Clinicopathological study for differential radiological diagnosis of dementia

• Project/Area Number: 24791232
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Psychiatric science
• Research Institution: Nagoya University (2013-2014); Juntendo University (2012)
• Principal Investigator: FUJISHIRO Hiroshige 名古屋大学, 医学(系)研究科(研究院), 寄附講座講師 (20536924)
• Project Period (FY): 2012-04-01 – 2015-03-31
• Project Status: Completed (Fiscal Year 2014)
• Budget Amount: ¥2,990,000 (Direct Cost: ¥2,300,000、Indirect Cost: ¥690,000); Fiscal Year 2014: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000); Fiscal Year 2013: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000); Fiscal Year 2012: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
• Keywords: DLB / AD / 早期診断 / レビー病理 / 神経原線維変化 / ブドウ糖代謝 / 神経画像 / レビー小体病 / 脳機能画像 / FDG-PET / 脳血流SPECT / レビー小体 / アミロイド / レビー小体型認知症 / アルツハイマー病 / 神経病理 / 神経基盤 / ドパミン

Outline of Final Research Achievements

It is extremely challenging to differentially diagnose dementia with Lewy bodies (DLB) from Alzheimer's disease (AD) at predementia stages. Olfactory dysfunction, dysautonomia, and mood and sleep disorders were present in most DLB patients before the onset of memory loss. The presence of prodromal symptoms of Lewy body disease (LBD) or findings of occipital hypometabolism helps us to predict the possible pathophysiological process of LBD in non-demented patients. On the other hand, some hippocampal sparing AD patients exhibited atypical presentation rather than memory loss as initial symptom. Clinicopathological correlations including brain blood perfusion supported the previous findings. The diversity and the long-term nature of prodromal states of neurodegenerative dementing disorders were partially revealed. Further clinicopathological studies including radiological findings will be needed.

Research Products

• [Journal Article] Clinical profiles of dementia with Lewy bodies with and without Alzheimer’s disease-like hypometabolism. (2015)
  • Author(s): Chiba Y, Fujishiro H, Ota K, Kasanuki K, Arai H, Hirayasu Y, Sato K, Iseki E.
  • Journal Title: Int J Geriatr Psychiatry Volume: 30 Issue: 3 Pages: 316-323
  • DOI: 10.1002/gps.4144
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Autopsy-confirmed hippocampal-sparing Alzheimer’s disease with delusional jealousy as initial manifestation. (2015)
  • Author(s): Fujishiro H, Iritani S, Hattori M, Sekiguchi H, Matsunaga S, Habuchi C, Torii Y, Umeda K, Ozaki N, Yoshida M, Fujita K.
  • Journal Title: Psychogeriatrics Volume: 15 Issue: 3 Pages: 198-203
  • DOI: 10.1111/psyg.12105
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Long-term efficacy of donepezil for relapse of visual hallucinations in patients with dementia with Lewy bodies. (2015)
  • Author(s): Ukai K, Fujishiro H, Iritani S, Ozaki N.
  • Journal Title: Psychogeriatrics Volume: 15 Issue: 2 Pages: 133-137
  • DOI: 10.1111/psyg.12089
  • Peer Reviewed
• [Journal Article] Prodromal dementia with Lewy bodies. (2015)
  • Author(s): Fujishiro H, Nakamura S, Sato K, Iseki E.
  • Journal Title: Geriatr Gerontol Int Volume: 15 Issue: 7 Pages: 817-826
  • DOI: 10.1111/ggi.12466
  • NAID: 40020615489
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Diagnostic Accuracy of 123I-Meta-Iodobenzylguanidine Myocardial Scintigraphy in Dementia with Lewy Bodies: A Multicenter Study. (2015)
  • Author(s): Yoshita M, Arai H, Arai H, Arai T, Asada T, Fujishiro H, Hanyu H, Iizuka O, Iseki E, Kashihara K, Kosaka K, Maruno H, Mizukami K, Mizuno Y, Mori E, Nakajima K, Nakamura H, Nakano S, Nakashima K, Nishio Y, et al.
