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Yorita A, Kawayama T, Inoue M, Kinoshita T, Oda H, Tokunaga Y, Tateishi T, Shoji Y, Uchimura N, Abe T, Hoshino T, Taniwaki T. Altered Functional Connectivity during Mild Transient Respiratory Impairment Induced by a Resistive Load. J Clin Med 2024; 13:2556. [PMID: 38731091 PMCID: PMC11084533 DOI: 10.3390/jcm13092556] [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: 03/19/2024] [Revised: 04/17/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
Background: Previous neuroimaging studies have identified brain regions related to respiratory motor control and perception. However, little is known about the resting-state functional connectivity (FC) associated with respiratory impairment. We aimed to determine the FC involved in mild respiratory impairment without altering transcutaneous oxygen saturation. Methods: We obtained resting-state functional magnetic resonance imaging data from 36 healthy volunteers during normal respiration and mild respiratory impairment induced by resistive load (effort breathing). ROI-to-ROI and seed-to-voxel analyses were performed using Statistical Parametric Mapping 12 and the CONN toolbox. Results: Compared to normal respiration, effort breathing activated FCs within and between the sensory perceptual area (postcentral gyrus, anterior insular cortex (AInsula), and anterior cingulate cortex) and visual cortex (the visual occipital, occipital pole (OP), and occipital fusiform gyrus). Graph theoretical analysis showed strong centrality in the visual cortex. A significant positive correlation was observed between the dyspnoea score (modified Borg scale) and FC between the left AInsula and right OP. Conclusions: These results suggested that the FCs within the respiratory sensory area via the network hub may be neural mechanisms underlying effort breathing and modified Borg scale scores. These findings may provide new insights into the visual networks that contribute to mild respiratory impairments.
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Affiliation(s)
- Akiko Yorita
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan; (A.Y.); (T.K.); (T.K.); (H.O.); (Y.T.); (T.T.); (T.H.)
| | - Tomotaka Kawayama
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan; (A.Y.); (T.K.); (T.K.); (H.O.); (Y.T.); (T.T.); (T.H.)
| | - Masayuki Inoue
- Cognitive and Molecular Research Institute of Brain Disease, Kurume University, Kurume 830-0011, Japan; (M.I.); (Y.S.); (N.U.)
| | - Takashi Kinoshita
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan; (A.Y.); (T.K.); (T.K.); (H.O.); (Y.T.); (T.T.); (T.H.)
| | - Hanako Oda
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan; (A.Y.); (T.K.); (T.K.); (H.O.); (Y.T.); (T.T.); (T.H.)
| | - Yoshihisa Tokunaga
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan; (A.Y.); (T.K.); (T.K.); (H.O.); (Y.T.); (T.T.); (T.H.)
| | - Takahisa Tateishi
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan; (A.Y.); (T.K.); (T.K.); (H.O.); (Y.T.); (T.T.); (T.H.)
| | - Yoshihisa Shoji
- Cognitive and Molecular Research Institute of Brain Disease, Kurume University, Kurume 830-0011, Japan; (M.I.); (Y.S.); (N.U.)
| | - Naohisa Uchimura
- Cognitive and Molecular Research Institute of Brain Disease, Kurume University, Kurume 830-0011, Japan; (M.I.); (Y.S.); (N.U.)
| | - Toshi Abe
- Department of Radiology, Kurume University School of Medicine, Kurume 830-0011, Japan;
| | - Tomoaki Hoshino
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan; (A.Y.); (T.K.); (T.K.); (H.O.); (Y.T.); (T.T.); (T.H.)
| | - Takayuki Taniwaki
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan; (A.Y.); (T.K.); (T.K.); (H.O.); (Y.T.); (T.T.); (T.H.)
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Ozone M, Hirota S, Ariyoshi Y, Hayashida K, Ikegami A, Habukawa M, Ohshima H, Harada D, Hiejima H, Kotorii N, Murotani K, Taninaga T, Uchimura N. Efficacy and Safety of Transitioning to Lemborexant from Z-drug, Suvorexant, and Ramelteon in Japanese Insomnia Patients: An Open-label, Multicenter Study. Adv Ther 2024; 41:1728-1745. [PMID: 38460107 PMCID: PMC10960898 DOI: 10.1007/s12325-024-02811-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 02/02/2024] [Indexed: 03/11/2024]
Abstract
INTRODUCTION For patients with chronic insomnia, conventional therapy may not always provide satisfactory efficacy and safety. Thus, switching to an alternative therapeutic agent can be explored. However, there is a lack of prospective studies evaluating the effectiveness of such changes. This prospective, non-randomized, open-label, interventional, multicenter study assessed whether Japanese patients with chronic insomnia dissatisfied with treatment could transition directly to lemborexant (LEM) from four cohorts-non-benzodiazepine sedative-hypnotic (zolpidem, zopiclone, or eszopiclone) monotherapy, dual orexin receptor antagonist (suvorexant) monotherapy, suvorexant + benzodiazepine receptor agonists (BZRAs), and melatonin receptor agonist (ramelteon) combination. We evaluated whether transitioning to LEM improved patient satisfaction based on efficacy and safety. METHODS The primary endpoint was the proportion of successful transitions to LEM at 2 weeks (titration phase end), defined as the proportion of patients on LEM by the end of the 2-week titration phase who were willing to continue on LEM during the maintenance phase (Weeks 2-14). Patient satisfaction and safety (the incidence of treatment-emergent adverse events [TEAEs]) were assessed at 14 weeks (end of titration and maintenance phases). RESULTS Among the 90 patients enrolled, 95.6% (95% confidence interval: 89.0-98.8%) successfully transitioned to LEM at 2 weeks. The proportions of patients who successfully continued on LEM were 97.8% and 82.2% at the end of the titration and maintenance phases (Weeks 2 and 14), respectively. The overall incidence of TEAEs was 47.8%; no serious TEAEs occurred. In all cohorts, the proportions of patients with positive responses were higher than the proportions with negative responses on the three scales of the Patient Global Impression-Insomnia version. During the maintenance phase, Insomnia Severity Index scores generally improved at Weeks 2, 6, and 14 of LEM transition. CONCLUSIONS Direct transition to LEM may be a valid treatment option for patients with insomnia who are dissatisfied with current treatment. TRIAL REGISTRATION ClinicalTrials.gov identifier, NCT04742699.
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Affiliation(s)
- Motohiro Ozone
- Department of Neuropsychiatry, Kurume University School of Medicine, 67 Asahi-machi, Kurume-shi, Fukuoka, Japan.
| | | | | | | | | | - Mitsunari Habukawa
- Department of Neuropsychiatry, Kurume University School of Medicine, 67 Asahi-machi, Kurume-shi, Fukuoka, Japan
| | - Hayato Ohshima
- Department of Neuropsychiatry, Kurume University School of Medicine, 67 Asahi-machi, Kurume-shi, Fukuoka, Japan
| | | | - Hiroshi Hiejima
- Department of Neuropsychiatry, Kurume University School of Medicine, 67 Asahi-machi, Kurume-shi, Fukuoka, Japan
| | | | | | | | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, 67 Asahi-machi, Kurume-shi, Fukuoka, Japan
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Kato T, Kotorii N, Ozone M, Murotani K, Ohshima H, Mori H, Wasano K, Hiejima H, Habukawa M, Uchimura N. Trends in the multiple prescriptions of hypnotic drugs in a university outpatient in Japan. Neuropsychopharmacol Rep 2024; 44:80-89. [PMID: 37946602 PMCID: PMC10932787 DOI: 10.1002/npr2.12386] [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] [Received: 02/09/2023] [Revised: 09/19/2023] [Accepted: 10/03/2023] [Indexed: 11/12/2023] Open
Abstract
AIMS In Japan, the daily dosage of hypnotic drugs for insomnia treatment is increasing year by year, and over-dependence on treatment with hypnotic drugs is a major problem. This study aimed to examine the factors related to the elimination of prescriptions of three or more hypnotic drugs within 1 year in our clinic. METHODS We conducted two surveys. Survey ① assessed the frequency of prescriptions of three or more hypnotic drugs by retrospectively reviewing the medical records of all patients who visited general and psychiatric outpatient clinics from January 2013 to March 2019. Survey ② assessed changes in prescriptions of hypnotic and psychotropic drugs within the subsequent year by retrospectively reviewing the medical records of all patients prescribed three or more hypnotic drugs who visited neuropsychiatric outpatient clinics multiple times between April 2013 and March 2019. RESULTS The frequency of prescribing three or more hypnotic drugs was six to nine times higher in psychiatry than in other departments. Flunitrazepam and brotizolam were the most common drugs prescribed and had the second lowest discontinuation rate after zolpidem. Conversely, eszopiclone, zopiclone, and suvorexant had the highest discontinuation rates. The success factors for drug reduction were age (odds ratio [OR]: 0.97, p < 0.0037), trazodone addition (OR: 12.86, p < 0.0194) and number of years of psychiatric experience. CONCLUSIONS The characteristics and success factors in relation to drug reduction in patients with multiple prescriptions of hypnotic drugs identified in this study may contribute to solving the problem of multiple prescriptions of hypnotic drugs.
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Affiliation(s)
- Takao Kato
- Department of NeuropsychiatryKurume University School of MedicineFukuokaJapan
- Department of PsychiatryKato HospitalKisarazuJapan
| | - Nozomu Kotorii
- Department of NeuropsychiatryKurume University School of MedicineFukuokaJapan
- Department of PsychiatryKotorii Isahaya HospitalNagasakiJapan
| | - Motohiro Ozone
- Department of NeuropsychiatryKurume University School of MedicineFukuokaJapan
| | | | - Hayato Ohshima
- Department of NeuropsychiatryKurume University School of MedicineFukuokaJapan
| | - Hiroyuki Mori
- Department of NeuropsychiatryKurume University School of MedicineFukuokaJapan
| | - Kenjirou Wasano
- Department of NeuropsychiatryKurume University School of MedicineFukuokaJapan
| | - Hiroshi Hiejima
- Department of NeuropsychiatryKurume University School of MedicineFukuokaJapan
| | - Mitsunari Habukawa
- Department of NeuropsychiatryKurume University School of MedicineFukuokaJapan
| | - Naohisa Uchimura
- Department of NeuropsychiatryKurume University School of MedicineFukuokaJapan
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Cheng JY, Lorch D, Lowe AD, Uchimura N, Hall N, Shah D, Moline M. A randomized, double-blind, placebo-controlled, crossover study of respiratory safety of lemborexant in moderate to severe obstructive sleep apnea. J Clin Sleep Med 2024; 20:57-65. [PMID: 37677076 PMCID: PMC10758559 DOI: 10.5664/jcsm.10788] [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] [Received: 03/27/2023] [Revised: 08/25/2023] [Accepted: 09/01/2023] [Indexed: 09/09/2023]
Abstract
STUDY OBJECTIVES To evaluate the respiratory safety of lemborexant among adults and older adults with moderate to severe obstructive sleep apnea (OSA). METHODS E2006-A001-113 (Study 113; NCT04647383) was a double-blind, two-period crossover, placebo-controlled study in adults (ages ≥ 45 to ≤ 90 years, n = 33) with moderate (apnea-hypopnea index [AHI] score ≥ 15 to < 30 events/h, n = 13) or severe (AHI ≥ 30 events/h, n = 20) OSA. Participants were randomized to lemborexant 10 mg (LEM10) or placebo (PBO) for two treatment periods of 8 nights with a ≥ 14-day washout period. AHI and peripheral oxygen saturation were evaluated after treatment on Day 1 (after a single dose) and Day 8 (after multiple doses). RESULTS No significant differences in AHI were observed after single and multiple doses of LEM10 compared with PBO in participants with moderate to severe OSA (least-squares mean: single-dose LEM10, 41.7; PBO, 44.8; multiple-dose LEM10, 44.9; PBO, 45.7). In addition, there were no significant differences between treatments in peripheral oxygen saturation (least-squares mean: single-dose LEM10, 93.0; PBO, 93.1; multiple-dose LEM10, 93.1; PBO, 93.4). Further, there were no significant differences between treatments in percentage of total sleep time with peripheral oxygen saturation < 90%, < 85%, or < 80%. No significant differences were observed between treatments when AHI and peripheral oxygen saturation outcomes were analyzed by OSA severity. Altogether, 6/33 (18.2%) participants receiving LEM10, vs 3/33 (9.1%) PBO, reported treatment-emergent adverse events, mostly mild in severity. CONCLUSIONS LEM10 demonstrated respiratory safety and was well tolerated with single-dose and multiple-dose administration in participants with moderate to severe OSA. This suggests that LEM may be a treatment option for patients with OSA and comorbid insomnia. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Name: A Study to Evaluate the Respiratory Safety of Lemborexant in Adult and Elderly Participants With Moderate to Severe Obstructive Sleep Apnea and in Adult and Elderly Participants With Moderate to Severe Chronic Obstructive Pulmonary Disease; URL: https://clinicaltrials.gov/ct2/show/NCT04647383; Identifier: NCT04647383. CITATION Cheng JY, Lorch D, Lowe AD, et al. A randomized, double-blind, placebo-controlled, crossover study of respiratory safety of lemborexant in moderate to severe obstructive sleep apnea. J Clin Sleep Med. 2024;20(1):57-65.
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Affiliation(s)
| | | | - Alan D. Lowe
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
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Kambe D, Hasegawa S, Imadera Y, Mano Y, Matsushita I, Konno Y, Ogo H, Uchimura N, Uchiyama M. Pharmacokinetics, pharmacodynamics and safety profile of the dual orexin receptor antagonist vornorexant/TS-142 in healthy Japanese participants following single/multiple dosing: Randomized, double-blind, placebo-controlled phase-1 studies. Basic Clin Pharmacol Toxicol 2023; 133:576-591. [PMID: 37563858 DOI: 10.1111/bcpt.13930] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/10/2023] [Accepted: 08/03/2023] [Indexed: 08/12/2023]
Abstract
The pharmacokinetics, pharmacodynamics and safety profile of vornorexant were investigated in healthy Japanese participants in three double-blind studies: a single ascending dose of 1-30 mg (Study 101; n = 6) and multiple ascending doses of 10-30 mg (Study 102; n = 6). Study 202 consisted of two steps: an open-label, 20 mg repeated-dose in non-elderly individuals (Step 1; n = 12) and a double-blind, 20 mg repeated-dose in elderly individuals (Step 2; n = 8/3 for vornorexant/placebo). Vornorexant was rapidly absorbed and eliminated under fasting conditions, with a time to maximum plasma concentration of 0.500-3.00 h (range) and elimination half-life of 1.32-3.25 h. The area under the plasma concentration-time curve (AUC) of vornorexant increased proportionally with dose increments. Sleepiness-related pharmacodynamic outcome changes (Karolinska sleepiness scale, digit symbol substitution test and psychomotor vigilance task) were generally increased with dose increments at 1 and 4 h post-dose, whereas no consistent dose-related changes were detected the next morning. Food intake did not affect the maximum observed plasma concentration of vornorexant but increased the AUC0-inf . Exposure in elderly individuals was generally comparable to that in non-elderly individuals. Altogether, vornorexant may have a favourable profile for insomnia treatment, including rapid onset of action and minimal next-day residual effects.
