1
|
Hoshi H, Hirata Y, Fukasawa K, Kobayashi M, Shigihara Y. Oscillatory characteristics of resting-state magnetoencephalography reflect pathological and symptomatic conditions of cognitive impairment. Front Aging Neurosci 2024; 16:1273738. [PMID: 38352236 PMCID: PMC10861731 DOI: 10.3389/fnagi.2024.1273738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 01/12/2024] [Indexed: 02/16/2024] Open
Abstract
Background Dementia and mild cognitive impairment are characterised by symptoms of cognitive decline, which are typically assessed using neuropsychological assessments (NPAs), such as the Mini-Mental State Examination (MMSE) and Frontal Assessment Battery (FAB). Magnetoencephalography (MEG) is a novel clinical assessment technique that measures brain activities (summarised as oscillatory parameters), which are associated with symptoms of cognitive impairment. However, the relevance of MEG and regional cerebral blood flow (rCBF) data obtained using single-photon emission computed tomography (SPECT) has not been examined using clinical datasets. Therefore, this study aimed to investigate the relationships among MEG oscillatory parameters, clinically validated biomarkers computed from rCBF, and NPAs using outpatient data retrieved from hospital records. Methods Clinical data from 64 individuals with mixed pathological backgrounds were retrieved and analysed. MEG oscillatory parameters, including relative power (RP) from delta to high gamma bands, mean frequency, individual alpha frequency, and Shannon's spectral entropy, were computed for each cortical region. For SPECT data, three pathological parameters-'severity', 'extent', and 'ratio'-were computed using an easy z-score imaging system (eZIS). As for NPAs, the MMSE and FAB scores were retrieved. Results MEG oscillatory parameters were correlated with eZIS parameters. The eZIS parameters associated with Alzheimer's disease pathology were reflected in theta power augmentation and slower shift of the alpha peak. Moreover, MEG oscillatory parameters were found to reflect NPAs. Global slowing and loss of diversity in neural oscillatory components correlated with MMSE and FAB scores, whereas the associations between eZIS parameters and NPAs were sparse. Conclusion MEG oscillatory parameters correlated with both SPECT (i.e. eZIS) parameters and NPAs, supporting the clinical validity of MEG oscillatory parameters as pathological and symptomatic indicators. The findings indicate that various components of MEG oscillatory characteristics can provide valuable pathological and symptomatic information, making MEG data a rich resource for clinical examinations of patients with cognitive impairments. SPECT (i.e. eZIS) parameters showed no correlations with NPAs. The results contributed to a better understanding of the characteristics of electrophysiological and pathological examinations for patients with cognitive impairments, which will help to facilitate their co-use in clinical application, thereby improving patient care.
Collapse
Affiliation(s)
- Hideyuki Hoshi
- Precision Medicine Centre, Hokuto Hospital, Obihiro, Japan
| | - Yoko Hirata
- Department of Neurosurgery, Kumagaya General Hospital, Kumagaya, Japan
| | | | - Momoko Kobayashi
- Precision Medicine Centre, Kumagaya General Hospital, Kumagaya, Japan
| | - Yoshihito Shigihara
- Precision Medicine Centre, Hokuto Hospital, Obihiro, Japan
- Precision Medicine Centre, Kumagaya General Hospital, Kumagaya, Japan
| |
Collapse
|
2
|
Michopoulou S, Prosser A, Dickson J, Guy M, Teeling JL, Kipps C. Perfusion Imaging and Inflammation Biomarkers Provide Complementary Information in Alzheimer's Disease. J Alzheimers Dis 2023; 96:1317-1327. [PMID: 38009439 PMCID: PMC10741328 DOI: 10.3233/jad-230726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND Single photon emission tomography (SPECT) can detect early changes in brain perfusion to support the diagnosis of dementia. Inflammation is a driver for dementia progression and measures of inflammation may further support dementia diagnosis. OBJECTIVE In this study, we assessed whether combining imaging with markers of inflammation improves prediction of the likelihood of Alzheimer's disease (AD). METHODS We analyzed 91 participants datasets (Institutional Ethics Approval 20/NW/0222). AD biomarkers and markers of inflammation were measured in cerebrospinal fluid. Statistical parametric mapping was used to quantify brain perfusion differences in perfusion SPECT images. Logistic regression models were trained to evaluate the ability of imaging and inflammation markers, both individually and combined, to predict AD. RESULTS Regional perfusion reduction in the precuneus and medial temporal regions predicted Aβ42 status. Increase in inflammation markers predicted tau and neurodegeneration. Matrix metalloproteneinase-10, a marker of blood-brain barrier regulation, was associated with perfusion reduction in the right temporal lobe. Adenosine deaminase, an enzyme involved in sleep homeostasis and inflammation, was the strongest predictor of neurodegeneration with an odds ratio of 10.3. The area under the receiver operator characteristic curve for the logistic regression model was 0.76 for imaging and 0.76 for inflammation. Combining inflammation and imaging markers yielded an area under the curve of 0.85. CONCLUSIONS Study results showed that markers of brain perfusion imaging and markers of inflammation provide complementary information in AD evaluation. Inflammation markers better predict tau status while perfusion imaging measures represent amyloid status. Combining imaging and inflammation improves AD prediction.
