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Brain cholinergic system and Delirium in the aged

Research Project

Project/Area Number 06670990
Research Category

Grant-in-Aid for General Scientific Research (C)

Allocation TypeSingle-year Grants
Research Field Psychiatric science
Research InstitutionNational Institute of Mental Health, National Center of Neurology and Psychiatry

Principal Investigator

UCHIYAMA Makoto  National Institute of Mental Health, Dept.of Psychophysiology section chief, 精神保健研究所, 室長 (20221111)

Co-Investigator(Kenkyū-buntansha) OZAKI Shigeru  National institute of Mental Health, Dept.of Psychophysiology researcher, 神経センター・精神保健研究所, 研究員
SHIRAKAWA Shuichiro  National institute of Mental Health, Dept.of Psychophysiology section chief, 神経センター・精神保健研究所, 室長 (20100141)
OKAWA Masako  National institute of Mental Health, Dept.of Psychophysiology Director, 神経センター・精神保健研究所, 部長 (80160430)
ISSE Kunihiro  Tokyo metropolitan Ebara general Hospital, Director of psychiatry, 精神科, 医長 (30126205)
Project Period (FY) 1994 – 1995
Project Status Completed (Fiscal Year 1995)
Budget Amount *help
¥1,300,000 (Direct Cost: ¥1,300,000)
Fiscal Year 1995: ¥400,000 (Direct Cost: ¥400,000)
Fiscal Year 1994: ¥900,000 (Direct Cost: ¥900,000)
KeywordsDelirium / Central cholinergic agent / Drag intoxication / Circadian rhythm / Melatonin rhythm / 概ロリズム / メラトニン / コルチゾール
Research Abstract

1) Clinical study
We studied consecutive 120 elderly patients (range of age, 60-93y) who developed delirium in a geriatric general hospital. Clinical investigation revealed that 20 cases out of 120 were diagnosed as drug intoxication delirium. Administration of anti-cholinergic agents such as anti-parkinsonian drug, or anti-depressants, were the main cause of drug intoxication delirium (18/20). These results indicate that anti-cholinergic agents may frequently develop delirium in the aged. This study was presented in 19th CINP Congress held in Washington. A part of this study was also published in Neurology.
2) Development of new drug treatment for delirium
We conducted an open trial study to validate an efficacy of tetra-cyclic antidepressant mianserin on symptoms of delirium in the aged. Subjects were 62 elderly patients with delirium. We found that mianserin had favorable effect on delirium and that this efficacy may be related to the drug's less anti-cholonergic property. This study w … More as submitted and accepted for publication in Progress in Neuro-Psychopharmacology and Biological Psychiatry (in press 1996).
3) Proposal of possible newer treatment for delirium
We aimed to activate human cholinergic system in the brain. We found that vitamin B12 was the safest drug among central cholinergic agents available in Japan. We administered vitamin B12 on healthy normal volunteers and assessed its effect on the circadian rhythm. We found that vitamin B12 enhanced the amplitude of circadian rhythm and increased the vigilance of the daytime. This property of vitamin B12 may be applicable to treatment of delirium because most patients with delirium displayd disturbances of the circadian rhythm.
4) Estrogen as a central cholinergic enhancer
Delirium is one of the most frequent symptoms in demented elderly. We administered estrogen on demented female patients. We found that this hormone had a property to ameliorate the symptoms of dementia including delirium. We postulated that this property may be related to estrogen's activating effect on cholin acetyl transferase in the brain. Less

Report

(3 results)
  • 1995 Annual Research Report   Final Research Report Summary
  • 1994 Annual Research Report
  • Research Products

    (32 results)

All Other

All Publications (32 results)

