Fujioka
- Department of Neurology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Yoshio Tsuboi
- Department of Neurology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Takenori Uozumi
- Department of Neurology, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Takanobu Takei
- Department of Neurology, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Shigeru Matsuzaki
- Shiga Prefectural Mental Health Medical Center, Kusatsu, Shiga, Japan
| | | | | | - Ryoichi Kurisaki
- Department of Neurology, National Hospital Organization Kumamoto Saishun Medical Center, Koshi, Kumamoto, Japan
| | | | - Nobuya Fujita
- Department of Neurology, Nagaoka Red Cross Hospital, Nagaoka, Niigata, Japan
| | - Yoshinori Hirata
- Department of Neurology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Yuichiro Ii
- Department of Neurology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Chizu Wada
- Department of Neurology, National Hospital Organization Akita National Hospital, Yurihonjo, Akita, Japan
| | - Nobuyuki Eura
- Department of Neurology, Nara Medical University School of Medicine, Kashihara, Nara, Japan
| | - Kazuma Sugie
- Department of Neurology, Nara Medical University School of Medicine, Kashihara, Nara, Japan
| | - Yujiro Higuchi
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan
| | - Fumikazu Kojima
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan
| | | | - Kazuyuki Noda
- Department of Neurology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
| | - Yasushi Shimo
- Department of Neurology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Manabu Funayama
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan; Research Institute for Diseases of Old Age, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan; Research Institute for Diseases of Old Age, Graduate School of Medicine, Juntendo University, Tokyo, Japan.
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14
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Hayashida A, Li Y, Yoshino H, Daida K, Ikeda A, Ogaki K, Fuse A, Mori A, Takanashi M, Nakahara T, Yoritaka A, Tomizawa Y, Furukawa Y, Kanai K, Nakayama Y, Ito H, Ogino M, Hattori Y, Hattori T, Ichinose Y, Takiyama Y, Saito T, Kimura T, Aizawa H, Shoji H, Mizuno Y, Matsushita T, Sato M, Sekijima Y, Morita M, Iwasaki A, Kusaka H, Tada M, Tanaka F, Sakiyama Y, Fujimoto T, Nagara Y, Kashihara K, Todo H, Nakao K, Tsuruta K, Yoshikawa M, Hara H, Yokote H, Murase N, Nakamagoe K, Tamaoka A, Takamiya M, Morimoto N, Nokura K, Kako T, Funayama M, Nishioka K, Hattori N. The identified clinical features of Parkinson's disease in homo-, heterozygous and digenic variants of PINK1. Neurobiol Aging 2020; 97:146.e1-146.e13. [PMID: 32713623 DOI: 10.1016/j.neurobiolaging.2020.06.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/22/2020] [Accepted: 06/25/2020] [Indexed: 02/04/2023]
Abstract
To investigate the prevalence and genotype-phenotype correlations of phosphatase and tensin homolog induced putative kinase 1 (PINK1) variants in Parkinson's disease (PD) patients, we analyzed 1700 patients (842 familial PD and 858 sporadic PD patients from Japanese origin). We screened the entire exon and exon-intron boundaries of PINK1 using Sanger sequencing and target sequencing by Ion torrent system. We identified 30 patients with heterozygous variants, 3 with homozygous variants, and 3 with digenic variants of PINK1-PRKN. Patients with homozygous variants presented a significantly younger age at onset than those with heterozygous variants. The allele frequency of heterozygous variants in patients with age at onset at 50 years and younger with familial PD and sporadic PD showed no differences. [123I]meta-iodobenzylguanidine (MIBG) myocardial scintigraphy indicated that half of patients harboring PINK1 heterozygous variants showed a decreased heart to mediastinum ratio (12/23). Our findings emphasize the importance of PINK1 variants for the onset of PD in patients with age at onset at 50 years and younger and the broad spectrum of clinical symptoms in patients with PINK1 variants.
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Affiliation(s)
- Arisa Hayashida
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Yuanzhe Li
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Hiroyo Yoshino
- Research Institute for Diseases of Old Age, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Kensuke Daida
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Aya Ikeda
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Kotaro Ogaki
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Atsuhito Fuse
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Akio Mori
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Masashi Takanashi
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Toshiki Nakahara
- Department of Neurology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Asako Yoritaka
- Department of Neurology, Juntendo University Koshigaya Hospital, Saitama, Japan
| | - Yuji Tomizawa
- Department of Neurology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Yoshiaki Furukawa
- Department of Neurology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
| | - Kazuaki Kanai
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan; Department of Neurology, Fukushima Medical University, Fukushima, Japan
| | - Yoshiaki Nakayama
- Department of Neurology, Wakayama Medical University, Wakayama Prefecture, Japan
| | - Hidefumi Ito
- Department of Neurology, Wakayama Medical University, Wakayama Prefecture, Japan
| | - Mieko Ogino
- International University of Health and Welfare, School of Medicine, Office of Medical Education, Chiba, Japan
| | | | | | - Yuta Ichinose
- Department of Neurology, University of Yamanashi, Yamanashi, Japan
| | | | - Tsukasa Saito
- Department of Neurology, National Hospital Organization Asahikawa Medical Center, Hokkaido, Japan
| | - Takashi Kimura
- Department of Neurology, National Hospital Organization Asahikawa Medical Center, Hokkaido, Japan
| | - Hitoshi Aizawa
- Department of Neurology, Tokyo Medical University, Tokyo, Japan
| | - Hiroshi Shoji
- Division of Neurology, St. Mary's Hospital, Fukuoka, Japan
| | - Yuri Mizuno
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takuya Matsushita
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mitsuto Sato
- Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto, Japan
| | - Yoshiki Sekijima
- Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto, Japan
| | - Masayo Morita
- Department of Neurology, Jikei University Katsushika Medical Center, Tokyo, Japan
| | - Akio Iwasaki
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Hirofumi Kusaka
- Department of Neurology, Kansai Medical University, Osaka, Japan
| | - Mikiko Tada
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Fumiaki Tanaka
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Yusuke Sakiyama
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takeshi Fujimoto
- Department of Neurology, Sasebo City General Hospital, Nagasaki, Japan
| | | | | | - Hiroyuki Todo
- Department of RNA Biology and Neuroscience, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kouichi Nakao
- Brain and Nerve Center, Junwakai Memorial Hospital, Miyazaki, Japan
| | - Kazuhito Tsuruta
- Brain and Nerve Center, Junwakai Memorial Hospital, Miyazaki, Japan
| | - Masaaki Yoshikawa
- Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Saga, Japan
| | - Hideo Hara
- Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Saga, Japan
| | - Hiroaki Yokote
- Department of Neurology, Nitobe Memorial Nakano General Hospital, Tokyo, Japan
| | - Nagako Murase
- Department of Neurology, National Hospital Organization Nara Medical Center, Nara, Japan
| | - Kiyotaka Nakamagoe
- Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Akira Tamaoka
- Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Motonori Takamiya
- Department of Neurology, Kagawa Prefectural Central Hospital, Kagawa, Japan
| | - Nobutoshi Morimoto
- Department of Neurology, Kagawa Prefectural Central Hospital, Kagawa, Japan
| | - Kazuya Nokura
- Department of Neurology, Fujita Health University, Bantane Hospital, Aichi, Japan
| | - Tetsuharu Kako
- Department of Neurology, Fujita Health University, Bantane Hospital, Aichi, Japan
| | - Manabu Funayama
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan; Research Institute for Diseases of Old Age, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Kenya Nishioka
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan.
