1
|
Kainuma M, Kawakatsu S, Kim JD, Ouma S, Iritani O, Yamashita KI, Ohara T, Hirano S, Suda S, Hamano T, Hieda S, Yasui M, Yoshiiwa A, Shiota S, Hironishi M, Wada-Isoe K, Sasabayashi D, Yamasaki S, Murata M, Funakoshi K, Hayashi K, Shirafuji N, Sasaki H, Kajimoto Y, Mori Y, Suzuki M, Ito H, Ono K, Tsuboi Y. Metabolic changes in the plasma of mild Alzheimer's disease patients treated with Hachimijiogan. Front Pharmacol 2023; 14:1203349. [PMID: 37377927 PMCID: PMC10292017 DOI: 10.3389/fphar.2023.1203349] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
Background: Alzheimer's disease (AD), the most prevalent form of dementia, is a debilitating, progressive neurodegeneration. Amino acids play a wide variety of physiological and pathophysiological roles in the nervous system, and their levels and disorders related to their synthesis have been related to cognitive impairment, the core feature of AD. Our previous multicenter trial showed that hachimijiogan (HJG), a traditional Japanese herbal medicine (Kampo), has an adjuvant effect for Acetylcholine estelase inhibitors (AChEIs) and that it delays the deterioration of the cognitive dysfunction of female patients with mild AD. However, there are aspects of the molecular mechanism(s) by which HJG improves cognitive dysfunction that remain unclear. Objectives: To elucidate through metabolomic analysis the mechanism(s) of HJG for mild AD based on changes in plasma metabolites. Methods: Sixty-seven patients with mild AD were randomly assigned to either an HJG group taking HJG extract 7.5 g/day in addition to AChEI or to a control group treated only with AChEI (HJG:33, Control:34). Blood samples were collected before, 3 months, and 6 months after the first drug administration. Comprehensive metabolomic analyses of plasma samples were done by optimized LC-MS/MS and GC-MS/MS methods. The web-based software MetaboAnalyst 5.0 was used for partial least square-discriminant analysis (PLS-DA) to visualize and compare the dynamics of changes in the concentrations of the identified metabolites. Results: The VIP (Variable Importance in Projection) score of the PLS-DA analysis of female participants revealed a significantly higher increase in plasma metabolite levels after HJG administration for 6 months than was seen in the control group. In univariate analysis, the aspartic acid level of female participants showed a significantly higher increase from baseline after HJG administration for 6 months when compared with the control group. Conclusion: Aspartic acid was a major contributor to the difference between the female HJG and control group participants of this study. Several metabolites were shown to be related to the mechanism of HJG effectiveness for mild AD.
Collapse
Affiliation(s)
- Mosaburo Kainuma
- Department of Japanese Oriental Medicine Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Shinobu Kawakatsu
- Aizu Medical Center, Department of Neuropsychiatry, Fukushima Medical University, Aizuwakamatsu, Japan
| | - Jun-Dal Kim
- Department of Research and Development, Division of Complex Biosystem Research (CBR), Institute of National Medicine (INM), University of Toyama, Toyama, Japan
| | - Shinji Ouma
- Department of Neurology, School of Medicine, Fukuoka University, Fukuoka, Japan
| | - Osamu Iritani
- Department of Geriatric Medicine, Kanazawa Medical University, Ishikawa, Japan
| | - Ken-Ichiro Yamashita
- Translational Neuroscience Center, Graduate School of Medicine, International University of Health and Welfare, Tochigi, Japan
| | - Tomoyuki Ohara
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shigeki Hirano
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shiro Suda
- Department of Psychiatry, Jichi Medical University, Tochigi, Japan
| | - Tadanori Hamano
- Second Department of Internal Medicine, Division of Neurology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Sotaro Hieda
- Department of Medicine, Division of Neurology, Showa University School of Medicine, Tokyo, Japan
| | - Masaaki Yasui
- Department of Neurology, Wakayama Medical University, Wakayama, Japan
| | - Aoi Yoshiiwa
- Department of General Medicine, Oita University Faculty of Medicine, Oita, Japan
| | - Seiji Shiota
- Department of General Medicine, Oita University Faculty of Medicine, Oita, Japan
| | - Masaya Hironishi
- Department of Internal Medicine, Wakayama Medical University Kihoku Hospital, Wakayama, Japan
| | - Kenji Wada-Isoe
- Department of Dementia Medicine, Kawasaki Medical School, Okayama, Japan
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Sho Yamasaki
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Masayuki Murata
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Kouta Funakoshi
- Department of Clinical Research Promotion, Kyushu University Hospital, Fukuoka, Japan
| | - Kouji Hayashi
- Department of Rehabilitation, Fukui Health Science University, Fukui, Japan
| | - Norimichi Shirafuji
- Second Department of Internal Medicine, Division of Neurology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hirohito Sasaki
- Second Department of Internal Medicine, Division of Neurology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yoshinori Kajimoto
- Department of Internal Medicine, Wakayama Medical University Kihoku Hospital, Wakayama, Japan
| | - Yukiko Mori
- Department of Medicine, Division of Neurology, Showa University School of Medicine, Tokyo, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Hidefumi Ito
- Department of Neurology, Wakayama Medical University, Wakayama, Japan
| | - Kenjiro Ono
- Department of Neurology, Kanazawa University Graduate School of Medical Sciences, Ishikawa, Japan
| | - Yoshio Tsuboi
- Department of Neurology, School of Medicine, Fukuoka University, Fukuoka, Japan
| |
Collapse
|
2
|
Kuroda T, Ono K, Honma M, Asano M, Mori Y, Futamura A, Yano S, Kanemoto M, Hieda S, Baba Y, Izumizaki M, Murakami H. Cerebral white matter lesions and regional blood flow are associated with reduced cognitive function in early-stage cognitive impairment. Front Aging Neurosci 2023; 15:1126618. [PMID: 36875693 PMCID: PMC9978183 DOI: 10.3389/fnagi.2023.1126618] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 02/01/2023] [Indexed: 02/18/2023] Open
Abstract
Background Differences in the extent of cerebral white matter lesions (WML) and regional cerebral blood flow (rCBF) in early-stage cognitive impairment (ESCI) contribute to the prognosis of cognitive decline; however, it is unclear precisely how WML and rCBF affect cognitive decline in ESCI. Objective We examined the association between WML, rCBF, and cognitive impairment in the ESCI, using path analysis to clarify how these variables affect each other. Methods Eighty-three patients who consulted our memory clinic regarding memory loss were included in this study based on the Clinical Dementia Rating. Participants underwent the Mini-Mental State Examination (MMSE), brain magnetic resonance imaging (MRI) for voxel-based morphometry analysis, and brain perfusion single-photon emission computed tomography (SPECT) for rCBF evaluation in cortical regions, using 3D stereotactic surface projection (3D-SSP) analysis. Results Path analysis was performed on the MRI voxel-based morphometry and SPECT 3D-SSP data, showing a significant correlation between both and MMSE scores. In the most suitable model (GFI = 0.957), correlations were observed between lateral ventricular (LV-V) and periventricular WML (PvWML-V) volumes [standardized coefficient (SC) = 0.326, p = 0.005], LV-V and rCBF of the anterior cingulate gyrus (ACG-rCBF; SC = 0.395, p < 0.0001), and ACG-rCBF and PvWML-V (SC = 0.231, p = 0.041). Furthermore, a direct relationship between PvWML-V and MMSE scores was identified (SC = -0.238, p = 0.026). Conclusion Significant interrelationships were observed among the LV-V, PvWML-V, and ACG-rCBF that directly affected the MMSE score in the ESCI. The mechanisms behind these interactions and the impact of PvWML-V on cognitive function require further investigation.
