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Ayaka Deguchi,1– 3 Jiro Masuya,1 Mayu Naruse,4 Chihiro Morishita,1 Motoki Higashiyama,1 Hajime Tanabe,5 Takeshi Inoue,1 Masahiko Ichiki1 1Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023, Japan; 2Department of Psychiatry, Maruyamasou Hospital, Ishioka, Ibaraki, 315-0116, Japan; 3Department of Psychiatry, Deguchi Hospital, Nagasaki, Nagasaki, 851-1134, Japan; 4Department of Welfare Psychology, Tokyo International University, Kawagoe, Saitama, 350-1198, Japan; 5Faculty of Humanities and Social Sciences, Shizuoka University, Suruga-ku, Shizuoka, 422-8529, JapanCorrespondence: Takeshi InoueDepartment of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, JapanTel +81 3 3342 6111Fax +81 3 3340 4499Email tinoue@Tokyo-med.ac.jpBackground: Several psychological studies have shown that depressive rumination is associated with the onset and severity of depression. However, it is unclear how rumination interacts with other predisposing factors to cause depression. In this study, we hypothesized that rumination mediates the association between depression and two predisposing factors of depression, ie, childhood maltreatment and trait anxiety.Subjects and Methods: Between 2017 and 2018, 473 adult volunteers were surveyed using self-report questionnaires regarding the following: demographic information, rumination (Ruminative Responses Scale), trait anxiety (State-Trait Anxiety Inventory-Y), and the experience of childhood maltreatment (Child Abuse and Trauma Scale). The effects of these factors on depression (Patient Health Questionnaire-9) were analyzed by multiple regression and path analysis to analyze the mediating effects of rumination. This study was conducted with approval from the relevant ethics committee.Results: Multiple regression analysis using depression as a dependent variable demonstrated that trait anxiety, rumination, childhood maltreatment, and living alone were significantly associated with depression. Path analysis showed that childhood maltreatment had a positive effect on trait anxiety, rumination, and depression; trait anxiety had a positive effect on rumination and depression; and rumination had a positive effect on depression. Regarding indirect effects, the experience of childhood maltreatment increased rumination and depression indirectly via trait anxiety. Furthermore, the experience of childhood maltreatment increased depression indirectly via rumination, and trait anxiety significantly increased depression via rumination. In other words, rumination mediated the indirect effects of abusive experiences and trait anxiety on depression. This model accounted for 50% of the variance in depression in adult volunteers.Conclusion: Our results suggest that rumination mediates the association between childhood maltreatment, trait anxiety, and depression in adulthood.Keywords: rumination, trait anxiety, childhood maltreatment, depression, path analysis

Background Childhood maltreatment has long-lasting psychological effects, which often manifest in adulthood. Previous studies have suggested that the effects of childhood maltreatment are not only direct but also indirect, being mediated by other factors. In this study, we hypothesized that the effects of childhood maltreatment on state anxiety in adulthood are mediated by interpersonal sensitivity and the evaluation of life events, and investigated this possibility by covariance structure analysis. Subjects and Methods Self-administered questionnaires (Child Abuse and Trauma Scale, State-Trait Anxiety Inventory Form Y, Life Experiences Survey, and Interpersonal Sensitivity Measure) were distributed to adult community volunteers in Japan, and 404 eligible responses were collected. A structural equation model was constructed to analyze the direct and indirect effects of childhood maltreatment on state anxiety, with interpersonal sensitivity and the evaluation of life events as potential mediators. Results Our model showed that childhood maltreatment increases state anxiety in adulthood both directly and indirectly via interpersonal sensitivity. In addition, interpersonal sensitivity mediated the effects of childhood maltreatment on the negative evaluation of life events, and the negative evaluation of life events mediated the effects of interpersonal sensitivity on anxiety symptoms. Limitations There may be possible recall bias owing to the self-administration of the questionnaire. In addition, this study had a cross-sectional design, and hence the results should be validated by a prospective study. Conclusion The effects of childhood maltreatment on the state anxiety of adult volunteers are not only direct but are also mediated by interpersonal sensitivity. Our results suggest that assessing interpersonal sensitivity may help to determine optimal treatments for patients with anxiety who experienced maltreatment in childhood.

