Neurobiological correlation between phosphorylated tau and mood symptoms in memory clinic patients
Takashi Ozaki, Naoki Hashimoto, Niki Udo, Hisashi Narita, Shin Nakagawa, Ichiro Kusumi
Psychogeriatrics, Wiley, 2023年10月08日
研究論文（学術雑誌）, Background

Alzheimer's disease (AD) dementia and mild cognitive impairment are characterised by impaired cognition accompanied by neuropsychiatric symptoms (NPS) relating to mood, including depression, anxiety, and apathy. However, the utility of AD biomarkers for predicting mood symptoms of NPS remains controversial. Herein, we analyzed the relationship between phosphorylated tau (p‐tau) and depression, anxiety, and apathy of NPS. We also examined the influence of genetic factors such as apolipoprotein E (APOE) ε4 on these relationships.

Methods

We conducted a cross‐sectional survey in older patients (n = 122) with normal cognition (n = 12), mild cognitive impairment (n = 46), and AD (n = 64) strictly diagnosed by the board of psychiatrists and neurologists of Hokkaido University. NPS of the patients were assessed using the Neuropsychiatric Inventory Questionnaire (NPI). All patients also received a lumbar puncture to obtain cerebral spinal fluid for assessment of p‐tau. The inverse probability weighting method was used to adjust for demographic differences between the p‐tau present group and the p‐tau absent group.

Results

There was an association between p‐tau accumulation and decreased incidence of depression and apathy. APOE ε4 non‐carriers also showed a trend toward a negative association between p‐tau and depression, which was not evident in APOE ε4 carriers.

Conclusions

We provide new evidence for a negative correlation between p‐tau and depression and apathy of NPS, which may be influenced by APOE ε4. Future longitudinal studies are required to confirm the utility of p‐tau for predicting the course of mood symptoms in patients with cognitive decline.

Prediction of amyloid positron emission tomography positivity using multiple regression analysis of quantitative susceptibility mapping.
Yohei Ikebe, Ryota Sato, Tomoki Amemiya, Niki Udo, Masaaki Matsushima, Ichiro Yabe, Akinori Yamaguchi, Makoto Sasaki, Masafumi Harada, Noriyuki Matsukawa, Yasuo Kawata, Yoshitaka Bito, Toru Shirai, Hisaaki Ochi, Kohsuke Kudo
Magnetic resonance imaging, 103, 192, 197, 2023年08月08日, ［国際誌］
英語, 研究論文（学術雑誌）, PURPOSE: To develop a method for predicting amyloid positron emission tomography (PET) positivity based on multiple regression analysis of quantitative susceptibility mapping (QSM). MATERIALS AND METHODS: This prospective study included 39 patients with suspected dementia from four centers. QSM images were obtained through a 3-T, three-dimensional radiofrequency-spoiled gradient-echo sequence with multiple echoes. The cortical standard uptake value ratio (SUVR) was obtained using amyloid PET with 18F-flutemetamol, and susceptibility in the brain regions was obtained using QSM. A multiple regression model to predict cortical SUVR was constructed based on susceptibilities in multiple brain regions, with the constraint that cortical SUVR and susceptibility were positively correlated. The discrimination performance of the Aβ-positive and Aβ-negative cohorts was evaluated based on the predicted SUVR using the area under the receiver operating characteristic curve (AUC) and Mann-Whitney U test. RESULTS: The correlation coefficients between true and predicted SUVR were increased by incorporating the constraint, and the AUC to discriminate between the Aβ-positive and Aβ-negative cohorts reached to 0.79 (p < 0.01). CONCLUSION: These preliminary results suggest that a QSM-based multiple regression model can predict amyloid PET positivity with fair accuracy.

