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Analysis of treatment-resistant schizophrenia focusing on dopamine supersensitivity psychosis and type of intolerance to antipsychotics

Research Project

Project/Area Number 17K10266
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Research Field Psychiatric science
Research InstitutionChiba University

Principal Investigator

Kanahara Nobuhisa  千葉大学, 社会精神保健教育研究センター, 講師 (70507350)

Project Period (FY) 2017-04-01 – 2020-03-31
Project Status Completed (Fiscal Year 2019)
Budget Amount *help
¥4,550,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥1,050,000)
Fiscal Year 2019: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2018: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2017: ¥2,730,000 (Direct Cost: ¥2,100,000、Indirect Cost: ¥630,000)
Keywords統合失調症 / 治療抵抗性 / 抗精神病薬 / モノアミン / ジストニア / 遺伝子 / ドパミン過感受性 / CT画像 / エクソーム解析 / 脳神経疾患 / 遺伝子解析 / 脳画像
Outline of Final Research Achievements

The present study explored the etiology of treatment-resistant schizophrenia (TRS), focusing particularly on dopamine supersensitivity psychosis (DSP) and tardive dystonia. (1) The longitudinal brain CT study for schizophrenia patients revealed that the progressive volume reduction could be related to the accumulated dosages of antipsychotics. (2) Under relapse episode due to rebound psychosis, the increase in turnover of monoamine (HVA) did not occur in patients with DSP, which differed from hyper-release of HVA in patients with first episode psychosis. (3) The exome sequencing for the three patients with severe tardive dystonia identified the novel rare variants on ZNF806 and SART3. But the subsequent association study for other 16 patients failed to confirm these genes’ involvement in dystonia. These findings suggest that patients with TRS are heterogeneous and further studies are needed to identify useful biological markers for each subtype in TRS.

Academic Significance and Societal Importance of the Research Achievements

DSPを対象とした研究では、頭部画像や血液中マーカーでの検証を通じ、確たる知見まで得られてこなかった統合失調症の病態に、DSPの視点を加味することで、より明確な知見を与える可能性が示唆されることとなった。抗精神病薬治療の影響によるDSPは統合失調症患者の長期予後にも強い影響を及ぼす可能性を示すものである。遅発性ジストニア研究では原因遺伝子にまで到達は出来ていないが、本病態において遺伝的背景を有する可能性は依然としてあり、今後研究の継続が必要であると考えられる。

Report

(4 results)
  • 2019 Annual Research Report   Final Research Report ( PDF )
  • 2018 Research-status Report
  • 2017 Research-status Report
  • Research Products

    (20 results)

All 2020 2019 2018 2017

All Journal Article (11 results) (of which Int'l Joint Research: 1 results,  Peer Reviewed: 9 results) Presentation (9 results) (of which Invited: 4 results)

  • [Journal Article] Plasma Monoamines Change Under Dopamine Supersensitivity Psychosis in Patients With Schizophrenia: A Comparison With First-Episode Psychosis.2020

    • Author(s)
      Takase M, Kimura H, Kanahara N, Nakata Y, Iyo M.
    • Journal Title

      J Psychopharmacol

      Volume: In Press Issue: 5 Pages: 540-547

    • DOI

      10.1177/0269881119900982

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed
  • [Journal Article] A Preliminary Exome Sequence in Three Patients With Tardive Dystonia2020

    • Author(s)
      Kanahara N, Nakata Y, Iyo M.
    • Journal Title

      Psychiatr Genet

      Volume: 30(2) Issue: 2 Pages: 57-59

    • DOI

      10.1097/ypg.0000000000000248

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Metabolism of risperidone by CYP2D6 and the presence of drug-induced dopamine supersensitivity psychosis in patients with schizophrenia.2019

    • Author(s)
      Kanahara N, Yoshimura K, Nakamura M, Oda Y, Watanabe M, Iyo M.
    • Journal Title

      Int Clin Psychopharmacol

      Volume: 34 Issue: 3 Pages: 124-130

    • DOI

      10.1097/yic.0000000000000257

    • Related Report
      2018 Research-status Report
    • Peer Reviewed
  • [Journal Article] First-episode psychosis in treatment-resistant schizophrenia: a cross-sectional study of a long-term follow-up cohort.2018

    • Author(s)
      Kanahara N, Yamanaka H, Suzuki T, Takase M, Iyo M.
    • Journal Title

      BMC Psychiatry

      Volume: 18 Issue: 1 Pages: 274-274

    • DOI

      10.1186/s12888-018-1853-1

    • Related Report
      2018 Research-status Report
    • Peer Reviewed
  • [Journal Article] Combination therapy of electroconvulsive therapy and aripiprazole for dopamine supersensitivity psychosis.2018

    • Author(s)
      Kanahara N, Hirabayashi M, Mamada T, Nishimoto M, Iyo M.
    • Journal Title

      Schizophr Res

      Volume: 202 Pages: 398-400

    • DOI

      10.1016/j.schres.2018.06.038

    • Related Report
      2018 Research-status Report
    • Peer Reviewed
  • [Journal Article] 抗精神病薬持効性注射剤導入の工夫2018