Collapse
Affiliation(s)
- Sofia Michopoulou
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Angus Prosser
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - John Dickson
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Matthew Guy
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Christopher Kipps
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| |
Collapse
|
3
|
Gaggi NL, Ware JB, Dolui S, Brennan D, Torrellas J, Wang Z, Whyte J, Diaz-Arrastia R, Kim JJ. Temporal dynamics of cerebral blood flow during the first year after moderate-severe traumatic brain injury: A longitudinal perfusion MRI study. Neuroimage Clin 2023; 37:103344. [PMID: 36804686 PMCID: PMC9969322 DOI: 10.1016/j.nicl.2023.103344] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 02/01/2023] [Accepted: 02/04/2023] [Indexed: 02/13/2023]
Abstract
Traumatic brain injury (TBI) is associated with alterations in cerebral blood flow (CBF), which may underlie functional disability and precipitate TBI-induced neurodegeneration. Although it is known that chronic moderate-severe TBI (msTBI) causes decreases in CBF, the temporal dynamics during the early chronic phase of TBI remain unknown. Using arterial spin labeled (ASL) perfusion magnetic resonance imaging (MRI), we examined longitudinal CBF changes in 29 patients with msTBI at 3, 6, and 12 months post-injury in comparison to 35 demographically-matched healthy controls (HC). We investigated the difference between the two groups and the within-subject time effect in the TBI patients using whole-brain voxel-wise analysis. Mean CBF in gray matter (GM) was lower in the TBI group compared to HC at 6 and 12 months post-injury. Within the TBI group, we identified widespread regional decreases in CBF from 3 to 6 months post-injury. In contrast, there were no regions with decreasing CBF from 6 to 12 months post-injury, indicating stabilization of hypoperfusion. There was instead a small area of increase in CBF observed in the right precuneus. These CBF changes were not accompanied by cortical atrophy. The change in CBF was correlated with change in executive function from 3 to 6 months post-injury in TBI patients, suggesting functional relevance of CBF measures. Understanding the time course of TBI-induced hypoperfusion and its relationship with cognitive improvement could provide an optimal treatment window to benefit long-term outcome.
Collapse
Affiliation(s)
- Naomi L Gaggi
- City University of New York (CUNY) School of Medicine, Townsend Harris Hall, 160 Convent Avenue, Convent Avenue, New York, NY 10031, United States; City University of New York (CUNY) Graduate Center, 365 5(th) Avenue, New York, NY 10016, United States.
| | - Jeffrey B Ware
- University of Pennsylvania, Perelman School of Medicine, 3400 Civic Center Boulevard, Philadelphia, PA 19104, United States.
| | - Sudipto Dolui
- University of Pennsylvania, Perelman School of Medicine, 3400 Civic Center Boulevard, Philadelphia, PA 19104, United States.
| | - Daniel Brennan
- City University of New York (CUNY) School of Medicine, Townsend Harris Hall, 160 Convent Avenue, Convent Avenue, New York, NY 10031, United States; City University of New York (CUNY) Graduate Center, 365 5(th) Avenue, New York, NY 10016, United States.
| | - Julia Torrellas
- City University of New York (CUNY) School of Medicine, Townsend Harris Hall, 160 Convent Avenue, Convent Avenue, New York, NY 10031, United States.