札幌市における救急患者精神科継続支援の実施状況　　　　　　　　　　　　　　　
石橋 竜太朗, 伊藤 侯輝, 宇土 仁木, 東谷 敬介, 坪内 雅行, 久住 一郎, 河西 千秋
精神神経学雑誌, 2023特別号, S395, S395, (公社)日本精神神経学会, 2023年06月
日本語

A diagnostic index based on quantitative susceptibility mapping and voxel-based morphometry may improve early diagnosis of Alzheimer's disease.
Ryota Sato, Kohsuke Kudo, Niki Udo, Masaaki Matsushima, Ichiro Yabe, Akinori Yamaguchi, Khin Khin Tha, Makoto Sasaki, Masafumi Harada, Noriyuki Matsukawa, Tomoki Amemiya, Yasuo Kawata, Yoshitaka Bito, Hisaaki Ochi, Toru Shirai
European radiology, 32, 7, 4479, 4488, 2022年07月, ［国際誌］
英語, 研究論文（学術雑誌）, OBJECTIVES: Voxel-based morphometry (VBM) is widely used to quantify the progression of Alzheimer's disease (AD), but improvement is still needed for accurate early diagnosis. We evaluated the feasibility of a novel diagnosis index for early diagnosis of AD based on quantitative susceptibility mapping (QSM) and VBM. METHODS: Thirty-seven patients with AD, 24 patients with mild cognitive impairment (MCI) due to AD, and 36 cognitively normal (NC) subjects from four centers were included. A hybrid sequence was performed by using 3-T MRI with a 3D multi-echo GRE sequence to obtain both a T1-weighted image for VBM and phase images for QSM. The index was calculated from specific voxels in QSM and VBM images by using a linear support vector machine. The method of voxel extraction was optimized to maximize diagnostic accuracy, and the optimized index was compared with the conventional VBM-based index using receiver operating characteristic analysis. RESULTS: The index was optimal when voxels were extracted as increased susceptibility (AD > NC) in the parietal lobe and decreased gray matter volume (AD < NC) in the limbic system. The optimized proposed index showed excellent performance for discrimination between AD and NC (AUC = 0.94, p = 1.1 × 10-10) and good performance for MCI and NC (AUC = 0.87, p = 1.8 × 10-6), but poor performance for AD and MCI (AUC = 0.68, p = 0.018). Compared with the conventional index, AUCs were improved for all cases, especially for MCI and NC (p < 0.05). CONCLUSIONS: In this preliminary study, the proposed index based on QSM and VBM improved the diagnostic performance between MCI and NC groups compared with the VBM-based index. KEY POINTS: • We developed a novel diagnostic index for Alzheimer's disease based on quantitative susceptibility mapping (QSM) and voxel-based morphometry (VBM). • QSM and VBM images can be acquired simultaneously in a single sequence with little increasing scan time. • In this preliminary study, the proposed diagnostic index improved the discriminative performance between mild cognitive impairment and normal control groups compared with the conventional VBM-based index.

Quantitative magnetic resonance imaging for evaluating of the cerebrospinal fluid kinetics with 17O-labeled water tracer: A preliminary report.
Hiroyuki Sugimori, Hiroyuki Kameda, Taisuke Harada, Kinya Ishizaka, Masayoshi Kajiyama, Tasuku Kimura, Niki Udo, Masaaki Matsushima, Azusa Nagai, Masahiro Wakita, Ichiro Kusumi, Ichiro Yabe, Kohsuke Kudo
Magnetic resonance imaging, 87, 77, 85, 2022年04月, ［国際誌］
英語, 研究論文（学術雑誌）, The aim of this study was to evaluate the feasibility of kinetic analysis of cerebrospinal fluid (CSF) using 17O-labeled water tracer. Four subjects (two idiopathic normal pressure hydrocephalus (iNPH) and two possible AD dementia patients) were prospectively included. Injectable formulation of 17O-labeled water containing 10 mol% of H217O (PSO17), was intrathecally administered to the subjects with the lateral decubitus position between the 3rd and 4th lumbar vertebrae. MRI acquisitions were performed in four-time points, before PSO17 administration, 1, 8, and 24 h after PSO17 administration. The 3-dimensional fast spin echo sequence was used. After image registration for all four-time points data, polygonal regions of interest (ROIs) were set in the 14 regions to obtain the signal intensity of CSF. Each signal intensity within the ROI was converted to 17O concentration [%]. The peak concentration at one hour after administration, the slope of concentration changes after PSO17 administration [%/s], and the root mean square error (RMSE) for evaluating the performance of a fitting were calculated. There was no significant difference in peak concentration between the iNPH and AD group. The slope in the AD group (-2.25 ± 1.62 × 10-3 [%/h]) was significantly smaller than in the iNPH group (-1.21 ± 2.31 × 10-3 [%/h]), which suggests the speed of CSF clearance in the iNPH group was slower than AD group. The RMSE indicating the fit to the concentration change in the AD group (4.86 ± 4.74 × 10-3) was also significantly smaller than in the iNPH group (8.64 ± 7.56 × 10-3). The kinetic evaluation of CSF using 17O-labeled water was feasible, and this preliminary study suggests that the differentiation of iNPH and possible AD dementia can be achieved using this method.

