413 results on '"Kenji, Kosaka"'
Search Results
2. Long-Term Efficacy and Safety of Zonisamide for Treatment of Parkinsonism in Patients With Dementia With Lewy Bodies: An Open-Label Extension of a Phase three Randomized Controlled Trial
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Kazuko Hasegawa, Kenji Kosaka, Toshinari Odawara, Masaaki Tagawa, Hisao Takeuchi, Miho Murata, and Ritsuko Kajiwara
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Lewy Body Disease ,Pediatrics ,medicine.medical_specialty ,Zonisamide ,Placebo ,law.invention ,Double-Blind Method ,Parkinsonian Disorders ,Randomized controlled trial ,law ,Outpatients ,medicine ,Humans ,Dementia ,Adverse effect ,Dementia with Lewy bodies ,business.industry ,Parkinsonism ,medicine.disease ,Clinical trial ,Psychiatry and Mental health ,Treatment Outcome ,Geriatrics and Gerontology ,business ,medicine.drug - Abstract
Objectives To evaluate the long-term efficacy and safety of zonisamide, an antiepileptic agent, in dementia with Lewy bodies (DLB). Design Phase three clinical trial with 12 week, randomized, placebo-controlled, double-blind, and subsequent 40 week, open-label, extension periods. Setting A total of 109 centers in Japan between April 2015 and November 2017. Participants Outpatients diagnosed with probable DLB. Intervention Outpatients were randomly assigned to receive placebo (P) or zonisamide 25 or 50 mg/day for 12 weeks. In the subsequent open-label 40 week period, all patients initially received zonisamide 25 mg/day for at least 2 weeks followed by optional flexible dosing with zonisamide 25 or 50 mg/day for the remaining period. Measurements The primary outcome was efficacy on motor symptoms, assessed using the Unified Parkinson's Disease Rating Scale part III (UPDRS-III) score, over the total 52 week trial period. Effects on behavioral and psychological symptoms of dementia and cognitive function, and safety were also evaluated. Results In total, 335 patients were included in the long-term analysis: 106, 117, and 112 in the P-, 25mg-, and 50mg-Flex groups, respectively. UPDRS-III score continued to improve for an additional 12 to 16 weeks in the open-label period (mean [standard deviation] change from baseline at Week 28: −5.1 [7.3] and −6.3 [8.2] in the 25mg- and 50mg-Flex groups) and remained almost constant thereafter. No unexpected neurological or psychiatric adverse events occurred, and no adverse events increased in incidence in the open-label period. Conclusions Long-term treatment with zonisamide was well tolerated and yielded sustained improvement in motor symptoms. Trial registration JapicCTI-152839 (Registered on 9 March 2015) https://www.clinicaltrials.jp/cti-user/trial/ShowDirect.jsp?japicId=JapicCTI-152839
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- 2022
3. When does cerebral β‐amyloid deposition begin in Lewy body dementia?
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Hiroshige Fujishiro and Kenji Kosaka
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Pathology ,medicine.medical_specialty ,Parkinson's disease ,Lewy body ,Dementia with Lewy bodies ,business.industry ,medicine.disease ,Neurology ,β amyloid ,medicine ,Dementia ,Neurology (clinical) ,Lewy body disease ,business ,Deposition (chemistry) - Published
- 2020
4. Intra-rater and Inter-rater Reliability of a Precordial Flexibility Test
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Hideto Mori, Hiroaki Koshimoto, Takashi Moriwaki, Kenji Tanaka, Ryohei Matsuno, Kenji Kosaka, Shin Sakamoto, and Yuya Kamizawa
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Inter-rater reliability ,Flexibility (anatomy) ,medicine.anatomical_structure ,Computer science ,medicine ,Physical Therapy, Sports Therapy and Rehabilitation ,Precordial examination ,Test (assessment) ,Reliability engineering - Published
- 2020
5. Diagnostic accuracy of 123I-meta-iodobenzylguanidine myocardial scintigraphy in dementia with Lewy bodies: a multicenter study.
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Mitsuhiro Yoshita, Heii Arai, Hiroyuki Arai, Tetsuaki Arai, Takashi Asada, Hiroshige Fujishiro, Haruo Hanyu, Osamu Iizuka, Eizo Iseki, Kenichi Kashihara, Kenji Kosaka, Hirotaka Maruno, Katsuyoshi Mizukami, Yoshikuni Mizuno, Etsuro Mori, Kenichi Nakajima, Hiroyuki Nakamura, Seigo Nakano, Kenji Nakashima, Yoshiyuki Nishio, Satoshi Orimo, Miharu Samuraki, Akira Takahashi, Junichi Taki, Takahiko Tokuda, Katsuya Urakami, Kumiko Utsumi, Kenji Wada, Yukihiko Washimi, Junichi Yamasaki, Shouhei Yamashina, and Masahito Yamada
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Medicine ,Science - Abstract
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.
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- 2015
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6. Development of DLC Film Coating Technology to Achieve both High Performance and High Productivity Utilizing High-Density Plasma
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Hiromichi NAKATA, Yoji SATO, Takayasu SATO, Kazutaka TACHIBANA, Osamu ARIYADA, and Kenji KOSAKA
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General Engineering - Published
- 2022
7. Prolactin Levels in Schizophrenic Patients Receiving Perospirone in Comparison to Risperidone
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Takashi Togo, Eizo Iseki, Mika Shoji, Ikuo Oyama, Akihiko Kase, Hirotake Uchikado, Omi Katsuse, and Kenji Kosaka
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Therapeutics. Pharmacology ,RM1-950 - Abstract
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.
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- 2003
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8. Correction: Is Genetically Associated with Late-Onset Alzheimer’s Disease in Japanese, Koreans and Caucasians.
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Akinori Miyashita, Asako Koike, Gyungah Jun, Li-San Wang, Satoshi Takahashi, Etsuro Matsubara, Takeshi Kawarabayashi, Mikio Shoji, Naoki Tomita, Hiroyuki Arai, Takashi Asada, Yasuo Harigaya, Masaki Ikeda, Masakuni Amari, Haruo Hanyu, Susumu Higuchi, Takeshi Ikeuchi, Masatoyo Nishizawa, Masaichi Suga, Yasuhiro Kawase, Hiroyasu Akatsu, Kenji Kosaka, Takayuki Yamamoto, Masaki Imagawa, Tsuyoshi Hamaguchi, Masahito Yamada, Takashi Morihara, Masatoshi Takeda, Takeo Takao, Kenji Nakata, Yoshikatsu Fujisawa, Ken Sasaki, Ken Watanabe, Kenji Nakashima, Katsuya Urakami, Terumi Ooya, Mitsuo Takahashi, Takefumi Yuzuriha, Kayoko Serikawa, Seishi Yoshimoto, Ryuji Nakagawa, Jong-Won Kim, Chang-Seok Ki, Hong-Hee Won, Duk L. Na, Sang Won Seo, Inhee Mook-Jung, Peter St. George-Hyslop, Richard Mayeux, Jonathan L. Haines, Margaret A. Pericak-Vance, Makiko Yoshida, Nao Nishida, Katsushi Tokunaga, Ken Yamamoto, Shoji Tsuji, Ichiro Kanazawa, Yasuo Ihara, Gerard D. Schellenberg, Lindsay A. Farrer, and Ryozo Kuwano
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Medicine ,Science - Published
- 2013
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9. SORL1 is genetically associated with late-onset Alzheimer's disease in Japanese, Koreans and Caucasians.
