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1.
Mol Psychiatry ; 2024 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-39406998

RESUMO

Synaptic phenotypes in living patients with psychiatric disorders are poorly characterized. Excitatory glutamate α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor (AMPAR) is a fundamental component for neurotransmission. We recently developed a positron emission tomography (PET) tracer for AMPAR, [11C]K-2, the first technology to visualize and quantify AMPARs density in living human brain. In this study, we characterized patients with major psychiatric disorders with [11C]K-2. One hundred forty-nine patients with psychiatric disorders (schizophrenia, n = 42; bipolar disorder, n = 37; depression, n = 35; and autism spectrum disorder, n = 35) and 70 healthy participants underwent a PET scan with [11C]K-2 for measurement of AMPAR density. We detected brain regions that showed correlation between AMPAR density and symptomatology scores in each of four disorders. We also found brain areas with significant differences in AMPAR density between patients with each psychiatric disorder and healthy participants. Some of these areas were observed across diseases, indicating that these are commonly affected areas throughout psychiatric disorders. Schizophrenia, bipolar disorder, depression, and autism spectrum disorder are uniquely characterized by AMPAR distribution patterns. Our approach to psychiatric disorders using [11C]K-2 can elucidate the biological mechanisms across diseases and pave the way to develop novel diagnostics and therapeutics based on the synapse physiology.

2.
Psychiatry Clin Neurosci ; 78(4): 220-228, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38102849

RESUMO

AIM: Live two-way video, easily accessible from home via smartphones and other devices, is becoming a new way of providing psychiatric treatment. However, lack of evidence for real-world clinical setting effectiveness hampers its approval by medical insurance in some countries. Here, we conducted the first large-scale pragmatic, randomized controlled trial to determine the effectiveness of long-term treatment for multiple psychiatric disorders via two-way video using smartphones and other devices, which are currently the primary means of telecommunication. METHODS: This randomized controlled trial compared two-way video versus face-to-face treatment for depressive disorder, anxiety disorder, and obsessive-compulsive disorder in the subacute/maintenance phase during a 24-week period. Adult patients with the above-mentioned disorders were allocated to either a two-way video group (≥50% video sessions) or a face-to-face group (100% in-person sessions) and received standard treatment covered by public medical insurance. The primary outcome was the 36-Item Short-Form Health Survey Mental Component Summary (SF-36 MCS) score. Secondary outcomes included all-cause discontinuation, working alliance, adverse events, and the severity rating scales for each disorder. RESULTS: A total of 199 patients participated in this study. After 24 weeks of treatment, two-way video treatment was found to be noninferior to face-to-face treatment regarding SF-36 MCS score (48.50 vs 46.68, respectively; p < 0.001). There were no significant differences between the groups regarding most secondary end points, including all-cause discontinuation, treatment efficacy, and satisfaction. CONCLUSION: Two-way video treatment using smartphones and other devices, was noninferior to face-to-face treatment in real-world clinical settings. Modern telemedicine, easily accessible from home, can be used as a form of health care.


Assuntos
Depressão , Transtorno Obsessivo-Compulsivo , Adulto , Humanos , Transtornos de Ansiedade/terapia , Transtornos de Ansiedade/psicologia , Transtorno Obsessivo-Compulsivo/terapia , Transtorno Obsessivo-Compulsivo/psicologia , Ansiedade , Psicoterapia , Resultado do Tratamento
3.
BMC Psychiatry ; 23(1): 135, 2023 03 03.
Artigo em Inglês | MEDLINE | ID: mdl-36869320

RESUMO

BACKGROUND: Distinct oral atypical antipsychotics have different effects on autonomic nervous system (ANS) activity. Among them, oral aripiprazole has been linked to dysfunction of the ANS in schizophrenia. Long-acting injectable aripiprazole is a major treatment option for schizophrenia, but the effect of the aripiprazole formulation on ANS activity remains unclear. In this study, we compared ANS activity between oral aripiprazole and aripiprazole once-monthly (AOM) in schizophrenia. METHODS: Of the 122 patients with schizophrenia who participated in this study, 72 received oral aripiprazole and 50 received AOM as monotherapy. We used power spectral analysis of heart rate variability to assess ANS activity. RESULTS: Patients who received oral aripiprazole showed significantly diminished sympathetic nervous activity compared with those who received AOM. Multiple regression analysis revealed that the aripiprazole formulation significantly influenced sympathetic nervous activity. CONCLUSION: Compared with oral aripiprazole, AOM appears to have fewer adverse effects, such as sympathetic nervous dysfunction.


