| Project/Area Number |
21K07488
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 52030:Psychiatry-related
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| Research Institution | Jikei University School of Medicine |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
小林 伸行 東京慈恵会医科大学, 医学部, 准教授 (20385321)
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| Project Period (FY) |
2021-04-01 – 2024-03-31
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| Project Status |
Completed (Fiscal Year 2023)
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| Budget Amount *help |
¥4,030,000 (Direct Cost: ¥3,100,000、Indirect Cost: ¥930,000)
Fiscal Year 2023: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2022: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2021: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
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| Keywords | BPSD / 神経精神症状 / 認知症 / アルツハイマー病 / DNAメチル化 / 治療反応性 |
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| Outline of Research at the Start |
本研究では1)Wntシグナル関連遺伝子を中心としたDNAメチル化量とBPSDの背景因子との関連を調べ、2)これらのDNAメチル化量が背景因子や神経基盤をあらわすBPSDのバイオマーカーとなるかを評価する。その後、3)DNAメチル化量と薬物治療反応性の関連を検証し、最終的に4)背景因子と治療反応性を踏まえたBPSD評価の再構築を目指す。
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| Outline of Final Research Achievements |
BPSD in dementia is a burdensome symptom for patients and caregivers, but treatment responsiveness is difficult to predict. 31 patients who were hospitalized for 12 weeks were compared before and after treatment for BPSD. BPSD was classified into three clusters by principal component analysis: 1) psychosis/emotional symptoms, 2) behavioral/circadian rhythm symptoms, and 3) apathy/agitation symptoms. There was a significant correlation between behavioral and circadian rhythm symptom scores and treatment course, but no significant association with psychotropic medication, the severity of apathy worsened over time, and treatment responsiveness of BPSD differed significantly by symptom. The relationship between treatment responsiveness and the amount of DNA methylation at candidate sites is currently being analyzed and will be reported.
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| Academic Significance and Societal Importance of the Research Achievements |
現在は緊急性の判断、薬剤無効例、副作用の危険性などから、BPSDに薬物治療を選択すべかの判断が困難な場合が多い。治療対象として個々のBPSDの症候ではなく「バイオマーカーとしての DNAメチル化」を用いるという発想の転換により、血液を利用した簡便に実施可能な治療反応性マ ーカーが実現すれば、速やかで適正な治療法の選択が可能となる。臨床医の視点に立脚したものと して、患者のQOLの向上と介護負担の軽減に繋がり、社会的な意義は大きい。
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