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Affiliation(s)
- Daiji Kambe
- Development Headquarters, Taisho Pharmaceutical Co., Ltd., Toshima, Tokyo, Japan
| | - Sayaka Hasegawa
- Development Headquarters, Taisho Pharmaceutical Co., Ltd., Toshima, Tokyo, Japan
| | - Yumiko Imadera
- Development Headquarters, Taisho Pharmaceutical Co., Ltd., Toshima, Tokyo, Japan
| | - Yoko Mano
- Development Headquarters, Taisho Pharmaceutical Co., Ltd., Toshima, Tokyo, Japan
| | - Isao Matsushita
- Development Headquarters, Taisho Pharmaceutical Co., Ltd., Toshima, Tokyo, Japan
| | - Yoshihiro Konno
- Research Headquarters, Taisho Pharmaceutical Co., Ltd., Kita, Saitama, Japan
| | - Hiroki Ogo
- Development Headquarters, Taisho Pharmaceutical Co., Ltd., Toshima, Tokyo, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Makoto Uchiyama
- Department of Psychiatry, Nihon University School of Medicine, Itabashi, Tokyo, Japan
- Tokyoadachi Hospital, Adachi, Tokyo, Japan
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Morita T, Motooka H, Ito Y, Yasumoto S, Uchimura N, Murotani K, Ozone M. A knowledge-based simple education program for patients with epilepsy in Japan: Effects sustained after the program implementation. Epilepsy Behav 2023; 145:109341. [PMID: 37451070 DOI: 10.1016/j.yebeh.2023.109341] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 06/22/2023] [Accepted: 06/22/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE To investigate the effects of an original education program on patients with epilepsy (PWE). The effects on knowledge about epilepsy, attitude to epilepsy, depression scales, and quality of life were investigated. METHOD Thirty-five PWE participated in a lecture-style educational program using an original knowledge-oriented textbook. All patients were administered a total of four rating scales: the Knowledge about Epilepsy Scale (KES), the Attitude toward Epilepsy Scale (AES), and the Japanese version of the Quality of Life in Epilepsy Inventory (QOLIE-31-P), the Beck Depression Inventory (BDI). The KES and AES of patients (pKES and pAES) were compared to those of medical students (St) and residents (Rd). RESULTS After education, pKES improved and showed significant differences among pre-and post-education and six months later. Before education, pKES was inferior to St and Rd. However, after education, pKES changed and became superior to St and Rd. Six months later, the advantage was lost, but not significantly. PAES also improved after education, with significant differences before, after, and six months later after education. PAES was statistically inferior to St and Rd before education, but the difference disappeared after education, and the effect persisted after six months. The non-depressed (BDI < 20) and depressed groups (BDI ≧ 20) improved in the KES after education. About the AES, the non-depressive group has a statistical tendency, but not the depressive group. At six months, the depressed group's AES is significantly lower than the non-depressed group. CONCLUSION While correct knowledge about epilepsy can improve attitudes and perceptions of epilepsy in PWE, special measures are needed for PWE with depression.
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Affiliation(s)
- Takenori Morita
- Department of Neuropsychiatry, Kurume University, Japan; Sasebo-Aikei Hospital, Japan
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Fujieda M, Uchida K, Ikebe S, Kimura A, Kimura M, Watanabe T, Sakamoto H, Matsumoto T, Uchimura N. Fatigue on Waking, Insomnia, and Workplace Relationship Problems May Help to Detect Suicidal Ideation among New Middle-Aged Primary Care Patients: A 6-Month Prospective Study in Japan. Int J Environ Res Public Health 2023; 20:ijerph20085547. [PMID: 37107831 PMCID: PMC10138726 DOI: 10.3390/ijerph20085547] [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] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/27/2023] [Accepted: 04/13/2023] [Indexed: 05/11/2023]
Abstract
Signs of suicidal depression often go undetected in primary care settings. This study explored predictive factors for depression with suicidal ideation (DSI) among middle-aged primary care patients at 6 months after an initial clinic visit. New patients aged 35-64 years were recruited from internal medicine clinics in Japan. Baseline characteristics were elicited using self-administered and physician questionnaires. DSI was evaluated using the Zung Self-Rating Depression Scale and the Profile of Mood States at enrollment and 6 months later. Multiple logistic regression analysis was conducted to calculate adjusted odds ratios for DSI. Sensitivity, specificity, and likelihood ratios for associated factors were calculated. Among 387 patients, 13 (3.4%) were assessed as having DSI at 6 months. Adjusted for sex, age, and related factors, significant odds ratios for DSI were observed for "fatigue on waking ≥1/month" (7.90, 95% confidence intervals: 1.06-58.7), "fatigue on waking ≥1/week" (6.79, 1.02-45.1), "poor sleep status" (8.19, 1.05-63.8), and "relationship problems in the workplace" (4.24, 1.00-17.9). Fatigue on waking, sleep status, and workplace relationship problems may help predict DSI in primary care. Because the sample size in this investigation was small, further studies with larger samples are needed to confirm our findings.
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Affiliation(s)
- Megumi Fujieda
- Department of Neuropsychiatry, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Fukuoka, Japan
- Department of Environmental Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Fukuoka, Japan
- Department of Healthcare Management, College of Healthcare Management, 960-4 Takayanagi, Setaka-machi, Miyama 835-0018, Fukuoka, Japan
- Correspondence: ; Tel.: +81-942-31-7564
| | - Katsuhisa Uchida
- Mental Health and Welfare Center of Shizuoka Prefectural Government, 2-20 Ariake-cho, Suruga-ku, Shizuoka-shi 422-8031, Shizuoka, Japan
| | - Shinichiro Ikebe
- Fuji Medical Association, 2850 Denbo, Fuji 417-0061, Shizuoka, Japan
| | - Akihiro Kimura
- Fuji Medical Association, 2850 Denbo, Fuji 417-0061, Shizuoka, Japan
| | - Masashi Kimura
- Fuji Medical Association, 2850 Denbo, Fuji 417-0061, Shizuoka, Japan
| | - Toshiaki Watanabe
- Fuji Medical Association, 2850 Denbo, Fuji 417-0061, Shizuoka, Japan
| | - Hisako Sakamoto
- Mental Health and Welfare Center of Shizuoka Prefectural Government, 2-20 Ariake-cho, Suruga-ku, Shizuoka-shi 422-8031, Shizuoka, Japan
| | - Teruaki Matsumoto
- Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka-shi 420-8527, Shizuoka, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Fukuoka, Japan
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Watanabe Y, Kuroki T, Ichikawa D, Ozone M, Uchimura N, Ueno T. Effect of smartphone-based cognitive behavioral therapy app on insomnia: a randomized, double-blind study. Sleep 2023; 46:6821283. [PMID: 36355920 DOI: 10.1093/sleep/zsac270] [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: 06/17/2022] [Revised: 10/31/2022] [Indexed: 11/12/2022] Open
Abstract
STUDY OBJECTIVES This study assessed the effects and safety of the smartphone-based cognitive behavioral therapy for insomnia (CBT-I) app compared with the sham app. METHODS In this multicenter, double-blind, and parallel-group study, 175 patients with insomnia were randomized to a smartphone-based CBT-I app (Active, n = 87) or a sham app (Sham, n = 88) group. The primary endpoint was the change in Athens Insomnia Score (AIS) from baseline after 8 weeks of treatment. RESULTS The change in AIS (mean ± standard deviation) from baseline, assessed using a modified-intent-to-treat analysis, was -6.7 ± 4.4 in the Active group and -3.3 ± 4.0 in the Sham group. The difference in the mean change between the groups was -3.4 (p < .001), indicating a greater change in the Active group. The change in CGI-I from the baseline was 1.3 ± 0.8 in the Active group and 0.7 ± 0.8 in the Sham group (p < .001). The proportion of patients with an AIS less than 6 was 37.9% in the Active group and 10.2% in the Sham group (p < .001). As for the safety assessment, no adverse reactions or device failures were detected in the Active group. CONCLUSIONS This study demonstrated the effectiveness of a smartphone-based CBT-I system for treating insomnia. CLINICAL TRIAL REGISTRATION ID: jRCT2032210071; trial name: Sham (software)-controlled, multicenter, dynamic allocation, double-blinded study of non-medication therapy with a software Yukumi in patients with insomnia disorders (verification study); URL: https://jrct.niph.go.jp/en-latest-detail/jRCT2032210071.
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Affiliation(s)
| | | | | | - Motohiro Ozone
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
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Kato T, Ozone M, Kotorii N, Ohshima H, Hyoudou Y, Mori H, Wasano K, Hiejima H, Habukawa M, Uchimura N. Sleep Structure in Untreated Adults With ADHD: A Retrospective Study. J Atten Disord 2023; 27:488-498. [PMID: 36851892 DOI: 10.1177/10870547231154898] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
OBJECTIVE Polysomnographic findings in neurodevelopmental disorders have been reported, but previous studies have had several limitations. The purpose of this study was to characterize sleep structure in untreated adults diagnosed with ADHD, excluding ADHD-related sleep disorders as determined by polysomnography and multiple sleep latency testing. METHODS This study included 55 patients aged 18 years or older who visited the Kurume University Hospital Sleep Clinic between April 2015 and March 2020. The diagnosis of ADHD was determined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (ADHD group, n = 28; non-ADHD, n = 27). RESULTS The ADHD group had significantly longer slow wave sleep (SWS) duration than the non-ADHD group (ADHD: 68.3 ± 31.0 minutes vs. non-ADHD: 43.4 ± 36.6 minutes; p = .0127). CONCLUSIONS The increased SWS volume observed in drug-naïve adult patients with ADHD may be related to the pathogenesis of this disorder.
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Affiliation(s)
- Takao Kato
- Kurume University School of Medicine, Japan
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Masuda R, Oe M, Kakuma T, Uchimura N. Development of a Subclinical Dissociation Scale by Comparing Healthy Controls with Patients. Kurume Med J 2022; 67:65-75. [PMID: 36288960 DOI: 10.2739/kurumemedj.ms6723002] [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] [Indexed: 06/16/2023]
Abstract
We developed a Subclinical Dissociation Scale by comparing healthy controls with patients with post-traumatic stress disorder (PTSD) or dissociative disorder. The Dissociative Experiences Scale, Subclinical Dissociation Scale, and General Health Questionnaire were completed by 441 healthy Japanese adolescents (mean age, 19.9 years) and 23 psychiatric inpatients (mean age, 28.8 years) diagnosed with PTSD or dissociative disorder. The initial Subclinical Dissociation Scale included 52 items grouped into five factors: F1, absentmindedness (14 items); F2, immersion or preoccupation (15 items); F3, temporary amnesia (10 items); F4, feelings of unreality (eight items); and F5, feelings of alienation (five items). Factor and correlation analyses revealed the validity and reliability of the Subclinical Dissociation Scale. The final version of the scale that comprised three factors (F1, F2, and F4) and 37 items underwent logistic regression and receiver operating characteristic (ROC) curve analyses to compare healthy controls with patients with PTSD or dissociative disorder. The ROC curve analysis using the Youden Index indicated a cut-off score of 18 for the borderline or abnormal range, which was calculated using the following formula: "(F1) + (F4) - (F2)." This study provides evidence of the partial test-retest reliability and con current validity of the Subclinical Dissociation Scale.
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Affiliation(s)
- Ryota Masuda
- Department of Psychology, School of Human Sciences, Sugiyama Jogakuen University
| | - Misari Oe
- Department of Neuropsychiatry, Kurume University School of Medicine
| | | | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine
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11
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Matsumoto Y, Uchimura N, Ishitake T, Itani O, Otsuka Y. Verification of sleep scales as predictors of suicidal ideation in Japanese dayworkers: a longitudinal study. Sleep Biol Rhythms 2022; 20:577-583. [PMID: 38468627 PMCID: PMC10899985 DOI: 10.1007/s41105-022-00404-6] [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: 02/25/2022] [Accepted: 07/09/2022] [Indexed: 10/17/2022]
Abstract
The objective of this study was to verify whether the assessment of poor sleep based on two sleep scales could predict suicidal ideation in Japanese dayworkers. A longitudinal survey was conducted among 446 Japanese dayworkers working at a company in Japan. Questionnaires were administered in 2013 (baseline) and 2014 (follow-up). To evaluate suicidal ideation, we used Question 19 of the Self-rating Depression Scale, categorizing participants who chose response options "some/a good part/most of the time" as suicidal ideation (+), and those who chose option "never or only a little of the time" as suicidal ideation (-). Two sleep scales, the Pittsburgh Sleep Quality Index (PSQI) and the 3-Dimensional Sleep Scale (3DSS), were selected as potential predictors of suicidal ideation. Only participants who were suicidal ideation (-) at baseline were included in the analysis, and suicidal ideation (+) individuals at follow-up were considered to have developed suicidal ideation during the interval between baseline and follow-up surveys. Data from 293 participants (236 men, 57 women) were analyzed. Twenty-two participants (7.5%) became suicidal ideation (+) at follow-up. Multiple logistic regression analysis showed that only sleep quality of the 3DSS subscale significantly predicted suicidal ideation, even after adjusting for depressive symptoms. That is, assessment of poor sleep did not predict suicidal ideation when based on the PSQI, but did when based on the 3DSS. Assessment of sleep quality based on the 3DSS may prove more useful in predicting worker suicidal ideation in industrial settings with limited facilities than PSQI. Supplementary Information The online version contains supplementary material available at 10.1007/s41105-022-00404-6.
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Affiliation(s)
- Yuuki Matsumoto
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, 30-1 Oyaguchi, Kami-cho, Itabashi-ku, Tokyo, Japan
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Tatsuya Ishitake
- Department of Environmental Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Osamu Itani
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, 30-1 Oyaguchi, Kami-cho, Itabashi-ku, Tokyo, Japan
| | - Yuichiro Otsuka
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, 30-1 Oyaguchi, Kami-cho, Itabashi-ku, Tokyo, Japan
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12
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Matsumoto Y, Uchimura N, Ishitake T. The relationship between marital status and multifactorial sleep in Japanese day workers. Sleep Biol Rhythms 2022; 20:211-217. [PMID: 38469263 PMCID: PMC10899942 DOI: 10.1007/s41105-021-00357-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/17/2021] [Indexed: 10/19/2022]
Abstract
Unmarried people often have disorderly lifestyles, and sleep problems (e.g., insomnia, short sleep duration, social jetlag) are becoming more complex due to the modern 24-h society. To improve health promotion measures for unmarried people, this study examined the relationship between marital status and sleep assessed as a multifactorial structure (phase, quality, quantity) in Japanese day workers. A cross-sectional survey was conducted with employees at five workplaces in Japan. Participants indicated their marital status, and the 3-Dimensional Sleep Scale measured sleep condition. We used scale cutoff values to define poor sleep phase, quality, and quantity (scores below the cutoff). "All poor sleep" and "all good sleep" were defined as when all scores were below or above the cutoff, respectively. Data from 786 participants (578 men, 208 women) were analyzed. Multivariate analysis showed that being unmarried was significantly related to poor sleep phase, quality, and quantity, with increased odds ratios. In unmarried participants, odds ratios (OR) were highest for poor sleep quantity in men (OR: 2.15) and poor sleep phase in women (OR: 2.73). All poor sleep showed the highest odds ratio for both unmarried men (OR: 2.74) and women (OR: 6.13), while unmarried men showed significantly decreased odds ratios for all good sleep (OR: 0.51). The finding that being unmarried was more closely associated with poor sleep quality and quantity in men, and more closely associated with poor sleep phase in women, could greatly contribute to creating measures to promote improved sleep in unmarried people. Supplementary Information The online version contains supplementary material available at 10.1007/s41105-021-00357-2.