Heterozygous mutations in the Berardinelli-Seip congenital lipodystrophy 2 (BSCL2) gene have been reported with different clinical phenotypes including Silver syndrome (SS)/spastic paraplegia 17 (SPG17), distal hereditary motor neuropathy type V (dHMN-V), and Charcot-Marie-Tooth (CMT) disease type 2. We screened 407 Japanese patients who were clinically suspected of having CMT by exome sequencing and searched mutations in BSCL2. As a result, we identified five patients with heterozygous mutations in BSCL2. We confirmed three cases of known mutations (p.N88S and p.S90L) and two cases of novel mutations (p.N88T and p.S141A). The clinical features of the cases with known mutations in Japan were similar to those previously reported in other countries. In particular, there were many cases with sensory disturbance. The case with p.N88T mutation showed severe phenotype such as early onset age and prominent vocal cord paresis. The case with p.S141A mutation showed characteristics of demyelinating neuropathy such as CMT disease type 1 by electrophysiological examination. In this article, we report the clinical features and spread of cases with BSCL2 mutation in a Japanese cohort.

We have been developing a liquid-helium-free magnet using High-Temperature Superconducting (HTS) wire for MRI. The aim of this research and development is to commercialize a 3-T HTS magnet for whole body MRI which has the characteristics of being liquid-helium-free, small, and light-weight. HTS coil requires tolerance of a high magnetic field, 7 T, and it must have high current density, 200 A/mm 2 , for developing a small and light weight magnet used for 3-T MRI. A half-size 5-T HTS magnet will be manufactured in order to demonstrate the tolerance of high magnetic field and high current density of the coil, which are equivalent to a whole-body 3-T MRI magnet in a half-size HTS magnet. In this paper, we have investigated the arrangement of coils of a half-size 5-T coil. The designed coil consists of 124 double-pancake coils, whose inner diameter is 560 mm, outer diameter is 1200 mm, and axial length is 1100 mm. The uniformity of designed magnetic field is under 2.0 ppm (250 mmDSV).

Yumi Wakatsuki,1 Takeshi Inoue,2 Naoki Hashimoto,1 Yota Fujimura,2 Jiro Masuya,2 Masahiko Ichiki,2 Hajime Tanabe,3 Ichiro Kusumi1 1Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan; 2Department of Psychiatry, Tokyo Medical University, Tokyo 160-0023, Japan; 3Department of Clinical Human Sciences, Graduate School of Humanities and Social Sciences, Shizuoka University, Shizuoka 422-8529, JapanCorrespondence: Takeshi InoueDepartment of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, JapanTel +81-3-3342-6111Fax +81-3-3340-4499Email tinoue@tokyo-med.ac.jpBackground: Previous studies have shown that childhood maltreatment is associated with premenstrual dysphoric disorder (PMDD). In this study we analyzed how multiple factors, such as childhood maltreatment, affective temperaments, and adult life events influence the severity of premenstrual mental (PMM) symptoms in nonclinical adult volunteers from the community.Methods: A total of 204 participants were recruited and administered the following self-administered questionnaire surveys: PMDD scale, visual analogue scale, Patient Health Questionnaire-9, Life Experience Survey, Temperament Evaluation of Memphis, Pisa, Paris, and San Diego autoquestionnaire version, and the Child Abuse and Trauma scale. In addition to single and multiple regression analyses, structural equation modeling was used for the statistical analyses.Results: A history of neglect indirectly predicted PMM symptoms through affective temperaments in nonclinical adult volunteers. Three affective temperaments (irritable, cyclothymic, and anxious) directly predicted PMM symptoms.Conclusion: This study is the first to report that childhood maltreatment, particularly neglect, indirectly predicted PMM symptoms through affective temperaments. The results of our study suggest that affective temperament is a mediator of the influence of childhood maltreatment on PMM symptoms.Keywords: premenstrual mental symptoms, neglect, childhood maltreatment, affective temperament, TEMPS-A, structural equation modeling