Assuntos
Terapia de Aceitação e Compromisso , Antipsicóticos , Esquizofrenia , Humanos , Aripiprazol , Sistema Nervoso Autônomo
4.
Rinsho Ketsueki ; 64(2): 113-118, 2023.
Artigo em Japonês | MEDLINE | ID: mdl-36990730

RESUMO

Aortic regurgitation, a thoracoabdominal aortic aneurysm, chronic myeloid leukemia, and chronic kidney disease were all being treated at two hospitals for an 83-year-old man. He was admitted to the Department of Orthopedics at our hospital with a lumbar compression fracture. Later, he experienced melena, for which the Department of Internal Medicine was consulted. Due to the aberrant results of PT-INR (7.1) and a PTT > 200 seconds on a coagulation test, we suspected the presence of an autoimmune coagulation factor deficiency, and prednisolone immunosuppressive therapy medication was started right away. Due to a sharp decline in FV/5 activity, the presence of FV/5 inhibitors, and the presence of anti-FV/5 autoantibodies, a final diagnosis of autoimmune coagulation factor V (FV/5) deficiency was made. After the start of immunosuppressive therapy, the FV/5 inhibitor and anti-FV/5 autoantibodies disappeared, and the FV/5 activity progressively returned to normal. Disseminated intravascular coagulation-which may have been caused by a known aortic aneurysm-worsened while tapering off prednisolone. Due to the patient's advanced age and other problems, the aneurysm was extensive and inappropriate for surgical repair. The coagulation test findings improved gradually upon initiation of warfarin therapy. Herein, the patient had autoimmune FV/5 deficiency, a rare disorder that made diagnosis and therapy difficult because of the patient's several coexisting conditions.


Assuntos
Coagulação Intravascular Disseminada , Deficiência do Fator V , Masculino , Humanos , Idoso de 80 Anos ou mais , Fator V , Coagulação Intravascular Disseminada/etiologia , Coagulação Intravascular Disseminada/complicações , Prednisolona/uso terapêutico , Autoanticorpos
6.
Eur Heart J ; 42(44): 4592-4600, 2021 11 21.
Artigo em Inglês | MEDLINE | ID: mdl-34038937

RESUMO

AIMS: To provide multi-national, multi-ethnic data on the clinical characteristics and prognosis of patients with microvascular angina (MVA). METHODS AND RESULTS: The Coronary Vasomotor Disorders International Study Group proposed the diagnostic criteria for MVA. We prospectively evaluated the clinical characteristics of patients according to these criteria and their prognosis. The primary endpoint was the composite of major cardiovascular events (MACE), verified by institutional investigators, which included cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and hospitalization due to heart failure or unstable angina. During the period from 1 July 2015 to 31 December 2018, 686 patients with MVA were registered from 14 institutes in 7 countries from 4 continents. Among them, 64% were female and the main ethnic groups were Caucasians (61%) and Asians (29%). During follow-up of a median of 398 days (IQR 365-744), 78 MACE occurred (6.4% in men vs. 8.6% in women, P = 0.19). Multivariable Cox proportional hazard analysis disclosed that hypertension and previous history of coronary artery disease (CAD), including acute coronary syndrome and stable angina pectoris, were independent predictors of MACE. There was no sex or ethnic difference in prognosis, although women had lower Seattle Angina Questionnaire scores than men (P < 0.05). CONCLUSIONS: This first international study provides novel evidence that MVA is an important health problem regardless of sex or ethnicity that a diagnosis of MVA portends a substantial risk for MACE associated with hypertension and previous history of CAD, and that women have a lower quality of life than men despite the comparable prognosis.