    • Author(s)
      金原信久、伊豫雅臣
    • Journal Title

      臨床精神医学

      Volume: 47増刊号 Pages: 73-75

    • Related Report
      2018 Research-status Report
  • [Journal Article] 統合失調症とドパミン過感受性2018

    • Author(s)
      金原信久、伊豫雅臣
    • Journal Title

      精神科

      Volume: 32(3) Pages: 227-233

    • Related Report
      2017 Research-status Report
  • [Journal Article] 治療抵抗性統合失調症患者に対するドパミン過感受性を考慮した長半減期型非定型抗精神病薬の効果検証:千葉大学精神科における後方視調査2018

    • Author(s)
      仲田祐介、金原信久、伊豫雅臣
    • Journal Title

      臨床精神薬理

      Volume: 印刷中

    • Related Report
      2017 Research-status Report
    • Peer Reviewed
  • [Journal Article] The impacts of dopamine D2 receptor polymorphism and antipsychotic dosage on dopamine supersensitivity psychosis in schizophrenia.2017

    • Author(s)
      Takase M, Kanahara N, Oda Y, Niitsu T, Watanabe H, Iyo M.
    • Journal Title

      Schizophrenia Research

      Volume: 190 Pages: 182-183

    • DOI

      10.1016/j.schres.2017.03.014

    • Related Report
      2017 Research-status Report
    • Peer Reviewed
  • [Journal Article] Antipsychotic-Induced Dopamine Supersensitivity Psychosis: Pharmacology, Criteria, and Therapy.2017

    • Author(s)
      Chouinard G, Samaha AN, Chouinard VA, Peretti CS, Kanahara N, Takase M, Iyo M.
    • Journal Title

      Psychotherapy and Psychosomatics

      Volume: 86(4) Issue: 4 Pages: 189-219

    • DOI

      10.1159/000477313

    • Related Report
      2017 Research-status Report
    • Peer Reviewed / Int'l Joint Research
  • [Journal Article] Dopamine supersensitivity psychosis in schizophrenia: Concepts and implications in clinical practice.2017

    • Author(s)
      Nakata Y, Kanahara N, Iyo M.
    • Journal Title

      Journal of Psychopharmacology

      Volume: 234(20) Issue: 12 Pages: 1511-1518

    • DOI

      10.1177/0269881117728428

    • Related Report
      2017 Research-status Report
    • Peer Reviewed
  • [Presentation] 治療抵抗性統合失調症におけるドパミン過感受性精神病について2019

    • Author(s)
      金原信久
    • Organizer
      第29回日本臨床精神神経薬理学会学術総会
    • Related Report
      2019 Annual Research Report
    • Invited
  • [Presentation] 古い頭部CT画像を用いた統合失調症患者の縦断的体積推移の検証2019

    • Author(s)
      山中浩嗣、金原信久、深見悟郎、伊豫雅臣
    • Organizer
      第29回日本臨床精神神経薬理学会学術総会
    • Related Report
      2019 Annual Research Report
  • [Presentation] 治療抵抗性統合失調症の病態と治療戦略2019

    • Author(s)
      金原信久
    • Organizer
      第27回日本精神科救急学会学術総会
    • Related Report
      2019 Annual Research Report
    • Invited
  • [Presentation] 遅発性ジストニアの遺伝子探索2019

    • Author(s)
      金原信久、仲田祐介、伊豫雅臣
    • Organizer
      千葉大学精神医学教室同門会
    • Related Report
      2019 Annual Research Report
  • [Presentation] 治療抵抗性統合失調症患者のExome解析:予備的検討2019

    • Author(s)
      金原信久、仲田祐介、伊豫雅臣
    • Organizer
      千葉大学精神医学教室同門会
    • Related Report
      2018 Research-status Report
  • [Presentation] ドパミン過感受性精神病を念頭にいれた難治性・難治化統合失調症患者への薬物療法の考察2018

    • Author(s)
      金原信久
    • Organizer
      第26回日本精神科救急学会学術総会
    • Related Report
      2018 Research-status Report
    • Invited
  • [Presentation] Exome解析による遅発性ジストニアの遺伝子探索2018

    • Author(s)
      金原信久、伊豫雅臣
    • Organizer
      千葉大学精神医学教室同門会
    • Related Report
      2017 Research-status Report
  • [Presentation] ドパミン過感受性精神病と治療抵抗性統合失調症:疫学・病態・薬物療法2017

    • Author(s)
      金原信久、伊豫雅臣
    • Organizer
      第113回日本精神神経学会
    • Related Report
      2017 Research-status Report
    • Invited
  • [Presentation] 治療抵抗性統合失調症患者における初発精神病エピソード「期間」の検討2017

    • Author(s)
      金原信久、山中浩嗣、鈴木智崇、髙瀬正幸、伊豫雅臣
    • Organizer
      第27回日本臨床精神神経薬理学会
    • Related Report
      2017 Research-status Report

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Published: 2017-04-28   Modified: 2021-02-19  

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