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan; Research Institute for Diseases of Old Age, Graduate School of Medicine, Juntendo University, Tokyo, Japan.
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15
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Nishiwaki H, Ito M, Ishida T, Hamaguchi T, Maeda T, Kashihara K, Tsuboi Y, Ueyama J, Shimamura T, Mori H, Kurokawa K, Katsuno M, Hirayama M, Ohno K. Meta-Analysis of Gut Dysbiosis in Parkinson's Disease. Mov Disord 2020; 35:1626-1635. [PMID: 32557853 DOI: 10.1002/mds.28119] [Citation(s) in RCA: 177] [Impact Index Per Article: 44.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/21/2020] [Accepted: 05/04/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND PD may begin with the intestinal accumulation of α-synuclein fibrils, which can be causally associated with gut dysbiosis. The variability of gut microbiota across countries prevented us from identifying shared gut dysbiosis in PD. OBJECTIVES To identify gut dysbiosis in PD across countries. METHODS We performed 16S ribosomal RNA gene sequencing analysis of gut microbiota in 223 patients with PD and 137 controls, and meta-analyzed gut dysbiosis by combining our dataset with four previously reported data sets from the United States, Finland, Russia, and Germany. We excluded uncommon taxa from our analyses. For pathway analysis, we developed the Kyoto Encyclopedia of Genes and Genomes orthology set enrichment analysis method. RESULTS After adjusting for confounding factors (body mass index, constipation, sex, age, and catechol-O-methyl transferase inhibitor), genera Akkermansia and Catabacter, as well as families Akkermansiaceae, were increased, whereas genera Roseburia, Faecalibacterium, and Lachnospiraceae ND3007 group were decreased in PD. Catechol-O-methyl transferase inhibitor intake markedly increased family Lactobacillaceae. Inspection of these bacteria in 12 datasets that were not included in the meta-analysis revealed that increased genus Akkermansia and decreased genera Roseburia and Faecalibacterium were frequently observed across countries. Kyoto Encyclopedia of Genes and Genomes orthology set enrichment analysis revealed changes in short-chain fatty acid metabolisms in our dataset. CONCLUSIONS We report that intestinal mucin layer-degrading Akkermansia is increased and that short-chain fatty acid-producing Roseburia and Faecalibacterium are decreased in PD across countries. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Hiroshi Nishiwaki
- Division of Neurogenetics, Center for Neurological Diseases and Cancer, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mikako Ito
- Division of Neurogenetics, Center for Neurological Diseases and Cancer, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomohiro Ishida
- Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomonari Hamaguchi
- Division of Neurogenetics, Center for Neurological Diseases and Cancer, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tetsuya Maeda
- Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Iwate, Japan
| | | | - Yoshio Tsuboi
- Department of Neurology, Fukuoka University, Fukuoka, Japan
| | - Jun Ueyama
- Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Teppei Shimamura
- Division of Systems Biology, Center for Neurological Diseases and Cancer, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroshi Mori
- Genome Evolution Laboratory, Department of Informatics, National Institute of Genetics, Mishima, Japan
| | - Ken Kurokawa
- Genome Evolution Laboratory, Department of Informatics, National Institute of Genetics, Mishima, Japan
| | - Masahisa Katsuno
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masaaki Hirayama
- Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kinji Ohno
- Division of Neurogenetics, Center for Neurological Diseases and Cancer, Nagoya University Graduate School of Medicine, Nagoya, Japan
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16
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Toyama M, Okuma Y, Yamamoto M, Kashihara K, Yoshida K, Saiki H, Maeda T, Tsuboi Y, Takahashi Y, Nakayama T. Non-motor symptoms depending on motor severity in Japanese patients with Parkinson's disease: A multicenter cross-sectional study. J Neurol Sci 2020; 412:116641. [PMID: 32151836 DOI: 10.1016/j.jns.2019.116641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 12/03/2019] [Accepted: 12/18/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although non-motor symptoms (NMS) in patients with Parkinson's disease (PD) often worsen as the severity of motor symptoms (MS) increases, few studies have assessed the associated factors of non-motor symptoms. OBJECTIVE This study aims to determine whether the presence of NMS in PD patients is associated with or independent from the severity of MS considering confounders. METHODS The registry of PD patients from seven facilities in Japan was used. Multiple logistic regression was performed with each domain and item of the Non-motor Symptoms Scale (NMSS) as objective variables. Severity of motor symptoms was assessed by Hoehn & Yahr stage (HY stage) as an explanatory variable. The analysis was adjusted for sex, age, disease duration, presence/absence of wearing off and dyskinesia, clinical phenotypes and Levodopa equivalent daily dose. RESULTS A total of 1037 patients were analyzed. Analysis by NMSS domain showed higher odds ratios (ORs) in patients with higher HY stages compared with patients with lower HY stages for domains D1 (cardiovascular), D2 (sleep/fatigue), D3 (mood/apathy), D4 (perceptual problems/hallucinations), D5 (attention/memory), and D6 (gastrointestinal) (ORs: 1.54-2.72, P < .05). However, only domains D7 (urinary) and D8 (sexual dysfunction) were not associated with HY stage. Item 2 (fainting) and Item 14 (delusions) showed higher ORs in the HY stage 4-5 (ORs: 9.95 and 5.92, P < .05). CONCLUSIONS Most NMS worsened with exacerbation of MS in PD patients, however some NMS domains were also affected with other factors. These findings contribute to the understanding of the clinical picture of PD and may improve personalized medicine and research in PD.
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Affiliation(s)
- Mayumi Toyama
- Department of Health Informatics, School of Public Health, Kyoto University, Yoshida-Konoecho, Sakyo-ku, Kyoto 606-8501, Japan.