  • Journal Title: PLoS One Volume: 10 Issue: 3 Pages: 0-0
  • DOI: 10.1371/journal.pone.0120540
  • Peer Reviewed / Open Access
• [Journal Article] Cognitive dysfunction in patients with very mild Alzheimer’s disease and amnestic mild cognitive impairment showing hemispheric asymmetries of hypometabolism on 18F-FDG PET. (2015)
  • Author(s): Murayama N, Ota K, Kasanuki K, Kondo D, Fujishiro H, Fukase Y, Tagaya H, Sato K, Isek E.
  • Journal Title: Geriat Psychiatr. Volume: 30 Issue: 1 Pages: 4287-4287
  • DOI: 10.1002/gps.4287
  • Peer Reviewed / Open Access
• [Journal Article] Neuropathological investigation of hypocretin expression in brains of dementia with Lewy bodies. (2014)
  • Author(s): Kasanuki K, Iseki E, Kondo D, Fujishiro H, Minegishi M, Sato K, Katsuse O, Hino H, Kosaka K, Arai H
  • Journal Title: Neurosci Lett Volume: 569 Pages: 68-73
  • DOI: 10.1016/j.neulet.2014.03.020
  • Peer Reviewed
• [Journal Article] Effects of gabapentin enacarbil on restless legs syndrome and leg pain in dementia with Lewy bodies. (2014)
  • Author(s): Fujishiro H
  • Journal Title: Psychogeriatrics Volume: 14 Issue: 2 Pages: 132-134
  • DOI: 10.1111/psyg.12043
  • Peer Reviewed
• [Journal Article] Primary visual metabolism and REM sleep behavior disorder in dementia with Lewy bodies (2014)
  • Author(s): Chiba Y, Iseki E, Fujishiro H, Kasanuki K, Ota K, Sato K
  • Journal Title: Psychiatry Clin Neurosci Volume: 68 Issue: 2 Pages: 137-144
  • DOI: 10.1111/pcn.12101
  • Peer Reviewed
• [Journal Article] Three presenile patients in which neuropsychological and neuroimaging examinations suggest possibility of progression to dementia with Lewy bodies (2014)
  • Author(s): Ota K, Iseki E, Murayama N, Chiba Y, Fijishiro H, Kasanuki K, Manabe Y, Arai H, Sato K
  • Journal Title: Psychogeriatrics Volume: 14 Issue: 1 Pages: 72-80
  • DOI: 10.1111/psyg.12039
  • Peer Reviewed
• [Journal Article] Cardiac 123I- metaiodobenzylguanidine scintigraphy in elderly depressed patients. (2014)
  • Author(s): Fujishiro H
  • Journal Title: Psychiatry Clin Neurosci Volume: 68 Issue: 8 Pages: 652-652
  • DOI: 10.1111/pcn.12180
  • Peer Reviewed
• [Journal Article] Lymphopenia Helps Early Diagnosis of Systemic Lupus Erythematosus for Patients With Psychosis as an Initial Symptom. (2014)
  • Author(s): Chiba Y, Katsuse O, Fujishiro H, Kamada A, Saito T, Ikura T, Takahashi Y,Kunii M, Takeno M, Hirayasu Y.
  • Journal Title: Psychosomatics. Volume: Epub ahead of print Issue: 1 Pages: 85-88
  • DOI: 10.1016/j.psym.2013.07.001
  • Peer Reviewed
• [Journal Article] Pathology and temporal onset of visual hallucinations, misperceptions and family misidentification distinguishes Dementia with Lewy bodies from Alzheimer’s disease. (2013)
  • Author(s): Ferman TJ, Arvanitakis Z, Fujishiro H, Duara R, Parfitt F, Purdy M, Waters C, Barker W, Graff-Radford NR, Dickson DW.
