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Background and purposeDementia with Lewy bodies (DLB) needs to be distinguished from Alzheimer's disease (AD) because of important differences in patient management and outcome. Severe cardiac sympathetic degeneration occurs in DLB, but not in AD, offering a potential system for a biological diagnostic marker. The primary aim of this study was to investigate the diagnostic accuracy, in the ante-mortem differentiation of probable DLB from probable AD, of cardiac imaging with the ligand 123I-meta-iodobenzylguanidine (MIBG) which binds to the noradrenaline reuptake site, in the first multicenter study.MethodsWe performed a multicenter study in which we used 123I-MIBG scans to assess 133 patients with clinical diagnoses of probable (n = 61) or possible (n = 26) DLB or probable AD (n = 46) established by a consensus panel. Three readers, unaware of the clinical diagnosis, classified the images as either normal or abnormal by visual inspection. The heart-to-mediastinum ratios of 123I-MIBG uptake were also calculated using an automated region-of-interest based system.ResultsUsing the heart-to-mediastinum ratio calculated with the automated system, the sensitivity was 68.9% and the specificity was 89.1% to differentiate probable DLB from probable AD in both early and delayed images. By visual assessment, the sensitivity and specificity were 68.9% and 87.0%, respectively. In a subpopulation of patients with mild dementia (MMSE ≥ 22, n = 47), the sensitivity and specificity were 77.4% and 93.8%, respectively, with the delayed heart-to-mediastinum ratio.ConclusionsOur first multicenter study confirmed the high correlation between abnormal cardiac sympathetic activity evaluated with 123I-MIBG myocardial scintigraphy and a clinical diagnosis of probable DLB. The diagnostic accuracy is sufficiently high for this technique to be clinically useful in distinguishing DLB from AD, especially in patients with mild dementia.

Serum prolactin levels were investigated in 41 patients with schizophrenia who were receiving clinically effective doses of perospirone or risperidone for more than 4 weeks. In order to determine baseline prolactin levels, blood samples were obtained in the morning, 10 – 14 h after antipsychotic medication. Median levels were within normal limits in both female and male patients receiving perospirone, while risperidone induced significant elevation. These results suggest that in contrast to risperidone, where baseline prolactin levels were elevated 5.3-fold in female and 4.2-fold in male patients, baseline prolactin levels are not elevated after treatment with perospirone. However, these results should be cautiously interpreted, because drug-by-time interaction has previously been reported in antipsychotic-induced hyperprolactinemia.

To discover susceptibility genes of late-onset Alzheimer's disease (LOAD), we conducted a 3-stage genome-wide association study (GWAS) using three populations: Japanese from the Japanese Genetic Consortium for Alzheimer Disease (JGSCAD), Koreans, and Caucasians from the Alzheimer Disease Genetic Consortium (ADGC). In Stage 1, we evaluated data for 5,877,918 genotyped and imputed SNPs in Japanese cases (n = 1,008) and controls (n = 1,016). Genome-wide significance was observed with 12 SNPs in the APOE region. Seven SNPs from other distinct regions with p-values

Background and Purpose: We previously reported the usefulness of iodine-123 metaiodobenzylguanidine (123I-MIBG) myocardial scintigraphy for differentiation of dementia with Lewy bodies (DLB) from Alzheimer's disease (AD) in a cross-sectional multicentre study. The aim of this study was, by using reassessed diagnosis after 3-year follow-up, to evaluate the diagnostic accuracy of 123I-MIBG scintigraphy in differentiation of probable DLB from probable AD.Methods: We undertook 3-year follow-up of 133 patients with probable or possible DLB or probable AD who had undergone 123I-MIBG myocardial scintigraphy at baseline. An independent consensus panel made final diagnosis at 3-year follow-up. Based on the final diagnosis, we re-evaluated the diagnostic accuracy of 123I-MIBG scintigraphy performed at baseline.Results: Sixty-five patients completed 3-year follow-up assessment. The final diagnoses were probable DLB (n=30), possible DLB (n=3) and probably AD (n=31), and depression (n=1). With a receiver operating characteristic curve analysis of heart-to-mediastinum (H/M) ratios for differentiating probable DLB from probable AD, the sensitivity/specificity were 0.77/0.94 for early images using 2.51 as the threshold of early H/M ratio, and 0.77/0.97 for delayed images using 2.20 as the threshold of delayed H/M ratio. Five of six patients who were diagnosed with possible DLB at baseline and with probable DLB at follow-up had low H/M ratio at baseline.Conclusions: Our follow-up study confirmed high correlation between abnormal cardiac sympathetic activity evaluated with 123I-MIBG myocardial scintigraphy at baseline and the clinical diagnosis of probable DLB at 3-year follow-up. Its diagnostic usefulness in early stage of DLB was suggested.Trial Registration Number: UMIN00003419. [ABSTRACT FROM AUTHOR]