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Affiliation(s)
- Yuuki Matsumoto
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, 30-1 Oyaguchi, Kami-cho, Itabashi-ku, Tokyo 173-8610 Japan
- Department of Neuropsychiatry, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011 Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011 Japan
| | - Tatsuya Ishitake
- Department of Environmental Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011 Japan
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13
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Inoue Y, Uchiyama M, Umeuchi H, Onishi K, Ogo H, Kitajima I, Matsushita I, Nishino I, Uchimura N. Optimal dose determination of enerisant (TS-091) for patients with narcolepsy: two randomized, double-blind, placebo-controlled trials. BMC Psychiatry 2022; 22:141. [PMID: 35193545 PMCID: PMC8862520 DOI: 10.1186/s12888-022-03785-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 02/09/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The histamine H3 receptor has emerged as one of the most promising targets of novel pharmacotherapy for narcolepsy. Studies now aim to investigate the optimal dose of enerisant, a novel H3 antagonist/inverse agonist, for the treatment of excessive daytime sleepiness in patients with narcolepsy. METHODS We conducted two phase 2, fixed-dose, double-blind, randomized, placebo-controlled trials in patients with narcolepsy. The first phase 2 study (Study 1) was conducted to investigate the efficacy and safety of enerisant at dosages of 25, 50, and 100 mg/day administered for 3 weeks based on the results of a phase 1 study conducted on healthy volunteers. The primary endpoint was mean sleep latency in maintenance of wakefulness test (MWT), and the secondary endpoint was the total score on the Epworth Sleepiness Scale (ESS). The dosages of enerisant in the second phase 2 study (Study 2) were set at 5 and 10 mg/day based on the simulation of receptor occupancy results from positron emission tomography study. RESULTS Forty-six and fifty-three patients were randomized in Study 1 and Study 2, respectively. The efficacy of enerisant was partially confirmed in Study 1 with ESS; however, the doses were not tolerated, and there were many withdrawals due to adverse events (mainly insomnia, headache, and nausea). The doses in Study 2 were well tolerated, with a lower incidence of adverse events in Study 2 than in Study 1, although the efficacy could not be confirmed with MWT and ESS in Study 2. CONCLUSIONS The optimal dose of enerisant could not be determined in these two studies. Although enerisant has a favorable pharmacokinetic profile, it is thought to have large interindividual variabilities in terms of efficacy and safety, suggesting the necessity of tailored dosage adjustments. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03267303 ; Registered 30 August 2017 (Study 2). Japic identifier: JapicCTI-142529 ; Registered 7 May 2014 (Study 1) and JapicCTI-173689 ; Registered 30 August 2017, https://www.clinicaltrials.jp/cti-user/trial/ShowDirect.jsp?clinicalTrialId=29277 (Study 2).
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Affiliation(s)
- Yuichi Inoue
- Japan Somnology Center, Institute of Neuropsychiatry, 5-10-10 Yoyogi, Shibuya-ku, Tokyo, 151-0053, Japan. .,Department of Somnology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
| | - Makoto Uchiyama
- grid.260969.20000 0001 2149 8846Department of Psychiatry, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi, , Tokyo 173-8610 Japan ,Tokyoadachi Hospital, 5-23-20 Hokima, Adachi, Tokyo 121-0064 Japan
| | - Hideo Umeuchi
- grid.419836.10000 0001 2162 3360Development Headquarters, Taisho Pharmaceutical Co., Ltd., 3-24-1 Takada, Toshima-Ku, Tokyo 170-8633 Japan
| | - Koichi Onishi
- grid.419836.10000 0001 2162 3360Development Headquarters, Taisho Pharmaceutical Co., Ltd., 3-24-1 Takada, Toshima-Ku, Tokyo 170-8633 Japan
| | - Hiroki Ogo
- grid.419836.10000 0001 2162 3360Development Headquarters, Taisho Pharmaceutical Co., Ltd., 3-24-1 Takada, Toshima-Ku, Tokyo 170-8633 Japan
| | - Iwao Kitajima
- grid.419836.10000 0001 2162 3360Development Headquarters, Taisho Pharmaceutical Co., Ltd., 3-24-1 Takada, Toshima-Ku, Tokyo 170-8633 Japan
| | - Isao Matsushita
- grid.419836.10000 0001 2162 3360Development Headquarters, Taisho Pharmaceutical Co., Ltd., 3-24-1 Takada, Toshima-Ku, Tokyo 170-8633 Japan
| | - Izumi Nishino
- grid.419836.10000 0001 2162 3360Development Headquarters, Taisho Pharmaceutical Co., Ltd., 3-24-1 Takada, Toshima-Ku, Tokyo 170-8633 Japan
| | - Naohisa Uchimura
- grid.410781.b0000 0001 0706 0776Department of Neuropsychiatry, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011 Japan
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14
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Akashiba T, Inoue Y, Uchimura N, Ohi M, Kasai T, Kawana F, Sakurai S, Takegami M, Tachikawa R, Tanigawa T, Chiba S, Chin K, Tsuiki S, Tonogi M, Nakamura H, Nakayama T, Narui K, Yagi T, Yamauchi M, Yamashiro Y, Yoshida M, Oga T, Tomita Y, Hamada S, Murase K, Mori H, Wada H, Uchiyama M, Ogawa H, Sato K, Nakata S, Mishima K, Momomura SI. Sleep Apnea Syndrome (SAS) Clinical Practice Guidelines 2020. Respir Investig 2022; 60:3-32. [PMID: 34986992 DOI: 10.1016/j.resinv.2021.08.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 08/03/2021] [Revised: 08/20/2021] [Accepted: 08/24/2021] [Indexed: 11/25/2022]
Abstract
The prevalence of sleep disordered breathing (SDB) is reportedly very high. Among SDBs, the incidence of obstructive sleep apnea (OSA) is higher than previously believed, with patients having moderate-to-severe OSA accounting for approximately 20% of adult males and 10% of postmenopausal women not only in Western countries but also in Eastern countries, including Japan. Since 1998, when health insurance coverage became available, the number of patients using continuous positive airway pressure (CPAP) therapy for sleep apnea has increased sharply, with the number of patients about to exceed 500,000 in Japan. Although the "Guidelines for Diagnosis and Treatment of Sleep Apnea Syndrome (SAS) in Adults" was published in 2005, a new guideline was prepared in order to indicate the standard medical care based on the latest trends, as supervised by and in cooperation with the Japanese Respiratory Society and the "Survey and Research on Refractory Respiratory Diseases and Pulmonary Hypertension" Group, of Ministry of Health, Labor and Welfare and other related academic societies, including the Japanese Society of Sleep Research, in addition to referring to the previous guidelines. Because sleep apnea is an interdisciplinary field covering many areas, this guideline was prepared including 36 clinical questions (CQs). In the English version, therapies and managements for SAS, which were written from CQ16 to 36, were shown. The Japanese version was published in July 2020 and permitted as well as published as one of the Medical Information Network Distribution Service (Minds) clinical practice guidelines in Japan in July 2021.
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Affiliation(s)
| | - Yuichi Inoue
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Motoharu Ohi
- Sleep Medical Center, Osaka Kaisei Hospital, Osaka, Japan
| | - Takatoshi Kasai
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Fusae Kawana
- Department of Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shigeru Sakurai
- Division of Behavioral Sleep Medicine, Iwate Medical University School of Medicine, Iwate, Japan
| | - Misa Takegami
- Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Rho Tachikawa
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Takeshi Tanigawa
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shintaro Chiba
- Ota Memorial Sleep Center, Ota General Hospital, Kanagawa, Japan
| | - Kazuo Chin
- Department of Sleep Medicine and Respiratory Care, Division of Sleep Medicine, Nihon University of Medicine, Tokyo, Japan; Department of Human Disease Genomics, Center for Genomic Medicine, Graduate School Medicine, Kyoto University, Japan.
| | | | - Morio Tonogi
- Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry, Tokyo, Japan
| | | | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Koji Narui
- Sleep Center, Toranomon Hospital, Tokyo, Japan
| | - Tomoko Yagi
- Ota Memorial Sleep Center, Ota General Hospital, Kanagawa, Japan
| | - Motoo Yamauchi
- Department of Respiratory Medicine, Nara Medical University, Nara, Japan
| | | | - Masahiro Yoshida
- Department of Hemodialysis and Surgery, Ichikawa Hospital, International University of Health and Welfare, Chiba, Japan
| | - Toru Oga
- Department of Respiratory Medicine, Kawasaki Medical School, Okayama, Japan
| | - Yasuhiro Tomita
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Satoshi Hamada
- Department of Advanced Medicine for Respiratory Failure, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kimihiko Murase
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroyuki Mori
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Hiroo Wada
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Makoto Uchiyama
- Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan
| | - Hiromasa Ogawa
- Department of Occupational Health, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Kazumichi Sato
- Department of Dental and Oral Surgery, International University of Health and Welfare, Chiba, Japan
| | - Seiichi Nakata
- Department of Otorhinolaryngology, Second Hospital, Fujita Health University School of Medicine, Aichi, Japan
| | - Kazuo Mishima
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
| | - Shin-Ichi Momomura
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
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15
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Tanida K, Shimada M, Khor SS, Toyoda H, Kato K, Kotorii N, Kotorii T, Ariyoshi Y, Kato T, Hiejima H, Ozone M, Uchimura N, Ikegami A, Kume K, Kanbayashi T, Imanishi A, Kamei Y, Hida A, Wada Y, Kuroda K, Miyamoto M, Hirata K, Takami M, Yamada N, Okawa M, Omata N, Kondo H, Kodama T, Inoue Y, Mishima K, Honda M, Tokunaga K, Miyagawa T. Genome-wide association study of idiopathic hypersomnia in a Japanese population. Sleep Biol Rhythms 2022; 20:137-148. [PMID: 38469065 PMCID: PMC10899960 DOI: 10.1007/s41105-021-00349-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 09/20/2021] [Indexed: 01/09/2023]
Abstract
Idiopathic hypersomnia (IH) is a rare sleep disorder characterized by excessive daytime sleepiness, great difficulty upon awakening, and prolonged sleep time. In contrast to narcolepsy type 1, which is a well-recognized hypersomnia, the etiology of IH remains poorly understood. No susceptibility loci for IH have been identified, although familial aggregations have been observed among patients with IH. Narcolepsy type 1 is strongly associated with human leukocyte antigen (HLA)-DQB1*06:02; however, no significant associations between IH and HLA alleles have been reported. To identify genetic variants that affect susceptibility to IH, we performed a genome-wide association study (GWAS) and two replication studies involving a total of 414 Japanese patients with IH and 6587 healthy Japanese individuals. A meta-analysis of the three studies found no single-nucleotide polymorphisms (SNPs) that reached the genome-wide significance level. However, we identified several candidate SNPs for IH. For instance, a common genetic variant (rs2250870) within an intron of PDE9A was suggestively associated with IH. rs2250870 was significantly associated with expression levels of PDE9A in not only whole blood but also brain tissues. The leading SNP in the PDE9A region was the same in associations with both IH and PDE9A expression. PDE9A is a potential target in the treatment of several brain diseases, such as depression, schizophrenia, and Alzheimer's disease. It will be necessary to examine whether PDE9A inhibitors that have demonstrated effects on neurophysiologic and cognitive function can contribute to the development of new treatments for IH, as higher expression levels of PDE9A were observed with regard to the risk allele of rs2250870. The present study constitutes the first GWAS of genetic variants associated with IH. A larger replication study will be required to confirm these associations. Supplementary Information The online version contains supplementary material available at 10.1007/s41105-021-00349-2.
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Affiliation(s)
- Kotomi Tanida
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mihoko Shimada
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Sleep Disorders Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo, 156-8506 Japan
- Genome Medical Science Project (Toyama), National Center for Global Health and Medicine, Tokyo, Japan
| | - Seik-Soon Khor
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Genome Medical Science Project (Toyama), National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiromi Toyoda
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kayoko Kato
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nozomu Kotorii
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
- Kotorii Isahaya Hospital, Nagasaki, Japan
| | | | | | - Takao Kato
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Hiroshi Hiejima
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Motohiro Ozone
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | | | - Kazuhiko Kume
- Sleep Center, Kuwamizu Hospital, Kumamoto, Japan
- Department of Stem Cell Biology, Institute of Molecular Genetics and Embryology, Kumamoto University, Kumamoto, Japan
- Department of Neuropharmacology, Graduate School of Pharmaceutical Sciences, Nagoya City University, Aichi, Japan
| | - Takashi Kanbayashi
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Ibaraki, Japan
- Ibaraki Prefectural Medical Center of Psychiatry, Ibaraki, Japan
| | - Aya Imanishi
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
| | - Yuichi Kamei
- Department of Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
- Kamisuwa Hospital, Nagano, Japan
| | - Akiko Hida
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yamato Wada
- Department of Psychiatry, Hannan Hospital, Osaka, Japan
| | - Kenji Kuroda
- Department of Psychiatry, Hannan Hospital, Osaka, Japan
| | | | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Masanori Takami
- Department of Psychiatry, Shiga University of Medical Science, Shiga, Japan
| | - Naoto Yamada
- Department of Psychiatry, Shiga University of Medical Science, Shiga, Japan
| | - Masako Okawa
- Department of Sleep Medicine, Shiga University of Medical Science, Shiga, Japan
- Japan Foundation for Neuroscience and Mental Health, Tokyo, Japan
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | - Naoto Omata
- Department of Nursing, Faculty of Health Science, Fukui Health Science University, Fukui, Japan
- Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hideaki Kondo
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Ibaraki, Japan
| | - Tohru Kodama
- Sleep Disorders Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo, 156-8506 Japan
| | - Yuichi Inoue
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
- Yoyogi Sleep Disorder Center, Neuropsychiatric Research Institute, Tokyo, Japan
| | - Kazuo Mishima
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Ibaraki, Japan
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Makoto Honda
- Sleep Disorders Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo, 156-8506 Japan
- Seiwa Hospital, Neuropsychiatric Research Institute, Tokyo, Japan
| | - Katsushi Tokunaga
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Genome Medical Science Project (Toyama), National Center for Global Health and Medicine, Tokyo, Japan
| | - Taku Miyagawa
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Sleep Disorders Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo, 156-8506 Japan
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16
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Itoh Y, Takeshima M, Kaneita Y, Uchimura N, Inoue Y, Honda M, Yamadera W, Watanabe N, Kitamura S, Okajima I, Ayabe N, Nomura K, Mishima K. Associations Between the 2011 Great East Japan Earthquake and Tsunami and the Sleep and Mental Health of Japanese People: A 3-Wave Repeated Survey. Nat Sci Sleep 2022; 14:61-73. [PMID: 35068942 PMCID: PMC8769050 DOI: 10.2147/nss.s338095] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/04/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Large-scale natural disasters have an enormous physical and mental impact, immediately after they occur, on people living near the central disaster areas. It is known that, in the early stages, a seismic disaster triggers high rates of symptoms for insomnia, depression, and anxiety. However, little information is available about their medium- to long-term clinical outcomes. In this study, we conducted a repeated cross-sectional nationwide questionnaire survey to clarify changes in the prevalence of insomnia and its background factors after the Great East Japan Earthquake, a huge earthquake with a moment magnitude of 9.0 that occurred on March 11, 2011. METHODS We conducted a repeated cross-sectional survey in November 2009 (pre-earthquake, 1224 participants), July 2011 (4 months post-earthquake, 1259 participants), and August 2012 (18 months post-earthquake, 1289 participants) using stratified random sampling from 157 Japanese sites. RESULTS Compared to 2009, the prevalence of insomnia statistically increased nationwide immediately post-disaster (11.7% vs 21.2%; p < 0.001) but significantly decreased in 2012 compared to immediately after the earthquake (10.6% vs 21.2%; p < 0.001). In 2011, insomnia was most frequent in the central disaster area. Multivariable logistic regression models demonstrated the association between the following factors and increased risk of insomnia: being a woman (odds ratio [OR] 1.48, 95% confidence interval [CI]: 1.00-2.19), being employed in 2009 (OR 1.74, 95% CI: 1.15-2.62), and being of younger age group (20-64 years) in 2011 (OR 1.64, 95% CI: 1.12-2.42) and 2012 (OR 2.50 95% CI: 1.47-4.23). Post-earthquake, the prevalence of insomnia symptoms in men increased, while the gender difference decreased and was no longer statistically significant. Additionally, insomnia was associated with psychological distress (scores ≥5 on the Kessler Psychological Distress Scale) in 2011 and 2012. CONCLUSION This study demonstrated that the prevalence of insomnia was significantly higher after the earthquake. Moreover, individuals with insomnia were more likely to experience psychological distress after the earthquake that continued until 2012.