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Akinori Miyashita, Asako Koike, Gyungah Jun, Li-San Wang, Satoshi Takahashi, Etsuro Matsubara, Takeshi Kawarabayashi, Mikio Shoji, Naoki Tomita, Hiroyuki Arai, Takashi Asada, Yasuo Harigaya, Masaki Ikeda, Masakuni Amari, Haruo Hanyu, Susumu Higuchi, Takeshi Ikeuchi, Masatoyo Nishizawa, Masaichi Suga, Yasuhiro Kawase, Hiroyasu Akatsu, Kenji Kosaka, Takayuki Yamamoto, Masaki Imagawa, Tsuyoshi Hamaguchi, Masahito Yamada, Takashi Morihara, Masatoshi Takeda, Takeo Takao, Kenji Nakata, Yoshikatsu Fujisawa, Ken Sasaki, Ken Watanabe, Kenji Nakashima, Katsuya Urakami, Terumi Ooya, Mitsuo Takahashi, Takefumi Yuzuriha, Kayoko Serikawa, Seishi Yoshimoto, Ryuji Nakagawa, Jong-Won Kim, Chang-Seok Ki, Hong-Hee Won, Duk L Na, Sang Won Seo, Inhee Mook-Jung, Alzheimer Disease Genetics Consortium, Peter St George-Hyslop, Richard Mayeux, Jonathan L Haines, Margaret A Pericak-Vance, Makiko Yoshida, Nao Nishida, Katsushi Tokunaga, Ken Yamamoto, Shoji Tsuji, Ichiro Kanazawa, Yasuo Ihara, Gerard D Schellenberg, Lindsay A Farrer, and Ryozo Kuwano
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Medicine ,Science - Abstract
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
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- 2013
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10. 123I-MIBG myocardial scintigraphy for the diagnosis of DLB: a multicentre 3-year follow-up study
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Junji Komatsu, Takahiko Tokuda, Kenji Wada, Mitsuhiro Yoshita, Tetsuaki Arai, Hiroyuki Arai, Yoshikuni Mizuno, Hirotaka Maruno, Junichi Taki, Takashi Asada, Kenji Kosaka, Akira Takahashi, Kenji Nakashima, Kenichi Nakajima, Seigo Nakano, Katsuya Urakami, Kenichi Kashihara, Satoshi Orimo, Etsuro Mori, Yukihiko Washimi, Hiroyuki Nakamura, Heii Arai, Eizo Iseki, Junichi Yamasaki, Katsuyoshi Mizukami, Yoshiyuki Nishio, Hiroshige Fujishiro, Osamu Iizuka, Haruo Hanyu, Masahito Yamada, Kumiko Utsumi, Miharu Samuraki, and Shouhei Yamashina
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Receiver operating characteristic ,medicine.diagnostic_test ,business.industry ,Dementia with Lewy bodies ,Cross-sectional study ,Scintigraphy ,medicine.disease ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,Myocardial scintigraphy ,Medicine ,Surgery ,Neurology (clinical) ,Medical diagnosis ,Stage (cooking) ,business ,Nuclear medicine ,030217 neurology & neurosurgery ,Depression (differential diagnoses) - Abstract
Background and purposeWe 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.MethodsWe 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.ResultsSixty-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.ConclusionsOur 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 numberUMIN00003419.
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- 2018
11. Effect of zonisamide on parkinsonism in patients with dementia with Lewy bodies: A phase 3 randomized clinical trial
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Kazuko Hasegawa, Masaaki Tagawa, Toshinari Odawara, Kenji Kosaka, Ritsuko Kajiwara, Miho Murata, and Hisao Takeuchi
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0301 basic medicine ,Lewy Body Disease ,Male ,medicine.medical_specialty ,Population ,Zonisamide ,Unified Parkinson's disease rating scale ,Placebo ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Double-Blind Method ,law ,Internal medicine ,medicine ,Clinical endpoint ,Humans ,education ,Aged ,Aged, 80 and over ,education.field_of_study ,Dyskinesias ,Dementia with Lewy bodies ,business.industry ,Parkinsonism ,Middle Aged ,medicine.disease ,Calcium Channel Blockers ,030104 developmental biology ,Treatment Outcome ,Neurology ,Female ,Neurology (clinical) ,Geriatrics and Gerontology ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Introduction Zonisamide is approved in Japan for treating motor dysfunction in Parkinson's disease, and might also be effective for parkinsonism in patients with dementia with Lewy bodies (DLB). Our study evaluated the safety and efficacy of zonisamide for treating parkinsonism in patients with DLB. Methods This multicenter, randomized, double-blind, phase 3 trial was conducted in Japan between April 2015 and November 2017. Following a 4-week run-in period, outpatients diagnosed with probable DLB who had developed parkinsonism were randomized to receive oral zonisamide (25 or 50 mg/day) or placebo for 12 weeks, followed by a 40-week open-label extension. The primary endpoint was the change in Unified Parkinson's Disease Rating Scale (UPDRS) part III total score at Week 12. Results Of 351 patients randomized, 346 (mean age, 77.2 years; 188 males) were included in the modified intention-to-treat population. At Week 12, the group difference (least squares mean ± SEM) for changes from baseline (vs placebo) in UPDRS part III total score was −2.7 ± 0.9 (95% confidence interval [CI]: −4.4, −0.9, P = 0.005) in the zonisamide 25-mg group and −2.6 ± 0.9 (95% CI: −4.4, −0.8, P = 0.005) in the zonisamide 50-mg group. Adverse events were reported in 47.1%, 48.7%, and 54.5% of patients in the placebo and zonisamide 25- and 50-mg groups, and led to treatment discontinuation in 5.0%, 4.3%, and 9.8% of patients, respectively. Conclusion Daily administration of 25- or 50-mg zonisamide significantly improved motor function compared with placebo; both doses were safe and well tolerated in patients with DLB.
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- 2018
12. Accumulated α-synuclein affects the progression of GM2 gangliosidoses
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Masato Kawashima, Yoshio Hirayasu, Ichiro Aoki, Eizo Iseki, Makoto Hashimoto, Kayoko Yamaguchi, Naoya Aoki, Shoji Yamanaka, Noriko Koumitsu, Takashi Togo, Omi Katsuse, Kenji Kosaka, Kyoko Suzuki, Seiichi Kanzaki, and Akira Yamaguchi
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0301 basic medicine ,Ganglioside ,GM2 gangliosidoses ,Microglia ,Autophagy ,Central nervous system ,Mitochondrion ,Sandhoff disease ,Biology ,medicine.disease ,Cell biology ,Pathogenesis ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,medicine.anatomical_structure ,Developmental Neuroscience ,Neurology ,Immunology ,medicine ,030217 neurology & neurosurgery - Abstract
The accumulation of α-synuclein (ASyn) has been observed in several lysosomal storage diseases (LSDs) but it remains unclear if ASyn accumulation contributes to LSD pathology. ASyn also accumulates in the neurons of Sandhoff disease (SD) patients and SD model mice (Hexb-/- ASyn+/+ mice). SD is a lysosomal storage disorder caused by the absence of a functional β-subunit on the β-hexosaminidase A and B enzymes, which leads to the accumulation of ganglioside in the central nervous system. Here, we explored the role of accumulated ASyn in the progression of Hexb-/- mice by creating a Hexb-/- ASyn-/- double-knockout mice. Our results show that Hexb-/- ASyn-/- mice demonstrated active microglia levels and less dopaminergic neuron loss, without altering the neuronal storage of ganglioside. The autophagy and ubiquitin proteasome pathways are defective in the neurons of Hexb-/- ASyn+/+ mice. In ultrastructural physiological studies, the mitochondria structures look degenerated and dysfunctional. As a result, expression of manganese superoxide dismutase 2 are reduced, and reactive oxygen species-mediated oxidative damage in the neurons of Hexb-/- ASyn+/+ mice. Interestingly, these dysfunctions improved in Hexb-/- ASyn-/- mice. But any clinical improvement were hardly observed in Hexb-/- ASyn-/- mice. Taken together, these findings suggest that ASyn accumulation plays an important role in the pathogenesis of neuropathy in SD and other LSDs, and is therefore a target for novel therapies.
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- 2016
13. Increased plasma donepezil concentration improves cognitive function in patients with dementia with Lewy bodies: An exploratory pharmacokinetic/pharmacodynamic analysis in a phase 3 randomized controlled trial
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Kenya Nakai, Kenji Kosaka, Masaki Nakagawa, Manabu Ikeda, Hideaki Miyagishi, and Etsuro Mori
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Male ,Dementia with Lewy bodies ,Blood Pressure ,Neuropsychological Tests ,Severity of Illness Index ,law.invention ,Cognition ,0302 clinical medicine ,Piperidines ,Randomized controlled trial ,law ,Cognitive/behavioral ,Donepezil ,030212 general & internal medicine ,Nootropic Agents ,Aged, 80 and over ,Dementia/aging ,medicine.diagnostic_test ,Parkinsonism ,Middle Aged ,Treatment Outcome ,Cytochrome P-450 CYP2D6 ,Neurology ,Indans ,Mini-Mental State Examination ,Female ,Safety ,Psychology ,Clinical psychology ,medicine.drug ,Lewy Body Disease ,medicine.medical_specialty ,Efficacy ,Clinical Neurology ,Urology ,Clinical ,03 medical and health sciences ,Rating scale ,mental disorders ,medicine ,Humans ,Pharmacokinetis ,Pulse ,Aged ,Mini–Mental State Examination ,Dose-Response Relationship, Drug ,Body Weight ,medicine.disease ,Blood pressure ,Neurology (clinical) ,Mental Status Schedule ,030217 neurology & neurosurgery - Abstract
ObjectiveTo investigate whether increasing plasma donepezil concentration further improves cognitive function and neuropsychiatric symptoms without compromising safety in patients with dementia with Lewy bodies (DLB).MethodsWe analyzed data from a 12-week phase 3 trial of donepezil (5 and 10mg/day) in patients with DLB. The contribution of factors affecting plasma donepezil concentration was evaluated using multivariate regression analysis. The relationships between plasma donepezil concentration and efficacy (cognitive function as measured by the Mini-Mental State Examination [MMSE], hallucinations and cognitive fluctuation), or safety (blood pressure, pulse rate, body weight, and parkinsonism as measured by the Unified Parkinson's Disease Rating Scale part III) were assessed by scatterplots and Pearson correlation.ResultsThe data of 87 patients were used in the analyses. Plasma donepezil concentration increased proportionally with increasing dose from 5 to 10mg/day. The dose (contribution rate: 0.39, p
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- 2016
14. Similarity of symptoms between transient epileptic amnesia and Lewy body disease
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Norio Ozaki, Masako Watanabe, Katsuyuki Ukai, Hiroshige Fujishiro, and Kenji Kosaka
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Pediatrics ,medicine.medical_specialty ,medicine.diagnostic_test ,Dementia with Lewy bodies ,Parkinsonism ,Amnesia ,Disease ,Electroencephalography ,medicine.disease ,03 medical and health sciences ,Psychiatry and Mental health ,Epilepsy ,0302 clinical medicine ,Transient epileptic amnesia ,mental disorders ,medicine ,Dementia ,030212 general & internal medicine ,Geriatrics and Gerontology ,medicine.symptom ,Psychiatry ,Psychology ,Gerontology ,030217 neurology & neurosurgery - Abstract
Epilepsy with the main symptom of amnesia is known as transient epileptic amnesia (TEA). Dementia with Lewy bodies (DLB) is the second most common form of neurodegenerative dementia. The concept that Lewy body disease includes Parkinson's disease with dementia and dementia with Lewy bodies was proposed in the 2005 revision of the Clinical Diagnostic Criteria. Here, we describe a woman with cognitive impairment, olfactory dysfunction, and reduced 123 I-meta-iodobenzylguanidine uptake on myocardial scintigraphy. The patient and her family and friends were unaware of parkinsonism, visual hallucinations, or epilepsy for a long period. After syncope occurred twice within a short interval, electroencephalography revealed sharp waves from the bilateral frontal to parietal lobes, indicating a diagnosis of TEA. The present case prompted us to compare the symptoms of TEA with the clinical diagnostic criteria for dementia with Lewy bodies, revealing their similarities. We also discuss whether Lewy body disease may cause TEA rather than having an incidental association with it.