Introduction: The efficacy of a cholinesterase inhibitor, donepezil, in patients with dementia with Lewy bodies (DLB) was investigated to confirm the superiority over placebo in the 12-week, double-blind phase of this phase III study. Methods: Patients with probable DLB (n = 142) were randomly assigned to placebo or to 5 mg or 10 mg of donepezil administered once daily for 12 weeks. The co-primary endpoints were changes in cognitive function assessed using the Mini-Mental State Examination (MMSE) and behavioral and neuropsychiatric symptoms using the Neuropsychiatric Inventory (NPI-2: hallucinations and fluctuations). The superiority of each active group over placebo was determined with simultaneous statistical significance in both endpoints. Safety evaluations included adverse events (AEs) and the unified Parkinson's disease rating scale (UPDRS) part III. Results: The predefined superiority of donepezil to the placebo was not confirmed in either active group in the primary analysis. MMSE score significantly improved compared to placebo in the 10 mg group (10 mg: 2.2 ± 0.4, placebo: 0.6 ± 0.5 (mean ± standard error); P = 0.016). The change in MMSE score in the 5 mg group was not significant (1.4 ± 0.5 (mean ± standard error); P = 0.232). Although NPI-2 improved compared to baseline in the active groups, the differences from placebo were not significant. Most AEs were mild or moderate. Although the incidence of parkinsonism was slightly higher in the 10 mg group, the change in the UPDRS score was minimal and without a significant difference from the placebo group. Conclusions: The co-primary endpoints were not achieved in this trial. However, significant improvement in MMSE score was demonstrated with 10 mg, but not 5 mg, of donepezil. The evaluation of psychiatric symptoms might be affected by advanced education and instructions given to caregivers. Overall, donepezil was well tolerated in patients with DLB. With careful attention on gastrointestinal or parkinsonian symptoms, patients with DLB can safely benefit from treatment with donepezil. Trial registration: ClinicalTrials.gov Identifier: NCT01278407 (trial registration date: 14 January 2011) [ABSTRACT FROM AUTHOR]

Introduction: The long-term efficacy and safety of donepezil 10 mg in patients with dementia with Lewy bodies (DLB) were investigated in a 52-week Phase 3 trial. Methods: This 52-week study consisted of 16-week randomized placebo-controlled (RCT) and 36-week open-label extension phases. Of 142 DLB patients enrolled in the RCT phase (three arms: placebo, 5 mg, and 10 mg), 110 entered the extension phase. The placebo group of the RCT phase initiated active treatment at week 16, and the active groups maintained allocated treatment and dosages until week 24. After week 24, all patients received 10 mg. Dose reduction to 5 mg for safety concerns was allowed. Efficacy measures included Mini-Mental State Examination (MMSE) for cognitive function and Neuropsychiatric Inventory (NPI) for behavioral symptoms. Safety evaluations included adverse events (AEs) and the unified Parkinson disease rating scale. Results: In total, 100 subjects completed the study. Cognitive function improvement was sustained for 52 weeks (MMSE at week 52 in 10 mg: 2.8 ± 3.5 (mean ± standard deviation); P <0.001, Student paired t test)). Those who received placebo in the RCT phase showed an improvement after starting active treatment. NPI improved in all the groups throughout the study, including the placebo period. In the subgroup of the 5 mg group without remarkable cognitive or behavioral improvement at week 24, further improvement was observed after a dose increase to 10 mg. After week 24, 21 patients experienced dose reduction. The incidence of any AEs did not increase over time. Conclusions: The long-term administration of donepezil at 10 mg/day improved cognitive function for up to 52 weeks in patients with DLB without increasing the risk of clinically significant safety events. Trial registration: NCT01278407. Trial registration date: January 14, 2011. [ABSTRACT FROM AUTHOR]