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Affiliation(s)
- Yu Itoh
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
| | - Masahiro Takeshima
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
| | - Yoshitaka Kaneita
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University, Fukuoka, Japan
| | - Yuichi Inoue
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | - Makoto Honda
- Sleep Disorders Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Wataru Yamadera
- Division of Bioregulatory Medicine, Department of Katsushika Medical Center, The Jikei University, Tokyo, Japan
| | - Norio Watanabe
- Health Promotion and Human Behavior, School of Public Health, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shingo Kitamura
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Isa Okajima
- Department of Psychological Counseling, Faculty of Humanities, Tokyo Kasei University, Tokyo, Japan
| | - Naoko Ayabe
- Department of Regional Studies and Humanities, Faculty of Education and Human Studies, Akita University, Akita, Japan
| | - Kyoko Nomura
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Kazuo Mishima
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
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17
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Matsuoka M, Matsuishi T, Nagamitsu S, Iwasaki M, Iemura A, Obara H, Yamashita Y, Maeda M, Kakuma T, Uchimura N. Sleep disturbance has the largest impact on children's behavior and emotions. Front Pediatr 2022; 10:1034057. [PMID: 36518780 PMCID: PMC9744255 DOI: 10.3389/fped.2022.1034057] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/11/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Children's behavior and emotions are affected by sleep disturbances, the parent-child relationship, media viewing time, and the social status of parents and caregivers. We conducted a questionnaire survey to identify the factors that have the greatest impact on children's behavior and emotions and how these factors relate to each other. METHODS A parental questionnaire survey was performed at a public elementary school. The questionnaire comprised questions on the family environment (e.g., family structure, media and game exposure, after-school lessons, and caregiver's work schedule) and physical information, the Strengths and Difficulties Questionnaire (SDQ), the Children's Sleep Habits Questionnaire (CSHQ), and the Pittsburgh Sleep Quality Index (PSQI) for parents' sleep condition. A path diagram was drawn to hypothesize the complex interrelationships among factors, and structural equation modeling was used to estimate the path coefficients. RESULT We identified several factors that significantly affected the SDQ score. The CSHQ total score had the largest impact, followed by after-school lessons, single-mother families, and children's sex. In addition, several indirect pathways that led to the CSHQ score (i.e., a pathway from time spent watching television to CSHQ score via children's bedtime and a pathway from single-mother family to CSHQ score via PSQI total score) significantly affected the SDQ score. CONCLUSION Children's sleep habits that were influenced by several environmental factors had the greatest impact on children's behavior and emotions, which suggested that children's behavioral problems can be improved by interventions focused on sleep habits, such as sleep hygiene instructions.
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Affiliation(s)
- Michiko Matsuoka
- Department of Pediatrics and Child Health, School of Medicine, Kurume University, Kurume, Japan.,Department of Neuropsychiatry, School of Medicine, Kurume University, Kurume, Japan
| | - Toyojiro Matsuishi
- Department of Pediatrics and Child Health, School of Medicine, Kurume University, Kurume, Japan.,Research Center for Children and Research Center for Rett Syndrome, St. Mary's Hospital, Kurume, Japan
| | - Shinichiro Nagamitsu
- Department of Pediatrics and Child Health, School of Medicine, Kurume University, Kurume, Japan.,Department of Pediatrics, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Mizue Iwasaki
- Department of Pediatrics and Child Health, School of Medicine, Kurume University, Kurume, Japan
| | - Akiko Iemura
- Department of Pediatrics and Child Health, School of Medicine, Kurume University, Kurume, Japan
| | - Hitoshi Obara
- Biostatistics Center, School of Medicine, Kurume University, Kurume, Japan
| | - Yushiro Yamashita
- Department of Pediatrics and Child Health, School of Medicine, Kurume University, Kurume, Japan
| | - Masaharu Maeda
- Department of Neuropsychiatry, School of Medicine, Kurume University, Kurume, Japan.,Department of Disaster Psychiatry, Fukushima Medical University, Fukushima, Japan
| | - Tatsuyuki Kakuma
- Biostatistics Center, School of Medicine, Kurume University, Kurume, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, School of Medicine, Kurume University, Kurume, Japan
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18
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Akashiba T, Inoue Y, Uchimura N, Ohi M, Kasai T, Kawana F, Sakurai S, Takegami M, Tachikawa R, Tanigawa T, Chiba S, Chin K, Tsuiki S, Tonogi M, Nakamura H, Nakayama T, Narui K, Yagi T, Yamauchi M, Yamashiro Y, Yoshida M, Oga T, Tomita Y, Hamada S, Murase K, Mori H, Wada H, Uchiyama M, Ogawa H, Sato K, Nakata S, Mishima K, Momomura SI. Sleep Apnea Syndrome (SAS) Clinical Practice Guidelines 2020. Sleep Biol Rhythms 2022; 20:5-37. [PMID: 38469064 PMCID: PMC10900032 DOI: 10.1007/s41105-021-00353-6] [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] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 10/28/2021] [Indexed: 12/17/2022]
Abstract
The prevalence of sleep-disordered breathing (SDB) is reportedly very high. Among SDBs, the incidence of obstructive sleep apnea (OSA) is higher than previously believed, with patients having moderate-to-severe OSA accounting for approximately 20% of adult males and 10% of postmenopausal women not only in Western countries but also in Eastern countries, including Japan. Since 1998, when health insurance coverage became available, the number of patients using continuous positive airway pressure (CPAP) therapy for sleep apnea has increased sharply, with the number of patients about to exceed 500,000 in Japan. Although the "Guidelines for Diagnosis and Treatment of Sleep Apnea Syndrome (SAS) in Adults" was published in 2005, a new guideline was prepared to indicate the standard medical care based on the latest trends, as supervised by and in cooperation with the Japanese Respiratory Society and the "Survey and Research on Refractory Respiratory Diseases and Pulmonary Hypertension" Group, of Ministry of Health, Labor and Welfare and other related academic societies, including the Japanese Society of Sleep Research, in addition to referring to the previous guidelines. Since sleep apnea is an interdisciplinary field covering many areas, this guideline was prepared including 36 clinical questions (CQs). In the English version, therapies and managements for SAS, which were written from CQ16 to 36, were shown. The Japanese version was published in July 2020 and permitted as well as published as one of the Medical Information Network Distribution Service (Minds) clinical practice guidelines in Japan in July 2021.
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Affiliation(s)
| | - Yuichi Inoue
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Motoharu Ohi
- Sleep Medical Center, Osaka Kaisei Hospital, Osaka, Japan
| | - Takatoshi Kasai
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Fusae Kawana
- Department of Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shigeru Sakurai
- Division of Behavioral Sleep Medicine, Iwate Medical University School of Medicine, Iwate, Japan
| | - Misa Takegami
- Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Ryo Tachikawa
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Takeshi Tanigawa
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shintaro Chiba
- Ota Memorial Sleep Center, Ota General Hospital, Kanagawa, Japan
| | - Kazuo Chin
- Department of Sleep Medicine and Respiratory Care, Division of Sleep Medicine, Nihon University of Medicine, 30-1 Oyaguchikami-cho, Itabashi-ku, Tokyo, 173-8610 Japan
- Department of Human Disease Genomics, Center for Genomic Medicine, Graduate School Medicine, Kyoto University, Kyoto, Japan
| | | | - Morio Tonogi
- Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry, Tokyo, Japan
| | | | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Koji Narui
- Sleep Center, Toranomon Hospital, Tokyo, Japan
| | - Tomoko Yagi
- Ota Memorial Sleep Center, Ota General Hospital, Kanagawa, Japan
| | - Motoo Yamauchi
- Department of Respiratory Medicine, Nara Medical University, Nara, Japan
| | | | - Masahiro Yoshida
- Department of Hemodialysis and Surgery, Ichikawa Hospital, International University of Health and Welfare, Chiba, Japan
| | - Toru Oga
- Department of Respiratory Medicine, Kawasaki Medical School, Okayama, Japan
| | - Yasuhiro Tomita
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Satoshi Hamada
- Department of Advanced Medicine for Respiratory Failure, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kimihiko Murase
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroyuki Mori
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Hiroo Wada
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | - Makoto Uchiyama
- Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan
| | - Hiromasa Ogawa
- Department of Occupational Health, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Kazumichi Sato
- Department of Dental and Oral Surgery, International University of Health and Welfare, Chiba, Japan
| | - Seiichi Nakata
- Department of Otorhinolaryngology, Second Hospital, Fujita Health University School of Medicine, Aichi, Japan
| | - Kazuo Mishima
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
| | - Shin-Ichi Momomura
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
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19
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Nakamura T, Tomita M, Horikawa N, Ishibashi M, Uematsu K, Hiraki T, Abe T, Uchimura N. Functional connectivity between the amygdala and subgenual cingulate gyrus predicts the antidepressant effects of ketamine in patients with treatment-resistant depression. Neuropsychopharmacol Rep 2021; 41:168-178. [PMID: 33615749 PMCID: PMC8340826 DOI: 10.1002/npr2.12165] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/21/2021] [Accepted: 01/23/2021] [Indexed: 12/28/2022] Open
Abstract
Aim Approximately one‐third of patients with major depressive disorder develop treatment‐resistant depression. One‐third of patients with treatment‐resistant depression demonstrate resistance to ketamine, which is a novel antidepressant effective for this disorder. The objective of this study was to examine the utility of resting‐state functional magnetic resonance imaging for the prediction of treatment response to ketamine in treatment‐resistant depression. Methods An exploratory seed‐based resting‐state functional magnetic resonance imaging analysis was performed to examine baseline resting‐state functional connectivity differences between ketamine responders and nonresponders before treatment with multiple intravenous ketamine infusions. Results Fifteen patients with treatment‐resistant depression received multiple intravenous subanesthetic (0.5 mg/kg/40 minutes) ketamine infusions, and nine were identified as responders. The exploratory resting‐state functional magnetic resonance imaging analysis identified a cluster of significant baseline resting‐state functional connectivity differences associating ketamine response between the amygdala and subgenual anterior cingulate gyrus in the right hemisphere. Using anatomical region of interest analysis of the resting‐state functional connectivity, ketamine response was predicted with 88.9% sensitivity and 100% specificity. The resting‐state functional connectivity of significant group differences between responders and nonresponders retained throughout the treatment were considered a trait‐like feature of heterogeneity in treatment‐resistant depression. Conclusion This study suggests the possible clinical utility of resting‐state functional magnetic resonance imaging for predicting the antidepressant effects of ketamine in treatment‐resistant depression patients and implicated resting‐state functional connectivity alterations to determine the trait‐like pathophysiology underlying treatment response heterogeneity in treatment‐resistant depression. This study illustrates that the alteration in the RSFC within the right AN in TRD patients reflects the antidepressant response to ketamine at baseline. The alteration remained throughout the 2‐week treatment with multiple ketamine infusions and seemed to reflect the trait‐like features underlying treatment heterogeneity in TRD. By employing an anatomical ROI of the sc/sgACC, the present study also suggests the possible clinical utility of the rsfMRI to predict the treatment response to ketamine in TRD patients.
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Affiliation(s)
- Tomoyuki Nakamura
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume City, Japan
| | - Masaru Tomita
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume City, Japan.,Elm-tree Mental Clinic, Ogori City, Japan
| | - Naoki Horikawa
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume City, Japan.,Nozoe Hills Hospital, Kurume City, Japan
| | - Masatoshi Ishibashi
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume City, Japan
| | - Ken Uematsu
- Uematsu Mental Clinic, Chikugo City, Japan.,Department of Pharmacology, Kurume University School of Medicine, Kurume City, Japan
| | - Teruyuki Hiraki
- Department of Anaesthesiology, Kurume University School of Medicine, Kurume City, Japan
| | - Toshi Abe
- Department of Radiology, Kurume University School of Medicine, Kurume City, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume City, Japan
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20
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Torimoto K, Uchimura N, Roitmann E, Marumoto M, Hirakata T, Burtea T. A large survey of nocturia related to sleep quality and daytime quality of life in a young Japanese population: NOCTURNE study. Neurourol Urodyn 2020; 40:340-347. [PMID: 33137236 DOI: 10.1002/nau.24565] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 04/30/2020] [Revised: 09/29/2020] [Accepted: 10/21/2020] [Indexed: 11/06/2022]
Abstract
AIMS Nocturia, due to nocturnal polyuria and other conditions associated with nocturnal voiding, affects sleep quality and daytime quality of life (QOL). We aimed to investigate the relationship among nocturia, sleep quality, and daytime QOL in a young Japanese population. METHODS This epidemiological study analyzed data from a retrospective data set containing sleep data from wearable devices worn by 9446 Japanese users and a prospective data set containing answers to a 10-item questionnaire completed by a subset of 605 users in the retrospective dataset. We recorded the first uninterrupted sleep period (FUSP), total sleep time (TST), number of nocturnal voids, sleep quality, daytime QOL, bothering nocturnal voids, and early wake-ups in the morning. RESULTS The subjects were 18-65 years old. The mean TST was 6.7 ± 0.9 h, and the mean number of wake-ups was 2.11 ± 1.1. FUSP and TST decreased (from 334 ± 114 to 173 ± 74 min and 5.9 ± 1.0 to 5.5 ± 1.0 h, respectively) with an increasing number of nocturnal voids, and the change was statistically significant. Logistic regression analysis showed a statistically significant relationship between nocturia and FUSP and the number of wake-ups. CONCLUSION Nocturia has close relationships with FUSP and the number of wake-ups and can result in decreased daytime QOL in young Japanese people.
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21
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Uchiyama M, Kambe D, Imadera Y, Sunaga H, Hasegawa S, Nogi T, Kajiyama Y, Yoshida S, Ogo H, Uchimura N. 0146 Efficacy and Safety of Single Dose of TS-142, a Novel and Potent Dual Orexin Receptor Antagonist, in Insomnia Patients. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.144] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
TS-142 is a novel dual orexin receptor antagonist (DORA) developed for the treatment of insomnia. Here we report its pharmacokinetic profile in the healthy subjects and its efficacy and safety in patients with insomnia.
Methods
A phase1 study was conducted to clarify pharmacokinetic profile, in which various doses of TS-142 (1–30 mg) were orally administered once to thirty two healthy subjects. Subsequently, a phase 2a study utilizing polysomnography (PSG) was carried out in patients with primary insomnia, in which 5, 10, or 30 mg of TS-142, or placebo was randomly administered in a double-blind manner. Karolinska Sleepiness Scale (KSS) and Digit Symbol Substitution Test (DSST) were also examined in the morning after PSG.
Results
Following single administration of TS-142, plasma concentration of unchanged compound reached maximum within 2.50 h (median), and then eliminated rapidly, giving mean elimination half-life between 1.32 and 3.25 h. Twenty-three patients with insomnia completed the Phase2a study. Both latency to persistent sleep (LPS) and wake after sleep onset (WASO) were significantly improved with TS-142 at all doses, in comparison with placebo (-42, -42 and -45 for LPS [min] and -28, -35 and -55 for WASO [min] in 5, 10, 30 mg, respectively). KSS and DSST administered in the morning indicated no serious hangover effects. No serious adverse events were observed in these trials.