| | | | - Mitsutoshi Yamamoto
- Department of Neurology, Kagawa Prefectural Central Hospital (current affiliation: Takamatsu Neurology Clinic, Takamatsu Institute for Parkinson Disease), Japan
| | | | | | - Hidemoto Saiki
- Department of Neurology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Japan
| | - Tetsuya Maeda
- Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Japan
| | | | - Yoshimitsu Takahashi
- Department of Health Informatics, School of Public Health, Kyoto University, Yoshida-Konoecho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Takeo Nakayama
- Department of Health Informatics, School of Public Health, Kyoto University, Yoshida-Konoecho, Sakyo-ku, Kyoto 606-8501, Japan
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17
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Watanabe H, Saiki H, Chiu SW, Yamaguchi T, Kashihara K, Tsuboi Y, Nomoto M, Hattori N, Maeda T, Shimo Y. Real-World Nonmotor Changes in Patients with Parkinson's Disease and Motor Fluctuations: J-FIRST. Mov Disord Clin Pract 2020; 7:431-439. [PMID: 32373660 PMCID: PMC7197319 DOI: 10.1002/mdc3.12939] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 02/13/2020] [Accepted: 02/20/2020] [Indexed: 11/30/2022] Open
Abstract
Background Nonmotor symptoms (NMSs) of Parkinson's disease (PD) impair health‐related quality of life. Objectives To identify changes in NMSs during 52 weeks in Japanese PD patients exhibiting motor fluctuations. Methods In PD patients with ≥1 NMS and wearing‐off, changes in total/subscore of the Movement Disorder Society Unified PD Rating Scale (MDS‐UPDRS) Part I and 8‐item PD Questionnaire were assessed. Group‐based trajectory models were used to characterize longitudinal patterns of MDS‐UPDRS Part I. Results Data from 996 patients were analyzed. MDS‐UPDRS Part I subscores for cognitive function decreased linearly over time. Total and subscores for apathy and lightheadedness on standing significantly deteriorated with fluctuations, whereas other subscores fluctuated without significant deterioration. Changes in the MDS‐UPDRS Part I total score correlated with changes in the 8‐item PD Questionnaire total score. Based on group‐based trajectory models, longitudinal pattern analysis of MDS‐UPDRS Part I scores yielded the following 3 separate groups: unchanged (63.8%), deteriorated (20.1%), and improved (16.2%). The improved group had significantly more NMSs at baseline, significantly higher MDS‐UPDRS Part I/8‐item PD Questionnaire total scores, and modified Hoehn and Yahr scores, and had received treatment for NMSs. The multivariate analysis revealed significant associations between severe motor disability and receiving any treatment for NMSs at baseline and improvement of MDS‐UPDRS Part I total scores. Conclusions Changes in MDS‐UPDRS Part I scores were variable and related to changes in health‐related quality of life in PD patients with motor fluctuations.
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Affiliation(s)
| | - Hidemoto Saiki
- Department of Neurology, Kitano Hospital The Tazuke Kofukai Medical Research Institute Osaka Japan
| | - Shih-Wei Chiu
- Division of Biostatistics Tohoku University Graduate School of Medicine Miyagi Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics Tohoku University Graduate School of Medicine Miyagi Japan
| | | | - Yoshio Tsuboi
- Department of Neurology, Faculty of Medicine Fukuoka University Fukuoka Japan
| | - Masahiro Nomoto
- Department of Neurology and Clinical Pharmacology Ehime University Graduate School of Medicine Ehime Japan
| | - Nobutaka Hattori
- Department of Neurology Juntendo University School of Medicine Tokyo Japan
| | - Tetsuya Maeda
- Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine Iwate Medical University Iwate Japan.,Department of Neurology and Movement Disorder Research Research Institute for Brain and Blood Vessels-Akita Akita Japan
| | - Yasushi Shimo
- Department of Neurology Juntendo University School of Medicine Tokyo Japan
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Komatsu J, Samuraki M, Nakajima K, Arai H, Arai H, Arai T, Asada T, Fujishiro H, Hanyu H, Iizuka O, Iseki E, Kashihara K, Kosaka K, Maruno H, Mizukami K, Mizuno Y, Mori E, Nakamura H, Nakano S, Nakashima K, Nishio Y, Orimo S, Takahashi A, Taki J, Tokuda T, Urakami K, Utsumi K, Wada K, Washimi Y, Yamashina S, Yamasaki J, Yoshita M, Yamada M. 123I-MIBG myocardial scintigraphy for the diagnosis of DLB: a multicentre 3-year follow-up study. J Neurol Neurosurg Psychiatry 2018; 89:1167-1173. [PMID: 29853532 DOI: 10.1136/jnnp-2017-317398] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 03/26/2018] [Accepted: 05/09/2018] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE We previously reported the usefulness of iodine-123 metaiodobenzylguanidine (123I-MIBG) myocardial scintigraphy for differentiation of dementia with Lewy bodies (DLB) from Alzheimer's disease (AD) in a cross-sectional multicentre study. The aim of this study was, by using reassessed diagnosis after 3-year follow-up, to evaluate the diagnostic accuracy of 123I-MIBG scintigraphy in differentiation of probable DLB from probable AD. METHODS We undertook 3-year follow-up of 133 patients with probable or possible DLB or probable AD who had undergone 123I-MIBG myocardial scintigraphy at baseline. An independent consensus panel made final diagnosis at 3-year follow-up. Based on the final diagnosis, we re-evaluated the diagnostic accuracy of 123I-MIBG scintigraphy performed at baseline. RESULTS Sixty-five patients completed 3-year follow-up assessment. The final diagnoses were probable DLB (n=30), possible DLB (n=3) and probably AD (n=31), and depression (n=1). With a receiver operating characteristic curve analysis of heart-to-mediastinum (H/M) ratios for differentiating probable DLB from probable AD, the sensitivity/specificity were 0.77/0.94 for early images using 2.51 as the threshold of early H/M ratio, and 0.77/0.97 for delayed images using 2.20 as the threshold of delayed H/M ratio. Five of six patients who were diagnosed with possible DLB at baseline and with probable DLB at follow-up had low H/M ratio at baseline. CONCLUSIONS Our follow-up study confirmed high correlation between abnormal cardiac sympathetic activity evaluated with 123I-MIBG myocardial scintigraphy at baseline and the clinical diagnosis of probable DLB at 3-year follow-up. Its diagnostic usefulness in early stage of DLB was suggested. TRIAL REGISTRATION NUMBER UMIN00003419.