Efficacy of Quantitative Susceptibility Mapping with Brain Surface Correction and Vein Removal for Detecting Increase Magnetic Susceptibility in Patients with Alzheimer's Disease.
Akinori Yamaguchi, Kohsuke Kudo, Ryota Sato, Yasuo Kawata, Niki Udo, Masaaki Matsushima, Ichiro Yabe, Makoto Sasaki, Masafumi Harada, Noriyuki Matsukawa, Toru Shirai, Hisaaki Ochi, Yoshitaka Bito
Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine, 2022年03月10日, ［国内誌］
英語, 研究論文（学術雑誌）, PURPOSE: Studies on quantitative susceptibility mapping (QSM) have reported an increase in magnetic susceptibilities in patients with Alzheimer's disease (AD). Despite the pathological importance of the brain surface areas, they are sometimes excluded in QSM analysis. This study aimed to reveal the efficacy of QSM analysis with brain surface correction (BSC) and/or vein removal (VR) procedures. METHODS: Thirty-seven AD patients and 37 age- and sex-matched, cognitively normal (CN) subjects were included. A 3D-gradient echo sequence at 3T MRI was used to obtain QSM. QSM images were created with regularization enabled sophisticated harmonic artifact reduction for phase data (RESHARP) and constrained RESHARP with BSC and/or VR. We conducted ROI analysis between AD patients and CN subjects who did or did not undergo BSC and/or VR using a t-test, to compare the susceptibility values after gray matter weighting. RESULTS: The susceptibility values in RESHARP without BSC were significantly larger in AD patients than in CN subjects in one region (precentral gyrus, 8.1 ± 2.9 vs. 6.5 ± 2.1 ppb) without VR and one region with VR (precentral gyrus, 7.5 ± 2.8 vs. 5.9 ± 2.0 ppb). Three regions in RESHARP with BSC had significantly larger susceptibilities without VR (precentral gyrus, 7.1 ± 2.0 vs. 5.9 ± 2.0 ppb; superior medial frontal gyrus, 5.7 ± 2.6 vs. 4.2 ± 3.1 ppb; putamen, 47,8 ± 16.5 vs. 40.0 ± 15.9 ppb). In contrast, six regions showed significantly larger susceptibilities with VR in AD patients than in CN subjects (precentral gyrus, 6.4 ± 1.9 vs. 4.9 ± 2.7 ppb; superior medial frontal gyrus, 5.3 ± 2.7 vs. 3.7 ± 3.3 ppb; orbitofrontal cortex, -2.1 ± 2.7 vs. -3.6 ± 3.2 ppb; parahippocampal gyrus, 0.1 ± 3.6 vs. -1.7 ± 3.7 ppb; putamen, 45.0 ± 14.9 vs. 37.6 ± 14.6 ppb; inferior temporal gyrus, -3.4 ± 1.5 vs. -4.4 ± 1.5 ppb). CONCLUSION: RESHARP with BSC and VR showed more regions of increased susceptibility in AD patients than in CN subjects. This study highlights the efficacy of this method in facilitating the diagnosis of AD.

