2019 Fiscal Year Final Research Report
Clinicopathological study for differential radiological diagnosis of dementia
| Project/Area Number |
15K09824
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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 | Yokohama City University (2018-2019)
Nagoya University (2015-2017) |
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Principal Investigator |
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| Project Period (FY) |
2015-04-01 – 2020-03-31
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| Keywords | 老人斑 / アミロイド / 神経原線維変化 / レビー病理 / レビー小体 / シヌクレイン / ドパミントランスポーター / 脳血流 |
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| Outline of Final Research Achievements |
In the recent research criteria, the prodromal phase of dementia with Lewy bodies includes psychiatric-onset presentations. However, its clinicopathological features remains unclear. In 36 autopsy cases with diffuse Lewy body disease, clinical and pathological variables were statistically compared among three groups according to initial symptoms. The severity of parkinsonism was significantly greater in the parkinsonism group than those in the psychotic state and memory disturbance. As to pathological findings, the median senile plaque score was significantly higher in the memory disturbance group than in the other groups. These results support the fact that cerebral β-amyloid accumulation contributes to determining the clinical phenotypes in terms of the timing the onset of dementia relative to that of parkinsonism in Lewy body dementia. Further clinicopathological studies with specific biomarker data are needed to clarify disease progression patterns in Lewy body dementia.
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| Free Research Field |
老年精神医学
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| Academic Significance and Societal Importance of the Research Achievements |
老年期にはじめて精神症状が出現する脳病態、とくに病理学的背景は明らかになっていない。しかし、近年の脳機能画像やレビー小体病の知見が蓄積されているが、症候学的による分類に基づく診療が実施されているのが現状である。レビー小体病は、病初期に精神症状が前景化する場合があり、老年期発症の精神疾患の鑑別診断に重要であるが、その方法は確立されていない。レビー小体病を早期に鑑別することは、薬物療法の選択ばかりでなく、認知機能低下を含む臨床経過を把握するうえで重要である。また、臨床病理学的知見の更なる蓄積は、今後の疾患修飾薬を見据え、貴重と考えられる。
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