A new high-temperature superconducting (HTS) application project supported by the New Energy and Industrial Technology Development Organization (NEDO) started in July 2016. One of the targets of this project is to demonstrate the half-size of whole-body magnetic resonance imaging (MRI) system using HTS magnets with REBCO conductors. In the first phase of this project (FY2016–FY2018), a three-tesla magnet with an active shield will be manufactured. The room-temperature bore of the magnet is 480 mm in diameter. The magnet will be cooled down to lower than 20 K with a G-M refrigerator and the MR imaging will be performed to evaluate the magnetic field uniformity and stability. The design of the half-size 3-T coil has been finished: it consists of 220 single-pancake coils, and it has an inner diameter of 560 mm, an outer diameter of 1200 mm, and an axial length of 1000 mm. The rated current is 148 A and the stored energy at the rated excitation is 1.58 MJ. The designed magnetic field homogeneity is 1.7 ppm (250 mm DSV) which is adequate for MR imaging. Furthermore, the fringe field is suppressed by active shielding technology. The number of 53 single-pancake coils was manufactured in FY2016, and the yield rate was about 95%.

Mutations in small heat shock protein beta-1 (HspB1) have been linked to Charcot-Marie-Tooth (CMT) disease type 2F and distal hereditary motor neuropathy type 2B. Only four cases with HSPB1 mutations have been reported to date in Japan. In this study between April 2007 and October 2014, we conducted gene panel sequencing in a case series of 1,030 patients with inherited peripheral neuropathies (IPNs) using DNA microarray, targeted resequencing, and whole-exome sequencing. We identified HSPB1 variants in 1.3% (13 of 1,030) of the patients with IPNs, who exhibited a male predominance. Based on neurological and electrophysiological findings, seven patients were diagnosed with CMT disease type 2F, whereas the remaining six patients were diagnosed with distal hereditary motor neuropathy type 2B. P39L, R127W, S135C, R140G, K141Q, T151I, and P182A mutations identified in 12 patients were described previously, whereas a novel K123* variant with unknown significance was found in 1 patient. Diabetes and impaired glucose tolerance were detected in 6 of the 13 patients. Our findings suggest that HSPB1 mutations result in two phenotypes of inherited neuropathies and extend the phenotypic spectrum of HSPB1-related disorders.

Background We previously reported that child abuse indirectly predicts the diagnosis of major depressive disorder (MDD) or bipolar disorder (BP) based on higher scores of affective temperaments; however, the subtypes of child abuse have not been examined sufficiently. Therefore, in the present study, we used the reclassified version of the Child Abuse and Trauma Scale (CATS) to determine how the subtypes of child abuse affect affective temperaments. Methods A total of 502 participants (212 healthy controls, 163 patients with MDD and 127 patients with BP) were administered the Japanese version of the CATS; the Japanese version of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire; and the Japanese version of the Patient Health Questionnaire-9. Data were analyzed by exploratory and confirmatory factor analyses, as well as by univariate and multivariate analyses. Results A five-factor structure was appropriate for the CATS. The MDD group scored significantly higher on all subtypes of the reclassified CATS than did the control group. Among the subscales of the reclassified CATS, physical abuse and loneliness/psychological stress were significant predictors of affective temperaments, although all subscales were significantly associated with affective temperaments compared to the original CATS. Limitations Since child abuse was assessed retrospectively, there might be recall bias. Furthermore, as the study was limited to Japanese individuals, particularly those with mood disorders, the findings might not be generalizable. Conclusions This study revealed that the subtypes of child abuse (especially physical abuse and loneliness/psychological stress) might be associated with MDD and BP.