A Brief, Individualized Exercise Program at Intensities Below the Ventilatory Threshold Exerts Therapeutic Effects for Depression: A Pilot Study
Yuri Sakai, Chong Chen, Atsuhito Toyomaki, Naoki Hashimoto, Kan Kitagawa, Takao Inoue, Asumi Sato, Keisuke Makihara, Rie Kameyama, Yumi Wakatsuki, Niki Udo, Ryosuke Shirakawa, Takashi Yokota, Shin Nakagawa, Ichiro Kusumi
Frontiers in Behavioral Neuroscience, 15, 787688, 787688, Frontiers Media SA, 2021年11月22日, ［国際誌］
英語, 研究論文（学術雑誌）, Due to the fact that existing pharmacological treatments for depression are not ideal, effort has been devoted to the development of complementary, alternative therapies such as physical exercise. The antidepressant effect of exercise is well documented. However, current recommendations and prescriptions of exercise may be too demanding for depressed patients, as some complain about the design of exercise programs and depression is associated with reduced motivation and capacity to exercise. Therefore, appropriately designed, patient-friendly exercise programs may prove critical for the long-term maintenance and therapeutic effects of exercise. In this pilot study, we developed an exercise program based on patients’ individual level of ventilatory threshold (VT), a submaximal index of aerobic capacity measured by Cardiopulmonary Exercise Testing (CPX). Compared to traditional measures, CPX provides more trustable indices of aerobic capacity and more homogenous exercise prescriptions. The main episode of the program consisted of 15–25 min of cycling twice a week at an intensity that approached but never went higher than subjects’ VT (considered low to moderate in intensity). We found that in patients diagnosed with major depressive disorder or persistent depressive disorder (n = 8), the program resulted in a significant reduction in depressive symptoms at week 8, which was maintained at week 16. Meanwhile, patients’ social functioning, quality of life, and cognitive functions improved. Although we used a single arm, non-randomized design, our results suggest that even a brief, low to moderate intensity exercise program may exert therapeutic effects for depression and CPX may be a useful tool for exercise prescriptions.

A pilot validation study of the Japanese translation of the Positive and Negative Syndrome Scale (PANSS).
Naoki Hashimoto, Katsuyoshi Takahashi, Daisuke Fujisawa, Kumi Aoyama, Atsuo Nakagawa, Naoe Okamura, Atsuhito Toyomaki, Matsuhiko Oka, Keisuke Takanobu, Ryo Okubo, Hisashi Narita, Kan Kitagawa, Niki Udo, Tamaki Maeda, Shinya Watanabe, Yuka Oyanagi, Akane Miyazaki, Koki Ito, Ichiro Kusumi
Asian journal of psychiatry, 54, 102210, 102210, 2020年12月, ［国際誌］
英語

Basic clinical characteristics of dementia with Lewy bodies with vs. without concomitant beta-amyloid pathology.
Naoya Hattori, Shin Yamamoto, Seigo Nakano, Niki Udo, Kunihiro Nakada, Shogo Ohno, Mikako Ogawa, Hiroki Sugie
JOURNAL OF NUCLEAR MEDICINE, 61, SOC NUCLEAR MEDICINE INC, 2020年05月
英語