Conclusion
The phase 1 trial showed favorable pharmacokinetic profiles. The phase 2a trial demonstrated that TS-142 was efficacious in objective sleep onset and maintenance with minimal next-day residual effects. TS-142 was generally well tolerated in both studies.
Support
Taisho Pharmaceutical. Co., Ltd.
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Affiliation(s)
- M Uchiyama
- Nihon University School of Medicine, Tokyo, JAPAN
| | - D Kambe
- Taisho Pharmaceutical Co., LTD, Tokyo, JAPAN
| | - Y Imadera
- Taisho Pharmaceutical Co., LTD, Tokyo, JAPAN
| | - H Sunaga
- Taisho Pharmaceutical Co., LTD, Tokyo, JAPAN
| | - S Hasegawa
- Taisho Pharmaceutical Co., LTD, Tokyo, JAPAN
| | - T Nogi
- Taisho Pharmaceutical Co., LTD, Tokyo, JAPAN
| | - Y Kajiyama
- Taisho Pharmaceutical Co., LTD, Tokyo, JAPAN
| | - S Yoshida
- Taisho Pharmaceutical Co., LTD, Tokyo, JAPAN
| | - H Ogo
- Taisho Pharmaceutical Co., LTD, Tokyo, JAPAN
| | - N Uchimura
- Kurume University School of Medicine, Fukuoka, JAPAN
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22
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Kobayashi Y, Oe M, Ishida T, Matsuoka M, Chiba H, Uchimura N. Workplace Violence and Its Effects on Burnout and Secondary Traumatic Stress among Mental Healthcare Nurses in Japan. Int J Environ Res Public Health 2020; 17:ijerph17082747. [PMID: 32316142 PMCID: PMC7215457 DOI: 10.3390/ijerph17082747] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 01/06/2023]
Abstract
Workplace violence (WPV) in healthcare settings has drawn attention for over 20 years, yet few studies have investigated the association between WPV and psychological consequences. Here, we used a cross-sectional design to investigate (1) the 12-month prevalence of workplace violence (WPV), (2) the characteristics of WPV, and (3) the relationship between WPV and burnout/secondary traumatic stress among 599 mental healthcare nurses (including assistant nurses) from eight hospitals. Over 40% of the respondents had experienced WPV within the past 12 months. A multivariate logistic regression analysis indicated that occupation and burnout were each significantly related to WPV. Secondary traumatic stress was not related to WPV. Our results suggest that WPV may be a long-lasting and/or cumulative stressor rather than a brief, extreme horror experience and may reflect specific characteristics of psychological effects in psychiatric wards. A longitudinal study measuring the severity and frequency of WPV, work- and non-work-related stressors, risk factors, and protective factors is needed, as is the development of a program that helps reduce the psychological burden of mental healthcare nurses due to WPV.
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23
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Hatta K, Kishi Y, Wada K, Takeuchi T, Hashimoto N, Suda K, Taira T, Tsuchida K, Ohmori T, Akizuki N, Nishio Y, Nakanishi Y, Usui C, Kurata A, Horikawa N, Eguchi H, Ito S, Muto H, Nakamura H, Uchimura N. Real-World Effectiveness of Ramelteon and Suvorexant for Delirium Prevention in 948 Patients With Delirium Risk Factors. J Clin Psychiatry 2019; 81. [PMID: 31851436 DOI: 10.4088/jcp.19m12865] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 08/01/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The aim of this study was to examine the effectiveness of ramelteon and suvorexant for delirium prevention in real-world practice. It explored whether ramelteon and/or suvorexant would affect delirium prevention among both patients at risk for but without delirium (patients at risk) and those with delirium the night before a consultation. METHODS This multicenter, prospective, observational study was conducted by trained psychiatrists at consultation-liaison psychiatric services from October 1, 2017, to October 7, 2018. Patients who were aged 65 years or older and hospitalized because of acute diseases or elective surgery, had risk factors for delirium, and had insomnia or delirium on the night before the consultation were prescribed ramelteon and/or suvorexant. The decision to take medication was left to the discretion of each patient. The primary outcome was incidence of delirium based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, during the first 7 days. RESULTS Among 526 patients at risk, those taking ramelteon and/or suvorexant developed delirium significantly less frequently than those who did not, after control for the effects of risk factors on the estimate of an independent association between the effects of ramelteon and/or suvorexant and the outcome of developing delirium (15.7% vs 24.0%; odds ratio [OR] = 0.48;, 95% CI, 0.29-0.80; P = .005). Similar results were found among 422 patients with delirium (39.9% vs 66.3%; OR = 0.36; 95% CI, 0.22-0.59; P < .0001). CONCLUSIONS Ramelteon and suvorexant appear to be effective for delirium prevention in real-world practice.
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Affiliation(s)
- Kotaro Hatta
- Department of Psychiatry, Juntendo University Nerima Hospital, Takanodai 3-1-10, Nerima-ku, Tokyo 177-8521, Japan. .,Department of Psychiatry, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Yasuhiro Kishi
- Department of Psychiatry, Nippon Medical School Musashikosugi Hospital, Kawasaki, Japan
| | - Ken Wada
- Department of Psychiatry, Hiroshima City Hospital, Hiroshima, Japan
| | - Takashi Takeuchi
- Department of Psychiatry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Naoko Hashimoto
- Department of Psychiatry, Tokushima Prefectural Central Hospital, Tokushima, Japan
| | - Kiyoko Suda
- Department of Psycho-oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Toshihiro Taira
- Department of Psychiatry, Fukuyama City Hospital, Fukuyama, Japan
| | - Kazuo Tsuchida
- Department of Psychiatry, Kurashiki Central Hospital, Kurashiki, Japan
| | - Takashi Ohmori
- Department of Psychiatry, Tokushima Prefectural Central Hospital, Tokushima, Japan
| | - Nobuya Akizuki
- Department of Psycho-oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Yuko Nishio
- Department of Psycho-oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Yukiko Nakanishi
- Department of Psycho-oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Chie Usui
- Department of Psychiatry, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Akiko Kurata
- Department of Psychiatry and Neurosciences, Hiroshima University Hospital, Hiroshima, Japan
| | - Naoki Horikawa
- Department of Psychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Hiroshi Eguchi
- Department of Psychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Shigeo Ito
- Department of Psychiatry, Nippon Medical School Musashikosugi Hospital, Kawasaki, Japan
| | - Hitoshi Muto
- Department of Psychiatry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroyuki Nakamura
- Department of Environmental and Preventive Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Naohisa Uchimura
- Department of Psychiatry, Kurume University School of Medicine, Kurume, Japan
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24
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Uchimura N, Nakatome K, Miyata K, Uchiyama M. Effect of ramelteon coadministered with antidepressant in patients with insomnia and major depressive disorder: an exploratory study. Sleep Biol Rhythms 2019. [DOI: 10.1007/s41105-019-00230-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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25
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Ohshima H, Kotorii N, Takii M, Hiejima H, Habukawa M, Kuwahara H, Uchimura N. Polysomnographic Sleep Disturbances Due to High-Dose Zolpidem Use: A Case Report. J Clin Sleep Med 2018; 14:1949-1952. [PMID: 30373692 DOI: 10.5664/jcsm.7500] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 04/26/2018] [Accepted: 08/17/2018] [Indexed: 11/13/2022]
Abstract
ABSTRACT Zolpidem is widely prescribed for the treatment of insomnia and is used to both induce and maintain sleep. Previously, zolpidem was thought to have low abuse potential; however, several reports have documented dose escalation and abuse in the past two decades. Here, we report the case of a patient with high-dose zolpidem dependence who underwent polysomnography (PSG) and the Multiple Sleep Latency Test (MSLT). The patient, a 29-year-old man, was administered zolpidem at doses of 300 to 1,200 mg/day, but he abused zolpidem to feel energetic. Consequently, he had a car accident while on a high dose, which the PSG revealed caused activation instead of sedation. The MSLT showed excessive daytime sleepiness despite a lack of subjective sleepiness under this condition. Our findings suggest that disrupted sleep and daytime sleepiness caused by supratherapeutic zolpidem doses could place individuals at high risk for accidents, including those who are unaware of sleepiness.
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Affiliation(s)
- Hayato Ohshima
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Nozomu Kotorii
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Minoru Takii
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Hiroshi Hiejima
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Mitsunari Habukawa
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Hiroo Kuwahara
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Fukuoka, Japan
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Miyagawa T, Khor SS, Toyoda H, Kanbayashi T, Imanishi A, Sagawa Y, Kotorii N, Kotorii T, Ariyoshi Y, Hashizume Y, Ogi K, Hiejima H, Kamei Y, Hida A, Miyamoto M, Ikegami A, Wada Y, Takami M, Higashiyama Y, Miyake R, Kondo H, Fujimura Y, Tamura Y, Taniyama Y, Omata N, Tanaka Y, Moriya S, Furuya H, Kato M, Kawamura Y, Otowa T, Miyashita A, Kojima H, Saji H, Shimada M, Yamasaki M, Kobayashi T, Misawa R, Shigematsu Y, Kuwano R, Sasaki T, Ishigooka J, Wada Y, Tsuruta K, Chiba S, Tanaka F, Yamada N, Okawa M, Kuroda K, Kume K, Hirata K, Uchimura N, Shimizu T, Inoue Y, Honda Y, Mishima K, Honda M, Tokunaga K. A variant at 9q34.11 is associated with HLA-DQB1*06:02 negative essential hypersomnia. J Hum Genet 2018; 63:1259-1267. [PMID: 30266950 DOI: 10.1038/s10038-018-0518-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 08/29/2018] [Accepted: 09/13/2018] [Indexed: 12/13/2022]
Abstract
Essential hypersomnia (EHS) is a lifelong disorder characterized by excessive daytime sleepiness without cataplexy. EHS is associated with human leukocyte antigen (HLA)-DQB1*06:02, similar to narcolepsy with cataplexy (narcolepsy). Previous studies suggest that DQB1*06:02-positive and -negative EHS are different in terms of their clinical features and follow different pathological pathways. DQB1*06:02-positive EHS and narcolepsy share the same susceptibility genes. In the present study, we report a genome-wide association study with replication for DQB1*06:02-negative EHS (408 patients and 2247 healthy controls, all Japanese). One single-nucleotide polymorphism, rs10988217, which is located 15-kb upstream of carnitine O-acetyltransferase (CRAT), was significantly associated with DQB1*06:02-negative EHS (P = 7.5 × 10-9, odds ratio = 2.63). The risk allele of the disease-associated SNP was correlated with higher expression levels of CRAT in various tissues and cell types, including brain tissue. In addition, the risk allele was associated with levels of succinylcarnitine (P = 1.4 × 10-18) in human blood. The leading SNP in this region was the same in associations with both DQB1*06:02-negative EHS and succinylcarnitine levels. The results suggest that DQB1*06:02-negative EHS may be associated with an underlying dysfunction in energy metabolic pathways.
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Affiliation(s)
- Taku Miyagawa
- Sleep Disorders Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan. .,Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Seik-Soon Khor
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiromi Toyoda
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takashi Kanbayashi
- Department of Neuropsychiatry, Akita University School of Medicine, Akita, Japan.,International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Ibaraki, Japan
| | - Aya Imanishi
- Department of Neuropsychiatry, Akita University School of Medicine, Akita, Japan
| | - Yohei Sagawa
- Department of Neuropsychiatry, Akita University School of Medicine, Akita, Japan
| | - Nozomu Kotorii
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan.,Kotorii Isahaya Hospital, Nagasaki, Japan
| | | | | | - Yuji Hashizume
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Kimihiro Ogi
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Hiroshi Hiejima
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Yuichi Kamei
- Department of Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Akiko Hida
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | | | | | - Yamato Wada
- Department of Psychiatry, Hannan Hospital, Osaka, Japan
| | - Masanori Takami
- Department of Psychiatry, Shiga University of Medical Science, Shiga, Japan
| | - Yuichi Higashiyama
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Ryoko Miyake
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Hideaki Kondo
- Center for Sleep Medicine, Saiseikai Nagasaki Hospital, Nagasaki, Japan
| | - Yota Fujimura
- Department of Psychiatry and Neurology, Asahikawa Medical University, Hokkaido, Japan.,Department of Psychiatry, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Yoshiyuki Tamura
- Department of Psychiatry and Neurology, Asahikawa Medical University, Hokkaido, Japan
| | - Yukari Taniyama
- Department of Neurology, Junwakai Memorial Hospital, Miyazaki, Japan
| | - Naoto Omata
- Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yuji Tanaka
- Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Shunpei Moriya
- Department of Psychiatry, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - Hirokazu Furuya
- Department of Neurology, Neuro-Muscular Center, National Omuta Hospital, Fukuoka, Japan.,Department of Neurology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Mitsuhiro Kato
- Department of Pediatrics, Yamagata University Faculty of Medicine, Yamagata, Japan.,Department of Pediatrics, Showa University School of Medicine, Tokyo, Japan
| | - Yoshiya Kawamura
- Department of Psychiatry, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Takeshi Otowa
- Graduate School of Clinical Psychology, Teikyo Heisei University Major of Professional Clinical Psychology, Tokyo, Japan
| | - Akinori Miyashita
- Department of Molecular Genetics, Center for Bioresources, Brain Research Institute, Niigata University, Niigata, Japan
| | | | | | - Mihoko Shimada
- Sleep Disorders Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Maria Yamasaki
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takumi Kobayashi
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Clinical Laboratory Medicine, Faculty of Health Science Technology, Bunkyo Gakuin University, Tokyo, Japan
| | - Rumi Misawa
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Clinical Laboratory Medicine, Faculty of Health Science Technology, Bunkyo Gakuin University, Tokyo, Japan
| | - Yosuke Shigematsu
- Department of Pediatrics, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Ryozo Kuwano
- Department of Molecular Genetics, Center for Bioresources, Brain Research Institute, Niigata University, Niigata, Japan
| | - Tsukasa Sasaki
- Department of Physical and Health Education, Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | | | - Yuji Wada
- Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kazuhito Tsuruta
- Department of Neurology, Junwakai Memorial Hospital, Miyazaki, Japan
| | - Shigeru Chiba
- Department of Psychiatry and Neurology, Asahikawa Medical University, Hokkaido, Japan
| | - Fumiaki Tanaka
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Naoto Yamada
- Department of Psychiatry, Shiga University of Medical Science, Shiga, Japan
| | - Masako Okawa
- Department of Sleep Medicine, Shiga University of Medical Science, Shiga, Japan.,Japan Foundation for Neuroscience and Mental Health, Tokyo, Japan.,Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | - Kenji Kuroda
- Department of Psychiatry, Hannan Hospital, Osaka, Japan
| | - Kazuhiko Kume
- Sleep Center, Kuwamizu Hospital, Kumamoto, Japan.,Department of Stem Cell Biology, Institute of Molecular Genetics and Embryology, Kumamoto University, Kumamoto, Japan.,Department of Neuropharmacology, Graduate School of Pharmaceutical Sciences, Nagoya City University, Aichi, Japan
| | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Tetsuo Shimizu
- Department of Neuropsychiatry, Akita University School of Medicine, Akita, Japan.,International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Ibaraki, Japan
| | - Yuichi Inoue
- Department of Somnology, Tokyo Medical University, Tokyo, Japan.,Yoyogi Sleep Disorder Center, Tokyo, Japan
| | - Yutaka Honda
- Seiwa Hospital, Neuropsychiatric Research Institute, Tokyo, Japan
| | - Kazuo Mishima
- Department of Neuropsychiatry, Akita University School of Medicine, Akita, Japan.,International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Ibaraki, Japan.,Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Makoto Honda
- Sleep Disorders Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Seiwa Hospital, Neuropsychiatric Research Institute, Tokyo, Japan
| | - Katsushi Tokunaga
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Kondo A, Shoji Y, Morita K, Sato M, Ishii Y, Yanagimoto H, Nakano S, Uchimura N. Characteristics of oxygenated hemoglobin concentration change during pleasant and unpleasant image-recall tasks in patients with depression: Comparison with healthy subjects. Psychiatry Clin Neurosci 2018; 72:611-622. [PMID: 29808572 DOI: 10.1111/pcn.12684] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 11/17/2017] [Revised: 04/09/2018] [Accepted: 05/13/2018] [Indexed: 11/29/2022]
Abstract
AIM Patients with major depressive disorder (MDD) have been reported to show cognitive impairment in attention, cognition control, and motivation. The prefrontal cortex plays an important role in the pathophysiology of depression. Neurophysiological abnormalities have been examined in MDD patients by several neuroimaging studies. However, the underlying neural mechanism is still unclear. We evaluated brain function during pleasant and unpleasant image-recall tasks using multichannel near-infrared spectroscopy (NIRS) in MDD patients. METHODS The subjects were 25 MDD patients and 25 age- and sex-matched healthy controls. Patients were classified according to DSM-IV-TR criteria. We measured the oxygenated hemoglobin concentration change (δoxyHb) in the forehead and temporal lobe during image-recall task with pleasant (e.g., puppy) and unpleasant (e.g., snake) images using NIRS. To check whether all subjects understood the task, they were asked to draw pictures of both image tasks after NIRS measurement. RESULTS The δoxyHb in the healthy group was significantly higher than that in the MDD group in the bilateral frontal region during the unpleasant condition. A significant negative correlation between the Hamilton Rating Scale for Depression score and δoxyHb was observed in the left frontal region during the unpleasant condition. CONCLUSION We suggest that image-recall tasks related to emotion measured by NIRS might be a visually useful psychophysiological marker to understand the decrease in the frontal lobe function in MDD patients. In particular, we suggest that the decrease in δoxyHb in the left frontal lobe is related to the severity of depression.
