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Verify drug efficacy based on genetic information and formulate a treatment algorithm for dementia with Lewy bodies

Research Project

Project/Area Number 19K17073
Research Category

Grant-in-Aid for Early-Career Scientists

Allocation TypeMulti-year Fund
Review Section Basic Section 52030:Psychiatry-related
Research InstitutionKansai Medical University

Principal Investigator

SUNADA Naotaka  関西医科大学, 医学部, 非常勤講師 (30809398)

Project Period (FY) 2019-04-01 – 2022-03-31
Project Status Completed (Fiscal Year 2021)
Budget Amount *help
¥2,600,000 (Direct Cost: ¥2,000,000、Indirect Cost: ¥600,000)
Fiscal Year 2021: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2020: ¥390,000 (Direct Cost: ¥300,000、Indirect Cost: ¥90,000)
Fiscal Year 2019: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Keywordsレビー小体型認知症 / 認知症を伴うパーキンソン病 / 介護者負担 / DLB / PDD / NPI-Q / レビー小体病 / 治療反応性 / 個別化医療 / 抗認知症薬 / 介護負担 / 治療効果 / ゲノム情報 / ドネペジル / 薬物療法
Outline of Research at the Start

レビー小体型認知症(DLB)は2017年に新しい診断基準が発表され、バイオマーカーの所見が重要視されるようになった。今後、バイオマーカーを重要視した診断基準からDLBの診断の感度、特異度が向上し、DLB患者は増加する可能性が十分にある。DLBの治療薬として、ドネペジルが唯一承認されており、その血中濃度はCYP2D6の遺伝子多型やCHAT遺伝子の一塩基対多型(SNP)に影響を受ける。本研究はDLB患者において、遺伝子情報に基づく薬理遺伝学の観点から、ドネペジルの治療反応性に関して検証をする前向き試験であり、遺伝子情報を元にしたDLB患者の個別化医療の一助となることを目的とする。

Outline of Final Research Achievements

The regular visits required to verify the efficacy of the drug were difficult due to the spread of COVID-19 infection. Therefore, we verified the burden on caregivers using other factors. Dementia with Lewy bodies (DLB) belong to the same spectrum as Parkinson’s disease with dementia (PDD). And, in Alzheimer's disease, diabetes mellitus (DM) is associated with caregiver burden.
We examined the relationship between DM and caregiver burden for DLB and PDD patients. The burden score of caregivers was higher in the DM group than in the non-DM group, but no significant difference was observed. In this study, the number of patients with type 1 DM was higher than the general prevalence, therefore, we performed an exploratory analysis. The burden score of caregivers in the type 1 DM group was higher than those in the other groups, but no significant difference was observed. In this study, factors related to caregiver burden were not clarified. We will continue to accumulate findings.

Academic Significance and Societal Importance of the Research Achievements

アルツハイマー型認知症(AD)と比較し、レビー小体型認知症(DLB)及び認知症を伴うパーキンソン病(PDD)は知見の集積が少ない。レビー小体病理は、認知症患者の剖検例で40%以上と多く認めている。バイオマーカーを重要視した診断基準から、適切な診断により、DLB及びPDDの患者数は増加が予想され、本研究の知見は学術的意義が大きいと考える。また、DLB及びPDDに対して、ADの分野でも注目されている糖尿病の因子に着眼点を置き、介護者負担を定量化し、知見の集積及び検証を行ったことは、エビデンスを構築する上で重要であり、認知症患者が地域社会で安定した生活を送る上でも社会的意義が大きいと考える。

Report

(4 results)
  • 2021 Annual Research Report   Final Research Report ( PDF )
  • 2020 Research-status Report
  • 2019 Research-status Report
  • Research Products

    (4 results)

All 2021 2019

All Journal Article (3 results) (of which Peer Reviewed: 3 results,  Open Access: 2 results) Presentation (1 results)

  • [Journal Article] Divergence of dose?response with asenapine: a cluster analysis of randomized, double-blind, and placebo control study2021

    • Author(s)
      Takekita Yoshiteru、Hiraoka Shuichi、Iwama Yasuhiro、Sunada Naotaka、Aoki Nobuatsu、Ogata Haruhiko、Funatsuki Toshiya、Takano Chikashi、Yanagida Tomoyo、Koshikawa Yosuke、Naito Minami、Yamamoto Atsuko、Kato Masaki、Kinoshita Toshihiko
    • Journal Title

      CNS Spectrums

      Volume: 19 Issue: 3 Pages: 1-9

    • DOI

      10.1017/s1092852921000043

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Sevoflurane in electroconvulsive therapy: A systematic review and meta-analysis of randomised trials2021

    • Author(s)
      Aoki Nobuatsu、Suwa Taro、Kawashima Hirotsugu、Tajika Aran、Sunada Naotaka、Shimizu Toshiyuki、Murai Toshiya、Kinoshita Toshihiko、Takekita Yoshiteru
    • Journal Title

      Journal of Psychiatric Research

      Volume: 141 Pages: 16-25

    • DOI

      10.1016/j.jpsychires.2021.06.030

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Brain Volume-Related Polymorphisms of the Glycogen Synthase Kinase-3β Gene and Their Effect on Antidepressant Treatment in Major Depressive Disorder2019

    • Author(s)
      Sunada Naotaka、Takekita Yoshiteru、Nonen Shinpei、Wakeno Masataka、Koshikawa Yosuke、Ogata Haruhiko、Kinoshita Toshihiko、Kato Masaki
    • Journal Title

      Neuropsychobiology

      Volume: 78 Issue: 3 Pages: 136-144

    • DOI

      10.1159/000500614

    • Related Report
      2019 Research-status Report
    • Peer Reviewed
  • [Presentation] 大うつ病性障害患者におけるミルタザピンと選択的セロトニン再取り込み阻害薬の治療反応とABCB1遺伝子多型の関連2019

    • Author(s)
      砂田尚孝
    • Organizer
      第29回日本臨床精神神経薬理学会
    • Related Report
      2019 Research-status Report

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Published: 2019-04-18   Modified: 2023-01-30  

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