Apathy in Alzheimer's Disease Correlates with the Dopamine Transporter Level in the Caudate Nuclei
Niki Udo, Naoki Hashimoto, Takuya Toyonaga, Tomoyuki Isoyama, Yuka Oyanagi, Hisashi Narita, Tohru Shiga, Shin Nakagawa, Ichiro Kusumi
DEMENTIA AND GERIATRIC COGNITIVE DISORDERS EXTRA, 10, 2, 86, 93, KARGER, 2020年
英語, 研究論文（学術雑誌）, Introduction:Apathy is a common neuropsychiatric symptom in patients with Alzheimer's disease (AD). The striatal binding potential (BP) of I-123-FP-CIT (N-delta-fluoropropyl-2 beta-carbomethoxy-3 beta-[4-iodophenyl]tropane) single-photon emission computed tomography (SPECT) is correlated with the degree of apathy in patients with Parkinson's disease (PD) and dementia with Lewy bodies (DLB). This study aimed to determine if dopaminergic activity in the basal ganglia is associated with the development of apathy in AD.Methods:Nineteen subjects with AD were included and underwent I-123-FP-CIT-SPECT. Patients with other types of dementia as a comorbidity, those taking antidepressants, and those with overt parkinsonism were excluded. Apathy was assessed using the Apathy Evaluation Scale Informant-Japanese version (AES-I-J). SPECT images were overlaid with images in striatal regions of interest (ROIs), and the SPECT values in these regions were counted. The relationship between BP values and AES-I-J scores was investigated using Spearman's rank correlation coefficient.Results:Significant inverse correlations were observed between BP values and AES-I-J scores in the left caudate nucleus and there was a marginally significant inverse correlation in the right caudate nucleus.Conclusion:The pathological basis of apathy might be the impairment of the dopaminergic nervous system. Further studies on more subjects with AD, healthy controls, and patients with PD and DLB are needed.

精神科診療におけるアミロイドPETの活用 FTDとADの鑑別にアミロイドPETが有効だった1例　　　　　　　　　　　　　　　
内藤 大, 宇土 仁木, 服部 直也, 大柳 有加, 北川 寛, 成田 尚, 久住 一郎
精神神経学雑誌, 121, 8, 662, 662, (公社)日本精神神経学会, 2019年08月, ［査読有り］
日本語

PHQ-9およびSF-8の調査結果から考察する肝移植ドナーの長期予後について　　　　　　　　　　　　　　　
成田 尚, 黒島 偉作, 大柳 有加, 高信 径介, 渡辺 晋也, 宇土 仁木, 前田 珠希, 岡 松彦, 北川 寛, 久住 一郎
精神神経学雑誌, 2019特別号, S764, S764, (公社)日本精神神経学会, 2019年06月
日本語

日本語版PANSSの信頼性、妥当性評価　　　　　　　　　　　　　　　
橋本 直樹, 岡 松彦, 高信 径介, 成田 尚, 北川 寛, 宇土 仁木, 前田 珠希, 渡辺 晋也, 大柳 有加, 宮崎 茜, 伊藤 侯輝, 久住 一郎
精神神経学雑誌, 2019特別号, S443, S443, (公社)日本精神神経学会, 2019年06月, ［査読有り］
日本語

Alzheimer型認知症のBPSDと脳内Dopamine神経系の関連　　　　　　　　　　　　　　　
宇土 仁木, 橋本 直樹, 中川 伸, 豊永 拓哉, 大柳 有加, 北川 寛, 成田 尚, 久住 一郎
精神神経学雑誌, 2019特別号, S618, S618, (公社)日本精神神経学会, 2019年06月, ［査読有り］
日本語