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- 2016
15. TOPOLOGY OPTIMIZATION OF FRAME STRUCTURES USING ESO METHOD AND GROUND STRUCTURE METHOD
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Daiji Fujii, Kenji Kosaka, and Shinya Matsumoto
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Computer science ,Architecture ,Frame (networking) ,Topology optimization ,0211 other engineering and technologies ,Structure (category theory) ,020101 civil engineering ,02 engineering and technology ,Building and Construction ,Topology ,021106 design practice & management ,0201 civil engineering - Published
- 2016
16. Pretreatment Cognitive Profile Likely to Benefit from Donepezil Treatment in Dementia with Lewy Bodies: Pooled Analyses of Two Randomized Controlled Trials
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Hideaki Miyagishi, Kenji Kosaka, Manabu Ikeda, Masaki Nakagawa, and Etsuro Mori
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Lewy Body Disease ,Male ,medicine.medical_specialty ,Cognitive Neuroscience ,Placebo ,01 natural sciences ,law.invention ,010104 statistics & probability ,03 medical and health sciences ,Cognition ,0302 clinical medicine ,Piperidines ,Randomized controlled trial ,law ,Internal medicine ,mental disorders ,medicine ,Humans ,Dementia ,Donepezil ,0101 mathematics ,Cognitive impairment ,Psychiatry ,Nootropic Agents ,Aged ,Randomized Controlled Trials as Topic ,Mini–Mental State Examination ,medicine.diagnostic_test ,Dementia with Lewy bodies ,Mental Status and Dementia Tests ,medicine.disease ,Psychiatry and Mental health ,Treatment Outcome ,Indans ,Mental Recall ,Female ,Drug Monitoring ,Geriatrics and Gerontology ,Psychology ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Background/Aims: Based on Mini-Mental State Examination (MMSE) subitem scores, in dementia with Lewy bodies (DLB), we aimed to delineate features of cognitive impairment, identify cognitive domains improved by donepezil, and define a pretreatment cognitive profile likely to benefit from donepezil. Methods: Pooled data were used from two randomized controlled trials of donepezil in DLB (n = 235). Baseline MMSE subitem scores were calculated for all patients. Mean changes in subitem scores at week 12 were compared between the placebo and the active group. Finally, the subgroup identification based on differential effect search (SIDES) method was applied. Results: Baseline subitem scores were relatively low for serial 7's, delayed recall, and copying. Significant improvement by donepezil was found for orientation, serial 7's, repetition, 3-step command, and copying. The subgroup with pretreatment scores of serial 7's = 1, 2, or 3, delayed recall ≥1, and copying = 0 were the best responders. MMSE change in subgroups increased as more of these three conditions were fulfilled. Conclusion: Cognitive domains characteristically impaired in DLB are particularly improved by donepezil. The number of fulfilled conditions for serial 7's = 1, 2, or 3, delayed recall ≥1, and copying = 0 (likely to benefit score) may predict the response to donepezil in DLB patients.
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- 2016
17. Diffuse neurofibrillary tangles with calcification (Kosaka-Shibayama disease) in Japan
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Katsuyuki Ukai and Kenji Kosaka
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0301 basic medicine ,Pathology ,medicine.medical_specialty ,business.industry ,General Neuroscience ,Kosaka-Shibayama Disease ,General Medicine ,medicine.disease ,03 medical and health sciences ,Psychiatry and Mental health ,030104 developmental biology ,0302 clinical medicine ,Neurology ,medicine ,Dementia ,Neurology (clinical) ,Fahr's disease ,business ,030217 neurology & neurosurgery ,Calcification - Abstract
Diffuse neurofibrillary tangles with calcification (DNTC) is a rare, pre-senile type of dementia. The term 'DNTC' was initially proposed by Kosaka in 1994. Although 26 autopsies and 21 clinical patients with DNTC have been described in Japan to date, DNTC has rarely been reported in the European and North American published work. We speculate that DNTC has been overlooked in other countries. Herein, we review all known reports of DNTC in Japan and propose clinical diagnostic criteria for DNTC.
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- 2015
18. Increased dosage of donepezil for the management of behavioural and psychological symptoms of dementia in dementia with Lewy bodies
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Katsuo Yamanaka, Kenji Kosaka, Yuta Manabe, and Ino T
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medicine.medical_specialty ,030214 geriatrics ,Exacerbation ,Dementia with Lewy bodies ,medicine.disease ,Irritability ,Euphoriant ,03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,Internal medicine ,mental disorders ,medicine ,Dementia ,Anxiety ,Geriatrics and Gerontology ,medicine.symptom ,Psychiatry ,Psychology ,Adverse effect ,Donepezil ,Gerontology ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Background As with other types of dementia, the behavioral and psychological symptoms of dementia (BPSD) can make caregiving difficult for patients with dementia with Lewy bodies (DLB). We hypothesized that administration of donepezil at an increased dose of 10 mg/day might dose-dependently improve BPSD in DLB patients with relapse, after their symptoms had been controlled initially by donepezil therapy at the standard dose. Methods The present study was as an open-label trial. We enrolled 24 patients with DLB (diagnosed according to the Consortium on Dementia with Lewy Bodies Guideline-Revised) who experienced a relapse of BPSD despite treatment with donepezil at the standard dose (5 mg/day). The donepezil dose for these patients was increased to 10 mg/day, and we evaluated the efficacy and safety of this dose escalation strategy. Results The Neuropsychiatric Inventory (NPI) scores for BPSD showed statistically significant improvements as a result of the increased dosage, except those for anxiety and euphoria, disinhibition, irritability/lability. High-dose donepezil therapy caused gastrointestinal symptoms in 4 patients, but there were no life-threatening adverse events, such as arrhythmias, or no exacerbation of parkinsonian symptoms. Conclusions We found that donepezil dose-dependently improved relapsing BPSD in these patients. Therefore, increasing the dosage of donepezil is a safe and effective treatment for patients with DLB who experience a relapse of BPSD.