Assuntos
Doença da Artéria Coronariana , Angina Microvascular , Angiografia Coronária , Doença da Artéria Coronariana/epidemiologia , Feminino , Humanos , Masculino , Prognóstico , Estudos Prospectivos , Qualidade de Vida , Fatores de Risco
7.
Child Adolesc Ment Health ; 27(4): 335-342, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-34432369

RESUMO

BACKGROUND: Suicide remains one of the leading causes of death among adolescents. Although recent studies have suggested a strong association between auditory hallucinations and suicidal behaviors, little is known regarding the association between suicidal behaviors and visual hallucinations, which are also common among adolescent psychiatric patients. METHOD: A cross-sectional study of all first-time patients aged 10-15 years was conducted at three child and adolescent psychiatric outpatient facilities in Kanagawa Prefecture, Japan, from April 2015 to March 2018. Self-reported questionnaires were administered to evaluate auditory and visual hallucinations, suicide planning, and suicide attempts within the two weeks prior to the first visit. Our logistic regression model included three covariates (sex, age, and presence of major depressive episode) for adjustments. Among the 1285 respondents, 37 who had moderate or severe intellectual disability were excluded, leaving 1248 for analysis. RESULTS: Among the 1069 patients who completed questionnaire items on hallucinations, 230 (21.5%) experienced auditory or visual hallucinations. After controlling for all confounders, visual hallucinations, but not auditory hallucinations, were significantly associated with increased odds of suicide planning (odds ratio [OR] 2.5, 95% confidence interval [CI] 1.5-4.1). In contrast, auditory hallucinations, but not visual hallucinations, were significantly associated with increased odds of suicide attempts (OR 2.8, 95% CI 1.3-6.1). No interaction effects were observed between suicidal behaviors and auditory or visual hallucinations. CONCLUSIONS: Clinicians should consider the prevalence of both auditory and visual hallucinations among young adolescent patients, with emphasis on auditory hallucinations, given their association with suicide attempts.


Assuntos
Transtorno Depressivo Maior , Ideação Suicida , Adolescente , Criança , Estudos Transversais , Alucinações/epidemiologia , Alucinações/psicologia , Humanos , Japão/epidemiologia , Pacientes Ambulatoriais
8.
Arterioscler Thromb Vasc Biol ; 40(5): 1400-1412, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32237907

RESUMO

OBJECTIVE: It remains to be elucidated whether and how endothelial functions are impaired in peripheral circulation of patients with coronary functional disorders, such as vasospastic angina (VSA) and microvascular angina (MVA). We simultaneously examined endothelial functions of peripheral conduit and resistance arteries in patients with coronary functional disorders, with a special reference to NO and endothelium-dependent hyperpolarization factors. Approach and Results: Based on the results of invasive coronary acetylcholine testing and coronary physiological measurements, we divided 43 patients into 3 groups; VSA, MVA, and VSA+MVA. Endothelium-dependent vasodilatations of the brachial artery and fingertip arterioles to intra-arterial infusion of bradykinin were simultaneously evaluated by ultrasonography and peripheral arterial tonometry, respectively. To assess NO and endothelium-dependent hyperpolarization factors, measurements were repeated after oral aspirin and intra-arterial infusion of NG-monomethyl-L-arginine. Additionally, endothelium-independent vasodilatations to sublingual nitroglycerin and plasma levels of biomarkers for endothelial functions were measured. Surprisingly, digital vasodilatations to bradykinin were almost absent in patients with MVA alone and those with VSA+MVA compared with those with VSA alone. Mechanistically, both NO- and endothelium-dependent hyperpolarization-mediated digital vasodilatations were markedly impaired in patients with MVA alone. In contrast, endothelium-independent vasodilatations to nitroglycerin were comparable among the 3 groups. Plasma levels of soluble VCAM (vascular cell adhesion molecule)-1 were significantly higher in patients with MVA alone compared with those with VSA alone. CONCLUSIONS: These results provide the first evidence that both NO- and endothelium-dependent hyperpolarization-mediated digital vasodilatations are markedly impaired in MVA patients, suggesting that MVA is a cardiac manifestation of the systemic small artery disease.