| | - Ze Wang
- University of Maryland School of Medicine, 655 W Baltimore St. S, Baltimore, MD 21201, United States.
| | - John Whyte
- Moss Rehabilitation Research Institute, 50 Township Line Road, Elkins Park, PA 19027, United States.
| | - Ramon Diaz-Arrastia
- University of Pennsylvania, Perelman School of Medicine, 3400 Civic Center Boulevard, Philadelphia, PA 19104, United States.
| | - Junghoon J Kim
- City University of New York (CUNY) School of Medicine, Townsend Harris Hall, 160 Convent Avenue, Convent Avenue, New York, NY 10031, United States; City University of New York (CUNY) Graduate Center, 365 5(th) Avenue, New York, NY 10016, United States.
| |
Collapse
|
4
|
Kobayashi R, Hayashi H, Kawakatsu S, Shibuya Y, Morioka D, Ohba M, Yoshioka M, Sakamoto K, Kanoto M, Otani K. Comparing Medial Temporal Atrophy Between Early-Onset Semantic Dementia and Early-Onset Alzheimer's Disease Using Voxel-Based Morphometry: A Multicenter MRI Study. Curr Alzheimer Res 2022; 19:503-510. [PMID: 35996258 DOI: 10.2174/1567205019666220820145429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/06/2022] [Accepted: 06/10/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Early-onset Semantic dementia (EOSD) and early-onset Alzheimer's disease (EOAD) are often difficult to clinically differentiate in the early stages of the diseases because of the overlaps of clinical symptoms such as language symptoms. We compared the degree of atrophy in medial temporal structures between the two types of dementia using the voxel-based specific regional analysis system for Alzheimer's disease (VSRAD). METHODS The participants included 29 (age: 61.7±4.5 years) and 39 (age: 60.2±4.9 years) patients with EOSD and EOAD, respectively. The degree of atrophy in medial temporal structures was quantified using the VSRAD for magnetic resonance imaging data. Receiver operating characteristic (ROC) analysis was performed to distinguish patients with EOSD and EOAD using the mean Z score (Z-score) in bilateral medial temporal structures and the absolute value (laterality score) of the laterality of Z-score (| right-left |) for indicating the degree of asymmetrical atrophy in medial temporal structures. RESULTS The EOSD group had significantly higher Z and laterality scores than the EOAD group (Zscores: mean ± standard deviation: 3.74±1.05 vs. 1.56±0.81, respectively; P<0.001; laterality score: mean ± standard deviation: 2.35±1.23 vs. 0.68±0.51, respectively; P<0.001). In ROC analysis, the sensitivity and specificity to differentiate EOSD from EOAD by a Z-score of 2.29 were 97% and 85%, respectively and by the laterality score of 1.05 were 93% and 85%, respectively. CONCLUSION EOSD leads to more severe and asymmetrical atrophy in medial temporal structures than EOAD. The VSRAD may be useful to distinguish between these dementias that have several clinically similar symptoms.
Collapse
Affiliation(s)
- Ryota Kobayashi
- Department of Psychiatry, Yamagata University School of Medicine, Iidanishi 2-2-2, Yamagata 990-9585, Japan
| | - Hiroshi Hayashi
- Department of Occupational Therapy, Fukushima Medical University School of Health Sciences, Sakaemachi 10-6, Fukushima 960-8516, Japan
| | - Shinobu Kawakatsu
- Department of Neuropsychiatry, Aizu Medical Center, Fukushima Medical University, Kawahigashi 21-2, Aizuwakamatsu 969-3492, Japan
| | - Yuzuru Shibuya
- Department of Psychiatry, Nihonkai General Hospital, Akihocho 30, Sakata 998-8501, Japan
| | - Daichi Morioka
- Department of Psychiatry, Yamagata University School of Medicine, Iidanishi 2-2-2, Yamagata 990-9585, Japan
| | - Makoto Ohba
- Department of Radiology, Yamagata University Hospital, Iidanishi 2-2-2, Yamagata 990- 9585, Japan
| | - Masanori Yoshioka
- Department of Radiology, Yamagata University Hospital, Iidanishi 2-2-2, Yamagata 990- 9585, Japan
| | - Kazutaka Sakamoto
- Department of Psychiatry, Yamagata University School of Medicine, Iidanishi 2-2-2, Yamagata 990-9585, Japan.,Department of Neuropsychiatry, Aizu Medical Center, Fukushima Medical University, Kawahigashi 21-2, Aizuwakamatsu 969-3492, Japan
| | - Masafumi Kanoto
- Department of Radiology, Division of Diagnostic Radiology, Yamagata University School of Medicine, Iidanishi 2-2-2, Yamagata 990-9585, Japan
| | - Koichi Otani
- Department of Psychiatry, Yamagata University School of Medicine, Iidanishi 2-2-2, Yamagata 990-9585, Japan