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- 2015
19. Effects of Donepezil on Extrapyramidal Symptoms in Patients with Dementia with Lewy Bodies: A Secondary Pooled Analysis of Two Randomized-Controlled and Two Open-Label Long-Term Extension Studies
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Manabu Ikeda, Kenji Kosaka, Etsuro Mori, Masaki Nakagawa, Hideaki Miyagishi, and Hideo Yamaguchi
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Lewy Body Disease ,Male ,medicine.medical_specialty ,Parkinson's disease ,Cognitive Neuroscience ,Datasets as Topic ,Neuropsychological Tests ,law.invention ,Piperidines ,Randomized controlled trial ,Extrapyramidal symptoms ,law ,Internal medicine ,mental disorders ,Humans ,Medicine ,Dementia ,Donepezil ,In patient ,Longitudinal Studies ,Psychiatry ,Aged ,Aged, 80 and over ,business.industry ,Dementia with Lewy bodies ,medicine.disease ,Clinical trial ,Psychiatry and Mental health ,Logistic Models ,Indans ,Disease Progression ,Female ,Cholinesterase Inhibitors ,Geriatrics and Gerontology ,medicine.symptom ,business ,medicine.drug - Abstract
Background/Aims: The aim of this study was to clarify the effects of donepezil on extrapyramidal symptoms in patients with dementia with Lewy bodies (DLB). Methods: Using pooled datasets from phase 2 and 3, 12-week randomized, placebo-controlled trials (RCT, n = 281) and 52-week open-label long-term extension trials (OLE, n = 241) of donepezil in DLB, the effects of donepezil on the incidence of extrapyramidal adverse events (AEs) and on the Unified Parkinson's Disease Rating Scale (UPDRS) part III were assessed, and potential baseline factors affecting the AEs were explored. Results: The RCT analysis did not show significant differences between the placebo and active (3, 5, and 10 mg donepezil) groups in extrapyramidal AE incidence (3.8 and 6.5%, p = 0.569) and change in the UPDRS (mean ± SD: -0.2 ± 4.3 and -0.6 ± 6.5, p = 0.562). In the OLE analysis (5 and 10 mg donepezil), the incidence did not increase chronologically; all AEs leading to a dose reduction or discontinuation except one were relieved. The UPDRS was unchanged for 52 weeks. An exploratory multivariate logistic regression analysis of the RCTs revealed that donepezil treatment was not a significant factor affecting the AEs. Baseline severity of parkinsonism was a predisposing factor for worsening of parkinsonism without significant interactions between donepezil and baseline severity. Conclusion: DLB can safely be treated with donepezil without relevant worsening of extrapyramidal symptoms, but treatment requires careful attention to symptom progression when administered to patients with relatively severe parkinsonism.
- Published
- 2015
20. An autopsied case of corticobasal degeneration showing severe cerebral atrophy over a protracted disease course of 16 years
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Masato Hosokawa, Hiroaki Hino, Kiyoshi Sato, Koshiro Fujisawa, Yoshio Hirayasu, Daizo Kondo, Heii Arai, Tetsuaki Arai, Eizo Iseki, Katsuhiko Shibuya, Ryoko Yamamoto, Michiko Minegishi, Kenji Kosaka, and Koji Kasanuki
- Subjects
Cerebral atrophy ,Pathology ,medicine.medical_specialty ,business.industry ,General Medicine ,medicine.disease ,Pathology and Forensic Medicine ,Temporal lobe ,White matter ,Atrophy ,medicine.anatomical_structure ,nervous system ,Frontal lobe ,Gliosis ,Cerebral cortex ,mental disorders ,medicine ,Corticobasal degeneration ,Neurology (clinical) ,medicine.symptom ,business - Abstract
The patient was a 72-year-old Japanese woman. At the age of 57, she started having difficulty performing daily work and developed agraphia. She also exhibited restlessness and loss of interest, and began to speak less. Thereafter, stereotypical behavior, gait disturbance and dysphagia were noted. CT scan demonstrated left-dominant frontal and temporal lobe atrophy. She died at the age of 72, about 16 years after the onset of symptoms. Neuropathologically, the brain weighed 867 g, and showed remarkable cerebral atrophy with degeneration of the white matter, predominantly in the left dorsal frontal lobe and anterior temporal lobe. Microscopically, severe neuronal loss and gliosis with rarefaction were found in the cerebral cortex, and severe destruction of myelin and axons was observed in the cerebral white matter. Moderate neuronal loss with gliosis was also found in the pallidum and substantia nigra. Gallyas-Braak staining and tau immunostaining revealed pretangle neurons, NFTs, ballooned neurons and astrocytic plaques in the cerebral cortex, subcortical nuclei and brainstem, and argyrophilic threads and coiled bodies in the subcortical white matter. Tau isoform-specific immunostaining revealed that most tau-immunoreactive structures were positive for 4-repeat (4R) tau, but some of the NFTs were positive for 3-repeat (3R) tau in the cerebral neocortex. Immunoblotting demonstrated an accumulation of 4R tau in the cerebral cortex and subcortical white matter. The patient was pathologically diagnosed as having corticobasal degeneration. Her long survival course likely accounts for the severe white matter degeneration and accumulation of 3R tau in NFTs.
- Published
- 2014
21. Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium
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Etsuro Mori, Daniel Weintraub, Pietro Tiraboschi, Bradley F. Boeve, David J. Burn, Masahito Yamada, Debby W. Tsuang, Glenda M. Halliday, David P. Salmon, Omar M. A. El-Agnaf, James B. Leverenz, Pamela J. McLean, Melissa E. Murray, Owen A. Ross, Stephen N. Gomperts, Kenji Kosaka, Laura Bonanni, Simon J.G. Lewis, Alan Thomas, Lawrence S. Honig, Ashley Bayston, Dennis W. Dickson, Daniel I. Kaufer, Nicolaas Bohnen, John E. Duda, Ronald B. Postuma, Jon B. Toledo, Zuzana Walker, Dag Aarsland, Jose Bras, Andrew B. Singleton, Johannes Attems, Tanis J. Ferman, Alice Chen-Plotkin, Virginia M.Y. Lee, Carol F. Lippa, John T. O'Brien, Thomas G. Beach, Alex Iranzo, Hiroshige Fujishiro, Angela Lunde, Frédéric Blanc, Dominic Ffytche, Ian G. McKeith, Clive Ballard, James E. Galvin, Patrik Brundin, Angela Taylor, Emilio Moreno, Brit Mollenhauer, Thomas J. Montine, Neill R. Graff-Radford, M Masellis, Shankar Ramaswamy, Jennifer G. Goldman, Eliezer Masliah, John Q. Trojanowski, Howard Feldman, Sotoshi Orimo, Douglas Galasko, John-Paul Taylor, Kejal Kantarci, Walter Kukull, O'Brien, John [0000-0002-0837-5080], Apollo - University of Cambridge Repository, Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie (ICube), École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Université de Strasbourg (UNISTRA)-Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Les Hôpitaux Universitaires de Strasbourg (HUS)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, and Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS)
- Subjects
0301 basic medicine ,Lewy Body Disease ,medicine.medical_specialty ,Sciences du Vivant [q-bio]/Neurosciences [q-bio.NC] ,Consensus ,[SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging ,Clinical Sciences ,Disease ,REM sleep behavior disorder ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Neuroimaging ,Randomized controlled trial ,law ,mental disorders ,medicine ,Humans ,Intensive care medicine ,Psychiatry ,Neurology & Neurosurgery ,Views & Reviews ,Dementia with Lewy bodies ,business.industry ,Neurosciences ,medicine.disease ,3. Good health ,Clinical trial ,030104 developmental biology ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,Practice Guidelines as Topic ,[SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] ,Cognitive Sciences ,Dementia ,Lewy Bodies ,Neurology (clinical) ,Alzheimer's disease ,business ,Neurocognitive ,030217 neurology & neurosurgery ,Biomarkers - Abstract
The Dementia with Lewy Bodies (DLB) Consortium has refined its recommendations about the clinical and pathologic diagnosis of DLB, updating the previous report, which has been in widespread use for the last decade. The revised DLB consensus criteria now distinguish clearly between clinical features and diagnostic biomarkers, and give guidance about optimal methods to establish and interpret these. Substantial new information has been incorporated about previously reported aspects of DLB, with increased diagnostic weighting given to REM sleep behavior disorder and 123iodine-metaiodobenzylguanidine (MIBG) myocardial scintigraphy. The diagnostic role of other neuroimaging, electrophysiologic, and laboratory investigations is also described. Minor modifications to pathologic methods and criteria are recommended to take account of Alzheimer disease neuropathologic change, to add previously omitted Lewy-related pathology categories, and to include assessments for substantia nigra neuronal loss. Recommendations about clinical management are largely based upon expert opinion since randomized controlled trials in DLB are few. Substantial progress has been made since the previous report in the detection and recognition of DLB as a common and important clinical disorder. During that period it has been incorporated into DSM-5, as major neurocognitive disorder with Lewy bodies. There remains a pressing need to understand the underlying neurobiology and pathophysiology of DLB, to develop and deliver clinical trials with both symptomatic and disease-modifying agents, and to help patients and carers worldwide to inform themselves about the disease, its prognosis, best available treatments, ongoing research, and how to get adequate support.