Assuntos
Arteríolas/fisiopatologia , Artéria Braquial/fisiopatologia , Endotélio Vascular/fisiopatologia , Dedos/irrigação sanguínea , Angina Microvascular/fisiopatologia , Doença Arterial Periférica/fisiopatologia , Vasodilatação , Idoso , Arteríolas/efeitos dos fármacos , Arteríolas/metabolismo , Fatores Biológicos/metabolismo , Artéria Braquial/efeitos dos fármacos , Artéria Braquial/metabolismo , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/metabolismo , Feminino , Humanos , Masculino , Angina Microvascular/diagnóstico , Pessoa de Meia-Idade , Óxido Nítrico/metabolismo , Doença Arterial Periférica/diagnóstico , Resistência Vascular , Vasodilatação/efeitos dos fármacos , Vasodilatadores/administração & dosagem
9.
Heart Vessels ; 36(3): 337-344, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33044621

RESUMO

Coronary spasm is an established cause for angina pectoris. Ethnic differences have been suggested among Asian compared to Caucasian patients regarding prevalence, gender distribution, and angiographic patterns of coronary spasm. The aim of this study was to compare contemporary German and Japanese patients with coronary spasm. Between 2011 and 2015, 149 patients with resting angina and unobstructed coronary arteries with acetylcholine-induced epicardial spasm were enrolled in Stuttgart, Germany (n = 69) and Sendai, Japan (n = 80). All patients underwent intracoronary acetylcholine testing according to a standardized protocol. Comprehensive analysis included type of spasm (focal/diffuse), dose of acetylcholine leading to spasm, and frequency of multivessel spasm. Patients in this study were 61 ± 11 years old, predominantly female (54%), and had normal left ventricular ejection fraction (73 ± 9%). Diffuse spasm was the most prevalent type of spasm (85%) whereas focal spasm was found in the remaining 15% of patients. 31% of patients had multivessel spasm. Comparing the German with the Japanese patients, distribution of spasm type (focal/diffuse, p = 0.19) and frequency of multivessel spasm (p = 0.22) were comparable. Moreover, when Japanese patients were compared with German patients and diffuse spasm with focal spasm patients, respectively, no significant differences were observed regarding the acetylcholine dose required to induce spasm (p = 0.078 and p = 0.46, respectively). In conclusion, diffuse epicardial coronary spasm is the most frequent finding among German and Japanese patients with resting angina, unobstructed coronary arteries, and epicardial spasm on acetylcholine testing. Japanese and German patients share several similarities including comparable types of spasm and frequency of multivessel spasm.


Assuntos
Acetilcolina/administração & dosagem , Vasoespasmo Coronário/epidemiologia , Vasos Coronários/fisiopatologia , Vasoconstrição/efeitos dos fármacos , Função Ventricular Esquerda/efeitos dos fármacos , Angiografia Coronária , Vasoespasmo Coronário/induzido quimicamente , Vasoespasmo Coronário/diagnóstico , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/efeitos dos fármacos , Feminino , Alemanha , Humanos , Injeções Intra-Arteriais , Japão , Masculino , Pessoa de Meia-Idade , Prevalência , Volume Sistólico/efeitos dos fármacos , Vasodilatadores/administração & dosagem
10.
Opt Express ; 28(10): 15138-15147, 2020 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-32403546

RESUMO

This paper presents the optimization of a dual-chirped optical parametric amplification (DC-OPA) scheme for producing an ultrafast intense infrared (IR) pulse. By employing a total energy of 0.77 J Ti:sapphire pump laser and type-I BBO crystals, an IR pulse energy at the center wavelength of 1.7 µm exceeded 0.1 J using the optimized DC-OPA. By adjusting the injected seed spectrum and prism pair compressor with a gross throughput of over 70%, the 1.7-µm pulse was compressed to 31 fs, which resulted in a peak power of up to 2.3 TW. Based on the demonstration of the BBO type-I DC-OPA, we propose a novel OPA scheme called the "dual pump DC-OPA" for producing a high-energy IR pulse with a two-cycle duration.