Collapse
Affiliation(s)
- Takeshi Kuroda
- Department of Neurology, Showa University School of Medicine, Tokyo, Japan
| | - Kenjiro Ono
- Department of Neurology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Motoyasu Honma
- Department of Physiology, Showa University School of Medicine, Tokyo, Japan
| | - Miki Asano
- Department of Neurology, Showa University School of Medicine, Tokyo, Japan
| | - Yukiko Mori
- Department of Neurology, Showa University School of Medicine, Tokyo, Japan
| | - Akinori Futamura
- Department of Neurology, Showa University Fujigaoka Hospital, Kanagawa, Japan
| | - Satoshi Yano
- Department of Neurology, Showa University School of Medicine, Tokyo, Japan
| | - Mizuki Kanemoto
- Department of Neurology, Showa University School of Medicine, Tokyo, Japan
| | - Sotaro Hieda
- Department of Neurology, Showa University School of Medicine, Tokyo, Japan
| | - Yasuhiko Baba
- Department of Neurology, Showa University Fujigaoka Hospital, Kanagawa, Japan
| | - Masahiko Izumizaki
- Department of Physiology, Showa University School of Medicine, Tokyo, Japan
| | - Hidetomo Murakami
- Department of Neurology, Showa University School of Medicine, Tokyo, Japan
| |
Collapse
|
3
|
Kainuma M, Ouma S, Kawakatsu S, Iritani O, Yamashita KI, Ohara T, Hirano S, Suda S, Hamano T, Hieda S, Yasui M, Yoshiiwa A, Shiota S, Hironishi M, Wada-Isoe K, Sasabayashi D, Yamasaki S, Murata M, Funakoshi K, Hayashi K, Shirafuji N, Sasaki H, Kajimoto Y, Mori Y, Suzuki M, Ito H, Ono K, Tsuboi Y. An exploratory, open-label, randomized, multicenter trial of hachimijiogan for mild Alzheimer’s disease. Front Pharmacol 2022; 13:991982. [PMID: 36313371 PMCID: PMC9616163 DOI: 10.3389/fphar.2022.991982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 07/12/2022] [Accepted: 09/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Alzheimer’s disease (AD) is a progressive neurodegeneration and is the most prevalent form of dementia. Intervention at an early stage is imperative. Although three acetylcholinesterase inhibitors (AChEIs) are currently approved for the treatment of mild AD, they are not sufficiently effective. Novel treatments for mild AD are of utmost importance. Objective: To assess the effectiveness of hachimijiogan (HJG), a traditional Japanese herbal medicine (Kampo), in the treatment of mild AD. Methods: This exploratory, open-label, randomized, multicenter trial enrolled patients with mild AD whose score on the Mini Mental State Examination (MMSE) was over 21points. All participants had been taking the same dosage of AChEI for more than 3 months. The participants were randomly assigned to an HJG group taking HJG extract 7.5 g/day in addition to AChEI or to a control group treated only with AChEI. The primary outcome was the change from baseline to 6 months post treatment initiation on the Alzheimer’s Disease Assessment Scale-cognitive component- Japanese version(ADAS-Jcog). The secondary outcomes were change from baseline of the Instrumental Activity of Daily Life (IADL), Apathy scale, and Neuropsychiatric Inventory (NPI) -Q score. Results: Among the 77 enrollees, the data of 69(34 HJG and 35 control)were available for analysis. The difference in the change of ADAS-Jcog from baseline to 6 months of the HJG and control groups was 1.29 (90% Confidence interval (CI), −0.74 to 3.32 p = 0.293). In the subgroup analysis, the differences in the change from baseline to 3 and 6 months for women were 3.70 (90% CI ,0.50 to 6.91, p = 0.059) and 2.90 (90% CI,0.09 to 5.71, p = 0.090), respectively. For patients over 65 years, the difference at 3 months was 2.35 (90%CI, 0.01 to 4.68 p = 0.099). No significant differences were found between the HJG and control groups in IADL score, Apathy scale, or NPI-Q score. Conclusion: Although not conclusive, our data indicate that HJG has an adjuvant effect for acetylcholinesterase inhibitors and that it delays the deterioration of the cognitive dysfunction of mild Altzheimer’s disease patients. Clinical Trial Registration:http://clinicaltrials.gov Japan Registry of clinical trials, identifier jRCTs 071190018
Collapse
Affiliation(s)
- Mosaburo Kainuma
- Department of Japanese Oriental Medicine, Toyama University Hospital, Toyama, Japan
- *Correspondence: Mosaburo Kainuma,
| | - Shinji Ouma
- Department of Neurology, School of Medicine, Fukuoka University, Fukuoka, Japan
| | - Shinobu Kawakatsu
- Department of Neuropsychiatry, Aizu Medical Center, Fukushima Medical University, Aizuwakamatsu, Japan
| | - Osamu Iritani
- Department of Geriatric Medicine, Kanazawa Medical University, Kanazawa, Ishikawa, Japan
| | - Ken-Ichiro Yamashita
- Translational Neuroscience Center, Graduate School of Medicine, International University of Health and Welfare, Tochigi, Japan
| | - Tomoyuki Ohara
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shigeki Hirano
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shiro Suda
- Department of Psychiatry, Jichi Medical University, Tochigi, Japan
| | - Tadanori Hamano
- Division of Neurology, Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Sotaro Hieda
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Masaaki Yasui
- Department of Neurology, Wakayama Medical University, Wakayama, Japan
| | - Aoi Yoshiiwa
- Department of General Medicine, Oita UniversityFaculty of Medicine, Oita, Japan
| | - Seiji Shiota
- Department of General Medicine, Oita UniversityFaculty of Medicine, Oita, Japan
| | - Masaya Hironishi
- Department of Internal Medicine, Wakayama Medical University Kihoku Hospital, Wakayama, Japan
| | - Kenji Wada-Isoe
- Department of Dementia Medicine, Kawasaki Medical School, Okayama, Japan
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Sho Yamasaki
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Masayuki Murata
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Kouta Funakoshi
- Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, Japan
| | - Kouji Hayashi
- Department of Rehabilitation, Fukui Health Science University, Fukui, Japan
| | - Norimichi Shirafuji
- Division of Neurology, Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hirohito Sasaki