- Published
- 2017
22. Adjunct zonisamide to levodopa for DLB parkinsonism: A randomized double-blind phase 2 study
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Kenji Kosaka, Toshinari Odawara, Masatoshi Nakamura, Kazuko Hasegawa, Sayaka Iiyama, Miho Murata, and Masaaki Tagawa
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0301 basic medicine ,Lewy Body Disease ,Male ,medicine.medical_specialty ,Zonisamide ,Placebo ,Severity of Illness Index ,law.invention ,Antiparkinson Agents ,Levodopa ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Double-Blind Method ,law ,Internal medicine ,Severity of illness ,medicine ,Clinical endpoint ,Dementia ,Humans ,Adverse effect ,Aged ,Aged, 80 and over ,business.industry ,Parkinsonism ,Middle Aged ,medicine.disease ,030104 developmental biology ,Treatment Outcome ,Drug Therapy, Combination ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
ObjectiveTo investigate the efficacy and safety of zonisamide as an adjunct to levodopa therapy for parkinsonism in patients with dementia with Lewy bodies (DLB).MethodsThis phase 2, placebo-controlled, randomized, double-blind study consisted of run-in (placebo, 4 weeks) and treatment (placebo or zonisamide 25 or 50 mg once daily, 12 weeks) periods. Outpatients diagnosed with probable DLB were eligible for inclusion. The primary endpoint was the change from baseline in Unified Parkinson's Disease Rating Scale (UPDRS) part 3 total score at week 12. Cognitive function, behavioral and psychological symptoms of dementia (BPSD), caregiver burden, other UPDRS parts as secondary endpoints, and safety were also assessed.ResultsOverall, 158 patients with DLB received the study drug; 21 discontinued during treatment and 137 completed treatment. Improvement in UPDRS part 3 total score at week 12 was significantly greater in the zonisamide 50 mg group compared with placebo (between-group difference −4.1; 95% confidence interval −6.8 to −1.4; p = 0.003). Zonisamide did not worsen cognitive function, BPSD, or caregiver burden. The overall incidence of adverse events was higher in the zonisamide 50 mg than the 25 mg and placebo groups (65.3%, 43.1%, and 50.0%, respectively); similar rates of serious adverse events were observed among all groups.ConclusionZonisamide (adjunctive to levodopa) improved parkinsonism accompanying DLB without worsening cognitive function or psychiatric symptoms.Clinical trial registrationJapicCTI-122040.Classification of evidenceThis study provides Class I evidence that zonisamide (adjunctive to levodopa) improves parkinsonism and is well-tolerated in patients with DLB.
- Published
- 2017
23. Dementia with Lewy Bodies
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Takashi Togo, Eizo Iseki, Kenji Kosaka, and Omi Katsuse
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0301 basic medicine ,medicine.medical_specialty ,business.industry ,Dementia with Lewy bodies ,education ,Disease ,medicine.disease ,nervous system diseases ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,mental disorders ,medicine ,Psychiatry ,Lewy body disease ,business ,Vascular dementia ,Pathological ,030217 neurology & neurosurgery - Abstract
"Dementia with Lewy bodies (DLB)" was proposed at the first international workshop in 1995. It has received much attention since we had proposed "Lewy body disease" in 1980 and "diffuse Lewy body disease" in 1984. In the CDLB guidelines, which were reported in 1996, the clinical and pathological diagnostic criteria for DLB were shown for the first time. At present, DLB as well as Alzheimer's disease (AD) and vascular dementia (VD) are known as the three major dementing illnesses. The second international workshop was held in 1998, and the third in 2003. One of the authors, K. Kosaka, presented a paper on DLB at each international workshop, based on series of our papers which we had reported since 1976. The revised CDLB guidelines will be reported soon. In addition, the fourth international workshop on DLB will be held by Kosaka in Yokohama in 2007. In this article, we review the history, the clinical, therapeutic, neuropathological, neurochemical and molecular biological issues, based on our previous papers and other important reports on DLB.
- Published
- 2017
24. A Paradox of Economic Growth and Relative Deprivation
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Kenji Kosaka, Hiroshi Hamada, and Atsushi Ishida
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Algebra and Number Theory ,Index (economics) ,Sociology and Political Science ,Gini coefficient ,Inequality ,Public economics ,media_common.quotation_subject ,Neoclassical economics ,medicine.disease_cause ,Economics ,medicine ,Subjective well-being ,Relative deprivation ,Social Sciences (miscellaneous) ,media_common - Abstract
Rapid economic growth sometimes intensifies people's frustration. In this article, we attempt to formulate this kind of paradox of economic growth, and to explain theoretically how economic growth increases people's dissatisfaction by way of the notion of relative deprivation by employing the theoretical framework of Yitzhaki's relative deprivation index. We introduce the problem of the China puzzle as the latest case of the paradox. Then, we introduce the definition of Yitzhaki's index of relative deprivation, and use this to explain the China puzzle. Besides, through a theoretical examination of Yitzhaki's index, we propose a proposition proving that an increase of relative deprivation in the society can occur even when the amount of wealth increases and the degree of inequality reduces.
- Published
- 2014
25. Latest concept of Lewy body disease
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Kenji Kosaka
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Parkinson's disease ,Lewy body ,Dementia with Lewy bodies ,business.industry ,General Neuroscience ,General Medicine ,medicine.disease ,Psychiatry and Mental health ,Neurology ,Distribution pattern ,medicine ,Diffuse type ,Dementia ,Neurology (clinical) ,Lewy body disease ,business ,Neuroscience ,hormones, hormone substitutes, and hormone antagonists - Abstract
We proposed the term 'Lewy body disease' (LBD) in 1980. Subsequently, we classified LBD into three types according to the distribution pattern of Lewy bodies: a brainstem type, a transitional type and a diffuse type. Later, we added the cerebral type. As we have proposed since 1980, LBD has recently been used as a generic term, including Parkinson's disease, Parkinson's disease with dementia and dementia with Lewy bodies. LBD has neuropathological characteristics whereby numerous Lewy bodies are present in the central and sympathetic nervous systems, and it is a type of alpha-synucleinopathy because the main component of Lewy body is alpha-synuclein. In this paper we explain the most recent concept of LBD from the historical viewpoint.
- Published
- 2014
26. A Theory of Relative Deprivation Revisited (11)
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Kenji, Kosaka
- Published
- 2014
27. Autopsy case of concurrent Huntington's disease and neurofibromatosis type 1
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Daisuke Isojima, Ito Kawakami, Takashi Togo, Eizo Iseki, Daizo Kondo, Naoya Aoki, Haruhiko Akiyama, Kyoko Suzuki, Yoshio Hirayasu, Kenji Kosaka, and Omi Katsuse
- Subjects
congenital, hereditary, and neonatal diseases and abnormalities ,Spastic gait ,Pathology ,medicine.medical_specialty ,Cerebellum ,Central nervous system ,medicine.disease ,Irritability ,nervous system diseases ,Psychiatry and Mental health ,medicine.anatomical_structure ,Atrophy ,Huntington's disease ,Cerebral cortex ,medicine ,Geriatrics and Gerontology ,medicine.symptom ,Neurofibromatosis ,Psychology ,Gerontology - Abstract
We report here an autopsy case of concurrent Huntington's disease (HD) and neurofibromatosis type 1 (NF1), also known as von Recklinghausen's disease. The patient was a Japanese woman with a significant hereditary burden: seven of her family members within four generations were affected by either NF1 or concurrent HD and NF1. She was diagnosed as having NF1 at age 24. At age 40, she showed signs of irritability, aggressive and childish behaviour, which became progressively worse. At age 48, rigidity and spastic gait were observed. One year later, choreoathetoid involuntary movements became apparent. Diagnosis of HD was made by identification of the abnormally expanded cytosine-adenine-guanine repeats in the Huntington's disease gene. Her condition deteriorated gradually to an apallic state and she died at age 60. Post-mortem examination revealed extensive brain atrophy, which was particularly severe in the frontal and temporal cortices and the striatum. The degree of neurodegenerative change seemed to correspond to grade IV. Polyglutamine positive inclusions were seen frequently in all layers of the cerebral cortex and in the amygdala and hippocampus. Inclusions were also present in the striatum, but there were fewer than in the cortex. Remarkably, neuronal intranuclear inclusions were present in the cerebellum, although they are usually not seen in HD. Features associated with the central nervous system involvement of NF1 were not found in the brain, but HD pathology might have been accelerated by the concurrence of NF1. This is the third report of a case with concurrent HD and NF1 in the world, and the first study in which occurrence of polyglutamine inclusions was confirmed on post-mortem examination.
- Published
- 2014
28. Lewy body disease and dementia with Lewy bodies
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Kenji Kosaka
- Subjects
Lewy Body Disease ,Pathology ,medicine.medical_specialty ,General Physics and Astronomy ,Review ,History, 21st Century ,mental disorders ,medicine ,Dementia ,Diffuse type ,Animals ,Humans ,History of Medicine ,dementia with Lewy bodies (DLB) ,Dementia with Lewy bodies ,Parkinson’s disease with dementia (PDD) ,diffuse Lewy body disease (DLBD) ,History, 19th Century ,General Medicine ,History, 20th Century ,medicine.disease ,Parkinson’s disease (PD) ,Lewy body disease (LBD) ,Distribution pattern ,General Agricultural and Biological Sciences ,Psychology ,Lewy body disease ,Neuroscience ,hormones, hormone substitutes, and hormone antagonists - Abstract
In 1976 we reported our first autopsied case with diffuse Lewy body disease (DLBD), the term of which we proposed in 1984. We also proposed the term “Lewy body disease” (LBD) in1980. Subsequently, we classified LBD into three types according to the distribution pattern of Lewy bodies: a brain stem type, a transitional type and a diffuse type. Later, we added the cerebral type. As we have proposed since 1980, LBD has recently been used as a generic term to include Parkinson’s disease (PD), Parkinson’s disease with dementia (PDD) and dementia with Lewy bodies (DLB), which was proposed in 1996 on the basis of our reports of DLBD. DLB is now known to be the second most frequent dementia following Alzheimer’s disease (AD). In this paper we introduce our studies of DLBD and LBD.