Motoki Higashiyama,1 Taito Hayashida,1 Keisuke Sakuta,1 Yota Fujimura,2 Jiro Masuya,3 Masahiko Ichiki,1 Hajime Tanabe,4 Ichiro Kusumi,5 Takeshi Inoue11Department of Psychiatry, Tokyo Medical University, Tokyo 160-0023, Japan; 2Department of Psychiatry, Tokyo Medical University Hachioji Medical Center, Tokyo 193-0998, Japan; 3Department of Psychiatry, Tokyo Medical University Ibaraki Medical Center, Ibaraki 300-0395, Japan; 4Department of Clinical Human Sciences, Graduate School of Humanities and Social Sciences, Shizuoka University, Shizuoka 422-8529, Japan; 5Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, JapanCorrespondence: Takeshi InoueDepartment of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, JapanTel +81 33 342 6111Fax +81 33 340 4499Email tinoue@tokyo-med.ac.jpBackground: How subjective social status is associated with childhood abuse and affective temperament in the mechanism of depressive symptom exacerbation remains unknown. In this study, we investigated how the complex effects of subjective social status, childhood abuse, and affective temperament influence depressive symptoms in adulthood.Methods: Self-report questionnaires were distributed to 853 adult volunteers between January and August 2014. Of them, 404 people gave full consent and returned complete anonymous responses. The following five questionnaires were analyzed: demographic information, Patient Health Questionnaire-9, subjective social status, Child Abuse and Trauma Scale, and Temperament Evaluation of Memphis, Pisa, Paris and San Diego autoquestionnaire. The associations between the scores were analyzed by structural equation modeling. This study was conducted with approval from the ethics committees of Tokyo Medical University and Hokkaido University Hospital.Results: Covariance structure analysis demonstrated that childhood abuse and subjective social status did not have a direct effect on adulthood depressive symptoms. Childhood abuse had direct effects on subjective social status and affective temperament and childhood abuse indirectly affected adulthood depressive symptoms through subjective social status and affective temperament. Subjective social status also affected depressive symptoms through an effect on affective temperament. This model explained 43% of the variability in depressive symptoms and the fitness of this model was good.Conclusion: Regarding childhood abuse and adulthood depressive symptoms, subjective social status as well as affective temperament may be mediators. The results of this study are expected to contribute to the elucidation of the mechanism of depression.Keywords: childhood abuse, subjective social status, affective temperament, depression, covariance structure analysis

Yoshihiro Uchida,1–3 Toshinao Takahashi,1,3 Shigemasa Katayama,1,3 Jiro Masuya,1,2 Masahiko Ichiki,1 Hajime Tanabe,4 Ichiro Kusumi,5 Takeshi Inoue1 1Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo 160-0023, Japan; 2Department of Psychiatry, Ibaraki Medical Center, Tokyo Medical University, Ami-machi, Inashiki-gun, Ibaraki 300-0395, Japan; 3Department of Psychiatry, Seijin Hopital, Adachi-ku, Tokyo 121-0815, Japan; 4Department of Clinical Human Sciences, Graduate School of Humanities and Social Sciences, Shizuoka University, Suruga-ku, Shizuoka 422-8529, Japan; 5Department of Psychiatry, Hokkaido University Graduate School of Medicine, Kita-ku, Sapporo 060-8638, Japan Background: Various personality traits mediate the association between childhood stress and depressive symptoms in adulthood. The aim of this study was to clarify the indirect effects of the experience of child maltreatment on depressive symptoms and appraisal of life events in adulthood through trait anxiety. Subjects and methods: A total of 404 participants who were volunteer subjects from the community were studied using the following self-administered questionnaire surveys: Patient Health Questionnaire-9, which measures depressive symptoms; State-Trait Anxiety Inventory Form Y, which measures trait anxiety; the Child Abuse and Trauma Scale, which measures child maltreatment; and Life Experiences Survey, which measures negative and positive appraisal of adulthood life events. Results: Structural equation modeling demonstrated that the experience of child maltreatment increased depressive symptoms in adulthood as well as the negative appraisal of life events in adulthood through an increase in trait anxiety. Furthermore, trait anxiety affected depressive symptoms in adulthood through its influence on the negative appraisal of adulthood life events. The following indirect effect was also significant: the experience of child maltreatment increased the negative appraisal of adulthood life events via trait anxiety and subsequently influenced adult depressive symptoms. Limitations: The subjects of this study are volunteer subjects from the community including healthy people, and hence the results may not be generalizable to major depressive patients. Recall bias should be considered when interpreting the results. Because this study is a cross-sectional study, the causality between the experience of child maltreatment and depression is not clear. Conclusion: This study suggests that trait anxiety may play a mediating role in the influence of the experience of child maltreatment on depressive symptoms in adulthood and negative appraisal of adulthood life events. Keywords: child maltreatment, covariance structure analysis, depression, STAI-Y, trait anxiety, life events