11.
BMC Psychiatry ; 20(1): 72, 2020 02 18.
Artigo em Inglês | MEDLINE | ID: mdl-32070304

RESUMO

BACKGROUND: Use of the antipsychotic drug olanzapine by patients with schizophrenia is associated with autonomic nervous system (ANS) dysfunction. It is presumed that there are interindividual differences in ANS dysfunction that correspond to pharmacogenetics. In this study, we investigated whether genetic polymorphisms in ABCB1, CYP1A2, and UGT1A4 are associated with this observed ANS dysfunction. METHODS: A total of 91 schizophrenia patients treated with olanzapine monotherapy participated in this study. A power spectral analysis of heart rate variability was used to assess ANS activity. The TaqMan system was used to genotype seven single nucleotide polymorphisms (SNPs) in CYP1A2 (rs2069514 and rs762551), UGT1A4 (rs2011425), and ABCB1 (rs1045642, rs1128503, rs2032582, rs2235048). RESULTS: Sympathetic nervous activity was significantly higher in individuals with the UGT1A4 rs2011425 G allele than in those with the UGT1A4 rs2011425 non-G allele (sympathetic activity, p = .001). Furthermore, sympathetic nervous activity was also significantly associated with UGT1A4 rs2011425 genotype as revealed by multiple regression analysis (sympathetic activity, p = .008). CONCLUSIONS: We suggest that the UGT1A4 rs2011425 polymorphism affects olanzapine tolerability because it is associated with the observed side effects of olanzapine in schizophrenia patients, namely sympathetic dysfunction.


Assuntos
Sistema Nervoso Autônomo/fisiopatologia , Citocromo P-450 CYP1A2/genética , Glucuronosiltransferase/genética , Olanzapina/efeitos adversos , Polimorfismo de Nucleotídeo Único/genética , Esquizofrenia/tratamento farmacológico , Esquizofrenia/genética , Subfamília B de Transportador de Cassetes de Ligação de ATP/genética , Sistema Nervoso Autônomo/metabolismo , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Olanzapina/uso terapêutico , Esquizofrenia/enzimologia , Esquizofrenia/fisiopatologia
12.
BMC Psychiatry ; 18(1): 231, 2018 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-30016952

RESUMO

BACKGROUND: There are interindividual differences in the adverse effects of atypical antipsychotics, which include autonomic nervous system (ANS) dysfunction. Accordingly, to clarify the interindividual differences in the adverse effects of specific atypical antipsychotics in schizophrenia, we investigated the association between ANS dysfunction and ATP-binding cassette transport sub-family B member 1 (ABCB1) gene polymorphisms in patients with schizophrenia. METHODS: In total, 233 Japanese patients with schizophrenia participated in this study. All of the participants received an atypical antipsychotic as monotherapy: 89 participants received risperidone, 69 olanzapine, 48 aripiprazole, and 27 quetiapine. ANS activity was assessed by means of a power spectral analysis of heart rate variability. Four single nucleotide polymorphisms (SNPs) in ABCB1 (rs1045642, rs1128503, rs2032582, and rs2235048) were genotyped using the TaqMan method. RESULTS: For aripiprazole, sympathetic and total autonomic nervous activities were significantly lower in the rs1045642 T allele carrier-rs2235048 C allele carrier group than in the rs1045642 non-T allele carrier-rs2235048 non-C allele carrier group. In addition, in the aripiprazole group, the T-C-T-A haplotype (rs1045642-rs2235048-rs1128503-rs2032582) was associated with decreased ANS activity. However, there were no significant associations between ANS activity and ABCB1 gene polymorphisms in the risperidone, olanzapine, and quetiapine groups. Multiple regression analysis revealed that sympathetic and total nervous activities were significantly associated with the ABCB1 rs1045642-rs2235048 genotype and the T-C-T-A haplotype (rs1045642-rs2235048-rs1128503-rs2032582). CONCLUSION: We suggest that ABCB1 genetic polymorphisms affect aripiprazole-related ANS dysfunction but do not affect risperidone-, olanzapine-, or quetiapine-related ANS dysfunction.


Assuntos
Antipsicóticos/uso terapêutico , Frequência Cardíaca/fisiologia , Polimorfismo de Nucleotídeo Único/genética , Esquizofrenia/tratamento farmacológico , Esquizofrenia/genética , Subfamília B de Transportador de Cassetes de Ligação de ATP/genética , Adulto , Idoso , Antipsicóticos/efeitos adversos , Antipsicóticos/farmacologia , Aripiprazol/efeitos adversos , Aripiprazol/farmacologia , Aripiprazol/uso terapêutico , Sistema Nervoso Autônomo/efeitos dos fármacos , Sistema Nervoso Autônomo/fisiologia , Sistema Nervoso Autônomo/fisiopatologia , Estudos Transversais , Feminino , Frequência Cardíaca/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Olanzapina/farmacologia , Olanzapina/uso terapêutico , Fumarato de Quetiapina/efeitos adversos , Fumarato de Quetiapina/farmacologia , Fumarato de Quetiapina/uso terapêutico , Risperidona/efeitos adversos , Risperidona/farmacologia , Risperidona/uso terapêutico , Esquizofrenia/fisiopatologia
13.
Compr Psychiatry ; 86: 119-122, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30118994