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Affiliation(s)
- Junji Komatsu
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Miharu Samuraki
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Kenichi Nakajima
- Department of Nuclear Medicine, Kanazawa University Hospital, Kanazawa, Japan
| | - Heii Arai
- Department of Psychiatry, Juntendo University School of Medicine, Tokyo, Japan
| | - Hiroyuki Arai
- Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Tetsuaki Arai
- Department of Neuropsychiatry, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
| | - Takashi Asada
- Department of Neuropsychiatry, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiroshige Fujishiro
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, Tokyo, Japan
| | - Haruo Hanyu
- Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan
| | - Osamu Iizuka
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Eizo Iseki
- PET/CT Dementia Research Center, Juntendo Tokyo Koto Geriatric Medical Center, Juntendo University School of Medicine, Tokyo, Japan
| | | | - Kenji Kosaka
- Department of Neurology, Medical Care Court Clinic, Yokohama, Japan
| | | | - Katsuyoshi Mizukami
- Faculty of Health and Sport Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Yoshikuni Mizuno
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Etsuro Mori
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroyuki Nakamura
- Department of Environmental and Preventive Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Seigo Nakano
- Center for Treatment, Care and Research of Dementia, Medical Co. LTA, Tokyo, Japan
| | - Kenji Nakashima
- Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Yoshiyuki Nishio
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Orimo
- Department of Neurology, Kanto Central Hospital of the Mutual Aid Association of Public School Teachers, Tokyo, Japan
| | | | - Junichi Taki
- Department of Nuclear Medicine, Kanazawa University Hospital, Kanazawa, Japan
| | - Takahiko Tokuda
- Department of Molecular Pathobiology of Brain Diseases, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Katsuya Urakami
- Department of Biological Regulation, Faculty of Medicine, School of Health Science, Tottori University, Tottori, Japan
| | - Kumiko Utsumi
- Department of Neuropsychiatry, Sunagawa City Medical Center, Sunagawa, Japan
| | - Kenji Wada
- Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Yukihiko Washimi
- Department for Cognitive Disorders, Hospital of National Center for Geriatrics and Gerontology, Toyota, Japan
| | - Shouhei Yamashina
- Division of Cardiovascular Medicine, Department of Internal Medicine, Ohmori Hospital, Toho University School of Medicine, Tokyo, Japan
| | - Junichi Yamasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Ohmori Hospital, Toho University School of Medicine, Tokyo, Japan
| | - Mitsuhiro Yoshita
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.,Department of Neurology, Hokuriku National Hospital, Toyama, Japan
| | - Masahito Yamada
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
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Mikasa M, Kanai K, Li Y, Yoshino H, Mogushi K, Hayashida A, Ikeda A, Kawajiri S, Okuma Y, Kashihara K, Sato T, Kondo H, Funayama M, Nishioka K, Hattori N. COQ2 variants in Parkinson’s disease and multiple system atrophy. J Neural Transm (Vienna) 2018; 125:937-944. [DOI: 10.1007/s00702-018-1885-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 04/08/2018] [Indexed: 12/01/2022]
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Shinoda T, Nakashita S, Hamada M, Hirono K, Ito M, Kashihara K, Miyagi T, Namihira Y, Tokashiki T, Nakashima K, Maeda T. Multi-center observational study of personality and impulse control disorders in Japanese patients with Parkinson’s disease. Parkinsonism Relat Disord 2018. [DOI: 10.1016/j.parkreldis.2017.11.232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Uchida Y, Tachibana H, Kamei Y, Kashihara K. Effectiveness of a simple and real-time baseline shift monitoring system during stereotactic body radiation therapy of lung tumors. Phys Med 2017; 43:100-106. [DOI: 10.1016/j.ejmp.2017.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 10/25/2017] [Accepted: 11/01/2017] [Indexed: 12/25/2022] Open
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22
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Shinoda T, Nakashita S, Hamada M, Nakashima K, Hirono K, Ito M, Kashihara K, Miyagi T, Namihira Y, Tokashiki T, Maeda T. Multi-center observational study of personality and impulse control disorders in Japanese patients with Parkinson’s disease. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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23
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Maeda T, Shimo Y, Chiu SW, Yamaguchi T, Kashihara K, Tsuboi Y, Nomoto M, Hattori N, Watanabe H, Saiki H. Clinical manifestations of nonmotor symptoms in 1021 Japanese Parkinson's disease patients from 35 medical centers. Parkinsonism Relat Disord 2017; 38:54-60. [DOI: 10.1016/j.parkreldis.2017.02.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 12/27/2016] [Accepted: 02/19/2017] [Indexed: 11/17/2022]
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24
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Morihara R, Kono S, Yamashita T, Deguchi K, Manabe Y, Yoshiki T, Kashihara K, Inoue S, Kiriyama H, Abe K. Thrombolysis with tPA 3-4.5 h after acute ischemic stroke in 5 hospital groups in Japan. J Stroke Cerebrovasc Dis 2017. [DOI: 10.1016/j.jstrokecerebrovasdis.2016.11.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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25
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Kashihara K. Neuropsychiatric symptoms in patients with Parkinson's disease. Nihon Rinsho 2017; 75:105-110. [PMID: 30566303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Neuropsychiatric symptoms that occur in patients with Parkinson's disease (PD) include depression, anxiety, apathy, hallucinations, delusions, and behavioral disorders such as pathological gambling, hypersexuality, dopamine dysregulation syndrome, and punding. The risk factors consist of intrinsic, extrinsic, and inducing factors. Intrinsic factors include aging and PD pathology-related neurodegeneration of the central nervous system. Extrinsic factors include the drugs used to manage Parkinsonian symptoms and concomitant medical conditions. Inducing factors include complicated medical conditions such as fever and dehydration, and psychosocial stress such as that following the death of a spouse, moving homes, or hospitalization. Psychiatric symptoms may lower the quality of life of patients and their caregivers. Better management may be attained by understanding risks associated with the patient's background and dealing with them appropriately.
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Kashihara K, Nomura T, Maeda T, Tsuboi Y, Mishima T, Takigawa H, Nakashima K. Beneficial Effects of Ramelteon on Rapid Eye Movement Sleep Behavior Disorder Associated with Parkinson's Disease - Results of a Multicenter Open Trial. Intern Med 2016; 55:231-6. [PMID: 26831015 DOI: 10.2169/internalmedicine.55.5464] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective Melatonin is effective for treating patients with rapid eye movement sleep behavior disorder (RBD). Ramelteon, a novel hypnotic, acts as a melatonin receptor agonist. In the current study, we investigated the effects of ramelteon on sleep disorders, including RBD, in patients with Parkinson's disease (PD). Methods We evaluated 35 patients from multiple centers with idiopathic PD accompanied by sleep disturbances (age: 69.1±11.1 years; 17 men, 18 women; PD morbidity: 6.9±5.7 years; Hoehn & Yahr stage: 2.5±0.8; levodopa dose equivalent: 561±401 mg/day). The patients received 8 mg of ramelteon before sleep once daily for 12 weeks. Motor and sleep symptoms were evaluated both before and after ramelteon administration. Results Of the 35 patients enrolled in this study, 24 (68.6%) were diagnosed with probable RBD (pRBD) using the Japanese version of the RBD screening questionnaire. Ramelteon administration reduced the severity of sleep disturbances in patients with PD. It also lowered scores on the Japanese version of the RBD questionnaire in patients with PD and pRBD. Conclusion Ramelteon may have beneficial effects on sleep disturbances, especially on RBD in patients with PD.
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Kashihara K, Hamaguchi T, Agari T, Takao Y. Long-term effects of STN-DBS on patients with Parkinson's disease suffering from impulse control disorders. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kashihara K. [Treatments for Parkinson's Disease -Essential Knowledge for General Physicians - Topics: IV. Management of Dementia in Parkinson's Disease]. Nihon Naika Gakkai Zasshi 2015; 104:1565-1571. [PMID: 30160423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Kawada S, Hamaguchi T, Kitayama M, Imamura T, Ohno M, Kashihara K, Iwasaki K. Multidetector Computed Tomography Angiography to Detect the Cause of Multiple Brain Infarctions. J Stroke Cerebrovasc Dis 2015; 24:348-53. [DOI: 10.1016/j.jstrokecerebrovasdis.2014.08.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 08/24/2014] [Accepted: 08/27/2014] [Indexed: 11/30/2022] Open
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Kashihara K, Kondo T, Mizuno Y, Kikuchi S, Kuno S, Hasegawa K, Hattori N, Mochizuki H, Mori H, Murata M, Nomoto M, Takahashi R, Takeda A, Tsuboi Y, Ugawa Y, Yamanmoto M, Yokochi F, Yoshii F, Stebbins GT, Tilley BC, Luo S, Wang L, LaPelle NR, Goetz CG. Official Japanese Version of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale: validation against the original English version. Mov Disord Clin Pract 2014; 1:200-212. [PMID: 25328906 DOI: 10.1002/mdc3.12058] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The Movement Disorder Society (MDS)-sponsored revision of the Unified Parkinson's Disease (PD) Rating Scale (UPDRS) (MDS-UPDRS) has been developed and is now available in English. Part of the overall program includes the establishment of official non-English translations of the MDS-UPDRS. We present the process for completing the official Japanese translation of the MDS-UPDRS with clinimetric testing results. METHODS In this trial, the MDS-UPDRS was translated into Japanese, underwent cognitive pre-testing, and the translation was modified after taking the results into account. The final translation was approved as Official Working Draft of the MDS-UPDRS Japanese version and tested in 365 native-Japanese-speaking patients with PD. Confirmatory analyses were used to determine whether the factor structure for the English-language MDS-UPDRS could be confirmed in data collected using the Official Working Draft of the Japanese translation. As a secondary analysis, we used exploratory factor analyses to examine the underlying factor structure without the constraint of a pre-specified factor organization. RESULTS Confirmatory factor analysis revealed that Comparative Fit Index for all Parts of the MDS-UPDRS exceeded the minimal standard of 0.90 relative to the English version and therefore Japanese translation met the pre-specified criterion to be designated called an OFFICIAL MDS TRANSLATION. Secondary analyses revealed some differences between the English-language MDS-UPDRS and the Japanese translation, however, these differences were considered to be within an acceptable range. CONCLUSIONS The Japanese version of the MDS-UPDRS met the criterion as an Official MDS Translation and is now available for use (www.movementdisorders.org).