- Division of Neurology, Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yoshinori Kajimoto
- Department of Internal Medicine, Wakayama Medical University Kihoku Hospital, Wakayama, Japan
| | - Yukiko Mori
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Hidefumi Ito
- Department of Neurology, Wakayama Medical University, Wakayama, Japan
| | - Kenjiro Ono
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
- Department of Neurology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, Japan
| | - Yoshio Tsuboi
- Department of Neurology, School of Medicine, Fukuoka University, Fukuoka, Japan
| |
Collapse
|
4
|
Kuroda T, Honma M, Mori Y, Futamura A, Sugimoto A, Kasai H, Yano S, Hieda S, Kasuga K, Ikeuchi T, Ono K. White Matter Lesions May Aid in Differentiating Idiopathic Normal Pressure Hydrocephalus and Alzheimer's Disease. J Alzheimers Dis 2021; 85:851-862. [PMID: 34864676 DOI: 10.3233/jad-215187] [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] [Indexed: 10/19/2022]
Abstract
BACKGROUND Idiopathic normal pressure hydrocephalus (iNPH) is often misdiagnosed as Alzheimer's disease (AD) due to overlapping pathophysiology and similar imaging characteristics, including ventricular enlargement and increased white matter lesions (WMLs). OBJECTIVE To compare the extent and distribution of WMLs directly between iNPH and AD and examine the association with underlying pathophysiology. METHODS Twelve patients with iNPH (mean age: 78.08 years; 5 females), 20 with AD (mean age: 75.40 years; 13 females), and 10 normal cognition (NC) participants (mean age: 76.60 years; 7 females) were recruited. The extent and distribution of WMLs and the lateral ventricular volume (LV-V) were evaluated on MRI using voxel-based morphometry analysis. Concentrations of cerebrospinal fluid biomarkers, such as amyloid-β protein (Aβ)42, Aβ 40, Aβ 38, and tau species, were also measured. Risk factors for small vessel disease (SVD) were assessed by blood examination and medical records. RESULTS The periventricular WML volume (PWML-V) and deep WML volume (DWML-V) were significantly larger in iNPH than in AD and NC. The DWML-V was dominant in iNPH, while the PWML-V was dominant in AD and NC. GM-V was significantly smaller in AD than in iNPH and NC. The LV-V positively correlated with WML-V in all participants. There was a significant negative correlation between LV-V and Aβ 38 in iNPH. Furthermore, there was no significant difference in SVD risk factors between the groups. CONCLUSION The differences in the extent and distribution of WMLs between iNPH and AD, especially predominance of DWML-V over PWML-V in iNPH, may reflect decreased fluid and Aβ clearance.
Collapse
Affiliation(s)
- Takeshi Kuroda
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Motoyasu Honma
- Department of Physiology, Showa University School of Medicine, Tokyo, Japan
| | - Yukiko Mori
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Akinori Futamura
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Azusa Sugimoto
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Hideyo Kasai
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Satoshi Yano
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Sotaro Hieda
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Kensaku Kasuga
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Chuo-ku, Niigata, Japan
| | - Takeshi Ikeuchi
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Chuo-ku, Niigata, Japan
| | - Kenjiro Ono
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan.,Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| |
Collapse
|
5
|
Fujishiro H, Ota K, Yamagata M, Ito T, Hieda S, Suga H, Fukui T, Nagahama Y. Early diagnosis of prodromal dementia with Lewy bodies using clinical history of probable REM sleep behaviour disorder and cardiac 123 I-MIBG scintigraphy in memory clinics. Psychogeriatrics 2021; 21:288-295. [PMID: 33565213 DOI: 10.1111/psyg.12662] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 12/13/2020] [Revised: 01/16/2021] [Accepted: 01/23/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Rapid eye movement sleep behaviour disorder (RBD) is associated with reduced cardiac 123 I-metaiodobenzylguanidine (MIBG) uptake and often precedes the onset of Lewy body (LB) disorders. We investigated the role of cardiac 123 I-MIBG scintigraphy in relation to probable RBD for the clinical diagnosis of prodromal dementia with Lewy bodies (DLB) in memory clinics. METHODS We reviewed clinical profiles of 60 consecutive patients who underwent cardiac 123 I-MIBG scintigraphy in our memory clinics. The diagnostic threshold of 2.20 was used as the cut-off for the heart-to-mediastinum ratio at the delayed phase. RESULTS Cardiac 123 I-MIBG abnormality was identified in 28 patients at baseline; six were cognitively unimpaired, six had mild cognitive impairment (MCI)-LB, and 16 had probable DLB based on the National Institute on Aging and Alzheimer's Association Research Framework. Although the number of core features increased in accordance with the progression of three cognitive categories, there were no differences in the prevalence of probable RBD and the cardiac MIBG scintigraphy indices among them. During the observation period, two cognitively unimpaired patients with probable RBD progressed to MCI-LB, and three MCI-LB patients with probable RBD developed DLB. The prevalence of final diagnosis of probable MCI-LB or DLB was significantly higher in these patients (85%) than the remaining 32 patients without (9%). Of 25 patients with probable RBD, 22 (88%) had a cardiac 123 I-MIBG abnormality regardless of cognitive conditions. Only one patient consulted a sleep centre for the abnormal sleep behaviour before visiting our memory clinics. Regarding the gender differences, male predominance was not identified and sleep-related injury more frequently occurred in men (7/12, 58%) than in women (1/10, 10%). CONCLUSIONS Proactive detection of probable RBD plus cardiac 123 I-MIBG abnormality provides the opportunity for an early diagnosis of prodromal DLB in memory clinics. This approach warrants further follow-up studies with polysomnographic and pathological verification.