RESUMO

BACKGROUND: Patients with schizophrenia have a higher mortality risk than the general population. Additionally, the autonomic nervous system (ANS) activity of patients with schizophrenia is lower and more dysfunctional than that of the general population. Nonetheless, the association between ANS dysfunction and mortality in schizophrenia is unclear. The aim of this study was to investigate the association between ANS activity and mortality in schizophrenia and to evaluate the predictive values of heart rate variability for long-term survival. METHODS: This study involves the 10-year follow-up of a sample population consisting of 59 Japanese inpatients with schizophrenia between 60 and 70 years of age from 2007 to 2016. The ANS activity of all patients was evaluated using heart rate variability in 2007. RESULTS: Fifty-three participants could be followed up because they stayed in the hospital during the follow-up period. Of these patients, 11 died during follow-up. Their mean age at death was 70.55 ±â€¯3.45 years. The parasympathetic activity of nonsurvivors was significantly lower than that of survivors, and multiple logistic regression analysis showed a significant association between death and parasympathetic activity. CONCLUSION: We suggest that decreased parasympathetic activity could be associated with 10-year all-cause mortality in older schizophrenic patients.


Assuntos
Sistema Nervoso Autônomo/fisiopatologia , Esquizofrenia/mortalidade , Idoso , Feminino , Seguimentos , Frequência Cardíaca , Humanos , Pacientes Internados/psicologia , Japão , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Esquizofrenia/fisiopatologia
14.
Circ J ; 81(12): 1758-1763, 2017 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-29093432

RESUMO

From August 26th to 30th, the 2017 Annual Congress of the European Society of Cardiology (ESC 2017) was held in Barcelona, Spain. Despite the terrorism tradegy just before the ESC congress, the congress attracted many medical professionals from all over the world to discuss the recent topics in cardiovascular medicine in more than 500 sessions, including COMPASS (Cardiovascular OutcoMes for People using Anticoagulation StrategieS Trial), CANTOS (Canakinumab Anti-Inflammatory Thrombosis Outcomes Study), and ORION (which assessed the effect of a novel siRNA inhibitor to PCSK9 on reductions in low-density lipoprotein cholesterol). Japanese cardiologists and the Japanese Circulation Society greatly contributed to the congress. This report briefly introduces some late-breaking registry results, late-breaking clinical trials, and ESC Guidelines from the ESC 2017 Congress.


Assuntos
Cardiologia , Congressos como Assunto , Humanos , Sociedades Médicas , Espanha
15.
BMC Psychiatry ; 17(1): 87, 2017 03 07.
Artigo em Inglês | MEDLINE | ID: mdl-28270120

RESUMO

BACKGROUND: The prevalence of smoking in patients with schizophrenia is higher than that in the general population and is an important medical issue. Short-term smoking cessation tends to worsen psychiatric symptoms in patients with schizophrenia but decreases sympathetic nervous system activity and improves plasma cholesterol levels in healthy people. Few studies have assessed the long-term effects of smoking cessation in patients with schizophrenia. METHODS: Subjects were 70 Japanese patients with schizophrenia (38 smokers, 32 non-smokers). We compared the following clinical parameters between the two groups at baseline (before smoking cessation) and in each group separately between baseline and at three years after smoking cessation: autonomic nervous system activity, plasma cholesterol levels, body weight, drug therapy, and Global Assessment of Functioning scores. We also compared the mean changes in clinical parameters throughout this study between the groups at both time points. Autonomic nervous system activity was assessed by power spectral analysis of heart rate variability. RESULTS: Parasympathetic nervous system activity and the doses of antiparkinsonian drugs in smokers were significantly higher than those in non-smokers at baseline. Smoking cessation was associated with significantly decreased sympathetic nervous system activity and decreased doses of antipsychotics and antiparkinsonian drugs at three years after smoking cessation. However, there was no significant difference in the mean change in clinical factors scores, except for Global Assessment of Functioning scores, between smokers and non-smokers at three years after smoking cessation. CONCLUSIONS: Our results suggest that smoking reduces both autonomic nervous system activity and the effectiveness of drug therapy with antipsychotics and antiparkinsonian drugs in patients with schizophrenia, but that both factors could be ameliorated over the long term by smoking cessation. Taken together with the findings of previous studies, smoking cessation in patients with schizophrenia has many long-term positive physiological effects.