  • [Publications] M. Uchiyama, K. Isse, et al.: "Incidental Lewy body disease in a patient with REM sleep behavior disorder," Neurology. 45. 709-712 (1995)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] M. Uchiyama, G. Mayer, et al.: "Effects of vitamin B12 on human circadian body temperature rhythm." Neuroscience Letters. 192. 1-4 (1995)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] T Ohkura, K Isse, et al.: "Long-term estrogen replacement therapy in female patients with dementia of the Alzheimer type: 7 case reports." Dementia. 6. 99-107 (1995)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] M. Uchiyama, K. Tanaka, et al.: "Efficacy of mianserin on symptoms of delirium in the aged: An open trial study." Progress in Neuro-Psychopharmacology and Biological Psychiatry. (1996)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] M. Uchiyama, K. Tanaka,: "Circadian rhythm and Demendia." Clinics and drug therapy. 14. 1135-1138 (1995)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] M. Uchiyama, M. Okawa, et al.: "Nocturnal delirium in the aged." Biomedicine and therapeutics. 28. 1037-1041 (1994)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] M. Uchiyama, K Isse, et al.: "Idiopathische REM-Schlaf-Verhaltnis-storung im Alter," Gustav Fischer Verlag,12 (1995)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] M. Uchiyama: "Hand book of sleep science and sleep medicine.(REM sleep behavior disorder)" Asakura shoten, 8 (1994)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] M.Uchiyama, K.Isse, K.Tanaka, N.Yokota, M.Hamamoto, S.Aida, Y.Ito, M.Yoshimura, M.Okawa: "Incidental Lewy body disease in a patient with REM sleep behavior disorder" Neurology. 45. 709-712 (1995)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] M.Uchiyama, G.Mayr, M.Okawa, K.Meier-ewert: "Effects of vitamin B12 on human circadian body temperature rhythm." Neuroscience Letters. 192. 1-4 (1995)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] T Ohkura, K Isse, K Akazawa, M Hamamoto, Y Yaoi, N Hagino: "Long-term estrogen replacement therapy in female patients with dementia of the Alzheimer type : 7 case reports." Dementia. 6. 99-107 (1995)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] M Uchiyama, K Tanaka, K Isse, M Toru: "Efficacy of mianserin on symptoms of delirium in the aged : An open trial study." Progress in Neuro-Psychopharmacology and Biological Psychiatry. (in press). (1996)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] M.Uchiyama, K.Tanaka: "Circadian rhythm and Demendia." Clinics and drug therapy. 14. 1135-1138 (1995)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] M.Uchiyama, M.Okawa, K.Tanaka, K.Isse: "Nocturnal delirium in the aged." Biomedicine and therapeutics. 28. 1037-1041 (1994)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] M.Uchiyama, K.Isse, M.Okawa, K.Meier-Ewert: "Idiopathische REM-Schlaf-Verhaltnis-storung im Alter, In ed.by K.Meier-Ewert and H.Stefan, Anfalle im Schlaf" Gustav Fischer Verlag, Stuttgart. 161-172 (1995)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] M.Uchiyama: REM sleep behavior disorder. In Hand book of sleep science and sleep medicine.Asakura shoten, 434-441 (1994)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1995 Final Research Report Summary
  • [Publications] M. Uchiyama, K. Isse, et al.: "Incidental Lewy body disease in a patient with REM sleep behavior disorder," Neurology. 45. 709-712 (1995)

    • Related Report
      1995 Annual Research Report
  • [Publications] M. Uchiyama, G. Mayer, et al.: "Effects of vitamin B12 on human circadian body temperature rhythm." Neuroscience Letters. 192. 1-4 (1995)

    • Related Report
      1995 Annual Research Report
  • [Publications] T Ohkura, K Isse, et al.: "Long-term estrogen replacement therapy in female patients with dementia of the Alzheimer type: 7 case reports." Dementia. 6. 99-107 (1995)

    • Related Report
      1995 Annual Research Report
  • [Publications] M Uchiyama, K Tanaka, et al.: "Efficacy of mianserin on symptoms of delirium in the aged: An open trial study." Progress in Neuro-Psychopharmacology and Biological Psychiatry. (1996)

    • Related Report
      1995 Annual Research Report
  • [Publications] M Uchiyama, K, Tanaka.: "Circadian rhythm and Demendia." Clinics and drug hterapy. 14. 1135-1138 (1995)

    • Related Report
      1995 Annual Research Report
  • [Publications] M Uchiyama, M, Okawa, et al.: "Nocturnal delirium in the aged." Biomedicine and therapeutics. 28. 1037-1041 (1994)

    • Related Report
      1995 Annual Research Report
  • [Publications] M. Uchiyama, K. Isse, et al.: "Idiopathische REM-Schlaf-Verhaltnis-storung im Alter," Gustav Fischer Verlag,12 (1995)

    • Related Report
      1995 Annual Research Report
  • [Publications] M. Uchiyama: "Hand book of sleep science and sleep medicine.( REM sleep behavior disorder.)" Asakura shoten, 8 (1994)

    • Related Report
      1995 Annual Research Report
  • [Publications] M.Uchiyama,G.Mayer,K Meier-Ewert: "Differential effects of extended sleep in narcoleptic patients," Electroencephalography and clinical Neurophysiology. 91. 212-218 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] M.Uchiyama,G.Mayer,K Meier-Ewert:"Effects of vitamin B12 on circadian body temperature rhythm," Japanese Journal of Psychiatry and Neurology,. 48. 504-505 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] K.Mshima,M.Okawa,et.al.: "Morning bright light therapy for sleep and behavior disorders in elderly patients with dementia," Acta Psychiatr Scand,. 89. 1-7 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] 内山真、大川匡子、他: "老人の夜間不穏の症例" 治療学. 28. 1037-1041 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] 内山真: "老人の情動変化と内分泌リズム" 老年精神医学雑誌. 5. 1067-1075 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] 内山真、大川匡子、他: "睡眠・覚醒リズム障害" 神経進歩. 39. 92-103 (1995)

    • Related Report
      1994 Annual Research Report
  • [Publications] 内山真: "睡眠学ハンドブック(レム睡眠行動障害の治療、)" 朝倉書店, 8 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] 内山真: "現代のエスプリ 332号(勤労者の睡眠障害と生体リズム障害)" 至文堂, 11 (1995)

    • Related Report
      1994 Annual Research Report

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Published: 1994-04-01   Modified: 2016-04-21  

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