Collapse
Affiliation(s)
- Hiroshige Fujishiro
- Department of Psychiatry, Kawasaki Memorial Hospital, Kawasaki, Japan.,Department of Dementia diagnostic Centre, Yokohama Shintoshi Neurosurgery Hospital, Yokohama, Japan
| | - Kazumi Ota
- Department of Dementia diagnostic Centre, Yokohama Shintoshi Neurosurgery Hospital, Yokohama, Japan
| | - Mayumi Yamagata
- Department of Dementia diagnostic Centre, Yokohama Shintoshi Neurosurgery Hospital, Yokohama, Japan
| | - Tatsuya Ito
- Department of Neurology, Kawasaki Memorial Hospital, Kawasaki, Japan
| | - Sotaro Hieda
- Department of Neurology, Kawasaki Memorial Hospital, Kawasaki, Japan.,Department of Neurology, Showa University, Tokyo, Japan
| | - Hiroko Suga
- Department of Psychiatry, Kawasaki Memorial Hospital, Kawasaki, Japan
| | - Toshiya Fukui
- Department of Neurology, Kawasaki Memorial Hospital, Kawasaki, Japan
| | - Yasuhiro Nagahama
- Department of Neurology, Kawasaki Memorial Hospital, Kawasaki, Japan
| |
Collapse
|
6
|
Mori Y, Tsuji M, Oguchi T, Kasuga K, Kimura A, Futamura A, Sugimoto A, Kasai H, Kuroda T, Yano S, Hieda S, Kiuchi Y, Ikeuchi T, Ono K. Serum BDNF as a Potential Biomarker of Alzheimer's Disease: Verification Through Assessment of Serum, Cerebrospinal Fluid, and Medial Temporal Lobe Atrophy. Front Neurol 2021; 12:653267. [PMID: 33967943 PMCID: PMC8102980 DOI: 10.3389/fneur.2021.653267] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [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: 01/14/2021] [Accepted: 03/16/2021] [Indexed: 12/16/2022] Open
Abstract
There is an urgent need to establish blood biomarkers for Alzheimer's disease (AD). Although it has been speculated that brain-derived neurotrophic factor (BDNF) is associated with AD, whether it can be used as a blood biomarker has yet to be determined. We used serum, cerebrospinal fluid (CSF), and medial temporal lobe atrophy from patients with AD to evaluate the association of BDNF with AD and assess its severity. For the blood analysis, 66 participants [21 normal controls (NCs) with normal cognitive function, 22 patients with mild cognitive impairment (MCI) due to AD, and 23 patients with AD] were included. For the CSF analysis, 30 participants were included. Magnetic resonance imaging, including a voxel-based specific regional analysis system for AD, and a Mini Mental State Examination were performed. Serum levels of BDNF and CSF levels of amyloid-β42, total tau, and phosphorylated tau were measured using ELISA. Serum BDNF levels were significantly lower in the MCI due to AD group than in the NC group (p = 0.037). Although there was no significant difference in the AD group, there was a downward trend compared to the NC group. Serum BDNF levels were positively correlated with CSF Aβ42 levels (r = 0.49, p = 0.005). There was a significant correlation between serum BDNF levels and medial temporal lobe atrophy. Decreased serum BDNF can potentially be used as a biomarker for early AD detection. Early detection of AD with a less invasive blood test is very beneficial, as it allows for intervention before dementia progresses.
Collapse
Affiliation(s)
- Yukiko Mori
- Department of Pharmacology, School of Medicine, Showa University, Tokyo, Japan.,Pharmacological Research Center, Showa University, Tokyo, Japan.,Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Mayumi Tsuji
- Pharmacological Research Center, Showa University, Tokyo, Japan
| | - Tatsunori Oguchi
- Department of Pharmacology, School of Medicine, Showa University, Tokyo, Japan.,Pharmacological Research Center, Showa University, Tokyo, Japan
| | - Kensaku Kasuga
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Niigata, Japan
| | - Atsushi Kimura
- Department of Pharmacology, School of Medicine, Showa University, Tokyo, Japan.,Pharmacological Research Center, Showa University, Tokyo, Japan.,Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Akinori Futamura
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Azusa Sugimoto
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Hideyo Kasai
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Takeshi Kuroda
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Satoshi Yano
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Sotaro Hieda
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Yuji Kiuchi
- Department of Pharmacology, School of Medicine, Showa University, Tokyo, Japan.,Pharmacological Research Center, Showa University, Tokyo, Japan
| | - Takeshi Ikeuchi
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Niigata, Japan
| | - Kenjiro Ono
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| |
Collapse
|
7
|
Miki A, Kinno R, Ochiai H, Kubota S, Mori Y, Futamura A, Sugimoto A, Kuroda T, Kasai H, Yano S, Hieda S, Kokaze A, Ono K. Sex Differences in the Relationship of Serum Vitamin B1 and B12 to Dementia Among Memory Clinic Outpatients in Japan. Front Aging Neurosci 2021; 13:667215. [PMID: 33897411 PMCID: PMC8064118 DOI: 10.3389/fnagi.2021.667215] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 03/15/2021] [Indexed: 11/27/2022] Open
Abstract
Dementia and cognitive impairment are considered to be one of the biggest social and medical problems. While there is a definite relationship between vitamin B and cognitive decline, this has yet to be fully assessed with regard to sex differences. Thus, the present study investigated the relationship of vitamin B1 or vitamin B12 with dementia in accordance with the sex in 188 patients who visited the Memory Clinic at Showa University Hospital in Japan from March 2016 to March 2019. Cognitive function was tested by the Japanese version of the Mini-Mental State Examination (MMSE) and Hasegawa Dementia Scale-Revised (HDS-R). Blood tests were performed to measure the vitamin levels. Logistic regression analysis was used to calculate the odds ratio (OR) for dementia and the 95% confidence interval (CI). Compared to the highest vitamin group (third tertile), the lowest vitamin group (first tertile) exhibited a significantly increased OR for dementia defined by MMSE for vitamin B1 (OR:3.73, 95% CI:1.52–9.16) and vitamin B12 (2.97, 1.22–7.28) among women. In contrast, vitamin levels were not significantly associated with dementia determined by MMSE in men. These findings were similar even when dementia was defined by HDS-R. The present study suggests that vitamin B1 plays a role in preventing development of dementia in women. Future longitudinal studies will need to be undertaken in order to examine whether decreasing vitamin levels occur before or after cognitive impairment, and whether maintaining a higher vitamin level can prevent a worsening of cognitive function and the development of dementia.