Introduction: Amyloid myopathy is a rare manifestation of primary systemic amyloid light-chain (AL) amyloidosis, but it has not been reported to occur in secondary amyloid A (AA) amyloidosis. Methods: We describe a 46-year-old man with psoriasis vulgaris who presented with idiopathic upper and lower limb weakness and was eventually diagnosed with hypertrophic cardiomyopathy. Muscle biopsy findings were compatible with mild inflammatory myopathy. He died of cardiopulmonary arrest, and an autopsy was performed. Results: The autopsy revealed amyloid plaques immunopositive for AA (but not AL or transthyretin) in the perimysial, perivascular, and endomysial regions of the iliopsoas muscle. The final diagnosis was systemic AA amyloidosis with muscle amyloid angiopathy, possibly induced by psoriasis vulgaris. Conclusion: This is an extremely rare autopsy case of myopathy in a patient with systemic AA amyloidosis. The reason for the unusually large amount of amyloid deposition in muscle blood vessel walls remains unclear. Muscle Nerve 52: 1113–1117, 2015

The study targeted Japanese employees who have visited hospital for spinal disorder. The study analyzed work environment and pain relief methods of work-related back pain patients, and the relationship between back pain and other body parts. The purpose of this study was to provide draw up measures for patients with back pain and to provide basic data for the sustainable prevention program. The study result of back pain, in other words, employees suffering from lumbago, had disparity between occupations; the highest number of patients were made up of 16-years or above long-serving employees, and below 5-years of short-serving employees. There were more patients complaining of chronic lumbago than acute lumbago, and patients recognized poor posture as the primary cause of lumbago. Furthermore, 99.5% of spinal disorder patients complain back pain, 23.2% use only alternative therapy, and 15.2% visit clinic and hospital with alternative therapy. Patients showed pain reduction and high satisfaction after using alternative therapy. The study targeted Japanese employees where complement therapy is more generalized than that of Korea, and thus there should be multilateral management programs provided in Korea as well.

Kotaro Ono,1 Yoshikazu Takaesu,1 Yukiei Nakai,2 Akiyoshi Shimura,1 Yasuyuki Ono,1 Akiko Murakoshi,1 Yasunori Matsumoto,1 Hajime Tanabe,3 Ichiro Kusumi,2 Takeshi Inoue1 1Department of Psychiatry, Tokyo Medical University, Tokyo, 2Department of Psychiatry, Hokkaido University Graduate School of Medicine, Hokkaido, 3Department of Clinical Human Sciences, Graduate school of Humanities and Social Sciences, Shizuoka University, Shizuoka, Japan Background: Recent studies have suggested that the interactions among several factors affect the onset, progression, and prognosis of major depressive disorder. This study investigated how childhood abuse, neuroticism, and adult stressful life events interact with one another and affect depressive symptoms in the general adult population. Subjects and methods: A total of 413 participants from the nonclinical general adult population completed the Patient Health Questionnaire-9, the Child Abuse and Trauma Scale, the neuroticism subscale of the shortened Eysenck Personality Questionnaire – Revised, and the Life Experiences Survey, which are self-report scales. Structural equation modeling (Mplus version 7.3) and single and multiple regressions were used to analyze the data. Results: Childhood abuse, neuroticism, and negative evaluation of life events increased the severity of the depressive symptoms directly. Childhood abuse also indirectly increased the negative appraisal of life events and the severity of the depressive symptoms through enhanced neuroticism in the structural equation modeling. Limitations: There was recall bias in this study. The causal relationship was not clear because this study was conducted using a cross-sectional design. Conclusion: This study suggested that neuroticism is the mediating factor for the two effects of childhood abuse on adulthood depressive symptoms and negative evaluation of life events. Childhood abuse directly and indirectly predicted the severity of depressive symptoms. Keywords: childhood abuse, depression, neuroticism, stressful life events, structural equation modeling