  • Journal Title: Parkinsonism Relat Disord Volume: 19 Issue: 2 Pages: 227-231
  • DOI: 10.1016/j.parkreldis.2012.10.013
  • Peer Reviewed
• [Journal Article] Dementia with Lewy bodies: early diagnostic challenges (2013)
  • Author(s): Fujishiro H, Iseki E, Nakamura S, Kasanuki K, Chiba Y, Ota K, Murayama N, Sato K
  • Journal Title: Psychogeriatrics Volume: 13 Issue: 2 Pages: 581-583
  • DOI: 10.1111/psyg.12005
  • Peer Reviewed
• [Journal Article] Effectiveness of remelteon for treatment of visual hallucinations in dementia with Lewy bodies: four cases report (2013)
  • Author(s): Kasanuki K, Iseki E, Nishida Y, Fujishiro H, Sato K, Arai H
  • Journal Title: J Clin Psychopharmacol Volume: 33 Issue: 4 Pages: 128-138
  • DOI: 10.1097/jcp.0b013e318295fdf4
  • Peer Reviewed
• [Journal Article] A follow up study of non-demented patients with primary visual cortical hypometabolism: prodromal dementia with Lewy bodies (2013)
  • Author(s): Fujishiro H, Iseki E, Kasanuki K, Chiba Y, Ota K, Murayama N, Sato K
  • Journal Title: J Neurol Sci Volume: 334 Issue: 1-2 Pages: 48-54
  • DOI: 10.1016/j.jns.2013.07.013
  • Peer Reviewed
• [Journal Article] Levodopa treatment and mood fluctuation in dementia with Lewy bodies: a case report. (2013)
  • Author(s): Fujishiro H, Kasanuki K, Nakamura S.
  • Journal Title: Psychogeriatrics Volume: 13 Issue: 4 Pages: 250-253
  • DOI: 10.1111/psyg.12025
  • Peer Reviewed
• [Journal Article] Diversity of pathological features other than Lewy bodies in familial Parkinson’s disease due to SNCA mutations. (2013)
  • Author(s): Fujishiro H, Imamura AY, Lin WL, Uchikado H, Mark MH, Golbe LI, Markopoulou K, Wszolek ZK, Dickson DW.
  • Journal Title: Am J Neurodegener Dis Volume: 2 Pages: 266-275
  • Peer Reviewed
• [Journal Article] Intelligence or years of education: which is better correlated with memory function in normal elderly Japanese subjects? (2012)
  • Author(s): Murayama N, et al.
  • Journal Title: Psychogeriatrics Volume: 13 Issue: 1 Pages: 9-16
  • DOI: 10.1111/j.1479-8301.2012.00408.x
  • Peer Reviewed
• [Journal Article] Neuropsychological Detection of the Early Stage of Amnestic Mild Cognitive Impairment without Objective Memory Impairment. (2012)
  • Author(s): Murayama N, et al.
  • Journal Title: Dementia and Geriatric Cognitive Disorders Volume: 35 Issue: 1-2 Pages: 98-105
  • DOI: 10.1159/000346286
  • Peer Reviewed
• [Journal Article] Rapid eye movement disorder and subtypes in autopsy-confirmed dementia with Lewy bodies (2012)
  • Author(s): Dugger BN, et al
  • Journal Title: Mov Disord Volume: 27 Issue: 1 Pages: 72-78
  • DOI: 10.1002/mds.24003
  • Peer Reviewed
• [Journal Article] Early detection of dementia with Lewy bodies in patients with amnestic mild cognitive impairment using 123I-MIBG cardiac scintigraphy. (2012)