Collapse
Affiliation(s)
- Ayako Miki
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Tokyo, Japan.,Department of Neurology, School of Medicine, Showa University, Tokyo, Japan
| | - Ryuta Kinno
- Department of Neurology, School of Medicine, Showa University, Tokyo, Japan
| | - Hirotaka Ochiai
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Satomi Kubota
- Department of Neurology, School of Medicine, Showa University, Tokyo, Japan
| | - Yukiko Mori
- Department of Neurology, School of Medicine, Showa University, Tokyo, Japan
| | - Akinori Futamura
- Department of Neurology, School of Medicine, Showa University, Tokyo, Japan
| | - Azusa Sugimoto
- Department of Neurology, School of Medicine, Showa University, Tokyo, Japan
| | - Takeshi Kuroda
- Department of Neurology, School of Medicine, Showa University, Tokyo, Japan
| | - Hideyo Kasai
- Department of Neurology, School of Medicine, Showa University, Tokyo, Japan
| | - Satoshi Yano
- Department of Neurology, School of Medicine, Showa University, Tokyo, Japan
| | - Sotaro Hieda
- Department of Neurology, School of Medicine, Showa University, Tokyo, Japan
| | - Akatsuki Kokaze
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Kenjiro Ono
- Department of Neurology, School of Medicine, Showa University, Tokyo, Japan
| |
Collapse
|
8
|
Futamura A, Hieda S, Mori Y, Kasuga K, Sugimoto A, Kasai H, Kuroda T, Yano S, Tsuji M, Ikeuchi T, Irie K, Ono K. Toxic Amyloid-β42 Conformer May Accelerate the Onset of Alzheimer's Disease in the Preclinical Stage. J Alzheimers Dis 2021; 80:639-646. [PMID: 33579852 DOI: 10.3233/jad-201407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/15/2022]
Abstract
BACKGROUND Toxic amyloid-β protein (Aβ) conformers play an important role in the progression of Alzheimer's disease (AD). The ratio of toxic conformer to total Aβ42 in cerebrospinal fluid (CSF) was significantly high in AD and mild cognitive impairment (MCI) due to AD using an enzyme-linked immunosorbent assay kit with a 24B3 antibody. OBJECTIVE We compared the toxic Aβ42, conformer at different stages of AD to identify its contribution to AD pathogenesis. METHODS We compared 5 patients with preclinical AD, 11 patients with MCI due to AD, 21 patients with AD, and 5 healthy controls to measure CSF levels of total Aβ42, total tau, tau phosphorylated at threonine 181 (p-tau), and toxic Aβ conformers. All were classified using the Clinical Dementia Rating. Cognitive function was assessed using the Japanese version of the Mini-Mental State Examination (MMSE-J). RESULTS Toxic Aβ conformer level was insignificant between groups, but its ratio to Aβ42 was significantly higher in AD than in preclinical AD (p < 0.05). Toxic Aβ42 conformer correlated positively with p-tau (r = 0.67, p < 0.01) and p-tau correlated negatively with MMSE-J (r = -0.38, p < 0.05). CONCLUSION Toxic Aβ conformer triggers tau accumulation leading to neuronal impairment in AD pathogenesis.
Collapse
Affiliation(s)
- Akinori Futamura
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Sotaro Hieda
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Yukiko Mori
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Kensaku Kasuga
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Chuo-ku, Niigata, Japan
| | - Azusa Sugimoto
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Hideyo Kasai
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Takeshi Kuroda
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Satoshi Yano
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Mayumi Tsuji
- Pharmacological Research Center, Showa University, Shinagawa-ku, Tokyo, Japan
| | - Takeshi Ikeuchi
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Chuo-ku, Niigata, Japan
| | - Kazuhiro Irie
- Division of Food Science and Biotechnology, Graduate School of Agriculture, Kyoto University, Kyoto, Japan
| | - Kenjiro Ono
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| |
Collapse
|
9
|
Futamura A, Hieda S, Mori Y, Sugimoto A, Kasai H, Kuroda T, Yano S, Kasuga K, Murakami H, Ikeuchi T, Ono K. Cingulate Island Sign in Single Photon Emission Computed Tomography: Clinical Biomarker Correlations in Lewy Body Disease and Alzheimer's Disease. J Alzheimers Dis 2020; 79:1003-1008. [PMID: 33361600 DOI: 10.3233/jad-201145] [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] [Indexed: 11/15/2022]
Abstract
We compared 'CIScore' determined by quantitative single photon emission computed tomography studies of the cingulate island sign to cerebrospinal fluid (CSF) biomarkers in Lewy body disease (LBD) and Alzheimer's disease (AD) to assess its usefulness and pathological background. Among the 16 each age-matched LBD and AD patients, the CIScore differed significantly but was not correlated with CSF biomarkers. In LBD, hippocampal atrophy significantly correlated with Clinical Dementia Rating and CSF p-tau and t-tau levels. Our results showed CIS was not related to CSF biomarkers in LBD and high CSF tau levels were related to clinical disease severity and hippocampal atrophy.