| |
Collapse
|
5
|
Numahata K, Miyamoto T, Akaiwa Y, Miyamoto M. Brain Perfusion Single-Photon Emission Computed Tomography Using an Easy Z-Score Imaging System Predicts Progression to Neurodegenerative Dementia in Rapid Eye Movement Sleep Behavior Disorder. Dement Geriatr Cogn Disord 2022; 50:577-584. [PMID: 35100582 PMCID: PMC9153334 DOI: 10.1159/000521645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 12/16/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Longitudinal studies have reported that patients with idiopathic rapid eye movement sleep behavior disorder (IRBD) have an increased risk of developing synucleinopathies, such as Parkinson's disease and dementia with Lewy bodies (DLB). Clinical trials of disease-modifying therapies for IRBD patients require suitable biomarkers that can predict the short-term onset of neurodegenerative dementia. METHODS We retrospectively examined if easy Z-score imaging system-specific volume-of-interest analysis (SVA) using brain perfusion single-photon emission computed tomography (SPECT) imaging or the cingulate island sign score can predict the short-term development of neurodegenerative dementia in 30 patients with IRBD. RESULTS Ten patients (33.3%) who exceeded the thresholds for three indicators (severity, extent, and ratio) were included in an SVA-positive group, while 20 (66.7%) were included in an SVA-negative group. Nine (30.0%) IRBD patients had phenoconversion, of which eight had DLB and one had Parkinson's disease with dementia. In Kaplan-Meier analysis, patients in the SVA-positive group converted to neurodegenerative dementia in a significantly shorter period of time compared to patients in the SVA-negative group. CONCLUSIONS These data suggest that SVA-positive IRBD patients have an increased short-term risk of developing neurodegenerative dementia.
Collapse
Affiliation(s)
- Kyoko Numahata
- Department of Neurology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Tomoyuki Miyamoto
- Department of Neurology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan,*Tomoyuki Miyamoto,
| | - Yasuhisa Akaiwa
- Department of Neurology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | | |
Collapse
|
6
|
Hayashi H, Kobayashi R, Kawakatsu S, Ohba M, Morioka D, Otani K. Comparison of the decreases in regional cerebral blood flow in the posterior cingulate cortex, precuneus, and parietal lobe between suspected non-Alzheimer's disease pathophysiology and Alzheimer's disease. Psychogeriatrics 2021; 21:716-721. [PMID: 34101304 DOI: 10.1111/psyg.12729] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/13/2021] [Accepted: 05/18/2021] [Indexed: 01/23/2023]
Abstract
BACKGROUND Suspected non-Alzheimer's disease pathophysiology (SNAP) shows Alzheimer's disease (AD)-like neurodegeneration; however, amyloid β, which is a biological marker in AD, remains within normal levels. Since the effectiveness of anti-dementia drugs for AD on SNAP is unknown, it is important to distinguish between patients with SNAP and AD. We aimed to compare decreases in regional cerebral blood flow (rCBF) of the posterior cingulate cortex (PCC), precuneus, and parietal lobe critical to AD between SNAP and AD groups using the easy Z-score imaging system in single-photon emission computed tomography (eZIS-SPECT). METHODS We retrospectively analysed eZIS-SPECT data of 13 SNAP and 24 AD patients. The three indicators (severity, extent, and ratio) that distinguished AD patients from healthy controls in previous studies were automatically calculated and were compared between the SNAP and AD groups. Receiver operating characteristic curve analysis and the area under the curve (AUC) were used to evaluate the diagnostic performance of the three indicators of eZIS in discriminating between the two groups. RESULTS The mean values of severity, extent, and ratio were significantly lower in the SNAP group than in the AD group (P = 0.024, P = 0.044, and P = 0.045, respectively). The AUC values for severity, extent, and ratio were 0.668, 0.683, and 0.692, respectively. CONCLUSIONS The present study suggests that SNAP shows milder reduction of rCBF in the PCC, precuneus, and parietal lobe as compared to AD. However, it may be difficult to distinguish between SNAP and AD with the degrees of decrease in rCBF in these regions.