Pilot Validation Study of the Japanese Translation of the Brief Negative Symptoms Scale (BNSS).
Naoki Hashimoto, Atsuhito Toyomaki, Matsuhiko Oka, Keisuke Takanobu, Ryo Okubo, Hisashi Narita, Kan Kitagawa, Niki Udo, Tamaki Maeda, Shinya Watanabe, Yuka Oyanagi, Akane Miyazaki, Koki Ito, Ichiro Kusumi
Neuropsychiatric disease and treatment, 15, 3511, 3518, 2019年, ［国際誌］
英語, 研究論文（学術雑誌）, Purpose: The brief negative symptoms scale (BNSS) is a concise instrument used to assess negative symptoms of subjects with schizophrenia covering five domains of negative symptoms and is suitable for use in clinical, experimental, and epidemiological settings. The original and translated version of BNSS has thus far been shown to have adequate psychometric properties. This study aimed to examine internal consistency, inter-rater and test-retest reliability, discriminant and convergent validity, and factor structure of the Japanese version of BNSS. Patients and methods: The assessment was performed by 11 raters using interview videos of nine subjects. Reliability was calculated with Cronbach's alpha for internal consistency and intra class correlation coefficient (ICC) for inter-rater reliability. Pearson's correlation coefficients were calculated to estimate the test-retest reliability. In addition to BNSS, Scale for assessment of negative symptoms (SANS) and scale for assessment of positive symptoms (SAPS) was obtained to assess the convergent and discriminant validity. Factor structure was assessed using principle factor analysis. Results: The Japanese BNSS showed excellent internal consistency (Cronbach's alpha=0.95), inter-rater reliability (intra class correlation coefficient=0.97), and test-retest reliability (r=0.94, p<0.001). The convergent validity shown by correlation with SANS total score (r=0.87, p<0.001) and discriminant validity shown by correlation with SAPS total score (r=0.17, p=-0.68) were also good. Principal factor analysis revealed a two-factor structure of BNSS, although the loading of each item differed from that in the literature. Conclusion: Our pilot study demonstrated that Japanese BNSS had good psychometric properties which were achieved with relatively brief training. Further studies with more subjects and raters with various backgrounds recruited from multiple sites are warranted.

PHQ-9およびSF-8の調査結果から考察する肝移植ドナーの長期予後について　　　　　　　　　　　　　　　
黒鳥 偉作, 成田 尚, 大柳 有加, 高信 径介, 渡辺 晋也, 宇土 仁木, 前田 珠希, 岡 松彦, 北川 寛, 久住 一郎
総合病院精神医学, 30, Suppl., S, 172, (一社)日本総合病院精神医学会, 2018年11月
日本語

Clinical impact of F-18 Flutemetamol (FMM) PET to assess cerebral A beta pathology in patients with various cognitive disorders.
Naoya Hattori, Shogo Ono, Niki Udo, Shin Yamamoto, Mikako Ogawa, Hiroki Sugie
JOURNAL OF NUCLEAR MEDICINE, 59, SOC NUCLEAR MEDICINE INC, 2018年05月
英語

Association between suicide-related ideations and affective temperaments in the Japanese general adult population.
Nobuyuki Mitsui, Yukiei Nakai, Takeshi Inoue, Niki Udo, Kan Kitagawa, Yumi Wakatsuki, Rie Kameyama, Atsuhito Toyomaki, Yoichi M Ito, Yuji Kitaichi, Shin Nakagawa, Ichiro Kusumi
PloS one, 12, 6, e0179952, 2017年, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: Suicide rates are vastly higher in Japan than in many other countries, although the associations between affective temperaments and suicide-related ideations in the general adult population remain unclear. Therefore, we aimed to elucidate these associations in the present study. METHODS: We analyzed data from 638 Japanese volunteers who completed both the Patient Health Questionnaire (PHQ-9) and the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A). Participants were then divided into three groups based on PHQ-9 summary scores and responses to the suicide-related ideation item: non-depressive control group (NC; N = 469), depressive symptoms without suicide-related ideations group (non-SI; N = 135), and depressive symptoms with suicide-related ideations group (SI; N = 34). The depressive symptoms were defined for PHQ-9 summary scores ≥5, and the suicide-related ideations were defined for PHQ-9 #9 score ≥1. We then compared TEMPS-A scores among the groups using Kruskal-Wallis tests. Then the 95% confidence intervals of differences in TEMPS-A subscale scores between the NC and non-SI groups, or between NC and SI groups, were calculated. RESULTS: Participants of the SI group exhibited significantly higher scores on the depressive, irritable, and anxious temperament subscales than those of the non-SI group. Similarly, women of the SI group exhibited significantly higher scores of the depressive and irritable temperament subscales than women of the non-SI group, while men of the SI group exhibited significantly higher depressive temperament scores than those of the non-SI group. Among all participants and only men, cyclothymic subscale scores were higher in those of the SI group than the non-SI group (not significant), although the 95% confidence intervals did not overlap. LIMITATIONS: The cross-sectional study design was the main limitation. CONCLUSIONS: Depressive, irritable, and anxious temperaments are significant risk factors for suicide-related ideations in the Japanese general adult population. Furthermore, irritable temperament in women and depressive temperament in men are associated with suicide-related ideations.