Yoshiaki Kanai,1,2 Yoshikazu Takaesu,1 Yukiei Nakai,3 Masahiko Ichiki,1 Mitsuhiko Sato,1 Yasunori Matsumoto,1 Jun Ishikawa,1 Yasuyuki Ono,1 Akiko Murakoshi,1 Hajime Tanabe,4 Ichiro Kusumi,3 Takeshi Inoue1 1Department of Psychiatry, Tokyo Medical University, 2Department of Palliative Medicine, The University of Tokyo Hospital, Tokyo, 3Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, 4Department of Clinical Human Sciences, Graduate School of Humanities and Social Sciences, Shizuoka University, Shizuoka, Japan Background: Previous studies have shown the effects of childhood abuse, life events, and temperaments on well-being (positive affect) and ill-being (negative affect). We hypothesized that childhood abuse, affective temperaments, and adult life events interact with one another and influence positive and negative affects in the general adult population and tested this hypothesis using structural equation modeling. Methods: A total of 415 participants from the general, nonclinical adult population were studied using the following self-administered questionnaires: the Subjective Well-Being Inventory (SUBI); Life Experiences Survey (LES); Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A); and the Child Abuse and Trauma Scale (CATS). The data were analyzed with single and multiple regression analyses and structural equation modeling (Mplus). Results: Childhood abuse indirectly predicted the worsening of positive and negative affects through cyclothymic, anxious, and irritable temperaments as measured by the TEMPS-A in the structural equation model. The cyclothymic, anxious, and irritable temperaments directly worsened the positive and negative affects and the negative appraisal of life events that occurred during the past year, while the hyperthymic temperament had the opposite effects. Limitations: The subjects of this study were nonclinical volunteers. The findings might not be generalizable to psychiatric patients. Conclusion: This study demonstrated that childhood abuse, particularly neglect, indirectly worsened the well-being of individuals through cyclothymic, anxious, and irritable affective temperaments. An important “mediator” role of affective temperaments in the effect of childhood abuse on well-being was suggested. Keywords: childhood abuse, well-being, affective temperament, TEMPS-A, adult life events, structural equation model

Objective The objective of this study was to identify new causes of Charcot–Marie–Tooth (CMT) disease in patients with autosomal-recessive (AR) CMT. Methods To efficiently identify novel causative genes for AR-CMT, we analyzed 303 unrelated Japanese patients with CMT using whole-exome sequencing and extracted recessive variants/genes shared among multiple patients. We performed mutation screening of the newly identified membrane metalloendopeptidase (MME) gene in 354 additional patients with CMT. We clinically, genetically, pathologically, and radiologically examined 10 patients with the MME mutation. Results We identified recessive mutations in MME in 10 patients. The MME gene encodes neprilysin (NEP), which is well known to be one of the most prominent beta-amyloid (Aβ)-degrading enzymes. All patients had a similar phenotype consistent with late-onset axonal neuropathy. They showed muscle weakness, atrophy, and sensory disturbance in the lower extremities. All the MME mutations could be loss-of-function mutations, and we confirmed a lack/decrease of NEP protein expression in a peripheral nerve. No patients showed symptoms of dementia, and 1 patient showed no excess Aβ in Pittsburgh compound-B positron emission tomography imaging. Interpretation Our results indicate that loss-of-function MME mutations are the most frequent cause of adult-onset AR-CMT2 in Japan, and we propose that this new disease should be termed AR-CMT2T. A loss-of-function MME mutation did not cause early-onset Alzheimer's disease. Identifying the MME mutation responsible for AR-CMT could improve the rate of molecular diagnosis and the understanding of the molecular mechanisms of CMT. Ann Neurol 2016