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Affiliation(s)
- Akihiko Kondo
- Cognitive and Molecular Research Institute of Brain Disease, Kurume University, Kurume, Japan
| | - Yoshihisa Shoji
- Cognitive and Molecular Research Institute of Brain Disease, Kurume University, Kurume, Japan.,Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Kiichiro Morita
- Cognitive and Molecular Research Institute of Brain Disease, Kurume University, Kurume, Japan.,Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Mamoru Sato
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Youhei Ishii
- Cognitive and Molecular Research Institute of Brain Disease, Kurume University, Kurume, Japan
| | - Hiroko Yanagimoto
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Shinya Nakano
- Cognitive and Molecular Research Institute of Brain Disease, Kurume University, Kurume, Japan
| | - Naohisa Uchimura
- Cognitive and Molecular Research Institute of Brain Disease, Kurume University, Kurume, Japan.,Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
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28
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Ayabe N, Okajima I, Nakajima S, Inoue Y, Watanabe N, Yamadera W, Uchimura N, Tachimori H, Kamei Y, Mishima K. Effectiveness of cognitive behavioral therapy for pharmacotherapy-resistant chronic insomnia: a multi-center randomized controlled trial in Japan. Sleep Med 2018; 50:105-112. [PMID: 30031988 DOI: 10.1016/j.sleep.2018.05.038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 03/15/2018] [Revised: 05/15/2018] [Accepted: 05/23/2018] [Indexed: 10/14/2022]
Abstract
OBJECTIVES An insomnia characterized by nighttime symptoms and daytime impairment is common. GABA-A receptor agonist (GABAA-RA) treatment is often used, but long-term use is controversial due to the poor risk-benefit ratio resulting from drug dependence and potential cognitive impairment. This study evaluated the effectiveness of add-on cognitive behavioral therapy for insomnia (CBT-I) and GABAA-RA dose-tapering in patients with primary insomnia resistant to pharmacotherapy. METHODS This randomized, multicenter, two-arm, parallel-group study compared CBT-I and treatment as usual (TAU) in patients with persistent primary insomnia despite GABAA-RA treatment. Screening was based on sleep diary entries, with ≥31-min sleep latency or wake after sleep onset, occurring ≥3 times in a week and total score of ≥8 on the Insomnia Severity Index (ISI). Primary outcome measures were severity of insomnia and GABAA-RA tapering rate. RESULTS A total of 51 patients were randomized and 49 patients were analyzed (CBT-I; n = 23, TAU; n = 26). A mixed-effects repeated-measures model revealed significant improvement in insomnia symptoms (ISI score) during the post-intervention (PI) and follow-up (FU) periods in the CBT-I versus the TAU group (PI; 10.91 vs. 14.33, p < 0.05, FU; 10.17 vs. 14.34, p < 0.01). GABAA-RA tapering rate approached 30% during follow-up in the CBT-I group; no significant intergroup difference was observed. CONCLUSION Add-on CBT-I improved insomnia symptoms that were unresponsive to GABAA-RA therapy. No effect on tapering rate was observed in this study. CBT-I may promote dose reduction by optimizing the protocol and duration of treatment. TRIAL REGISTRATION UMIN Clinical Trials Registry identifier: UMIN000014297.
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Affiliation(s)
- Naoko Ayabe
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan.
| | - Isa Okajima
- Department of Psychological Counseling, Faculty of Humanities, Tokyo Kasei University, 1-18-1 Kaga, Itabashi-ku, Tokyo, 173-8602, Japan; Japan Somnology Center, Institute of Neuropsychiatry, 5-10-10 Yoyogi, Shibuya-ku, Tokyo, 151-0053, Japan.
| | - Shun Nakajima
- Department of Psychology, Faculty of Liberal Arts, Teikyo University, 359 Otsuka, Hachioji, Tokyo, 192-0395, Japan.
| | - Yuichi Inoue
- Japan Somnology Center, Institute of Neuropsychiatry, 5-10-10 Yoyogi, Shibuya-ku, Tokyo, 151-0053, Japan.
| | - Norio Watanabe
- Department of Health Promotion and Human Behavior/Clinical Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.
| | - Wataru Yamadera
- Department of Psychiatry, The Jikei University Katsushika Medical Center, 6-41-2 Aoto, Katsushika-ku, Tokyo, 125-8506, Japan.
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, 67 Asahi Machi, Kurume, Fukuoka, 830-0011, Japan.
| | - Hisateru Tachimori
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan.
| | - Yuichi Kamei
- National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan.
| | - Kazuo Mishima
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan.
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Sato M, Shoji Y, Morita K, Kato Y, Ishii Y, Nakano S, Uchimura N. Comparison of changes in the oxygenated hemoglobin level during a 'modified rock-paper-scissors task' between healthy subjects and patients with schizophrenia. Psychiatry Clin Neurosci 2018; 72:490-501. [PMID: 29582515 DOI: 10.1111/pcn.12653] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 02/21/2018] [Accepted: 03/22/2018] [Indexed: 01/27/2023]
Abstract
AIM The purpose of this study, using single-event-related near-infrared spectroscopy (NIRS), was to examine the psychophysiological and social function assessment of 30 schizophrenic patients during a modified rock-paper-scissors task. METHODS We set up a screen in front of the subjects, on which pictures of hand-gestures for rock, paper, and scissors were randomly presented. Subjects were asked to give verbal answers under the conditions of win, lose, and draw, respectively. Using the 44-channel NIRS system, we evaluated the maximum amplitude of oxygenated hemoglobin, latency, and the area based on the arithmetic mean of resulting values after the task between 30 outpatients with schizophrenia and 30 healthy subjects, and analyzed the frontal pole area, dorsolateral prefrontal region, and parietal association area as regions of interest (ROI). RESULTS In schizophrenic patients, oxygenated hemoglobin changes (Δoxy-Hb) when losing the task showed a significantly lower level of Δoxy-Hb in ROI than controls. In addition, a significant positive correlation was observed between the Global Assessment of Functioning Scale and Δoxy-Hb in ROI, and a significant negative correlation was observed between the Negative Syndrome scale of the Positive and Negative Syndrome Scale and Δoxy-Hb in ROI. CONCLUSION From these results, we conclude that Δoxy-Hb levels when performing the modified rock-paper-scissors task assessed using NIRS may be a useful psychophysiological marker to evaluate the cognitive and social functions of schizophrenic patients.
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Affiliation(s)
- Mamoru Sato
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan.,Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan
| | - Yoshihisa Shoji
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan.,Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan
| | - Kiichiro Morita
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan.,Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan
| | - Yusuke Kato
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan.,Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan
| | - Youhei Ishii
- Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan
| | - Shinya Nakano
- Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan.,Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan
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30
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Nakano S, Shoji Y, Morita K, Igimi H, Sato M, Ishii Y, Kondo A, Uchimura N. Comparison of changes in oxygenated hemoglobin during the tree-drawing task between patients with schizophrenia and healthy controls. Neuropsychiatr Dis Treat 2018; 14:1071-1082. [PMID: 29719398 PMCID: PMC5916263 DOI: 10.2147/ndt.s159984] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Tree-drawing test is used as a projective psychological test that expresses the abnormal internal experience in patients with schizophrenia (SZ). Despite the widely accepted view that the cognitive function is involved in characteristic tree-drawing in patients with SZ, no study has psychophysiologically examined it. The present study aimed to investigate the involvement of cognitive function during tree-drawing in patients with SZ. For that purpose, we evaluated the brain function in patients with SZ during a tree-drawing task by using near-infrared spectroscopy (NIRS) and compared them with those in healthy controls. PATIENTS AND METHODS The subjects were 28 healthy controls and 28 patients with SZ. Changes in the oxygenated hemoglobin ([oxy-Hb]) concentration in both the groups during the task of drawing a tree imagined freely (free-drawing task) and the task of copying an illustration of a tree (copying task) were measured by using NIRS. RESULTS Because of the difference between the task conditions, [oxy-Hb] levels in controls during the free-drawing task were higher than that during the copying task at the bilateral frontal pole regions and left inferior frontal region. Because of the difference between the groups, [oxy-Hb] levels at the left middle frontal region, bilateral inferior frontal regions, bilateral inferior parietal regions, and left superior temporal region during the free-drawing task in patients were lower than that in controls. CONCLUSION [oxy-Hb] during the tree-drawing task in patients with SZ was lower than that in healthy controls. Our results suggest that brain dysfunction in patients with SZ might be associated with their tree-drawing.
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Affiliation(s)
- Shinya Nakano
- Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan.,Department of Clinical Laboratory Medicine, Kurume University Hospital, Kurume, Japan
| | - Yoshihisa Shoji
- Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan.,Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Kiichiro Morita
- Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan.,Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Hiroyasu Igimi
- Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan.,Department of Neuropsychiatry, Horikawa Hospital, Medical Corporation Association Horikawakai, Kurume, Japan
| | - Mamoru Sato
- Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan.,Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Youhei Ishii
- Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan
| | - Akihiko Kondo
- Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan
| | - Naohisa Uchimura
- Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan.,Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
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31
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Matsumoto Y, Uchimura N, Ishida T, Morimatsu Y, Masuda H, Mori M, Inoue M, Ishitake T. A cohort study: changes in depression among eight sleep types based on the 3 dimensional sleep scale. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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32
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Chikama K, Yamada H, Tsukamoto T, Kajitani K, Nakabeppu Y, Uchimura N. Chronic atypical antipsychotics, but not haloperidol, increase neurogenesis in the hippocampus of adult mouse. Brain Res 2017; 1676:77-82. [DOI: 10.1016/j.brainres.2017.09.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 08/31/2017] [Accepted: 09/04/2017] [Indexed: 11/28/2022]
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Habukawa M, Uchimura N, Maeda M, Ogi K, Hiejima H, Kakuma T. Differences in rapid eye movement (REM) sleep abnormalities between posttraumatic stress disorder (PTSD) and major depressive disorder patients: REM interruption correlated with nightmare complaints in PTSD. Sleep Med 2017; 43:34-39. [PMID: 29482809 DOI: 10.1016/j.sleep.2017.10.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [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: 07/31/2017] [Revised: 10/01/2017] [Accepted: 10/06/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The presence of repeated nightmares in posttraumatic stress disorder (PTSD) has been hypothesized as a dysfunction of rapid eye movement (REM) sleep, but there has been remarkably little agreement about the pathophysiology. This presents a deterrent to more effective treatments. REM sleep abnormalities including elevated REM density also have been replicated in major depressive disorder (MDD). The purpose of this study was to clarify the difference of REM sleep abnormalities between the two disorders for understanding the pathophysiology of sleep disturbances in PTSD. METHODS Polysomnographic measures were compared among 14 PTSD patients (aged 23.7 ± 5.5 years) and 14 MDD patients (aged 27.9 ± 10.1 years) under drug-naive or drug-free conditions. We defined REM interruption by summing the intrusive wake times during the REM period and adding the subsequent wake times to the last epoch of REM period. The significant polysomnographic measures were correlated with PTSD symptoms within the PTSD group. RESULTS REM interruption was significantly increased in the PTSD group compared with the MDD group (12.2 vs 2.1 min, p = 0.001). REM density was also significantly increased in the PTSD group compared with the MDD group (30.5 vs 23.1%, p = 0.019). Within the PTSD group, we found significant correlations between the severity of trauma-related nightmare complaints and the percentage of REM interruption (R = 0.62, p = 0.017), but not REM density. CONCLUSIONS REM sleep abnormalities are different between PTSD and MDD. Increased REM interruption may be a biological marker correlated with nightmare complaints in PTSD patients. Treatments including pharmacotherapy that reduces REM interruption might ameliorate nightmares in PTSD.
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Affiliation(s)
- Mitsunari Habukawa
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Masaharu Maeda
- Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, Hukushima, Hukushima, Japan
| | - Kimihiro Ogi
- Department of Psychiatry, Ueda Hospital, Chikugo, Fukuoka, Japan
| | - Hiroshi Hiejima
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Tatsuyuki Kakuma
- The Biostatistics Center, Medical School, Kurume University, Kurume, Fukuoka, Japan
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34
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Ishii Y, Morita K, Shoji Y, Sato M, Yanagimoto H, Uchimura N. P2-28. Single-event-related changes in Oxy-Hb during verbal discrimination tasks in schizophrenic patients: Correlation with the symptom. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2017.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Matsumoto Y, Uchimura N, Ishida T, Morimatsu Y, Mori M, Inoue M, Kushino N, Hoshiko M, Ishitake T. The relationship of sleep complaints risk factors with sleep phase, quality, and quantity in Japanese workers. Sleep Biol Rhythms 2017; 15:291-297. [PMID: 28989323 PMCID: PMC5605601 DOI: 10.1007/s41105-017-0110-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 07/17/2017] [Indexed: 01/21/2023]
Abstract
Numerous studies have determined that lifestyle factors (smoking, drinking, snacking, etc.) and the bedroom environment can influence sleep. We developed a new sleep scale-the 3-Dimensional Sleep Scale (3DSS)-which measures three elements of sleep: phase, quality, and quantity. The purpose of this study is to determine which risk factors of sleep complaints are associated with these sleep elements. Data were obtained from 366 Japanese day workers (302 men and 64 women). Sleep condition was assessed with the 3DSS, and we also assessed various habits within 2 h of going to bed, including smoking, drinking, snacking, caffeine intake, mobile phone use, and working. We also asked about bedroom environmental conditions (noise, lighting, and temperature and humidity). Multivariate logistic regression analysis using the backward selection method (likelihood ratio) was used, with 3DSS scores as the outcome (i.e., over or under the cutoff). The results showed that smoking was associated with significantly greater odds ratio [2.71 (1.65-4.44)] of disordered sleep phase, while lighting as well as temperature and humidity led to greater odds [3.67 (1.55-8.68), 1.93 (1.20-3.11)] of poor sleep quality. Finally, only noise was significantly related to greater odds [1.98 (1.13-3.46)] of low sleep quantity. These findings indicated the various risk factors of sleep complaints could be associated with different sleep elements. This might help in the effective treatment of sleep complaints.