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Affiliation(s)
| | - Tomoyoshi Kondo
- Department of Neurology, Wakayama Medical University, Wakayama, Japan ; Department of Neurology, Rehabilitation Hananosya Hospital, Tochigi, Japan
| | - Yoshikuni Mizuno
- Department of Neuroregenerative Medicine, Kitasato University School of Medicine, Kanagawa, Japan
| | - Seiji Kikuchi
- Department of Neurology, National Hospital Organization Hokkaido Medical Center, Hokkaido, Japan
| | | | - Kazuko Hasegawa
- Department of Neurology, National Sagamihara Hospital, Kanagawa, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Hideki Mochizuki
- Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hideo Mori
- Department of Neurology, Juntendo University Koshigaya Hospital, Saitama, Japan
| | - Miho Murata
- Department of Neurology, National Center of Neurology and Psychiatry Parkinson Disease and Movement Disorder Center, Tokyo, Japan
| | - Masahiro Nomoto
- Department of Neurology and Clinical Pharmacology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Atsushi Takeda
- Department of Neurology, National Hospital Organization Nishitaga Hospital, Miyagi, Japan
| | - Yoshio Tsuboi
- Department of Neurology, Fukuoka University Medical School, Fukuoka, Japan
| | - Yoshikazu Ugawa
- Department of Neurology, Fukushima Medical University, Fukushima, Japan
| | | | - Fusako Yokochi
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Fumihito Yoshii
- Department of Neurology, Tokai University School of Medicine, Kanagawa, Japan
| | - Glenn T Stebbins
- Department of Neurological Sciences, Rush University Medical Center, Chicago IL, USA
| | - Barbara C Tilley
- Division of Biostatistics, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Sheng Luo
- Division of Biostatistics, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Lu Wang
- Division of Biostatistics, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Nancy R LaPelle
- Division of Preventive and Behavioral Medicine, University of Massachusetts, Worcester, MA, USA
| | - Christopher G Goetz
- Department of Neurological Sciences, Rush University Medical Center, Chicago IL, USA
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Iwasaki K, Haraoka K, Hamaguchi T, Imamura T, Kawada S, Ohno M, Kashihara K. Prevalence of subclinical coronary artery disease in ischemic stroke patients. J Cardiol 2014; 65:71-5. [PMID: 24861913 DOI: 10.1016/j.jjcc.2014.04.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 04/04/2014] [Accepted: 04/09/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Recently, ischemic stroke has emerged as a new coronary artery disease (CAD) risk equivalent. Our purpose is to study the prevalence of CAD in ischemic stroke patients compared with that in non-stroke patients. METHODS AND RESULTS We measured coronary calcium score (CCS) in 151 ischemic stroke patients without known CAD (stroke group) and compared it with 151 age- and sex-matched non-stroke patients (control group). CCS was significantly higher in the stroke group than in the control group (stroke group, median: 64, interquartile range: 3-382 vs. control group, median: 3, interquartile range: 0-65, p<0.0001). High-risk CAD, defined as a CCS≥400, was detected in 24.5% of the stroke group compared with 9.3% of the control group (p<0.0001). Agreement between the Framingham risk score and CCS was found in only 62 patients (41.1%). In a multiple logistic regression analysis, age [hazard ratio (HR) 1.09, 95% confidence interval (CI) 1.03-1.14], diabetes (HR 2.97, 95%CI 1.52-5.78), stroke (HR 3.85, 95%CI 1.89-7.81), and male sex (HR 4.41, 95%CI 1.82-0.75) were significantly associated with high-risk CAD (p<0.001). CONCLUSIONS Our results show that the prevalence of subclinical CAD in ischemic stroke patients was high, and that a quarter of them had high-risk CAD. Age, diabetes, stroke, and male sex were independent predictors of high-risk CAD.
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Affiliation(s)
| | - Kayo Haraoka
- Department of Cardiology, Okayama Kyokuto Hospital, Okayama, Japan
| | | | - Takaki Imamura
- Department of Neurology, Okayama Kyokuto Hospital, Okayama, Japan
| | - Sanami Kawada
- Department of Neurology, Okayama Kyokuto Hospital, Okayama, Japan
| | - Manabu Ohno
- Department of Neurology, Okayama Kyokuto Hospital, Okayama, Japan
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Kawada S, Kashihara K, Imamura T, Ohno M. High-dose intravenous methylprednisolone for the prophylactic treatment of cluster headache. Springerplus 2013; 2:156. [PMID: 23667809 PMCID: PMC3647094 DOI: 10.1186/2193-1801-2-156] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 03/10/2013] [Indexed: 11/13/2022]
Abstract
Background Triptans are effective for immediate relief of episodic cluster headache (CH) but do not reduce the frequency of attacks. Intravenous bolus injection of corticosteroids like methylprednisolone (MP) has been reported to decrease the frequency of CH attacks. We validated the prophylactic efficacy of MP pulse therapy by monitoring CH recurrence over several years following treatment of six consecutive male patients (mean age: 38.8 years, range: 26–54 years) afflicted by frequent (often daily) CH attacks. Findings Total MP dose per infusion was 250–500 mg for five patients and 125 mg for the sixth (a diabetic). High-dose MP was administered for 2 or 3 consecutive days in hospital for the first two patients treated. The next four patients received a single bolus injection at presentation, and in some cases a second injection days later at an outpatient clinic. The first two cases treated were also prescribed daily oral prednisolone for at most 6 months while the latter four cases were not. The frequency of CH attacks was markedly reduced in all patients, with intervals between attacks ranging from 4 to 23 months. We noted no apparent adverse events following MP administration. Conclusions High-dose MP therapy reduced CH attack frequency and improved patient quality of life.