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- 2014
29. History and Latest Concepts of Lewy Body Disease and Dementia with Lewy Bodies
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Kenji Kosaka
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Pathology ,medicine.medical_specialty ,Parkinson's disease ,business.industry ,Dementia with Lewy bodies ,Disease ,medicine.disease ,nervous system diseases ,Distribution pattern ,mental disorders ,medicine ,Diffuse type ,Dementia ,business ,Lewy body disease ,hormones, hormone substitutes, and hormone antagonists - Abstract
We proposed the term “Lewy body disease” (LBD) in 1980. Subsequently, we classified LBD into three types according to the distribution pattern of Lewy bodies: a brain stem type, a transitional type, and a diffuse type. Later, we added the cerebral type. As we have proposed since 1980, LBD has recently been used as a generic term including Parkinson’s disease (PD), Parkinson’s disease with dementia (PDD), and dementia with Lewy bodies (DLB).
- Published
- 2016
30. Behavioral and Psychological Symptoms of Dementia
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Yuta Manabe and Kenji Kosaka
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medicine.medical_specialty ,genetic structures ,business.industry ,Dementia with Lewy bodies ,Parkinsonism ,Eye movement ,Cognition ,medicine.disease ,behavioral disciplines and activities ,Visual Hallucination ,nervous system diseases ,nervous system ,Delusion ,mental disorders ,medicine ,Dementia ,medicine.symptom ,Psychiatry ,business ,Depression (differential diagnoses) - Abstract
Behavioral and psychological symptoms of dementia (BPSD) are observed in all forms of dementia. We discuss representative forms of BPSD such as hallucination and delusion, depression, and rapid eye movement (REM) sleep behavior disorder (RBD) observed in patients with dementia with Lewy bodies (DLB). The most representative BPSD for DLB is visual hallucination. McKeith et al. reported that 80 % of DLB cases involved visual hallucination. Delusions occur more frequently in DLB, compared with Alzheimer’s disease (AD). These in the patients with DLB are characterized by delusional misidentification either as a continuation of visual hallucinations or related to delusions resulting from visual misidentification of places, people, or surroundings. Depression is one of the first symptoms of DLB and is listed in the CDLB guidelines as one of the supportive features. One suggestive sign of DLB is rapid eye movement (REM) sleep behavior disorder (RBD), which is significantly more common in the patients with DLB than other forms of neurodegenerative dementia. RBD also occurs earlier than cognitive dysfunction and primary core symptoms such as parkinsonism and visual hallucination.
- Published
- 2016
31. Dementia with Lewy Bodies : Clinical and Biological Aspects
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Kenji Kosaka and Kenji Kosaka
- Subjects
- Lewy body dementia
- Abstract
This book describes biological and clinical aspects of dementia with Lewy bodies (DLB), one of the most common types of progressive dementia, although in most cases the cause is unknown. The editor has made a major contribution to the understanding of the disease since he first reported DLB in 1976. Written by renowned experts in the field, the book discusses not only diagnostic criteria and clinical symptoms of DLB but also various imaging modalities and biological markers such as alpha-synuclein, which are useful for diagnosis of DLB. Dementia with Lewy Bodies is aimed at psychiatrists, neurologists, and researchers who are interested in DLB.
- Published
- 2016
32. A Theory of Relative Deprivation Revisited (10)
- Author
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Kenji, Kosaka
- Published
- 2013
33. Prediction of outcomes in MCI with 123I-IMP-CBF SPECT: a multicenter prospective cohort study
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Toshimitsu Momose, Satoru Mori, Haruo Hanyu, Yoshiharu Yonekura, Kazuo Hashikawa, Tatsuo Yamada, Yoshitaka Uchida, Kazunari Ishii, Kenichi Meguro, Hidenao Fukuyama, Hiroshi Matsuda, Takashi Asada, Jun Hatazawa, Shin Kitamura, Kengo Ito, Seigo Nakano, Yukihiko Washimi, Etsuro Mori, Yasuo Kuwabara, Satoshi Minoshima, and Kenji Kosaka
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Male ,Pediatrics ,medicine.medical_specialty ,123i imp ,Cohort Studies ,mental disorders ,medicine ,Image Processing, Computer-Assisted ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Cognitive Dysfunction ,Prospective study ,Cognitive impairment ,Prospective cohort study ,Aged ,Tomography, Emission-Computed, Single-Photon ,business.industry ,Mild cognitive impairment ,Cognition ,General Medicine ,Cerebral blood flow ,Iofetamine ,Prognosis ,Surgery ,Clinical trial ,Logistic Models ,Radiology Nuclear Medicine and imaging ,SPECT ,Cerebrovascular Circulation ,Original Article ,Female ,business ,Alzheimer’s disease ,Cohort study - Abstract
Objective The multicenter prospective cohort study (Japan Cooperative SPECT Study on Assessment of Mild Impairment of Cognitive Function: J-COSMIC) aimed to examine the value of 123I-N-isopropyl-4-iodoamphetamine cerebral blood flow (IMP-CBF) SPECT in regards to early diagnosis of Alzheimer’s disease (AD) in patients with mild cognitive impairment (MCI). Methods Three hundred and nineteen patients with amnestic MCI at 41 participating institutions each underwent clinical and neuropsychological examinations and 123I-IMP-CBF SPECT at baseline. Subjects were followed up periodically for 3 years, and progression to dementia was evaluated. SPECT images were classified as AD/DLB (dementia with Lewy bodies) pattern and non-AD/DLB pattern by central image interpretation and automated region of interest (ROI) analysis, respectively. Logistic regression analyses were used to assess whether baseline 123I-IMP-CBF SPECT was predictive of longitudinal clinical outcome. Results Ninety-nine of 216 amnestic MCI patients (excluding 3 cases with epilepsy (n = 2) or hydrocephalus (n = 1) and 100 cases with incomplete follow-up) converted to AD within the observation period. Central image interpretation and automated ROI analysis predicted conversion to AD with 56 and 58 % overall diagnostic accuracy (sensitivity, 76 and 81 %; specificity, 39 and 37 %), respectively. Multivariate logistic regression analysis identified SPECT as a predictor, which distinguished AD converters from non-converters. The odds ratio for a positive SPECT to predict conversion to AD with automated ROI analysis was 2.5 and combining SPECT data with gender and mini-mental state examination (MMSE) further improved classification (joint odds ratio 20.08). Conclusions 123I-IMP-CBF SPECT with both automated ROI analysis and central image interpretation was sensitive but relatively nonspecific for prediction of clinical outcome during the 3-year follow-up in individual amnestic MCI patients. A combination of statistically significant predictors, both SPECT with automated ROI analysis and neuropsychological evaluation, may increase predictive utility.