Assuntos
Hospitalização/tendências , Esquizofrenia/terapia , Psicologia do Esquizofrênico , Abandono do Hábito de Fumar/psicologia , Fumar/psicologia , Fumar/terapia , Adulto , Idoso , Antipsicóticos/uso terapêutico , Feminino , Frequência Cardíaca/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Esquizofrenia/diagnóstico , Esquizofrenia/epidemiologia , Fumar/epidemiologia , Abandono do Hábito de Fumar/métodos , Resultado do Tratamento
17.
Neuropsychobiology ; 74(1): 60-67, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27923235

RESUMO

BACKGROUND: Patients with schizophrenia have abnormal autonomic nervous system (ANS) activity compared with the general population. One reason for this difference is the muscarinic affinity for antipsychotic drugs; therefore, single nucleotide polymorphisms (SNPs) of the muscarinic receptor gene influence this ANS dysfunction. This study sought to determine the effect of SNPs of the cholinergic muscarinic receptor (CHRM) gene on ANS activity in patients with schizophrenia receiving antipsychotic drugs. METHODS: A total of 173 Japanese patients with schizophrenia were included in this study. Heart rate variability (HRV) was measured as an index of ANS activity. SNPs in CHRM1 (rs542269 and rs2075748), CHRM2 (rs324640, rs8191992, rs1824024, and rs7810473), and CHRM3 (rs3738435, rs4620530, and rs6429157) were genotyped using the TaqMan® method. Patients were grouped according to standard equivalent conversions of chlorpromazine (CP) into a high-CP group (HG; ≥1,000 mg) and a low-CP group (LG; <1,000 mg). ANS activity was compared between the groups. In addition, we compared the total, low-frequency (LF), high-frequency (HF), and LF/HF components of the patients' HRV, and the genotype of the SNPs in both the HG and LG groups. Bonferroni correction was applied for multiple comparisons, and the Bonferroni-corrected critical p value was <0.005. RESULTS: The A allele of the CHRM2 rs8191992 polymorphism in HG was associated with decreased ANS activity. CONCLUSION: Our results show reduced ANS activity in association with the CHRM2 rs8191992 polymorphism in patients with schizophrenia on high-dose antipsychotics. CHRM2 polymorphisms may play an important role in ANS activity in patients with schizophrenia.


Assuntos
Frequência Cardíaca/genética , Receptor Muscarínico M2/genética , Receptores Muscarínicos/genética , Esquizofrenia/genética , Adulto , Antipsicóticos/uso terapêutico , Povo Asiático/genética , Sistema Nervoso Autônomo/fisiopatologia , Feminino , Genótipo , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Receptor Muscarínico M1 , Receptor Muscarínico M3 , Esquizofrenia/tratamento farmacológico , Esquizofrenia/fisiopatologia
18.
Heart Vessels ; 31(12): 1904-1914, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26936449

RESUMO

We aimed to design a rapid and reliable method to identify coronary lesions at high risk for the no-reflow phenomenon before elective coronary stent implantation using integrated backscatter intravascular ultrasound (IB-IVUS). The no-reflow phenomenon occurring during elective percutaneous coronary intervention (PCI) worsens patient prognosis, regardless of whether the phenomenon is transient or persistent. We retrospectively studied 353 coronary lesions to identify factors potentially promoting the no-reflow phenomenon, including lesion location and severity. We also performed component analysis by two- and three-dimensional IB-IVUS before elective stent implantation. The cutoff values of the true lipid volume and estimated lipid volume (lipid area at the minimal lumen diameter site × total stent length) for the no-reflow phenomenon were determined by receiver operating curve analysis. Type C lesions, regardless of location and a thrombolysis in myocardial flow grade of 0, were risk factors for the no-reflow phenomenon during PCI. The estimated lipid volume was significantly correlated with the true lipid volume (R 2 = 0.778, p < 0.0001). The cutoff value of the estimated lipid volume for the no-reflow phenomenon was 132.6 mm3 (area under the curve = 0.719), and the predictive value was equivalent to that of the true lipid volume. Lesions with an estimated lipid volume of ≥132.6 mm3 had a significantly higher risk of the no-reflow phenomenon during elective stent implantation (odds ratio, 4.35; 95 % confidence interval, 1.67-12.7; p = 0.0024). The simple and rapid measurement of the estimated lipid volume immediately before stenting during PCI constitutes a reliable predictor of lesions at high risk for the no-reflow phenomenon.