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Affiliation(s)
- Sanami Kawada
- Department of Neurology, Okayama Kyokuto Hospital, 567-1 Kurata, Naka-ku, Okayama, 703-8265 Japan
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Kono S, Deguchi K, Morimoto N, Kurata T, Deguchi S, Yamashita T, Ikeda Y, Matsuura T, Narai H, Omori N, Manabe Y, Yunoki T, Takao Y, Kawata S, Kashihara K, Abe K. Tissue Plasminogen Activator Thrombolytic Therapy for Acute Ischemic Stroke in 4 Hospital Groups in Japan. J Stroke Cerebrovasc Dis 2013; 22:190-6. [DOI: 10.1016/j.jstrokecerebrovasdis.2011.07.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Revised: 06/22/2011] [Accepted: 07/21/2011] [Indexed: 10/17/2022] Open
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Kono S, Deguchi K, Morimoto N, Kurata T, Yamashita T, Ikeda Y, Narai H, Manabe Y, Takao Y, Kawada S, Kashihara K, Takehisa Y, Inoue S, Kiriyama H, Abe K. Intravenous thrombolysis with neuroprotective therapy by edaravone for ischemic stroke patients older than 80 years of age. J Stroke Cerebrovasc Dis 2013; 22:1175-83. [PMID: 23507462 DOI: 10.1016/j.jstrokecerebrovasdis.2013.02.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2012] [Revised: 12/17/2012] [Accepted: 02/05/2013] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Alteplase, a recombinant tissue plasminogen activator (tPA), was approved for patients with acute ischemic stroke within 3 hours of stroke onset in Japan in October 2005 at a dose of 0.6 mg/kg. The aim of this study was to assess the safety and efficacy of alteplase in elderly patients in Japan. METHODS One hundred twenty-nine consecutive patients who were admitted to our 5 hospital groups and who received intravenous tPA within 3 hours of stroke onset between January 2010 and December 2011 were divided into 2 groups by age (<80 years of age [younger group] and >80 years of age [older group]) and by treatment with or without edaravone. Clinical backgrounds and outcomes were investigated. RESULTS The National Institutes of Health Stroke Scale score on admission was not different in both groups, but the National Institutes of Health Stroke Scale scores 7 days after stroke onset were significantly higher in the older group (score 8; P < .05) than in the younger group (score 4), and the ratio of patients with a modified Rankin Scale score of 4 to 6 was significantly greater in the older group (41.7%; P < .05) than in the younger group (22.2%). However, there was no difference in asymptomatic and symptomatic intracerebral hemorrhage rates between the younger and older groups (asymptomatic 20.2% v 18.8%; symptomatic 2.6% v 2.1%). Patients with edaravone showed a higher recanalization rate (61.9%; P < .01) and a better modified Rankin Scale score at 3 months poststroke (P < .01) than the nonedaravone group. CONCLUSIONS These data suggest that intravenous alteplase (0.6 mg/kg) within 3 hours of stroke onset was safe and effective, even for very old patients (≥ 80 years of age), but resulted in poor outcomes relating not to tPA but to aging. In addition, edaravone may be a good partner for combination therapy with tPA to enhance recanalization and reduce hemorrhagic transformation.
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Affiliation(s)
- Syoichiro Kono
- Department of Neurology at the Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
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Kashihara K. Postural disorders in Parkinson’s disease: clinical characteristics, frequency, pathophysiology and management. Neurodegener Dis Manag 2012. [DOI: 10.2217/nmt.12.69] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY Postural disorders are frequently observed in Parkinson’s disease patients and significantly affect patients’ quality of life. They may develop because of increased muscle tonus, which results in shortened muscle fibers and induces contracted postures and subsequent changes in muscles, connective tissue, bones and peripheral nerves. Enhanced muscle tonus may induce forward and/or lateral flexion of the spine. Abnormal postures usually occur in the middle or later stages of the disease, and are often reversible in the supine position. Forward flexion, lateral flexion and, less frequently, antecollis are the common axial postural disorders in Parkinson’s disease patients. While antiparkinsonian drugs may improve these symptoms, they may also induce or worsen them. As postural disorders become irreversible after the development of secondary changes, such as muscle atrophy and bone fracture, physicians should recognize postural disorders at early stages.
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Affiliation(s)
- Kenichi Kashihara
- Department of Neurology, Okayama Kyokuto Hospital, 567-1 Kurata, Naka-ku, Okayama 703-8265, Japan
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Ando M, Funayama M, Li Y, Kashihara K, Murakami Y, Ishizu N, Toyoda C, Noguchi K, Hashimoto T, Nakano N, Sasaki R, Kokubo Y, Kuzuhara S, Ogaki K, Yamashita C, Yoshino H, Hatano T, Tomiyama H, Hattori N. VPS35 mutation in Japanese patients with typical Parkinson's disease. Mov Disord 2012; 27:1413-7. [PMID: 22991136 DOI: 10.1002/mds.25145] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Revised: 07/11/2012] [Accepted: 07/17/2012] [Indexed: 11/07/2022] Open
Abstract
Vacuolar protein sorting 35 (VPS35) was recently reported to be a pathogenic gene for late-onset autosomal dominant Parkinson's disease (PD), using exome sequencing. To date, VPS35 mutations have been detected only in whites with PD. The aim of the present study was to determine the incidence and clinical features of Asian PD patients with VPS35 mutations. We screened 7 reported nonsynonymous missense variants of VPS35, including p.D620N, known as potentially disease-associated variants of PD, in 300 Japanese index patients with autosomal dominant PD and 433 patients with sporadic PD (SPD) by direct sequencing or high-resolution melting (HRM) analysis. In addition, we screened 579 controls for the p.D620N mutation by HRM analysis. The p.D620N mutation was detected in 3 patients with autosomal dominant PD (1.0%), in 1 patient with SPD (0.23%), and in no controls. None of the other reported variants of VPS35 were detected. Haplotype analysis suggested at least 3 independent founders for Japanese patients with p.D620N mutation. Patients with the VPS35 mutation showed typical tremor-predominant PD. We report Asian PD patients with the VPS35 mutation. Although VPS35 mutations are uncommon in PD, the frequency of such mutation is relatively higher in Japanese than reported in other populations. In VPS35, p.D620N substitution may be a mutational hot spot across different ethnic populations. Based on the clinical features, VPS35 should be analyzed in patients with PD, especially autosomal dominant PD or tremor-predominant PD.