Collapse
Affiliation(s)
- Akinori Futamura
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Sotaro Hieda
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Yukiko Mori
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Azusa Sugimoto
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Hideyo Kasai
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Takeshi Kuroda
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Satoshi Yano
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Kensaku Kasuga
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Chuo-ku, Niigata, Japan
| | - Hidetomo Murakami
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan.,Department of Neurology, School of Medicine, The Jikei University, Minato-ku, Tokyo, Japan
| | - Takeshi Ikeuchi
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Chuo-ku, Niigata, Japan
| | - Kenjiro Ono
- Division of Neurology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| |
Collapse
|
10
|
Hieda S, Yasumoto T, Kokudai Y, Ono K. Optic Nerve Tortuosity in Idiopathic Intracranial Hypertension. Intern Med 2020; 59:2635. [PMID: 32581174 PMCID: PMC7662055 DOI: 10.2169/internalmedicine.5086-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Sotaro Hieda
- Division of Neurology, Department of Internal Medicine, Showa University, Japan
| | - Taro Yasumoto
- Division of Neurology, Department of Internal Medicine, Showa University, Japan
| | - Yumika Kokudai
- Division of Neurology, Department of Internal Medicine, Showa University, Japan
| | - Kenjiro Ono
- Division of Neurology, Department of Internal Medicine, Showa University, Japan
| |
Collapse
|
11
|
Sugimoto A, Shozawa H, Mizuma K, Hieda S, Ono K. Pallidal dementia with underlying sleep apnea syndrome: a case report and literature review. Neurol Sci 2020; 41:1961-1963. [PMID: 31997121 DOI: 10.1007/s10072-020-04273-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 01/24/2020] [Indexed: 10/25/2022]
Affiliation(s)
- Azusa Sugimoto
- Division of Neurology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Hidenobu Shozawa
- Division of Neurology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Keita Mizuma
- Division of Neurology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Sotaro Hieda
- Division of Neurology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Kenjiro Ono
- Division of Neurology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo, 142-8666, Japan.
| |
Collapse
|
12
|
Hirano K, Fukae J, Hieda S, Fujimaki M, Ishii H, Tsuboi Y, Kawamura M, Arai H, Hattori N. Eosinophilic meningitis caused by primary angiitis of the central nervous system. Intern Med 2013; 52:1393-6. [PMID: 23774554 DOI: 10.2169/internalmedicine.52.9578] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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
Eosinophilic meningitis is defined as the presence of 10 eosinophils/mm(3) in the cerebrospinal fluid (CSF) or eosinophils accounting for more than 10% of CSF leukocytes. A 76-year-old man who developed cognitive dysfunction and consciousness disturbance had eosinophilic meningitis (his CSF contained 19.0% eosinophils). Because the etiology was unknown, we performed a brain biopsy. The pathological findings showed inflammatory infiltration in the small-sized arteries of the meninges. The patient was ultimately diagnosed as having primary angiitis of the central nervous system (PACNS). Eosinophilic meningitis occurring in a patient with PACNS is extremely rare, and this is the first report of this condition in Japan.
Collapse
Affiliation(s)
- Kazuoki Hirano
- Department of Neurology, Juntendo University School of Medicine, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Sugimoto A, Midorikawa A, Koyama S, Futamura A, Hieda S, Kawamura M. Picture Agnosia as a Characteristic of Posterior Cortical Atrophy. Eur Neurol 2012; 68:34-41. [DOI: 10.1159/000335589] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Accepted: 12/04/2011] [Indexed: 11/19/2022]
|
14
|
Hieda S, Nakajima M, Ishigaki S, Kawamura M. [Neuroimaging Findings of a 29-year-old woman with 22q11.2 deletion presenting with cognitive deterioration]. Brain Nerve 2011; 63:1294-1295. [PMID: 22068483] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Sotaro Hieda
- Department of Neurology, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | | | | | | |
Collapse
|
15
|
Shi Z, Hayashi YK, Mitsuhashi S, Goto K, Kaneda D, Choi YC, Toyoda C, Hieda S, Kamiyama T, Sato H, Wada M, Noguchi S, Nonaka I, Nishino I. Characterization of the Asian myopathy patients with VCP mutations. Eur J Neurol 2011; 19:501-9. [PMID: 22040362 DOI: 10.1111/j.1468-1331.2011.03575.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE Mutations in the valosin-containing protein (VCP) gene are known to cause inclusion body myopathy with Paget's disease of bone and frontotemporal dementia (IBMPFD) and familial amyotrophic lateral sclerosis (ALS). Despite an increasing number of clinical reports, only one Asian family with IBMPFD has been described. METHODS To characterize patients with VCP mutations, we screened a total of 152 unrelated Asian families who were suspected to have rimmed vacuolar myopathy. RESULTS We identified VCP mutations in seven patients from six unrelated Asian families. Five different missense mutations were found, including a novel p.Ala439Pro substitution. All patients had adult-onset progressive muscle wasting with variable involvement of axial, proximal, and distal muscles. Two of seven patients were suggested to have mild brain involvement including cerebellar ataxia, and only one showed radiological findings indicating a change in bone. Findings from skeletal muscle indicated mixed neurogenic and myogenic changes, fibers with rimmed vacuoles, and the presence of cytoplasmic and nuclear inclusions. These inclusions were immunopositive for VCP, ubiquitin, transactivation response DNA-binding protein 43, and also histone deacetylase 6 (HDAC6), of which function is regulated by VCP. Evidence of early nuclear and mitochondrial damage was also characteristic. CONCLUSIONS Valosin-containing protein mutations are not rare in Asian patients, and gene analysis should be considered for patients with adult-onset rimmed vacuolar myopathy with neurogenic changes. A wide variety of central and peripheral nervous system symptoms coupled with rare bone abnormalities may complicate diagnosis.