Assuntos
Doença da Artéria Coronariana/terapia , Circulação Coronária , Vasos Coronários/diagnóstico por imagem , Fenômeno de não Refluxo/etiologia , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/instrumentação , Stents , Ultrassonografia de Intervenção , Idoso , Idoso de 80 Anos ou mais , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/fisiopatologia , Vasos Coronários/fisiopatologia , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Lipídeos/análise , Masculino , Pessoa de Meia-Idade , Fenômeno de não Refluxo/diagnóstico , Fenômeno de não Refluxo/fisiopatologia , Placa Aterosclerótica , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fatores de Risco , Espalhamento de Radiação , Resultado do Tratamento
19.
Psychiatry Clin Neurosci ; 70(7): 261-8, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26909665

RESUMO

AIM: Numerous reports have described differences in the distribution of orbitofrontal cortex (OFC) sulcogyral patterns between patients with schizophrenia (SZ patients) and healthy controls (HC). Alterations in OFC morphology are also observed in those at high risk for developing SZ and in first-episode SZ, suggesting that genetic associations may be extant in determining OFC sulcogyral patterns. We investigated the association between single nucleotide polymorphisms (SNP) in NRG1 and OFC sulcogyral patterns. METHODS: A total of 59 Japanese patients diagnosed with SZ and 60 HC were scanned on a 1.5-T magnet. Patients were also assessed clinically. OFC sulcogyral patterns were evaluated for each participant, and genotyping was performed for four SNP in NRG1 (SNP8NRG243177, SNP8NRG221533, SNP8NRG241930, and rs1081062). RESULTS: There were significant differences in the distribution of OFC sulcogyral patterns between SZ patients and HC (χ(2) = 6.52, P = 0.038). SZ patients showed an increase in the frequency of Type III expression, which was associated with an earlier age of disease onset (ß = -0.302, F = 4.948, P = 0.030). Although no difference was found in genotype frequencies between SZ patients and HC, an NRG1 SNP, SNP8NRG243177, was associated with Type II expression in SZ patients (ß = 0.237, F = 4.120, P = 0.047). CONCLUSION: Our results suggest that OFC sulcogyral pattern formation in schizophrenia may be associated with NRG1 allele frequency, which is closely related to neurodevelopment.


Assuntos
Neuregulina-1/genética , Córtex Pré-Frontal/diagnóstico por imagem , Esquizofrenia/diagnóstico por imagem , Esquizofrenia/genética , Adulto , Feminino , Genótipo , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único
20.
Foods ; 13(13)2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38998600

RESUMO

Recently, global warming has led to an increase in chalky rice grains. This has consequently resulted in the deterioration in quality of rice products. Although we previously reported that hard water, rich in Ca, is useful for the quality improvement of high-temperature-damaged rice grains, the mechanism was not elucidated sufficiently. Therefore, we used various kinds of rice cultivars, from waxy to high-amylose ones, for soaking and boiling in hard water and compared physical and chemical properties of the products. It was shown that the degree of quality improvement, such as final viscosities in pasting property, and textural properties of boiled rice, was more remarkable for high-amylose rice than low-amylose rice. As we found that the phosphorus contents showed positive correlations with amylose and long chains of amylopectin, we estimate that the effects are mainly due to binding of calcium and phosphorus. Because that high-amylose or long-chain-rich amylopectin rice cultivars showed high calcium contents in rice products, these rice cultivars would be very useful to supply calcium through dietary intake via hard water cooking.

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