Paliperidoneで好中球減少をきたした統合失調症の1例
今本真衣子, 大柳有加, 磯山友幸, 石川修平, 宇土仁木, 成田尚, 久住一郎, 精神神経学雑誌, 123, 5, 2021年

MRI構造画像と磁化率画像に基づくアルツハイマー病の診断指標　　　　　　　　　　　　　　　
佐藤 良太, 工藤 與亮, 河田 康雄, 宇土 仁木, 松島 理明, 矢部 一郎, 山口 晃典, 尾藤 良孝, 越智 久晃, 白猪 亨, Dementia Japan, 33, 4, 553, 553, 2019年10月
(一社)日本認知症学会, 日本語

MRI構造画像と磁化率画像に基づくアルツハイマー病の診断指標　　　　　　　　　　　　　　　
佐藤 良太, 工藤 與亮, 河田 康雄, 宇土 仁木, 松島 理明, 矢部 一郎, 山口 晃典, 尾藤 良孝, 越智 久晃, 白猪 亨, Dementia Japan, 33, 4, 553, 553, 2019年10月
(一社)日本認知症学会, 日本語

日本語版BNSSの信頼性,妥当性評価
橋本直樹, 岡松彦, 高信径介, 成田尚, 北川寛, 宇土仁木, 前田珠希, 渡辺晋也, 大柳有加, 宮崎茜, 伊藤侯輝, 久住一郎, 統合失調症研究, 9, 1, 2019年

認知症診療におけるアミロイドPETの診断に与える影響　　　　　　　　　　　　　　　
服部 直也, 松井 美詠子, 大野 章吾, 原田 智也, 山本 晋, 宇土 仁木, 小川 美香子, 杉江 広紀, 核医学, 55, Suppl., S169, S169, 2018年11月
(一社)日本核医学会, 日本語

臨床診断の限界とアミロイドPETの有用性
服部 直也, 山本 晋, 大野 章吾, 宇土 仁木, 小川 美香子, 杉江 広紀, 断層映像研究会雑誌, 45, 1, 9, 9, 2018年09月
断層映像研究会, 日本語

アクチグラフィを用いた双極性障害患者における概日リズム障害の検討
北川寛, 北市雄士, 中川伸, 宇土仁木, 若槻百美, 亀山梨絵, 仲唐安哉, 山仲勇二郎, 山仲勇二郎, 本間さと, 本間さと, 本間研一, 本間研一, 井上猛, 井上猛, 久住一郎, 日本神経精神薬理学会プログラム・抄録集, 47th, 2017年

【認知症の薬物療法-最新Update-】認知症の抑うつ状態、心気状態に対する薬物療法
宇土 仁木, 中川 伸, 久住 一郎, 臨床精神薬理, 19, 9, 1311, 1317, 2016年09月
認知症患者の抑うつ状態や心気状態は認知症の行動心理症状(Behavioral and Psychological Symptoms of Dementia:BPSD)として生じているのか、他のうつ病など精神疾患を合併しているのかを鑑別することが困難である場合が多い。このため本稿では両者を包含した状態像の薬物療法について俯瞰した。アルツハイマー型認知症(AD)の抑うつ状態については、抗認知症薬、抗うつ薬ともに積極的な効果は示されていない。また、それらの併用については長期的には否定的な報告が見られる。心気状態に関しても報告は少ないが、抗うつ薬の有効性を示す報告が見られた。認知症の抑うつ状態、心気状態に対して明らかな有効性が示されている薬物療法は存在せず、コリンエステラーゼ阻害薬、抗うつ薬等を、症状や重症度に応じて組み合わせて使用せざるを得ないのが現状であり、今後さらなる知見の集積が求められる。(著者抄録), (株)星和書店, 日本語