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Affiliation(s)
- Maya Ando
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
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Uchida Y, Tachibana H, Takada Y, Kashihara K, Yamashita T. SU-E-J-165: Development of a Low-Cost and Clinically Available Patient Intrafraction Motion Monitoring System. Med Phys 2012; 39:3690. [DOI: 10.1118/1.4735004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Kashihara K, Imamura T. Clinical correlates of anterior and lateral flexion of the thoracolumbar spine and dropped head in patients with Parkinson’s disease. Parkinsonism Relat Disord 2012; 18:290-3. [PMID: 22119504 DOI: 10.1016/j.parkreldis.2011.11.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2011] [Revised: 11/08/2011] [Accepted: 11/09/2011] [Indexed: 11/18/2022]
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Tsujino K, Kashihara K, Kotani S, Hayakawa K, Imanaka K, Takada Y, Uno T, Hirata H, Kaneyasu Y, Sekiguchi K, Ogo E, Hiratsuka J, Yoden E, Soejima T. A survey of patients with inflammatory skin recurrence corresponding to the area of previous irradiation after postoperative radiotherapy for breast cancer. J Radiat Res 2011; 52:797-803. [PMID: 21997194 DOI: 10.1269/jrr.11010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
One of the unusual patterns of local recurrence in breast cancer patient is an inflammatory skin recurrence (ISR) sharply demarcating the area of previous radiation fields. To clarify the characteristics of this recurrence, we conducted a nationwide survey. We sent a survey to radiation oncologists at 200 institutions in Japan and received answers from 92. Of these, 24 institutions had some experience with patients who developed ISR affecting the previously irradiated area. The case details of 16 patients from 11 institutions were available and analyzed in this study. Eight patients experienced ISR after breast conservative therapy (groupA) and 8 patients experienced ISR after post-mastectomy radiotherapy (groupB). The postoperative pathological examination of groups A and B showed positive axillary lymph-nodes in 7/8 and 8/8 patients, positive lymphatic invasion in 4/7 and 7/8 patients, and ER status negative in 7/8 and 6/7 patients respectively. Median survival period was 266 days in groupA and 1105 days in groupB (p = 0.0001). Patients who developed the ISR tended to have several characteristics, including positive lymph-node metastases, intensive lymphatic invasion, and ER status negative. Physicians should contemplate the diagnosis of ISR next to radiation recall or radiation dermatitis, especially when the aforementioned risk factors are present.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Breast Neoplasms/radiotherapy
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/etiology
- Carcinoma, Ductal, Breast/radiotherapy
- Carcinoma, Ductal, Breast/secondary
- Carcinoma, Ductal, Breast/surgery
- Data Collection
- Female
- Humans
- Inflammatory Breast Neoplasms/etiology
- Inflammatory Breast Neoplasms/pathology
- Japan
- Lymphatic Metastasis
- Mastectomy
- Middle Aged
- Neoplasm Recurrence, Local/etiology
- Neoplasm Recurrence, Local/pathology
- Skin Neoplasms/etiology
- Skin Neoplasms/pathology
- Skin Neoplasms/secondary
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Affiliation(s)
- Kayoko Tsujino
- Department of Radiation Oncology, Hyogo Cancer Center, Akashi-city, Hyogo 673-8558, Japan.
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Kashihara K, Shinya T, Higaki F. Neuromelanin magnetic resonance imaging of nigral volume loss in patients with Parkinson’s disease. J Clin Neurosci 2011; 18:1093-6. [DOI: 10.1016/j.jocn.2010.08.043] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Revised: 04/04/2010] [Accepted: 08/07/2010] [Indexed: 10/18/2022]
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Abstract
OBJECTIVE Patients with Parkinson's disease (PD) frequently complain of a diminished sense of smell. Less frequently, they may complain of taste impairment. In the present study, we investigated the symptoms, frequency, and severity of taste impairment as well as smell impairment in PD patients and compared the results with those of age- and sex-matched healthy controls. PATIENTS AND METHODS We interviewed 285 PD patients (120 men, 165 women) without dementia or nasal problems. Control subjects comprised 61 (20 men, 41 women) healthy spouses of the PD patients. Alteration of smell and taste sense lasting more than 3 months was defined as abnormal. RESULTS One hundred and sixteen patients with PD complained of smell impairment and 26 complained of taste impairment. Only 5 controls complained of smell impairment, and no control subjects reported taste impairment. Taste impairment was more marked in patients with smell impairment. Impaired taste included diminished taste perception in 21 patients, altered sense of taste in 4 patients and burning mouth in 1 patient. CONCLUSION Taste as well as smell perception is impaired in patients with PD. The frequency of smell and taste impairments tended to increase with disease progression.
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Abstract
OBJECTIVE Diseases presenting extrapyramidal symptoms are accompanied by nigral cell loss. In the previous study, we demonstrated the reduction of the neuromelanin-positive volume of substantia nigra (SN) pars compacta (SNc) in patients with Parkinson's disease (PD) using 3-Tesla MRI. In the present study we investigated the neuromelanin-positive SNc volume in patients with the other parkinsonian disorders including multiple system atrophy (MSA), progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) and compared the results with those with PD, spinocerebellar ataxia (SCA) and controls. PATIENTS AND METHODS Axial T1-weighted (T1W) images were obtained with a 3-Tesla MRI scanner. The border of the neuromelanin-positive region of the SNc was traced manually on these images with a pentablet pointing device and the SNc volume was calculated. The SNc volumes of 28 patients with MSA, 11 patients with PSP and 10 patients with CBD were compared with those of 80 patients with PD, 9 patients with SCA and 54 patients who had suffered mild acute ischemic stroke as controls. The mean volumes for the left and right SN were used for statistical analyses. RESULTS The volumes of the neuromelanin-positive SNc region in patients with MSA, PSP and CBD, but not SCA were reduced to the same extent as PD patients compared with controls. CONCLUSION Reduced volume of the neuromelanin-positive SNc region of patients with MSA, PSP and CBD was detected by neuromelanin MR imaging. Volumetric evaluation of neuromelanin MR imaging may provide a biomarker of nigral degeneration in patients with MSA, PSP and CBD as in patients with PD.
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Kashihara K, Imamura T, Shinya T. Cardiac 123I-MIBG uptake is reduced more markedly in patients with REM sleep behavior disorder than in those with early stage Parkinson's disease. Parkinsonism Relat Disord 2010; 16:252-5. [DOI: 10.1016/j.parkreldis.2009.12.010] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2009] [Revised: 12/22/2009] [Accepted: 12/24/2009] [Indexed: 11/29/2022]
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Tsujino K, Kashihara K, Kotani S, Imanaka K, Takada Y, Uno T, Hirata H, Kaneyasu Y, Sekiguchi K, Ogo E. A Survey of the Inflammatory Skin Recurrence Corresponding to the Area of Previous Irradiation after Postoperative Radiotherapy for Breast Cancer. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hiraoka A, Horiike N, Yamashita Y, Koizumi Y, Doi H, Yamamoto Y, Ichikawa S, Hasebe A, Yano M, Miyamoto Y, Ninomiya T, Ootani H, Takamura K, Kawasaki H, Otomi Y, Kogame M, Sogabe I, Ishimaru Y, Kashihara K, Miyagawa M, Hirooka M, Hiasa Y, Matsuura B, Michitaka K, Onji M. Risk factors for death in 224 cases of hepatocellular carcinoma after transcatheter arterial chemoembolization. Hepatogastroenterology 2009; 56:213-217. [PMID: 19453060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND/AIMS Transcatheter arterial chemoembolization (TACE) has been reported as effective therapy for unresectable hepatocellular carcinoma (HCC), however, few have described methods for predicting prognosis, especially in patients treated by repeated TACE. To determine risk factors for death and try to predict the prognosis, we evaluated clinical data. METHODOLOGY We retrospectively analyzed the clinical parameters of 224 patients with unresectable HCC treated with repeated TACE from January 1997 to December 2007. TACE was repeated when recurrence was diagnosed by tumor marker elevation and/or dynamic computed tomography findings. Factors affecting survival were evaluated using multivariate analysis after univariate analysis. Next, we combined the score for each significant factor into a single prognostic score and added up the positive factors in each case, then analyzed the significance of prognosis, after which the results were compared with other prognostic scoring systems. RESULTS Multivariate analysis revealed that bilobular HCC, alpha-fetoprotein (> or = 400 ng/ml), tumor invasion of the portal vein, tumor size (> or = 10 cm), and albumin (< 2.8 g/dl) were related to poor prognosis, and developed a prognostic scoring system from those. According to that score, patients were classified into 5 groups. CONCLUSION Our scoring system was easily performed and the results showed that repeated TACE should not be administered to patients with scores of 3 or more.