  • Author(s): Fujishiro H, Iseki E, et al
  • Journal Title: J Neurol Sci Volume: 315 Issue: 1-2 Pages: 115-119
  • DOI: 10.1016/j.jns.2011.11.012
  • Peer Reviewed
• [Journal Article] Retrospective survey of prodromal symptoms in dementia with Lewy bodies: comparison with Retrospective survey of prodromal symptoms in dementia with Lewy bodies: comparison with Alzheimer’s disease. (2012)
  • Author(s): Chiba Y, Iseki E, et al
  • Journal Title: Dement Geriatr Cogn Disord Volume: 33 Issue: 4 Pages: 278-281
  • DOI: 10.1159/000339363
  • Peer Reviewed
• [Journal Article] Glucose hypomatabolism in primary visual cortex is commonly associated with clinical features of dementia with Lewy bodies regardless of cognitive conditions. (2012)
  • Author(s): Fujishiro H, Iseki E, et al
  • Journal Title: Int J Geriatr Psychiatry Volume: 27 Issue: 11 Pages: 1138-1146
  • DOI: 10.1002/gps.2836
  • Peer Reviewed
• [Journal Article] Urinary homocysteic acid levels correlate with mini-mental state examination scores in Alzheimer's disease patients. (2012)
  • Author(s): Hasegawa T, Hatano T (5番目)
  • Journal Title: Journal of Alzheimers Disease Volume: 1 Issue: 1 Pages: 59-64
  • DOI: 10.3233/jad-2012-120022
  • Peer Reviewed
• [Presentation] DLB research in Asia (2015)
  • Author(s): Fujishiro Hiroshige
  • Organizer: International dementia with Lewy bodies conference
  • Place of Presentation: Ft. Lauderdale (USA)
  • Year and Date: 2015-12-04
  • Invited
• [Presentation] 認知症在宅診療における睡眠障害について (2015)
  • Author(s): 藤城弘樹
  • Organizer: 第30回日本老年精神医学会
  • Place of Presentation: パシフィコ横浜（神奈川県横浜市）
  • Year and Date: 2015-06-13
  • Invited
• [Presentation] 身体不定愁訴を認めた78歳男性の1剖検例：レビー小体型認知症の初期症状について (2014)
  • Author(s): 藤城弘樹、入谷修司、関口裕孝、松永慎史、鳥居洋太、梅田健太郎、羽渕知可子、尾崎紀夫、吉田眞理、藤田潔
  • Organizer: 第33回 日本認知症学会
  • Place of Presentation: パシフィコ横浜（神奈川県横浜市）
  • Year and Date: 2014-12-01
• [Presentation] ADおよびDLBへ移行するMCIの特徴（１）－神経心理検査から－ (2014)
  • Author(s): 太田一実、近藤大三、笠貫浩史、藤城弘樹、村山憲男、佐藤潔、平安良雄、新井平伊、井関栄三
  • Organizer: 第33回 日本認知症学会
  • Place of Presentation: パシフィコ横浜（神奈川県横浜市）
  • Year and Date: 2014-12-01
• [Presentation] レビー小体病の幻覚妄想に対しドネぺジルからリバスタグミンへの切替えが著効した2例 (2014)
  • Author(s): 安江一朗、松永慎史、藤城弘樹、藤田潔、岩田仲生
  • Organizer: 第33回 日本認知症学会
  • Place of Presentation: パシフィコ横浜（神奈川県横浜市）
  • Year and Date: 2014-11-30
• [Presentation] ADおよびDLBへ移行するMCIの特徴（１）－FDG-PET画像から－ (2014)
  • Author(s): 近藤大三、太田一実、笠貫浩史、藤城弘樹、村山憲男、佐藤潔、平安良雄、新井平伊、井関栄三
  • Organizer: 第33回 日本認知症学会
  • Place of Presentation: パシフィコ横浜（神奈川県横浜市）
  • Year and Date: 2014-11-30
• [Presentation] 生体肝移植ドナー候補者における精神医学的合併症 (2014)
  • Author(s): 鈴木伸幸、砂田紗季、岸辰一、藤城弘樹、木村宏之、岡田俊、尾崎紀夫、山口尚子、坪井千里、亀井秀弥、大西康晴、小倉靖弘
  • Organizer: 第27回日本総合病院精神医学会
  • Place of Presentation: つくば国際会議場（茨城県つくば市）