Collapse
Affiliation(s)
- Z Shi
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP), Kodaira, Tokyo, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Ichikawa H, Mukai M, Katoh H, Hieda S, Murakami H, Kawamura M. Cerebral Microbleeds and Dilative Remodeling of the Basilar Artery: A Magnetic Resonance Imaging Study. J Stroke Cerebrovasc Dis 2011; 20:429-35. [DOI: 10.1016/j.jstrokecerebrovasdis.2010.02.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2009] [Revised: 02/17/2010] [Accepted: 02/19/2010] [Indexed: 11/16/2022] Open
|
17
|
Ichikawa H, Hieda S, Ohno H, Ohnaka Y, Shimizu Y, Nakajima M, Kawamura M. Kana versus Kanji in Amyotrophic Lateral Sclerosis: A Clinicoradiological Study of Writing Errors. Eur Neurol 2010; 64:148-55. [DOI: 10.1159/000317011] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2010] [Accepted: 06/15/2010] [Indexed: 11/19/2022]
|
18
|
Hieda S, Fukui T. [Germinoma presenting with personality and socio-behavioral abnormalities may challenge differential diagnoses]. Brain Nerve 2008; 60:949-953. [PMID: 18717199] [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: 05/26/2023]
Abstract
We described the major diagnostic difficulties encountered in the case of a 25-year-old man with the pathological diagnosis of a germinoma. The patient initially developed an eating disorder at the end of 2003 and a character change ensued since the beginning of 2004. On admission in August 2004, his cardinal symptoms and signs included marked apathy, depersonalization, generalized muscle wasting, and decreased tendon reflexes. Brain T2-weighted (T2-WI) MR and FLAIR images showed high signal intensities in the suprasellar region and at the genu of the corpus callosum that extended along the sub-pia mater of the right anterior horn. These lesions showed mild enhancement on gadolinium-enhanced T1-WI. CSF examination revealed a mildly elevated level of protein and increased cell counts but did not show any malignant cells on repeated spinal tap. The patient's status remained practically unchanged till December 2004 when he developed diabetes insipidus. Soon afterward, the patient collapsed into akinetic mutism and developed corresponding new lesions at the tegmentum of the midbrain. These new lesions disappeared spontaneously and akinetic mutism regressed without any specific therapy. We tentatively diagnosed of neurosarcoidosis based on a characteristic progressive-regressive clinical course, CSF data, and radiological findings. Clinical symptoms and the enhanced masses on MRI were highly responsive to steroid therapy after which the patient was able to return home. However, disturbances in consciousness and tenacious vomiting recurred in September. Brain MRI revealed a markedly re-enlarged and easily enhanced mass at the right anterior horn, which extended into the cerebral aqueduct and resulted in obstructive hydrocephalus. On surgery, histopathological investigation revealed germinoma. This case highlights the need for careful discrimination between a slow growing germinoma and chronic granulomatous diseases of the brain such as neurosarcoidosis. Early histological investigation may be warranted in patients who present difficulties during differential diagnoses.
Collapse
Affiliation(s)
- Sotaro Hieda
- Division of Neurology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Tokyo, Japan
| | | |
Collapse
|
19
|
Yabushita H, Sawaguchi K, Hieda S, Ogawa A, Tomatsu A, Noguchi M, Ishihara M. Clinical usefulness of sialyl SSEA-1 antigen as tumor marker for ovarian cancer as compared with CA125, CA19-9, TPA, IAP, CEA and ferritin. Nihon Sanka Fujinka Gakkai Zasshi 1989; 41:217-24. [PMID: 2566639] [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: 01/01/2023]
Abstract
In order to determine the clinical significance of sialyl SSEA-1 antigen, we compared its usefulness as a tumor marker for ovarian cancer with simultaneously measured CA125, CA19-9, TPA, IAP, CEA and ferritin. The sialyl SSEA-1 antigen in serum was measured by radioimmunoassay with an "FH-6" Otsuka Kit. The immunohistochemical localization of sialyl SSEA-1 antigen in ovarian carcinoma tissues was determined by an immunoperoxidase method using FH-6 monoclonal antibody. Among fifty-one patients with ovarian cancer, the incidence of elevated serum levels was 54.9% with sialyl SSEA-1 antigen, 90.2% with CA125, 48.8% with CA19-9, 78.0% with TPA, 73.1% with IAP, 17.1% with CEA and 63.4% with ferritin. On the other hand, among the patients with uterine malignancies and gynecologic benign tumors, the incidence of elevated sialyl SSEA-1 antigen levels in serum was lower than that of other tumour markers. In the patients with ovarian cancer, the serum levels of sialyl SSEA-1 antigen increased in accordance with the advance of the clinical stage and were also correlated with the effect of therapy. In the examination of immunohistochemical localization of sialyl SSEA-1 antigen, a positive reaction occurred in 10 out of 30 ovarian carcinoma specimens. Intense staining appeared in the secretory materials, in the luminal surface of the glands, and in the cytoplasm of cells. Thus, sialyl SSEA-1 antigen appears to be a useful tumor marker for the diagnosis of ovarian cancer, especially when measured simultaneously with CA125, CA19-9, TPA, ferritin and IAP.
Collapse
Affiliation(s)
- H Yabushita
- Department of Obstetrics and Gynecology, Aichi Medical University
| | | | | | | | | | | | | |
Collapse
|
20
|
Yabushita H, Sawaguchi K, Ueno N, Hieda S, Noguchi M, Ishihara M. [Experimental study on the effect of UFT with concomitant radiotherapy of uterine cervical cancer]. Gan To Kagaku Ryoho 1989; 16:235-41. [PMID: 2493223] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
In order to examine effectiveness of the chemotherapy with concomitant radiotherapy, an experimental study was designed using AMCC-1 cell line established from a human uterine cervical carcinoma in our laboratory. The growth of AMCC-1 cells cultured in plastic flask was inhibited significantly in the group treated with a half of minimal effective doses of 60Co and 5-FU in comparison with the control group. The 5-FU treatment after radiation inhibited the AMCC-1 cell growth more effectively than that before radiation. The growth of AMCC-1 tumor transplanted into nude mice was inhibited significantly in the group given a combination chemoradiotherapy, consisted of oral administration of three quarters of minimal effective dose of UFT for fourteen consecutive days and radiation of a half of minimal effective dose of 60Co. The oral administration of UFT after radiation inhibited the AMCC-1 tumor growth more effectively than that before radiation. These results suggest that the radiotherapy with administration of UFT was more effective against uterine cervical cancer than radiation alone and it is important to administer UFT orally after radiation as well as before radiation.