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Affiliation(s)
- Atsushi Hiraoka
- Department of Gastroenterology, Ehime Prefectural Central Hospital, Ehime, Japan.
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Hiraoka A, Horiike N, Yamashita Y, Koizumi Y, Doi K, Yamamoto Y, Hasebe A, Ichikawa S, Yano M, Miyamoto Y, Ninomiya T, Otomi Y, Kokame M, Iwamura T, Ishimaru Y, Sogabe I, Kashihara K, Nishiura S, Ootani H, Takamura K, Kawasaki H. Efficacy of radiofrequency ablation therapy compared to surgical resection in 164 patients in Japan with single hepatocellular carcinoma smaller than 3 cm, along with report of complications. Hepatogastroenterology 2008; 55:2171-2174. [PMID: 19260499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND/AIMS Radiofrequency ablation therapy (RFA) has become widely used against hepatocellular carcinoma (HCC), mainly because of its ease of use, lower level of invasiveness, and high level of effectiveness. To compare the efficacy and safety of RFA with surgery, we retrospectively investigated relevant patient clinical data. METHODOLOGY The patients with a single HCC (3 cm > or =, Child-Pugh A or B) who were treated with RFA (RFA-group: n=105) or surgery (Surgery-group: n=59) from January 2000 to June 2007 were enrolled. RESULTS The ratio of patients classified as Child-Pugh B was greater in RFA-group (24.8% vs. 8.5%, P=0.011), though the sizes of the tumors were not significantly different. There were no significant differences for survival rates or disease free survival rates after 3- and 5-years (RFA-group vs. Surgery-group; survival: 87.8 and 59.3% vs. 91.4 and 59.4%, disease free survival: 58.7 and 24.6% vs. 64.3 and 22.4%, respectively). As for complications, in RFA-group there was no severe complication while there was 1 case of postoperative hepatic failure death and 2 with a postoperative abscess in Surgery-group. CONCLUSIONS In the present study, patients with a single HCC smaller than 3cm who underwent RFA had a lower frequency of severe complications, thus the efficacy of RFA was thought to be equal to a surgical procedure.
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Affiliation(s)
- Atsushi Hiraoka
- Department of Gastroenterology, Ehime Prefectural Central Hospital, Ehime, Japan.
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Abstract
Nocturnal vocalization is frequent in Parkinson's disease patients with rapid eye movement (REM) sleep behaviour disorder (RBD). We investigated the frequency of nocturnal vocalization and other sleep problems in patients with pure autonomic failure (PAF) and compared the results with idiopathic Parkinson's disease (IPD) and dementia with Lewy bodies (DLB). We interviewed consecutive patient-caregiver pairs with PAF (n = 13), IPD (n = 200) and DLB (n = 19), and ischaemic stroke patients (controls, n = 43). Nocturnal vocalization was similarly frequent in PAF, IPD and DLB. Other dream enactments and vivid dreams also were more frequent in PAF, IPD and DLB compared with controls. Excessive night-time awakenings and daytime sleepiness were frequent in IPD but rare in PAF and controls. Clinical manifestation of sleep disturbances, at least of RBD-like symptoms including nocturnal vocalization and other dream enactments, may occur in PAF, as in IPD and DLB.
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Affiliation(s)
- K Kashihara
- Department of Neurology, Okayama Kyokuto Hospital, 567-1 Kuraka, Okayama, Japan.
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Kumazawa R, Tomiyama H, Li Y, Imamichi Y, Funayama M, Yoshino H, Yokochi F, Fukusako T, Takehisa Y, Kashihara K, Kondo T, Elibol B, Bostantjopoulou S, Toda T, Takahashi H, Yoshii F, Mizuno Y, Hattori N. Mutation analysis of the PINK1 gene in 391 patients with Parkinson disease. ACTA ACUST UNITED AC 2008; 65:802-8. [PMID: 18541801 DOI: 10.1001/archneur.65.6.802] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES To determine the frequency, distribution, and clinical features of Parkinson disease (PD) with PINK1 mutations. DESIGN Retrospective clinical and genetic review. SETTING University hospital. PATIENTS We performed extensive mutation analyses of PINK1 in 414 PD patients negative for parkin mutations (mean [SD] age at onset, 42.8 [14.3] years), including 391 unrelated patients (190 patients with sporadic PD and 201 probands of patients with familial PD) from 13 countries. RESULTS We found 10 patients with PD from 9 families with PINK1 mutations and identified 7 novel mutations (2 homozygous mutations [p.D297MfsX22 and p.W437R] and 5 single heterozygous mutations [p.A78V, p.P196QfsX25, p.M342V, p.W437R, and p.N542S]). No compound heterozygous mutations were found. The frequency of homozygous mutations was 4.26% (2 of 47) in families with autosomal recessive PD and 0.53% (1 of 190) in patients with sporadic PD. The frequency of heterozygous mutations was 1.89% (2 of 106) in families with potential autosomal dominant PD and 1.05% (2 of 190) in patients with sporadic PD. The mean (SD) age at onset in patients with single heterozygous mutations (53.6 [11.1] years; range, 39-69 years) was higher than that in patients with homozygous mutations (34.0 [20.3] years; range, 10-55 years). Myocardial iodine-123 metaiodobenzylguanidine uptake was low in patients with heterozygous mutations but not in those with homozygous mutations. CONCLUSIONS Our results suggest that homozygous PINK1 mutations tend to be diagnosed as the early-onset autosomal recessive form of PD. Single heterozygous mutations may contribute to the development of sporadic PD and also could be an additional genetic predisposition for developing familial PD. The reduced myocardial iodine-123 metaiodobenzylguanidine uptake observed in patients with single heterozygous PINK1 mutations is similar to that seen in patients with sporadic PD.
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Affiliation(s)
- Ryuya Kumazawa
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
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Abstract
Punding, complex stereotyped behavior, sometimes occurs in patients with Parkinson's disease under dopaminergic replacement therapy. Reduction of dopaminergic drugs may reduce the problem but risks enhancing motor impairment. We report a patient with Parkinson's disease presenting disabling punding, which was reversed by amantadine without aggravating motor function. Amantadine may reduce punding by blocking NMDA receptors, in the same manner as in levodopa-induced dyskinesias.
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Affiliation(s)
- Kenichi Kashihara
- Department of Neurology, Okayama Kyokuto Hospital, Kurata, Okayama, Japan.
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