- Published
- 2013
34. A Theory of Relative Deprivation Revisited (9)
- Author
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Kenji, Kosaka
- Published
- 2013
35. Improvement in delusions and hallucinations in patients with dementia with Lewy bodies upon administration of yokukansan, a traditional Japanese medicine
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Mitsuhiro Yoshita, Michio Kitayama, Koh Iwasaki, Shinji Ouma, Aya Kanamori, Shin Takayama, Kenji Kosaka, Nobuo Ito, Hideo Mori, Seigo Nakano, Toru Kinoshita, Katsutoshi Furukawa, Ryuji Fukuhara, Reina Okitsu, Kenji Wada, Mamoru Hashimoto, Jun Horiguchi, Yuta Manabe, and Shuhei Yamaguchi
- Subjects
medicine.medical_specialty ,Exacerbation ,Dementia with Lewy bodies ,Nausea ,Yokukansan ,Caregiver burden ,medicine.disease ,Psychiatry and Mental health ,Extrapyramidal symptoms ,Internal medicine ,medicine ,Dementia ,Geriatrics and Gerontology ,medicine.symptom ,Adverse effect ,Psychology ,Psychiatry ,Gerontology - Abstract
Background: This multicentre open-label trial examined the efficacy and safety of the traditional Japanese medicine, or Kampo medicine, yokukansan (YKS), for behavioural and psychological symptoms of dementia (BPSD) in patients with dementia with Lewy bodies. Methods: Sixty-three dementia with Lewy bodies patients with probable BPSD (M : W, 30 : 33; mean age, 78.2 ± 5.8 years) were enrolled and treated with YKS for 4 weeks. Results: Significant improvements in Neuropsychiatric Inventory scores (mean decrease, 12.5 points; P < 0.001) and Zarit Burden Interview-Japanese edition tests (mean decrease, 3.6 points; P= 0.024) were observed. In patients who consented to an assessment after 2 weeks of treatment, a time-dependent significant improvement was observed in the Neuropsychiatric Inventory score (n= 23; mean decrease, 14.4; P < 0.001), each subscale, including delusions and hallucinations, the Zarit Burden Interview-Japanese edition (n= 22; mean decrease, 8.2; P < 0.01) and the behavioural pathology in Alzheimer's disease insomnia subscale. The Mini-Mental State Examination and the Disability Assessment for Dementia (DAD) showed no significant change. Adverse events were observed in 11 (18%) patients. Three patients (5%) discontinued YKS due to adverse reactions, namely, spasticity and exacerbation of BPSD, edema, and nausea. Hypokalaemia (
- Published
- 2012
36. Response to 'Challenging the concept of diffuse neurofibrillary tangles with calcification (Kosaka-Shibayama disease)'
- Author
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Kenji, Kosaka
- Subjects
Diffuse Neurofibrillary Tangles with Calcification ,Humans - Published
- 2016
37. 123I-metaiodobenzylguanidine myocardial scintigraphy with early images alone is useful for the differential diagnosis of dementia with Lewy bodies
- Author
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Kenji Kosaka, Hiroshi Toyama, Yuta Manabe, and Yoshitaka Inui
- Subjects
Lewy Body Disease ,Male ,Pathology ,medicine.medical_specialty ,Parkinson's disease ,Neuroscience (miscellaneous) ,behavioral disciplines and activities ,Sensitivity and Specificity ,030218 nuclear medicine & medical imaging ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Myocardial scintigraphy ,Alzheimer Disease ,mental disorders ,medicine ,Dementia ,Humans ,Radiology, Nuclear Medicine and imaging ,Aged ,Aged, 80 and over ,Dementia with Lewy bodies ,123i mibg ,Area under the curve ,Myocardial Perfusion Imaging ,Mediastinum ,Heart ,Middle Aged ,medicine.disease ,nervous system diseases ,Psychiatry and Mental health ,3-Iodobenzylguanidine ,medicine.anatomical_structure ,nervous system ,Female ,Radiology ,Differential diagnosis ,Radiopharmaceuticals ,Psychology ,030217 neurology & neurosurgery - Abstract
123I-metaiodobenzylguanidine cardiac scintigraphy (MIBG) is a useful imaging technique for the diagnosis of dementia with Lewy bodies (DLB). However, MIBG has a serious disadvantage in that it demands a long examination time. The objective of this study was to evaluate statistically the usefulness of the heart/mediastinum ratio (H/M) from the early phase of MIBG for the differential diagnosis of DLB. In total, 113 patients were examined, including 32 non-DLB (19 with Alzheimer's dementia) and 79 DLB patients. The mean early-H/M ratio was 2.83 in the non-DLB group and 1.95 in the DLB group. The mean delayed-H/M ratio was 3.0 in the non-DLB group and 1.76 in the DLB group. With a cutoff point of 2.27 on early images, the sensitivity, specificity, and diagnostic accuracy were 65%, 94%, and 73%, respectively, and the area under the curve was 0.82, indicating moderate accuracy. This analysis indicates that images from the early phase of MIBG alone are sufficient for the differential diagnosis of Alzheimer's disease and DLB.
- Published
- 2016
38. Psychiatric symptoms typical of patients with dementia with Lewy bodies - similarity to those of levodopa-induced psychosis
- Author
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Eizo Iseki, Kenji Kosaka, Namiko Nihashi, and Wami Marui
- Subjects
Psychosis ,Levodopa ,medicine.medical_specialty ,Dementia with Lewy bodies ,Reduplicative paramnesia ,Dopaminergic ,medicine.disease ,Visual Hallucination ,Psychiatry and Mental health ,nervous system ,Delusion ,medicine ,medicine.symptom ,Psychology ,Occipital lobe ,Psychiatry ,Neuroscience ,Biological Psychiatry ,medicine.drug - Abstract
We examined psychiatric symptoms in eight cases with dementia with Lewy bodies (DLB), which included visual hallucination of persons or small animals, visual illusion, metamorphosia, leibhaftige Bewusstheit, personal or topographical misidentification, Capgras' syndrome and reduplicative paramnesia as well as depressive state and delusion of persecution. These psychiatric symptoms are identical to those of levodopa-induced psychosis, although these symptoms appeared before medication with anti-Parkinson drugs. The hypersensitivity of the dopamine receptor in the meso-limbic dopaminergic system has been presumed in levodopa-induced psychosis. We previously showed disturbance of the nigro-amygdaloid dopaminergic connections in DLB brains on pathological studies. Hypoperfusion or glucose hypometabolism in the occipital lobe has been demonstrated in DLB patients using SPECT or PET. The amygdala has reciprocal connections with the visual cortex in the occipital lobe. From these findings, it is supposed that the disturbance of the nigro-amygdaloid connections induces hypersensitivity of the dopamine receptor in the amygdala, causing psychiatric symptoms with dysfunction of the visuo-amygdaloid connections.
- Published
- 2016
39. A Theory of Relative Deprivation Revisited (8) : A digression on J. Davies’s J-curve theory
- Author
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Kenji, Kosaka
- Published
- 2012
40. A Theory of Relative Deprivation Revisited (7)
- Author
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Kenji, Kosaka
- Published
- 2012
41. Prospects of Mathematical Sociology
- Author
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Kenji, Kosaka
- Published
- 2012
42. Neuropathological investigation of the hypometabolic regions on positron emission tomography with [18F] fluorodeoxyglucose in patients with dementia with Lewy bodies
- Author
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Eizo Iseki, Yoshiko Furukawa, Shinji Higashi, Heii Arai, Kenji Kosaka, Omi Katsuse, Takashi Togo, Koji Kasanuki, Ryoko Yamamoto, Kiyoshi Sato, Michiko Minegishi, Hirotake Uchikado, Hiroshige Fujishiro, and Hiroaki Hino
- Subjects
Lewy Body Disease ,Male ,Pathology ,medicine.medical_specialty ,Cell Count ,tau Proteins ,Autopsy ,Neuropathology ,behavioral disciplines and activities ,Alzheimer Disease ,Fluorodeoxyglucose F18 ,mental disorders ,Lewy pathology ,medicine ,Humans ,In patient ,Senile plaques ,Aged ,Aged, 80 and over ,Neurons ,Fluorodeoxyglucose ,Amyloid beta-Peptides ,medicine.diagnostic_test ,Dementia with Lewy bodies ,Brain ,Neurofibrillary Tangles ,Middle Aged ,medicine.disease ,Immunohistochemistry ,nervous system diseases ,nervous system ,Neurology ,Positron emission tomography ,Data Interpretation, Statistical ,Positron-Emission Tomography ,Disease Progression ,alpha-Synuclein ,Female ,Neurology (clinical) ,Radiopharmaceuticals ,Psychology ,medicine.drug - Abstract
We performed a quantitative neuropathological examination of the hypometabolic regions on FDG PET in dementia with Lewy bodies (DLB), Alzheimer's disease (AD) and control cases. When the DLB cases were divided into two groups according to concomitant AD pathology (ADP), neuronal loss in the temporo-parietal association area was milder in the DLB groups than in the AD group, although there were no differences between the two DLB groups. Tau and Aβ immunoreactivities were observed in the AD group and the DLB group with ADP, but were rare in the DLB group without ADP. Tau and Aβ immunoreactivities as well as numbers of neurofibrillary tangles (NFTs) and neuritic plaques (NPs) were more common in the AD group than in the DLB group with ADP. There was no difference in neuronal loss in the occipital area among the three groups. α-Synuclein immunoreactivity was observed in the DLB groups but not in the AD group. There were no differences in α-synuclein immunoreactivity and number of Lewy bodies (LBs) between the two DLB groups. These findings indicate that the neuropathological bases of the hypometabolic regions in the temporo-parietal association and occipital area in DLB may be AD pathology and Lewy pathology, respectively.