In this study, we attempt to elucidate the dynamic change of the levels of relative deprivation (RD) over time in a society where a number of immigrants enter a society or, conceptually equivalently, a number of newly emerging social groups are formed within a society. The objective of this study is to ascertain whether immigration increases or decreases the level of societal RD and how this mechanism occurs. We explore the problem by using the social network theory, which assumes either a random social network where actors are linked randomly with others in a given society or a biased social network where actors select some others preferentially as possible reference partners, whom we collectively term “reference group.” Estimating the change in the amount of societal RD over time and in accordance with various types of social networks formed by native residents and immigrants through simulation, we conclude that the higher the degree of "inbreeding bias," the lower the degree of societal RD. [ABSTRACT FROM AUTHOR]

There is an urgent need for sociological inspiration and intellect to construct original sociological theories. However, even more pressing is the need for scientific "formulae" or norms to be followed. The author pointed out in an earlier study that there are three types of theories in sociology: general theory, historical theory, and normative theory. The present paper claims the necessity of the following aspects that are common to the abovementioned types of sociological theories: truth, justice, beauty, coherence, pragmatic norms, and explication. It examines a "T-shaped strategy of research" suggested by Funabashi, in determining the problems of "middle range theories" (MRT). The following three fallacies appear to be involved in the Mertonian concept of MRT: the fallacies of misplaced "consolidation" of theory and research, misplaced abstraction, and misplaced object system of a study. It is concluded that these aspects should be accompanied by an additional two features: the spirit of unification of the previous theoretical frameworks and the spirit of the interpenetration of the-three types of theories. [ABSTRACT FROM AUTHOR]

The present paper attempts to extend the comparative method of narratives by Peter Abell by incorporating Robert F. Bales idea of interaction process analysis. Thereby, descriptions and analysis of syntax of social life would be elaborated further by retaining the information on who interacts with whom and on the nature of interaction with respect to Bales categories. [ABSTRACT FROM AUTHOR]

The article deals with the development of mathematical sociology in Japan and introduces the articles featured in the 1989 issue of the Journal of Mathematical Sociology. A burgeoning of interest in mathematical sociology may well be traced back even to prewar Japan. A study of the structure of Japanese families by Teizo Toda in 1937 is such an example. In that study, Toda showed by examining census data that the distribution of types of families was determined by the age of first marriage of those involved, although he did not use a model building method explicitly. However, it was not until the mid-1960's that mathematical sociology was pursued as such. Around 1970, the Tokyo University Press published a set of sociology textbooks of eighteen volumes including one volume titled Mathematical Sociology edited by Yasuda. This was the first book in Japan which had the title of mathematical sociology as such. In the 1970's, there emerged more than a few semi-formal societies scattered within the nation for the study of mathematical sociology, which were unified into a nationwide semi-formal society formed in 1980. A dozen of active core members and about two more dozens of scholars and students had regular meetings twice a year by coming together for a few nights. Mathematical sociology in Japan has plunged into a specialty stage in the sense that a formal society, the Japanese Association for Mathematical Sociology, was set up and an official journal was newly published.

The notion of "relative deprivation" as well as of "reference group" seems to be widely accepted among sociologists and social psychologists as one of significant concepts. However, there have been only few efforts to represent formally the mechanisms or processes where relative deprivation is generated. Sociologist R. Boudon has earlier attempted to formalize "the logic of frustration" within a game-theoretic framework as a case of what he calls perverse effects or unintended consequences of social action. Individuals behave more or less rationally trying to maximize their subjective expected utility; but as a consequence of aggregation of individual behavior, the end-result might be frustrating to them. Boudon constructs a simple model to capture such a situation, thereby to see implications of the phenomena generated by the model. The article aims firstly to follow Boudon's discussion and go a step further to see more precisely the implications of Boudon's model; secondly to see how well it captures various empirical episodes; and finally to modify a model from a non-stratified to a stratified society model, again according to Boudon's suggestion.

The article is a reply by the author to his critique Martin Everett on his article "Algebraic Reinterpretation of IKI No Kozo." The author's aim in his article was twofolded. First, he attempted to show that different types of IKI, might be identified by means of mathematical formulation and some derivations. Second, he also wanted to show that there could be a variety of paths from any entity to any other entity. Or any entity, when combined with another entity, transforms itself to some another entity. According to the author, step one is to construct the permutation group using his original transformation. The next is to examine the orbits of IKI, which corresponds to each of the possible subgroups. Successive steps within a single theoretical framework will attain his twofolded aims. Anthropologists might claim that actual social organizations are too complex for this kind of formal analysis to be employed at all. Group theory seems to have enormous potentialities in its application in sociology and related fields of study.