Hiroyuki Toda,1 Takeshi Inoue,2,3 Tomoya Tsunoda,1 Yukiei Nakai,2 Masaaki Tanichi,1 Teppei Tanaka,1 Naoki Hashimoto,2 Yasuya Nakato,2 Shin Nakagawa,2 Yuji Kitaichi,2 Nobuyuki Mitsui,2 Shuken Boku,4 Hajime Tanabe,5 Masashi Nibuya,1 Aihide Yoshino,1 Ichiro Kusumi2 1Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan; 2Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan; 3Department of Psychiatry, Tokyo Medical University, Tokyo, Japan; 4Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan; 5Department of Clinical Human Sciences, Graduate School of Humanities and Social Sciences, Shizuoka University, Shizuoka, Japan Background: Previous studies have shown the interaction between heredity and childhood stress or life events on the pathogenesis of a major depressive disorder (MDD). In this study, we tested our hypothesis that childhood abuse, affective temperaments, and adult stressful life events interact and influence the diagnosis of MDD. Patients and methods: A total of 170 healthy controls and 98 MDD patients were studied using the following self-administered questionnaire surveys: the Patient Health Questionnaire-9 (PHQ-9), the Life Experiences Survey, the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire, and the Child Abuse and Trauma Scale (CATS). The data were analyzed with univariate analysis, multivariable analysis, and structural equation modeling. Results: The neglect scores of the CATS indirectly predicted the diagnosis of MDD through cyclothymic and anxious temperament scores of the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire in the structural equation modeling. Two temperaments – cyclothymic and anxious – directly predicted the diagnosis of MDD. The validity of this result was supported by the results of the stepwise multivariate logistic regression analysis as follows: three factors – neglect, cyclothymic, and anxious temperaments – were significant predictors of MDD. Neglect and the total CATS scores were also predictors of remission vs treatment-resistance in MDD patients independently of depressive symptoms. Limitations: The sample size was small for the comparison between the remission and treatment-resistant groups in MDD patients in multivariable analysis. Conclusion: This study suggests that childhood abuse, especially neglect, indirectly predicted the diagnosis of MDD through increased affective temperaments. The important role as a mediator of affective temperaments in the effect of childhood abuse on MDD was suggested. Keywords: neglect, major depressive disorder, affective temperament, mediator

We constructed open MRI superconducting magnets with an iron yoke that generates a 0.7T highly uniform magnetic field. A program that compensates for the error field of those magnets was developed that uses linear programming to achieve an optimal arrangement of a large number of small iron shims. Since additional homogeneity compensation near the target value becomes difficult, we also used nonlinear programming. We must evaluate all shim magnetizations precisely by making a 3D finite element shim model. Since, it is impossible to make such shims in a large magnet model, we describe a fast calculation method of shim magnetizations without that model. Homogeneity of 0.35ppm (Vrms) at 35cm Diameter Spherical Volume (DSV), which is the top value of an open MRI magnet, is obtained by applying these methods. The number of correction times were reduced by half of initial manufactured magnets.

We investigated a progression of brain atrophy and somatosensory system dysfunction in multiple system atrophy (MSA). Subjects were 21 MSA patients [12 MSA-C (cerebellar type) and 9 MSA-P (parkinsonism type)]. The relative volumes of cerebrum, brainstem and cerebellum to the intracranial volume were obtained from three-dimensional computed tomography (3D-CT) of the brain. The median nerve somatosensory evoked potentials (SEPs) were recorded, and the latencies and amplitudes of N9, N11, P13/14, N20 and P25 components were measured. We studied correlations between brain volumes, SEP and clinical features. The brainstem and cerebellar atrophies were aggravated with progression of the disease. The central sensory conduction time (CSCT) was progressively prolonged in parallel with the disease duration irrespective of the actual age of the patients. In MSA patients, the volume reductions of cerebellum and brainstem could be one of structural markers of disease progression, and the sensory pathway is progressively involved with the progression of disease processes.

A 59-year-old man with abnormal vascular features (intracranial aneurysm, a cervical arteriovenous shunt, bilateral internal jugular vein occlusions, and left transverse sinus hypoplasia), as well as left optic atrophy was suspected to have familial polycystic kidney disease. The possibility of autosomal dominant polycystic kidney disease complicated by Ehlers-Danlos syndrome type IV due to the coexistence of vasculopathy and polycystic kidneys was considered. However, the negative results of a skin fibroblast culture rendered the diagnosis of Ehlers-Danlos syndrome type IV unlikely. The cause of left optic atrophy in our patient remains unclear although it was suspected to be a secondary consequence of papilledema, which was caused by intracranial hypertension.