- Published
- 2012
43. 'Social Opium' as a Social Mechanism : A Sociological Analysis of the Vicissitudes of the Fukushima Power Plant-based Town
- Author
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Kenji, Kosaka
- Published
- 2012
44. Zonisamide improves DLB parkinsonism: A randomized double-blind placebo-controlled phase 3 study
- Author
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Kenji Kosaka, M. Tagawa, R. Kajiwara, H. Takeuchi, Miho Murata, Kazuko Hasegawa, and Toshinari Odawara
- Subjects
Double blind ,Neurology ,business.industry ,Anesthesia ,Parkinsonism ,medicine ,Zonisamide ,Phases of clinical research ,Neurology (clinical) ,medicine.disease ,Placebo ,business ,medicine.drug - Published
- 2017
45. Yamaguchi fox-pigeon imitation test (YFPIT) for dementia in clinical practice
- Author
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Yasuo Harigaya, Koichi Okamoto, Makoto Osawa, Masaki Ikeda, Kenji Kosaka, Masakuni Amari, Haruyasu Yamaguchi, Shuichi Awata, Tsuneo Yamazaki, Satoshi Takahashi, and Yohko Maki
- Subjects
medicine.medical_specialty ,Clinical Dementia Rating ,Dementia with Lewy bodies ,media_common.quotation_subject ,chemical and pharmacologic phenomena ,Audiology ,medicine.disease ,Test (assessment) ,Developmental psychology ,Clinical Practice ,Psychiatry and Mental health ,Severe dementia ,mental disorders ,Severity of illness ,medicine ,Dementia ,Geriatrics and Gerontology ,Imitation ,Psychology ,Gerontology ,media_common - Abstract
Background: In out-patient clinics, having simple procedures to check for signs of dementia is invaluable. In the present study, we evaluated the imitation of hand gestures to detect visuomotor deficits in dementia in clinical practice. Methods: In all, 1219 subjects were enrolled in the present study, including 497 with Alzheimer's disease (AD), 98 with dementia with Lewy bodies (DLB), 71 with other types of dementia diseases, 175 with a Clinical Dementia Rating (CDR) of 0.5, and 378 normal controls. All subjects were aged 65 years or older. Subjects were recruited from 10 clinics and two communities. Visuomotor function was evaluated by the Yamaguchi fox–pigeon imitation test (YFPIT), which consists of a simple one-handed sign for ‘fox’ and a complex two-handed sign for ‘pigeon’, a rapid, game-like test with low psychological burden. Results: The success rate (successful/total) for imitating the ‘pigeon’ hand gesture was reduced as the severity of the dementia increased: 85.7% in normal controls, 60.6% in CDR 0.5 (mild cognitive impairment), 39.2% in CDR 1 (mild dementia), 21.2% in CDR 2 (moderate dementia), and 5.7% in CDR 3 (severe dementia). The success rate for imitating the ‘pigeon’ hand gesture was higher in patients with DLB than AD within the CDR 1 group (51.2% vs 35.4%, respectively), but lower for patients with DLB than AD within the CDR 2 group (12.5% vs 24.4%, respectively). The success of imitating the hand gesture for ‘fox’ was similar for patients with AD and DLB. Of those subjects who failed to imitate the hand gesture for ‘pigeon’, 49.5% of those with AD showed the palm–palm pattern (both palms facing outward), suggesting deficits of perspective conversion from the first-person to the third-person. Conversely, 52.8% of patients with DLB showed a dorsum–dorsum pattern (both dorsa facing outwards), suggesting deterioration of visual attention and recognition. Conclusion: In conclusion, the YFPIT is a useful test to detect visuomotor deficits in dementia that can differentiate between AD and DLB.
- Published
- 2011
46. The Theory of Relative Deprivation Revisited (6)
- Author
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Kenji, Kosaka
- Published
- 2011
47. Localization of MAP1-LC3 in Vulnerable Neurons and Lewy Bodies in Brains of Patients With Dementia With Lewy Bodies
- Author
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Michiko Minegishi, Omi Katsuse, Heii Arai, Kiyoshi Sato, Keiji Wada, Darren J. Moore, Takashi Togo, Hiroshige Fujishiro, Kenji Kosaka, Yoshiko Furukawa, Eizo Iseki, Shinji Higashi, Koji Kasanuki, Hirotake Uchikado, Tomohiro Kabuta, and Hiroaki Hino
- Subjects
Male ,Nervous system ,Pathology ,Dementia with Lewy bodies ,Fluorescent Antibody Technique ,Cell Count ,Chaperone-Mediated Autophagy ,Pathogenesis ,chemistry.chemical_compound ,Endosome ,Entorhinal Cortex ,Alzheimers-Disease ,Aged, 80 and over ,Neurons ,Brain ,Neurofibrillary Tangles ,General Medicine ,Middle Aged ,Immunohistochemistry ,Lysosome ,medicine.anatomical_structure ,Neurology ,alpha-Synuclein ,Female ,Alzheimer's disease ,Microtubule-Associated Proteins ,Mutations ,Plasmids ,Adult ,Lewy Body Disease ,medicine.medical_specialty ,Mutant Alpha-Synuclein ,Cells ,Blotting, Western ,Biology ,Amygdala ,Pathology and Forensic Medicine ,Cellular and Molecular Neuroscience ,Alzheimer Disease ,Lysosomal-Associated Membrane Protein 2 ,mental disorders ,Autophagy ,medicine ,Humans ,Aged ,Alpha-synuclein ,Amyloid beta-Peptides ,Ubiquitin ,Protein ,Lysosome-Associated Membrane Glycoproteins ,rab7 GTP-Binding Proteins ,Colocalization ,medicine.disease ,Entorhinal cortex ,Familial Parkinsons-Disease ,Nervous-System ,HEK293 Cells ,chemistry ,rab GTP-Binding Proteins ,Lc3 ,Lewy Bodies ,Neurology (clinical) ,Neuroscience - Abstract
There is emerging evidence implicating a role for the autophagy-lysosome pathway in the pathogenesis of Lewy body disease. We investigated potential neuropathologic and biochemical alterations of autophagy-lysosome pathway-related proteins in the brains of patients with dementia with Lewy bodies (DLB), Alzheimer disease (AD), and control subjects using antibodies against Ras-related protein Rab-7B (Rab7B), lysosomal-associated membrane protein 2 (LAMP2), and microtubule-associated protein 1A/1B light chain 3 (LC3). In DLB, but not in control brains, there were large Rab7B-immunoreactive endosomal granules. LC3 immunoreactivity was increased in vulnerable areas of DLB brains relative to that in control brains; computerized cell counting analysis revealed that LC3 levels were greater in the entorhinal cortex and amygdala of DLB brains than in controls. Rab7B levels were increased, and LAMP2 levels were decreased in the entorhinal cortex of DLB brains. In contrast, only a decrease in LAMP2 levels versus controls was found in AD brains. LC3 widely colocalized with several types of Lewy pathology; LAMP2 localized to the periphery or outside of brainstem-type Lewy bodies; Rab7B did not colocalize with Lewy pathology. Immunoblot analysis demonstrated specific accumulation of the autophagosomal LC3-II isoform in detergent-insoluble fractions from DLB brains. These results support apotential role for the autophagy-lysosome pathway in the pathogenesis of DLB.
- Published
- 2011
48. Longitudinal study on MRI intensity changes of Machado–Joseph disease: correlation between MRI findings and neuropathological changes
- Author
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Yoshihiko Horimoto, Kenji Kosaka, Shigehisa Mitake, Hiroyuki Yuasa, Yoshio Hashizume, Mari Yoshida, Hiroyasu Akatsu, Kazuya Nokura, Takayuki Yamamoto, Akihiro Kojima, Mitsuhiro Matsumoto, Eiichi Katada, and Hiroko Yamamoto
- Subjects
Male ,Pathology ,medicine.medical_specialty ,Neuropathology ,Globus Pallidus ,medicine ,Humans ,Longitudinal Studies ,Aged ,Neuroradiology ,Neurons ,medicine.diagnostic_test ,Pontine nuclei ,Brain ,Magnetic resonance imaging ,Machado-Joseph Disease ,Anatomy ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Pons ,Globus pallidus ,Neurology ,Gliosis ,Disease Progression ,Female ,Neurology (clinical) ,medicine.symptom ,Psychology ,Machado–Joseph disease - Abstract
To disclose the neuropathological progression course of Machado-Joseph disease (MJD), magnetic resonance imaging (MRI) findings of six genetically confirmed MJD cases (four males and two females, including an autopsied female, all unrelated to one another) were further investigated on neurodegeneration. Brain MRI studies were repeated in all cases at different stages of the disease. Ages at the first MRI study ranged from 47 to 65 years (55.2 ± 7.1), with observation periods from 4.5 to 10.6 years (6.95 ± 2.48). We paid particular attention to two types of previously reported MRI findings detectable using T2-weighted images. One is located just outside the internal capsules, and another in the pons. A linear high-intensity change along the internal capsules was detected in all cases, and showed progression during the observation period. A comparison between MRI and autopsy findings suggested that the lesion might reflect degeneration with neuronal loss, astrocytosis, and gliosis in the internal segment of the globus pallidus. A cross-shaped high-intensity change in the pons was well advanced but still incomplete in all cases. In this region, pontine transverse fibers were atrophic, while longitudinal fibers remained intact. Pontine nuclei showed apparent nerve cell loss, and the remaining cells had many 1C2-positive intranuclear inclusions. Since these findings were detected both by lifetime images and by postmortem examination, MRI intensity changes could track the progression of neurodegeneration. Based on a comparison between MRI findings and neuropathology, the degeneration of an internal segment of the globus pallidus (one of the pathological features of MJD) had progressed following the initial symptoms.
- Published
- 2011
49. The Theory of Relative Deprivation Revisited (5)
- Author
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Kenji, Kosaka
- Published
- 2011
50. The Theory of Relative Deprivation Revisited (4)
- Author
-
Kenji, Kosaka
- Published
- 2011
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