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Affiliation(s)
- Yuuki Matsumoto
- Department of Environmental Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011 Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Tetsuya Ishida
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Yoshitaka Morimatsu
- Department of Environmental Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011 Japan
| | - Mihoko Mori
- Department of Environmental Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011 Japan
| | - Miyako Inoue
- Department of Environmental Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011 Japan
| | - Nanae Kushino
- Department of Environmental Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011 Japan
| | - Michiko Hoshiko
- Department of Environmental Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011 Japan
| | - Tatsuya Ishitake
- Department of Environmental Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011 Japan
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Kato Y, Shoji Y, Morita K, Inoue M, Ishii Y, Sato M, Yamashita Y, Okawa J, Uchimura N. Evaluation of changes in oxyhemoglobin during Shiritori task in elderly subjects including those with Alzheimer‧s disease. Psychogeriatrics 2017; 17:238-246. [PMID: 28130872 DOI: 10.1111/psyg.12226] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 02/15/2016] [Revised: 07/23/2016] [Accepted: 08/19/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND In recent years, as the prevalence of Alzheimer‧s disease (AD) has increased rapidly, demand has increased for early detection and treatment. Therefore, discovery and treatment intervention at the mild cognitive impairment stage are important. Dysfunction of the working memory is known to be conspicuously present in AD patients or mild cognitive impairment subjects from an early stage. Near-infrared spectroscopy (NIRS) is a method to measure hemoglobin concentration changes during an activation task. In the present study, we evaluated the cognitive function of elderly subjects, including those with AD, by means of NIRS. METHODS The subjects were divided into three groups-the AD group, the intermediate group, and the healthy group (HG)-based on assement of dementia using the Hasegawa‧s Dementia Scale-Revised, Mini-Mental State Examination, and Clinical Dementia Rating. The intermediate group was divided into two groups-the high score group (HSMG) and the low score group (LSMG)-based on Hasegawa‧s Dementia Scale-Revised and Mini-Mental State Examination scores. In this study, during Shiritori tasks using single-event-related NIRS, we analyzed oxyhemoglobin changes in an area, the peak amplitude, and latency, and compared them among four groups: AD group, HSMG, LSMG, and HG. RESULT In the AD group, the area at left channel (Ch)9, 11, and 19, the area at right Ch22, and the peak ampulitude at left Ch11 and 19 and right Ch5,12, and 22 were significantly smaller than those in HSMG and HG. Furthermore, the latency of the AD group was significantly longer than that of HSMG and HG at all region of interests. However, no significant difference was observed between the AD group and LSMG. CONCLUSION These findings suggest that analysis of changes in oxyhemoglobin during Shiritori tasks may be a useful neuropsychological index for the early diagnosis of AD. Detailed studies will be conducted in LSMG to facilitate the early introduction of NIRS as a screening tool for cognitive impairment.
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Affiliation(s)
- Yusuke Kato
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan.,Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan
| | - Yoshihisa Shoji
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan.,Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan
| | - Kiichiro Morita
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan.,Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan
| | - Masayuki Inoue
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Yohei Ishii
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Mamoru Sato
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan.,Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan
| | - Yuuji Yamashita
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan.,Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan
| | - Junji Okawa
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan.,Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan.,Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan
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Fujieda M, Uchida K, Ikebe S, Kimura A, Kimura M, Watanabe T, Sakamoto H, Matsumoto T, Uchimura N. Inquiring about insomnia may facilitate diagnosis of depression in the primary care setting. Psychiatry Clin Neurosci 2017; 71:383-394. [PMID: 28094458 DOI: 10.1111/pcn.12507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 03/24/2016] [Revised: 10/28/2016] [Accepted: 01/10/2017] [Indexed: 11/28/2022]
Abstract
AIM Depression is often undiagnosed in primary care. Asking about sleep status is much easier than asking about mood. This study was conducted to examine the relation between insomnia and depression. METHODS New patients aged 35-64 years were recruited from internal medicine clinics in Japan. Self-administered questionnaires were employed. Depression was evaluated by the Zung Self-Rating Depression Scale and the Profile of Mood States. Sleep status was investigated using the Pittsburgh Sleep Quality Index. Likelihood ratios of insomnia for depression were calculated. To assess the relation between insomnia and depression independent of confounding factors, adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated using multiple logistic regression analyses. RESULTS Among 598 subjects, 153 (25.6%) were assessed as having depression. 'Very bad sleep quality, with difficulty falling asleep within 30 min ≥3 times/week' showed a positive likelihood ratio of 20.36 (95%CI, 2.53-164) while 'not very good sleep quality' had a negative likelihood ratio of 0.32 (95%CI, 0.14-0.72). Adjusted for sex, age, underlying diseases, major life events, lifestyle habits, and relationship problems, significant OR for depression were observed for 'difficulty falling asleep within 30 min ≥3 times/week' (OR, 2.53; 95%CI, 1.07-5.98), 'waking up in the middle of the night or early morning ≥3 times/week' (OR, 3.09; 95%CI, 1.58-6.05), and 'fairly bad sleep quality' (OR, 3.65; 95%CI, 1.34-9.96). CONCLUSION Inquiring about the weekly frequency of difficulty 'falling asleep within 30 min,' 'waking up in the middle of the night or early morning,' and 'sleep quality' may help to diagnose depression.
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Affiliation(s)
- Megumi Fujieda
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan.,Department of Environmental Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Katsuhisa Uchida
- Mental Health and Welfare Center of Shizuoka Prefectural Government, Shizuoka, Japan
| | | | | | | | | | - Hisako Sakamoto
- Mental Health and Welfare Center of Shizuoka Prefectural Government, Shizuoka, Japan
| | | | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
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Abstract
This study aimed to examine the significance of intervention to improve medication adherence in long-term inpatients by providing psychoeducation and then elucidating the effects of this training in terms of patient knowledge and attitudes. Subjects were patients who had been hospitalized for more than 1 year after being admitted to a psychiatric hospital, had been diagnosed as F2 (schizophrenia, schizoaffective disorder) according to the International Classification of Diseases, 10th Edition, and were capable of verbal communication. Patients suspected of having dementia were excluded. Items surveyed were patient background, prescriptions, Global Assessment of Functioning (GAF) score, Drug Attitude Inventory-10 (DAI-10) score, and Knowledge of Illness and Drugs Inventory (KIDI) score. The amount of medication taken and GAF, DAI-10, and KIDI scores were evaluated within 1 week of starting psychoeducation and within 1 week of completing psychoeducation. The Wilcoxon signed-rank test and McNemar test was used to compare scores before and after intervention. The mean overall KIDI score increased significantly, and the mean overall DAI-10 score improved significantly after intervention. Furthermore, the mean overall KIDI score of very long-term inpatients with schizophrenia and schizoaffective disorder increased significantly after intervention. Psychoeducation produced improvement in some areas of knowledge and attitudes towards medication among long-term inpatients. These results demonstrate that psychoeducation has an effect on long-term inpatients that is similar to the effect observed in earlier studies on patients leading community lives, including patients who have just been admitted or discharged and patients attending day care or outpatient visits.
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Affiliation(s)
- Nobuhiko Yanagida
- Department of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University
| | - Toshiro Uchino
- Department of Psychiatry, Kurume University School of Medicine
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39
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Inoue M, Shoji Y, Ueno T, Morita K, Abe T, Uchimura N. Right hemispheric hyperfrontality in schizophrenia during a Shiritori task: An fMRI study. Psychiatry Clin Neurosci 2017; 71:213-214. [PMID: 28039921 DOI: 10.1111/pcn.12503] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 11/30/2016] [Accepted: 12/27/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Masayuki Inoue
- Department of Psychiatry, Fukuma Hospital, Fukuoka, Japan.,Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan
| | - Yoshihisa Shoji
- Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan.,Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Takefumi Ueno
- Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan.,Divison of Clinical Research, National Hospital Organization, Hizen Psychiatric Center, Saga, Japan.,Department of Neuropsychiatry, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Kiichiro Morita
- Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan.,Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Toshi Abe
- Department of Radiology, Kurume University School of Medicine, Kurume, Japan
| | - Naohisa Uchimura
- Cognitive and Molecular Research Institute of Brain Diseases, Kurume University, Kurume, Japan.,Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
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40
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Chiba H, Nagamitsu S, Sakurai R, Mukai T, Shintou H, Koyanagi K, Yamashita Y, Kakuma T, Uchimura N, Matsuishi T. Children's Eating Attitudes Test: Reliability and validation in Japanese adolescents. Eat Behav 2016; 23:120-125. [PMID: 27643567 DOI: 10.1016/j.eatbeh.2016.09.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 05/16/2016] [Revised: 09/02/2016] [Accepted: 09/06/2016] [Indexed: 11/29/2022]
Abstract
Eating disorders (ED) are serious psychosomatic disorders that commonly occur in girls during adolescence. An increase in earlier onset ED has recently been suggested. Therefore, accurate assessment of eating attitudes in children is a necessary part of school mental health. The 26-item Children's Eating Attitudes Test (ChEAT-26) is widely used internationally to assess abnormal eating attitudes. The present study aimed to validate the Japanese version of the ChEAT-26. Participants were 7076 school children (aged 10-15years) from large, medium-sized, and small cities, and 44 children with anorexia nervosa. We examined the average ChEAT-26 score by participant attributes, including sex, age, geographical region, and school style. Factor analysis of the ChEAT-26 content was performed with varimax rotation. The optimal cut-off point was evaluated using receiver operating characteristic (ROC) analysis. The mean ChEAT-26 score was 7.94 for girls and 5.86 for boys. The mean score was significantly higher in children from larger cities than small cities, and was higher with increasing age, and private schools. Five factors explained 31.4% of the variance. The Cronbach's alpha was 0.81 for the scale. The area under the ROC curve was 0.83; sensitivity was 0.69 and specificity was 0.93 for a cut-off score of 18. The Japanese version of the ChEAT-26 is a reliable and valid psychometric tool that may be useful in the triage and assessment of children with anorexia nervosa.
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Affiliation(s)
- Hiromi Chiba
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan; Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Shinichiro Nagamitsu
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan.
| | - Rieko Sakurai
- Biostatistics Center, Kurume University School of Medicine, Fukuoka, Japan
| | - Takayo Mukai
- Department of Psychology, University of the Sacred Heart, Tokyo, Japan
| | - Hiroko Shintou
- Department of Psychology, University of Seinan Gakuin, Fukuoka, Japan
| | - Kenshi Koyanagi
- Nagasaki Prefectural Center of Medicine and Welfare for Children, Nagasaki, Japan
| | - Yushiro Yamashita
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Tatsuyuki Kakuma
- Biostatistics Center, Kurume University School of Medicine, Fukuoka, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Toyojiro Matsuishi
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
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41
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Matsumoto Y, Uchimura N, Ishida T, Toyomasu K, Morimatsu Y, Mori M, Kushino N, Hoshiko M, Ishitake T. Day workers suffering from a wider range of sleep problems are more likely to experience suicidality. Sleep Biol Rhythms 2016; 14:369-376. [PMID: 27738408 PMCID: PMC5037152 DOI: 10.1007/s41105-016-0067-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 06/06/2016] [Indexed: 12/17/2022]
Abstract
Both a higher suicide rate and widespread sleep problems are serious health concerns in Japan when compared with those of other countries. We investigated the relationship between suicidal ideation and sleep problems in Japanese day workers using the 3-dimensional sleep scale (3DSS), which measures three sleep elements (phase, quality, and quantity). Data from 635 Japanese day workers (461 mens and 174 womens) were included. The 3DSS was used to assess participants' sleep condition. Participants were classified into eight sleep types based on scores of phase, quality, and quantity: All Good Sleep, Owl (poor phase), Inefficient (poor quality), Short (poor quantity), Owl + Inefficient (poor phase and quality), Owl + Short (poor phase and quantity), Inefficient + Short (poor quality and quantity), and All Poor Sleep. We assessed participants' suicidal ideation using question 19 of the self-rating depression scale (SDS); 119 cases (18.7 %) had ratings of 2-4 for this question and were considered to have suicidal ideation. The higher the number of sleep problems, the higher the risk of suicidal ideation compared to sleep types not indicative of problems. All Poor Sleep had the highest risk of the eight sleep types. Individuals with Owl + Short, Inefficient + Short, or All Poor Sleep had a significant risk of suicidal ideation even after adjusting for hopelessness and nightmares. Our findings suggested that sleep problems assessed by the 3DSS were related to suicidal ideation. Analysis of various aspects of sleep could be helpful for suicide prevention.
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Affiliation(s)
- Yuuki Matsumoto
- Department of Environmental Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011 Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Tetsuya Ishida
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Kouji Toyomasu
- Institute of Health and Sports Science, Kurume University, Kurume, Japan
| | - Yoshitaka Morimatsu
- Department of Environmental Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011 Japan
| | - Mihoko Mori
- Department of Environmental Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011 Japan
| | - Nanae Kushino
- Department of Environmental Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011 Japan
| | - Michiko Hoshiko
- Department of Environmental Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011 Japan
| | - Tatsuya Ishitake
- Department of Environmental Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011 Japan
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42
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Suekane S, Ueda K, Suyama S, Hayashi T, Toyozawa N, Yoshitake M, Nishihara K, Sakashita N, Uchimura N, Matsuoka K. Comprehensive Health-Related Quality of Life is Influenced by Nocturia and Sleep Disturbance: Investigation Based on the SF-8. Kurume Med J 2016; 62:9-16. [PMID: 26935441 DOI: 10.2739/kurumemedj.ms64010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We investigated the influence of nocturia and sleep disturbance on health-related quality of life(HRQOL) using the Medical Outcomes Study 8-item Short Form Health Survey (SF-8) in patients with nocturia. We also assessed the effect of therapeutic intervention by means of an anticholinergic agent on the results of the SF-8. One hundred and eighty-four patients who voided at least once per night were surveyed using the SF-8, Overactive Bladder Symptom Score (OABSS), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS). These parameters were also evaluated before and after 12 weeks of imidafenacin treatment in 51 patients with OAB accompanied by nocturia. The SF-8 physical component summary score (PCS) showed a significant decrease as nighttime voiding frequency increased. The mental health component summary score was 47.1 and 47.6 (which were lower than the standard value of 50) in the group with a nighttime frequency of once and ≥3/night, respectively. The SF-8 PCS and 6 subscales were negatively associated with nighttime voiding frequency, while the PSQI global score was positively associated with it. Imidafenacin significantly improved the OABSS, PSQI, and ESS, as well as the SF-8 score. This is the first study using the SF-8 to show that nocturia and sleep disturbance have a major influence on comprehensive HRQOL and that the SF-8 can be used to monitor HRQOL in OAB patients receiving treatment for nocturia.