Collapse
Affiliation(s)
- Hiroshi Hayashi
- Department of Psychiatry, Yamagata University School of Medicine, Yamagata, Japan
| | - Ryota Kobayashi
- Department of Psychiatry, Yamagata University School of Medicine, Yamagata, Japan
| | - Shinobu Kawakatsu
- Department of Neuropsychiatry, Aizu Medical Center, Fukushima Medical University, Aizuwakamatsu, Japan
| | - Makoto Ohba
- Department of Radiology, Yamagata University Hospital, Yamagata, Japan
| | - Daichi Morioka
- Department of Psychiatry, Yamagata University School of Medicine, Yamagata, Japan
| | - Koichi Otani
- Department of Psychiatry, Yamagata University School of Medicine, Yamagata, Japan
| |
Collapse
|
7
|
Ohba M, Kobayashi R, Kirii K, Fujita K, Kanezawa C, Hayashi H, Kawakatsu S, Otani K, Kanoto M, Suzuki K. Comparison of Alzheimer's disease patients and healthy controls in the easy Z-score imaging system with differential image reconstruction methods using SPECT/CT: verification using normal database of our institution. Ann Nucl Med 2021; 35:307-313. [PMID: 33394329 DOI: 10.1007/s12149-020-01562-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/29/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The easy Z-score imaging system (eZIS) analysis is used for the diagnosis of dementia by cerebral blood flow on single photon emission computed tomography (SPECT). Differences in the acquisition and reconstruction conditions in SPECT may affect the eZIS analysis results. The present study aimed to construct our institutional normal database (NDB) and Alzheimer's disease (AD)-specific volumes of interest (VOIs) in eZIS analysis, and to compare the differential diagnostic ability between healthy controls (HC) and patients with AD in the image reconstruction filtered back projection (FBP) and ordered subset expectation maximization (OSEM) methods. METHODS An NDB was constructed at our institution from 30 healthy individual using the FBP and OSEM reconstruction methods. We divided 51 HC and 51 AD patients into two groups, one for AD disease-specific VOI construction (HC, AD) and the other for NDB verification (HC, AD); image reconstruction was performed using FBP and OSEM. The areas of reduced blood flow in AD patients were compared with those of HC using the two types of image reconstruction methods. We used AD disease-specific VOI and NDB from each reconstruction method in eZIS analysis and compared the differential diagnostic ability for HC and AD with the different reconstruction methods. RESULTS Comparing the areas of reduced blood flow in AD patients using the different image reconstruction methods, OSEM showed decreased blood flow in the medial region of the temporal lobes compared to FBP. Comparing the differential diagnostic ability for HC and AD using eZIS, the Severity, Extent, and Ratio showed higher values in the analysis performed using OSEM image reconstruction compared to FBP. CONCLUSION With the 99mTc-ECD SPECT, the eZIS analysis equipped with our institutional AD-specific VOI and NDB using OSEM image reconstruction could distinguish HC from AD better than eZIS analysis using FBP image reconstruction. This study is registered in UMIN Clinical Trials Registry (UMIN-CTR) as UMIN study ID: UMIN000042362.
Collapse
Affiliation(s)
- Makoto Ohba
- Department of Radiology, Yamagata University Hospital, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
| | - Ryota Kobayashi
- Department of Psychiatry, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Kazukuni Kirii
- Division of Diagnostic Radiology, Department of Radiology, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Kyosuke Fujita
- Department of Radiology, Yamagata University Hospital, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Chika Kanezawa
- Department of Radiology, Yamagata University Hospital, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Hiroshi Hayashi
- Department of Psychiatry, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Shinobu Kawakatsu
- Department of Neuropsychiatry, Aizu Medical Center, Fukushima Medical University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Koichi Otani
- Department of Psychiatry, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Masafumi Kanoto
- Division of Diagnostic Radiology, Department of Radiology, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Koji Suzuki
- Department of Radiology, Yamagata University Hospital, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| |
Collapse
|