Collapse
Affiliation(s)
- H Yabushita
- Dept. of Obstetrics and Gynecology, Aichi Medical University
| | | | | | | | | | | |
Collapse
|
21
|
Noguchi M, Okamoto T, Akita T, Hieda S, Ishihara M. [Chlamydia trachomatis infection in the female patients]. Nihon Sanka Fujinka Gakkai Zasshi 1988; 40:452-8. [PMID: 3373074] [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: 01/05/2023]
Abstract
With recent advances in the development of detection methods, the number of STD (Sex transmitted disease) cases detected is greater than ever. Among many STD, Chlamydia trachomatis (= CT), a microbe that has been given a great deal of attention in the urologic field as a cause of nonspecific urethritis and has a characteristic life cycle, has been gradually proved to exist commonly and to become a cause of various obstetrical and gynecological diseases. However, as it is clinically still unknown which symptoms are actually influenced by CT, we studied infection with CT in 706 cases, consists of a group of patients with some symptoms and an asymptomatic group mainly consisting of pregnant women. As a result, the positive rate was found to be 12.3% (87 cases); 10.8% (21 out of 194) in asymptomatic pregnant women, 11.0% (13 out of 118) in patients with cervicitis, and 14.9% (30 out of 202) in patients with adnexitis including PID. As to age, the positive rate was highest, 23.1%, in patients under 20 years old. In fact, 1) CT positive pregnant women are not rare, and 2) CT was detected in high frequency in the young generation under 20 years old; and in these young women, the possibility of transmission of the disease to the infant in the birth canal should be considered in connection with future pregnancy and delivery. Tubal sterility may also result. We concluded that it was necessary to establish a satisfactory examination system.
Collapse
Affiliation(s)
- M Noguchi
- Department of Obstetrics and Gynecology, Aichi Medical University
| | | | | | | | | |
Collapse
|
22
|
Noguchi M, Hieda S, Akita T, Yamada M, Tsuji K, Nakanishi M, Ishihara M. Studies on experimentally induced hydrosalpinges in rabbits--experimental approach for tubo-microsurgery. Nihon Sanka Fujinka Gakkai Zasshi 1983; 35:1653-1657. [PMID: 6619616] [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: 05/21/2023]
Abstract
Hydrosalpinx proved macroscopically and microscopically which was quite similar to that observed in the damage human fallopian tube could be induced by ligation of the rabbit fallopian tube. Where ligatures have been placed on two places of the fallopian tube, hydrosalpinx can be induced in 100 percent of cases if ligation is done securely. About 1-2 weeks after ligation, no change of ciliated cells was observed in the mucosal fold in SEM findings, nor was there much change in the external shape of non-ciliated cells even though hydrosalpinx was induced. With the lapse of time after development of hydrosalpinx, however, both of these cells on the surface of the mucosal fold gradually changed to loose their normal shapes. After 15 weeks, ciliated cells all but disappeared to be replaced by large, filled, irregular non-ciliated cells. Accordingly, hydrosalpinx in the early stage can be cured fully by tubal salpingostomy using microsurgery. In the case of hydrosalpinx many hours after ligation, however, end-to-end anastomosis of the normal regions should be performed since no recovery can be expected.
Collapse
|
23
|
Ishihara M, Ito Y, Nakakita T, Maehama T, Hieda S, Yamamoto K, Ueno N. [Clinical effect of gamma-oryzanol on climacteric disturbance -on serum lipid peroxides (author's transl)]. Nihon Sanka Fujinka Gakkai Zasshi 1982; 34:243-51. [PMID: 7061906] [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: 01/23/2023]
Abstract
Though gamma-Oryzanol has been applicated as the autonomic agent in various fields for a few decades, recently its effect on lipid metabolism comes to be much more interested. We studied on the effect of gamma-Oryzanol on climacteric disturbance, and besides on the difference of lipid peroxides level which has an important and indispensable connection with mary syndromes involving aging. We obtained the following results from 40 subjects with climacteric disturbance after administration of gamma-Oryzanol Fine Particule 1.5 g (gamma-Oryzanol 300 mg included) for 4 to 8 weeks. 1. 90% of the cases improved generally; Excellent 16 (40%), Good 14 (35%), Effective 6 (15%), No change 4 (10%). 2. Effect on climacteric disturbance was judged by the Kupperman method and the Ueda method; generally recovered 85%, 80% each. 3. Significantly reduced total cholesterol, triglyceride and increased HDL-cholesterol were noted in cases with hyperlipidemia (TC greater than or equal to 220 mg/dl, TG greater than or equal to 140 mg/dl, HDL-chol. less than or equal to 45 mg/dl). Therefore, atherogenic index was excellently recovered. 4. In cases with climacteric disturbance lipid peroxides level was high, and they were significantly recovered by administration of gamma-Oryzanol. 5. During this study, no side effects have been recognized and no particular change in function test was found. Thus, we confirmed the efficacy and utility of gamma-Oryzanol on many complaints in climacteric disturbance and also on lipid metabolism.
Collapse
|
24
|
Kumazawa J, Nakamuta S, Hieda S, Takesue T. [Clinical experience with gentamicin in urinary tract infections (author's transl)]. Jpn J Antibiot 1976; 29:309-17. [PMID: 818418] [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: 12/24/2022]
Abstract
1) Gentamicin (GM) was intramuscularly injected to 1 patient with simple acute cystitis and to 21 patients with complicated chronic urinary tract infections in the doses of 40-160 mg per day for 3-12 days (mean: 5-2 days). 2) The clinical effect was excellent in 6, good in 9, poor in 7, which is classified as excellent in 1 with simple acute cystitis, good in 5 and poor in 5 out of 11 with complicated chronic cystitis, and excellent in 4, good in 4 and poor in 2 out of 10 with complicated chronic pyelonephritis. 3) In complicated urinary tract infections, the effective rate was 61.5% (8/13) in GM 80 mg/day dosage group and 75.0% (6/8) in GM 120 mg/day dosage group. 4) No abnormal change was noted in the kidney, liver and auditory function throughout this clinical study. 5) When GM therapy is conducted in the treatment of complicated urinary tract infections, it is considered that more favorable clinical results could be obtained with dosage of GM 120 mg/day or more. However, in this case a caution has to be paid to the kidney and auditory functions.
Collapse
|