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43
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Chiba H, Oe M, Uchimura N. Patients with Posttraumatic Stress Disorder with Comorbid Major Depressive Disorder Require a Higher Dose of Psychotropic Drugs. Kurume Med J 2016; 62:23-28. [PMID: 26935570 DOI: 10.2739/kurumemedj.ms65010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Major depressive disorder (MDD) has been associated with stressful life events and with posttraumatic stress disorder (PTSD). PTSD and MDD comorbidity was also reported to be associated with greater symptom severity and lower levels of functioning. However, the characteristics of pharmacotherapy for PTSD with MDD are not fully understood. To understand this relationship, we conducted a retrospective review using medical charts at the Department of Neuropsychiatry, Kurume University Hospital. Information from 55 patients with PTSD was analyzed. Five cases were excluded after re-evaluation of the PTSD diagnosis. A higher rate of type II trauma was observed in the PTSD with MDD group (50.0%) than in the PTSD-only group [13.6%; χ(2) (1, n =50) = 7.26, p<0.01]. Patients with comorbid MDD were significantly older, had more severe PTSD symptomatology, and a longer duration of treatment. They also received higher doses of psychotropic drugs, regardless of the type (antidepressants, antipsychotics, benzodiazepines), than the PTSD-only group. Our results showed that comorbid MDD is associated with higher doses of psychotropic drugs, suggesting difficulties in treatment.
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Affiliation(s)
- Hiromi Chiba
- Department of Neuropsychiatry, Kurume University School of Medicine
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44
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Matsumoto Y, Uchimura N, Ishida T, Toyomasu K, Kushino N, Mori M, Morimatsu Y, Hoshiko M, Ishitake T. Suicidal feelings are related to sleep phase, sleep quality, and sleep quantity: A study on the relationship between sleep and suicide prevention by using 3DSS (3 Dimensional Sleep Scale). Sleep Med 2015. [DOI: 10.1016/j.sleep.2015.02.1484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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45
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Toyoda H, Miyagawa T, Koike A, Kanbayashi T, Imanishi A, Sagawa Y, Kotorii N, Kotorii T, Hashizume Y, Ogi K, Hiejima H, Kamei Y, Hida A, Miyamoto M, Imai M, Fujimura Y, Tamura Y, Ikegami A, Wada Y, Moriya S, Furuya H, Takeuchi M, Kirino Y, Meguro A, Remmers EF, Kawamura Y, Otowa T, Miyashita A, Kashiwase K, Khor SS, Yamasaki M, Kuwano R, Sasaki T, Ishigooka J, Kuroda K, Kume K, Chiba S, Yamada N, Okawa M, Hirata K, Mizuki N, Uchimura N, Shimizu T, Inoue Y, Honda Y, Mishima K, Honda M, Tokunaga K. A polymorphism in CCR1/CCR3 is associated with narcolepsy. Brain Behav Immun 2015; 49:148-55. [PMID: 25986216 DOI: 10.1016/j.bbi.2015.05.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [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: 03/06/2015] [Revised: 05/01/2015] [Accepted: 05/08/2015] [Indexed: 11/28/2022] Open
Abstract
Etiology of narcolepsy-cataplexy involves multiple genetic and environmental factors. While the human leukocyte antigen (HLA)-DRB1*15:01-DQB1*06:02 haplotype is strongly associated with narcolepsy, it is not sufficient for disease development. To identify additional, non-HLA susceptibility genes, we conducted a genome-wide association study (GWAS) using Japanese samples. An initial sample set comprising 409 cases and 1562 controls was used for the GWAS of 525,196 single nucleotide polymorphisms (SNPs) located outside the HLA region. An independent sample set comprising 240 cases and 869 controls was then genotyped at 37 SNPs identified in the GWAS. We found that narcolepsy was associated with a SNP in the promoter region of chemokine (C-C motif) receptor 1 (CCR1) (rs3181077, P=1.6×10(-5), odds ratio [OR]=1.86). This rs3181077 association was replicated with the independent sample set (P=0.032, OR=1.36). We measured mRNA levels of candidate genes in peripheral blood samples of 38 cases and 37 controls. CCR1 and CCR3 mRNA levels were significantly lower in patients than in healthy controls, and CCR1 mRNA levels were associated with rs3181077 genotypes. In vitro chemotaxis assays were also performed to measure monocyte migration. We observed that monocytes from carriers of the rs3181077 risk allele had lower migration indices with a CCR1 ligand. CCR1 and CCR3 are newly discovered susceptibility genes for narcolepsy. These results highlight the potential role of CCR genes in narcolepsy and support the hypothesis that patients with narcolepsy have impaired immune function.
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Affiliation(s)
- Hiromi Toyoda
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Taku Miyagawa
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Asako Koike
- Research & Development Group, Hitachi, Ltd., Japan
| | - Takashi Kanbayashi
- Department of Neuropsychiatry, Akita University School of Medicine, Akita, Japan
| | - Aya Imanishi
- Department of Neuropsychiatry, Akita University School of Medicine, Akita, Japan
| | - Yohei Sagawa
- Department of Neuropsychiatry, Akita University School of Medicine, Akita, Japan
| | - Nozomu Kotorii
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan; Kotorii Isahaya Hospital, Nagasaki, Japan
| | | | - Yuji Hashizume
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Kimihiro Ogi
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Hiroshi Hiejima
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Yuichi Kamei
- Sleep Disorder Center, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Akiko Hida
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | | | - Makoto Imai
- Department of Psychiatry, Shiga University of Medical Science, Shiga, Japan
| | - Yota Fujimura
- Department of Psychiatry and Neurology, Asahikawa Medical University, Hokkaido, Japan
| | - Yoshiyuki Tamura
- Department of Psychiatry and Neurology, Asahikawa Medical University, Hokkaido, Japan
| | | | - Yamato Wada
- Department of Psychiatry, Hannan Hospital, Osaka, Japan
| | - Shunpei Moriya
- Department of Psychiatry, Tokyo Women's Medical University, School of Medicine, Tokyo, Japan
| | - Hirokazu Furuya
- Department of Neurology, Neuro-Muscular Center, National Omuta Hospital, Fukuoka, Japan
| | - Masaki Takeuchi
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Kanagawa, Japan; Inflammatory Disease Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Yohei Kirino
- Inflammatory Disease Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA; Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Akira Meguro
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Elaine F Remmers
- Inflammatory Disease Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Yoshiya Kawamura
- Department of Psychiatry, Sakae Seijinkai Hospital, Kanagawa, Japan
| | - Takeshi Otowa
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akinori Miyashita
- Department of Molecular Genetics, Center for Bioresources, Brain Research Institute, Niigata University, Niigata, Japan
| | - Koichi Kashiwase
- Department of HLA Laboratory, Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Tokyo, Japan
| | - Seik-Soon Khor
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Maria Yamasaki
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryozo Kuwano
- Department of Molecular Genetics, Center for Bioresources, Brain Research Institute, Niigata University, Niigata, Japan
| | - Tsukasa Sasaki
- Laboratory of Health Education, Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Jun Ishigooka
- Department of Psychiatry, Tokyo Women's Medical University, School of Medicine, Tokyo, Japan
| | - Kenji Kuroda
- Department of Psychiatry, Hannan Hospital, Osaka, Japan
| | - Kazuhiko Kume
- Sleep Center, Kuwamizu Hospital, Kumamoto, Japan; Department of Stem Cell Biology, Institute of Molecular Genetics and Embryology, Kumamoto University, Kumamoto, Japan; Department of Neuropharmacology, Graduate School of Pharmaceutical Sciences, Nagoya City University, Aichi, Japan
| | - Shigeru Chiba
- Department of Psychiatry and Neurology, Asahikawa Medical University, Hokkaido, Japan
| | - Naoto Yamada
- Department of Psychiatry, Shiga University of Medical Science, Shiga, Japan
| | - Masako Okawa
- Department of Sleep Medicine, Shiga University of Medical Science, Shiga, Japan; Japan Foundation for Neuroscience and Mental Health, Tokyo, Japan; Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Nobuhisa Mizuki
- Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Tetsuo Shimizu
- Department of Neuropsychiatry, Akita University School of Medicine, Akita, Japan
| | - Yuichi Inoue
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan; Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | - Yutaka Honda
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
| | - Kazuo Mishima
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Makoto Honda
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan; Sleep Disorders Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Katsushi Tokunaga
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Matsumoto Y, Uchimura N, Ishida T, Toyomasu K, Hoshiko M, Kushino N, Mori M, Morimatsu Y, Ishitake T. [The cut-off point of the 3 Dimensional Sleep Scale (3DSS)--day workers version--based on the Pittsburgh Sleep Quality Index (PSQI)]. Sangyo Eiseigaku Zasshi 2015; 57:140-3. [PMID: 26084386 DOI: 10.1539/sangyoeisei.c14001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Yuuki Matsumoto
- Department of Environmental Medicine, Kurume University School of Medicine, Japan
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Yasumoto S, Motooka H, Ito Y, Uchimura N. A change in electrographic activity and blood flow during interictal and postictal psychotic states in a patient with epilepsy. Epilepsy Behav Case Rep 2015; 4:13-9. [PMID: 26106577 PMCID: PMC4475786 DOI: 10.1016/j.ebcr.2015.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 02/21/2015] [Accepted: 02/25/2015] [Indexed: 11/09/2022]
Abstract
We report a patient with epilepsy who experienced interictal and postictal psychoses. Her psychiatric symptoms consisted of grandiose and fantastic delusions during both psychotic states. During remission, electroencephalography showed bitemporal epileptiform discharges that were predominant in the right temporal region. Epileptiform discharges present during the psychotic states were predominant in the left temporal region. Single-photon emission computed tomography showed hyperperfusion in the left basal ganglia during the interictal psychotic state and hyperperfusion in the right temporal lobe and left basal ganglia during the postictal psychotic state. We suggest that the occurrence of postictal and interictal psychotic states in this patient were associated with a common change in electrographic activity and blood flow.
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Affiliation(s)
- Shingo Yasumoto
- Department of Neuropsychiatry, The University of Kurume Hospital, Japan
| | - Hiromichi Motooka
- Department of Neuropsychiatry, The University of Kurume Hospital, Japan
| | - Yuji Ito
- Department of Neuropsychiatry, The University of Kurume Hospital, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, The University of Kurume Hospital, Japan
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48
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Ayuse T, Yanamoto S, Shinohara K, Uchimura N, Esaki K, Takafumi K. Problem-based learning is suitable for the curriculum of “Sleep disorders and disease” for students in dentistry. Sleep Biol Rhythms 2015. [DOI: 10.1111/sbr.12088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Takao Ayuse
- Department of Clinical Physiology; Course of Medical and Dental Sciences; Unit of Translational Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Souichi Yanamoto
- Department of Clinical Oral Oncology; Course of Medical and Dental Sciences; Unit of Translational Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Kazuyuki Shinohara
- Department of Neurobiology and Behavior; Course of Medical and Dental Sciences; Unit of Translational Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry; Kurume University School of Medicine; Kurume Japan
| | - Kazuhisa Esaki
- Department of Neuropsychiatry; Kurume University School of Medicine; Kurume Japan
| | - Kato Takafumi
- Department of Oral Anatomy and Neurobiology; Osaka University Graduate School of Dentistry; Suita Osaka Japan
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49
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Aritake S, Kaneita Y, Ohtsu T, Uchiyama M, Mishima K, Akashiba T, Uchimura N, Nakaji S, Munezawa T, Ohida T. Prevalence of fatigue symptoms and correlations in the general adult population. Sleep Biol Rhythms 2014. [DOI: 10.1111/sbr.12099] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Sayaka Aritake
- Department of Psychophysiology; National Institute of Mental Health; National Center of Neurology and Psychiatry; Tokyo Japan
- Division of Sports Psychiatry and Neuroscience; Faculty of Sport Sciences; Waseda University; Tokyo Japan
| | - Yoshitaka Kaneita
- Department of Public Health; Nihon University School of Medicine; Tokyo Japan
- Department of Public Health and Epidemiology; Faculty of Medicine; Oita University; Oita Japan
| | - Tadahiro Ohtsu
- Department of Public Health; Showa University School of Medicine; Tokyo Japan
| | - Makoto Uchiyama
- Department of Psychiatry; Nihon University School of Medicine; Tokyo Japan
| | - Kazuo Mishima
- Department of Psychophysiology; National Institute of Mental Health; National Center of Neurology and Psychiatry; Tokyo Japan
| | - Tsuneto Akashiba
- Department of Sleep and Respiratory Medicine; Nihon University School of Medicine; Tokyo Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry; Kurume University School of Medicine; Kurume Japan
| | - Shigeyuki Nakaji
- Department of Social Medicine; Hirosaki University Graduate School of Medicine; Hirosaki Japan
| | - Takeshi Munezawa
- Department of Public Health; Nihon University School of Medicine; Tokyo Japan
| | - Takashi Ohida
- Department of Public Health; Nihon University School of Medicine; Tokyo Japan
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50
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Miyagawa T, Toyoda H, Hirataka A, Kanbayashi T, Imanishi A, Sagawa Y, Kotorii N, Kotorii T, Hashizume Y, Ogi K, Hiejima H, Kamei Y, Hida A, Miyamoto M, Imai M, Fujimura Y, Tamura Y, Ikegami A, Wada Y, Moriya S, Furuya H, Kato M, Omata N, Kojima H, Kashiwase K, Saji H, Khor SS, Yamasaki M, Wada Y, Ishigooka J, Kuroda K, Kume K, Chiba S, Yamada N, Okawa M, Hirata K, Uchimura N, Shimizu T, Inoue Y, Honda Y, Mishima K, Honda M, Tokunaga K. New susceptibility variants to narcolepsy identified in HLA class II region. Hum Mol Genet 2014; 24:891-8. [PMID: 25256355 DOI: 10.1093/hmg/ddu480] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- Taku Miyagawa
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiromi Toyoda
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akane Hirataka
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Aya Imanishi
- Department of Neuropsychiatry, Akita University, Akita, Japan
| | - Yohei Sagawa
- Department of Neuropsychiatry, Akita University, Akita, Japan
| | - Nozomu Kotorii
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan Kotorii Isahaya Hospital, Nagasaki, Japan
| | | | - Yuji Hashizume
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Kimihiro Ogi
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Hiroshi Hiejima
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | | | - Akiko Hida
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | | | | | - Yota Fujimura
- Department of Psychiatry and Neurology, Asahikawa Medical University, Asahikawa, Japan
| | - Yoshiyuki Tamura
- Department of Psychiatry and Neurology, Asahikawa Medical University, Asahikawa, Japan
| | | | - Yamato Wada
- Department of Psychiatry, Hannan Hospital, Osaka, Japan
| | - Shunpei Moriya
- Department of Psychiatry, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - Hirokazu Furuya
- Department of Neurology, Neuro-Muscular Center, National Omuta Hospital, Fukuoka, Japan
| | - Mitsuhiro Kato
- Department of Pediatrics, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Naoto Omata
- Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | | | - Koichi Kashiwase
- Department of HLA Laboratory, Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Tokyo, Japan
| | | | - Seik-Soon Khor
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Maria Yamasaki
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuji Wada
- Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Jun Ishigooka
- Department of Psychiatry, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - Kenji Kuroda
- Department of Psychiatry, Hannan Hospital, Osaka, Japan
| | - Kazuhiko Kume
- Sleep Center, Kuwamizu Hospital, Kumamoto, Japan Department of Stem Cell Biology, Institute of Molecular Genetics and Embryology, Kumamoto University, Kumamoto, Japan Department of Neuropharmacology, Graduate School of Pharmaceutical Sciences, Nagoya City University, Aichi, Japan
| | - Shigeru Chiba
- Department of Psychiatry and Neurology, Asahikawa Medical University, Asahikawa, Japan
| | | | - Masako Okawa
- Department of Sleep Medicine, Shiga University of Medical Science, Shiga, Japan Japan Foundation for Neuroscience and Mental Health, Tokyo, Japan
| | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Tetsuo Shimizu
- Department of Neuropsychiatry, Akita University, Akita, Japan
| | - Yuichi Inoue
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan Department of Somnology, Tokyo Medical University, Tokyo, Japan and
| | - Yutaka Honda
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
| | - Kazuo Mishima
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Makoto Honda
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan Sleep Disorders Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Katsushi Tokunaga
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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