2018 Fiscal Year Final Research Report
Evaluation of the pathogenesis of hypersomnolence and psychosis disorders caused by auto-antibodies
| Project/Area Number |
16K10203
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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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| Research Field |
Psychiatric science
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| Research Institution | Akita University |
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Principal Investigator |
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| Project Period (FY) |
2016-04-01 – 2019-03-31
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| Keywords | 睡眠覚醒障害 / 抗NMDA受容体脳炎 |
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| Outline of Final Research Achievements |
Of the 36 NMO cases, 28 were positive for AQP4 antibody, 8 were negative, and 2 were negative for MOG. Orexin levels were relatively high in MOG positive cases. In both cases where both antibodies were negative, improvement in orexin levels after treatment was poor.
NMDAR antibody was positive in 14 out of 169 cases. Seven of the 14 cases had encephalitis and were initially diagnosed with tension disease. The other 7 cases were cases of only mental symptoms without neurological symptoms, and psychiatric diagnosis was 3 cases of tension disorders, 2 cases of short-term mental disorders and 2 cases of schizophrenia. In 25 sleep disorders, 6 positive cases were found. 5 were narcolepsy and 1 was recurrent hypersomnia in these 6 positive cases.
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| Free Research Field |
睡眠覚醒障害
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| Academic Significance and Societal Importance of the Research Achievements |
オレキシン神経障害を来して、過眠症状を示すNMO36症例のうちで、AQP4抗体陽性例は28例と大部分を占めている。NMOの国際診断基準の中核症状の1つにも過眠症状があげられており、頻度が高いことは妥当な結果と思われる。NMDAR抗体が精神症状のみの7例で陽性であったことは特筆すべきことであり、統合失調症と考えられていた症例のうちで、僅かではあるが神経抗体により症状が発現している症例が存在することになる。睡眠障害に精神症状を呈した症例でも陽性例があり、抗体による精神症状の発現は希有な物ではないと考えられる。
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