  • Year and Date: 2014-11-28
• [Presentation] 身体不定愁訴を認めた78歳男性の1剖検例 (2014)
  • Author(s): 藤城弘樹、入谷修司、松永慎史、藤田潔、関口裕孝、鳥居洋太、梅田健太郎、羽渕知可子、赤木明生、三室マヤ、岩崎靖、吉田眞理
  • Organizer: 第51回 名古屋臨床神経病理アカデミー
  • Place of Presentation: 大日本住友製薬名古屋支店5Fホール(愛知県名古屋市）
  • Year and Date: 2014-07-12
• [Presentation] 精神病症状が先行した舞踏病の一例 (2014)
  • Author(s): 関口裕孝、入谷修司、鳥居洋太、梅田健太郎、藤城弘樹、赤木明生、三室マヤ、岩崎靖、吉田眞理、藤田潔、羽渕知可子
  • Organizer: 第51回 名古屋臨床神経病理アカデミー
  • Place of Presentation: 大日本住友製薬名古屋支店5Fホール(愛知県名古屋市）
  • Year and Date: 2014-07-12
• [Presentation] 精神科における高齢者の睡眠障害 (2014)
  • Author(s): 藤城弘樹
  • Organizer: 第39回 日本睡眠学会
  • Place of Presentation: ホテルクレメント徳島（徳島県徳島市）
  • Year and Date: 2014-07-03
• [Presentation] レビー小体病の補助診断に睡眠ポリグラフ検査が有用であった二例 (2014)
  • Author(s): 大橋 知明、棟近 孝之、藤城 弘樹、奥田 将人、大竹 宏直、岩本 邦弘、宮田 聖子、入谷 修司、野田 明子、尾崎 紀夫
  • Organizer: 第39回 日本睡眠学会
  • Place of Presentation: あわぎんホール（徳島県徳島市）
  • Year and Date: 2014-07-03
• [Presentation] 幻聴が前景化した非定型アルツハイマー病と考えられた一例 －非定型アルツハイマー病における初発症状についての考察－ (2014)
  • Author(s): 辻里花、藤城弘樹、入谷修司、藤田潔、尾崎紀夫
  • Organizer: 第29回日本老年精神医学会
  • Place of Presentation: 日本教育会館（東京都千代田区）
  • Year and Date: 2014-06-12
• [Presentation] レビー小体型認知症剖検脳のMelanin-Concentrating Hormone (MCH)発現に関する神経病理学的検討 (2014)
  • Author(s): 近藤大三、笠貫浩史、藤城弘樹、峯岸道子、佐藤潔、日野博昭、勝瀬大海、小阪憲司、平安良雄、新井平伊、井関栄三
  • Organizer: 第55回 日本神経病理学会
  • Place of Presentation: 学術総合センター(東京都千代田区）
  • Year and Date: 2014-06-06
• [Presentation] Non-demented patients with primary visual cortical hypometabolism in memory clinic: a follow-up study. (2013)
  • Author(s): Fujishiro H, Iseki E, Kasanuki K, Chiba Y, Ota K, Murayama N, Sato K.
  • Organizer: Alzheimer disease and Parkinson's disease congress
  • Place of Presentation: Florence
• [Presentation] Dementia with Lewy bodies: clinicopathological concepts and early diagnostic challenge
  • Author(s): Fujishiro H
  • Organizer: The 9th International Congress on Mental dysfunction & other non-motor features in Parkinson’s disease and related disorders
  • Place of Presentation: ソウル, 韓国
  • Invited
• [Presentation] 嫉妬妄想が前景化したアルツハイマー病の１剖検例
  • Author(s): 藤城弘樹、入谷修司、服部美穂、関口裕孝、鳥居洋太、羽渕知可子、梅田健太郎、松永慎史 、安江一朗 、吉田眞理、尾崎紀夫、藤田潔
  • Organizer: 第32回日本認知症学会
  • Place of Presentation: キッセイ文化ホール（松本市）
• [Presentation] Two autopsy cases of minimum nigral degeneration in psychiatric hospital: implication of early stages of dementia with Lewy bodies
  • Author(s): Fujishiro H, Habuchi C, Iritani S, Sekiguchi H, Torii Y, Umeda K, Miyata M, Yoshida M, Ozaki O, Fujita K.
  • Organizer: 第20回世界パーキンソン病会議
  • Place of Presentation: ジュネーブ, スイス
• [Book] レビー小体型認知症 臨床と病理 臨床診断基準・診断法 (2014)
  • Author(s): 藤城弘樹，井関栄三
  • Total Pages: 173
  • Publisher: 中外医学社
• [Book] レビー小体型認知症 臨床と病理 病態・病理 (2014)
  • Author(s): 藤城弘樹，井関栄三
  • Total Pages: 173
  • Publisher: 中外医学社