市立札幌病院精神医療センターにおける精神疾患合併妊婦の後方視的検討
宇土 仁木, 武村 史, 中下 並人, 嶋 香菜子, 鹿野 智子, 林下 善行, 上村 恵一, 高田 秀樹, 市立札幌病院医誌, 75, 2, 213, 216, 2016年03月
本邦における精神疾患合併妊婦の割合は全妊婦の10%前後とされ、これは国際的な研究結果とほぼ一致している。本邦では精神疾患合併妊婦が精神的な治療を継続しながら出産することの出来る医療機関は限られており、各医療機関・医療職種間の連携も十分であるとは言いがたい。また、妊娠中の向精神薬の使用についても統一した見解は示されていない。当院は産婦人科、精神科の入院病床を併せ持つ総合病院であり、他医療機関から精神疾患合併妊婦の診療依頼を受ける頻度が比較的高い。このような背景から我々は精神疾患合併妊婦の適切な治療環境の選択について前向き研究をおこないたいと考え、その予備研究として、平成24年4月1日から平成27年5月31日までに外来を初診した70症例の精神疾患合併妊婦を対象として診療録を後方視的に調査した。調査の結果、当院で出産に至った症例数はF4圏、F2圏、F3圏の順に多かった。また、F2圏の精神疾患合併妊婦は、他の精神疾患を合併する妊婦と比較して有意に精神科病棟へ入院に至りやすく、精神科病棟での入院は一般病棟への入院と比べ長期化しやすい可能性が示唆された。一方で症例数の少なさなどから、妊娠、周産期に生じた母体、胎児の問題と向精神薬の関連については検討をおこなうことができなかった。これらの結果を踏まえ、精神疾患合併妊婦、特に統合失調症合併妊婦の適切な治療環境選択についてさらに詳細に明らかにすべく、今後、前向き観察研究をおこなっていきたい。(著者抄録), 市立札幌病院, 日本語

私のカルテから 修正型電気けいれん療法が有効であった退行期メランコリーの1例
宇土 仁木, 中川 伸, 井上 猛, 仲唐 安哉, 亀山 梨絵, 小山 司, 精神医学, 54, 10, 1043, 1045, 2012年10月
62歳女。主訴は不安が強く何も手につかないということであった。不安焦燥感が強まり希死念慮が出現したため、入院した。うつ病と診断され薬剤投与されるも改善せず、carbamazepine、sulpirideを併用し寛解した。退院後、寛解状態を維持していたが、1年後歩行時のつまずきのため神経内科に入院し、不安焦燥感を訴えるようになり精神病院に転院となった。統合失調症と診断され、薬物治療を受けたが改善しなかった。退行期メランコリーに診断を変更し、修正型電気けいれん療法(mECT)を3クール施行した。1、2クール目で、開始後数回で抑うつ症状は改善したが、微小妄想や不安感が持続していたため薬物療法も行ったが、mECT終了後に増悪し、抑うつ症状も増悪した。3クール目にも改善が見られ、維持療法としてVPAを開始したところ、改善し、退院となった。, (株)医学書院, 日本語

退行期メランコリーと思われる一症例　　　　　　　　　　　　　　　
宇土 仁木, 中川 伸, 亀山 梨絵, 仲唐 安哉, 鈴木 克治, 井上 猛, 小山 司, 精神神経学雑誌, 2011特別, S, 204, 2011年10月
(公社)日本精神神経学会, 日本語

退行期メランコリーと思われる1症例　　　　　　　　　　　　　　　
宇土 仁木, 中川 伸, 亀山 梨絵, 仲唐 安哉, 鈴木 克治, 井上 猛, 小山 司, 精神神経学雑誌, 113, 4, 421, 421, 2011年04月
(公社)日本精神神経学会, 日本語