Life philosophy of Bin Kimura.

Bin Kimura, the most internationally renowned Japanese psychopathologist, developed a unique life-theoretical position in his later years. The concept of "aida" or "betweenness," which was in the social dimension in his earlier thought, came to be called "horizontal betweenness," and the "vertical betweenness" in the vital dimension came to be emphasized. In relation to his time theory, the "intra festum," which signifies the tendency to immerse oneself in the present, has come to be highlighted as a direct contact with life. He used many coupled concepts, such as "mizukara/onozukara" and "reality/actuality," to contrast his life-theoretical position with the scientific-epistemological one. He was also heavily influenced by the ideas of Viktor von Weizsäcker, and superimposed his concept of "vertical betweenness" over Weizsäcker's concept of "ground relationship" by interpreting it as expressing the dependence of individual life (bios) on life in general (zoé). However, the strongest influences on his life theory were the ideas of Kitaro Nishida, the leading philosopher of the Kyoto School, with whom he had been familiar since his youth. In his last years, Kimura, under Nishida's influence, came to equate life in general with generalized death. Kimura's life philosophy might provide the foundation of psychotherapy by deepening subjective and empathetic understanding of psychiatric patients.

Frontal theta activation during motor synchronization in autism.

Autism is characterized by two primary characteristics: deficits in social interaction and repetitive behavioral patterns. Because interpersonal communication is extremely complicated, its underlying brain mechanisms remain unclear. Here we showed that both characteristics can be explained by a unifying underlying mechanism related to difficulties with irregularities. To address the issues, we measured electroencephalographm during a cooperative tapping task, which required participants to tap a key alternately and synchronously with constant rhythmic a PC program, a variable rhythmic PC program, or a human partner. We found that people with autism had great difficulty synchronizing tapping behavior with others, and exhibited greater than normal theta-wave (6 Hz) activity in the frontal cortex during the task, especially when their partner behaved somewhat irregularly (i.e. a variable rhythmic PC program or a human partner). Importantly, the higher theta-wave activity was related to the severity of autism, not the performance on the task. This indicates that people with autism need to use intense cognition when trying to adapt to irregular behavior and can easily become overtaxed. Difficulty adapting to irregular behavior in others is likely related to their own tendencies for repetitive and regular behaviors. Thus, while the two characteristics of autism have been comprehended separately, our unifying theory makes understanding the condition and developing therapeutic strategies more tractable.

Possible induction of multiple seizure foci due to parietal tumour and anti-NMDAR antibody.

"Formes frustes" of encephalopathy associated with anti-NMDAR antibody have been recently described in cases of chronic epilepsy. We report a young woman with a parietal lesion and anti-NMDAR antibody who acquired bilateral, secondary epileptogenesis in the temporal lobes within a period as short as six years. Removal of the primary epileptogenic lesion of oligoastrocytoma in the right parietal lobe resulted in seizure freedom, disappearance of secondary foci, and substantial decrease of the antibody titre. Chronic exposure to anti-NMDAR antibody, albeit at a low titre, may have resulted in a smoldering chronic course and relatively early acquisition of "reversible" secondary foci without development of a high degree of epileptogenicity and structural changes.

Magnetoencephalographic correlates of different types of aura in temporal lobe epilepsy.

PURPOSE: To estimate magnetoencephalography (MEG) correlates of different types of aura in temporal lobe epilepsy (TLE). METHODS: MEG study was performed on 57 patients (26 male and 31 female) with TLE, whose ages ranged from 14-46 years (mean 27 years). Interictal magnetoencephalograms showing discharges were analyzed, and spike-dipole clusters were categorized into left and right inferotemporal-horizontal (IH) and superotemporal-vertical (SV) types. Auras were classified into autonomic, auditory, and psychic seizures. The correlation between the four types of interictal spike-dipole and three types of aura was analyzed using Fisher's exact probability test. RESULTS: IH type correlated with autonomic seizures (p = 0.0004), whereas SV type correlated with both auditory (p = 0.0002) and psychic seizures (p = 0.042). When subdivided into left and right, left IH type correlated with autonomic seizures (p = 0.046), but right IH type did not. Right SV type correlated with both auditory (p = 0.014) and psychic seizures (p = 0.002), but left SV did not correlate with either. Both types did not correlate with "no aura." CONCLUSIONS: Using our proposed classification of spike-dipoles, MEG distinguishes auras of mesial temporal origin from those of lateral temporal region. Furthermore, by adopting our classification, laterality of spike-dipoles is clearly demonstrated in auditory and psychic seizures.

Magnetoencephalographic characteristics of psychosis in temporal lobe epilepsy.

To test the hypothesis that some particular magnetoencephalographic findings characterize psychosis manifesting in temporal lobe epilepsy (TLE) patients, the authors performed statistical analyses on the correlation between a history of psychosis and four magnetoencephalographic spike-dipole patterns, namely, left and right inferotemporal-horizontal (IH) and superotemporal-vertical (SV) types. Fifty-seven patients with TLE were studied, 16 of whom had a history of psychosis. Of the four types of spike-dipoles, only left SV type showed a strong correlation with psychosis, suggesting that dysfunction of the left temporal neocortex specifically contributes to the manifestation of psychotic symptoms in TLE patients.

Classification of psychotic symptoms in dementia with Lewy bodies.

OBJECTIVE: The aim of this study is to determine empirically a possible classification of psychotic symptoms, and identify the frequency of such symptoms in dementia with Lewy bodies (DLB). METHODS: This was a clinical study of prospectively observed patients from the memory clinic at Shiga Medical Center. The authors conducted a factor analysis of psychotic symptoms in 96 probable DLB and 4 possible DLB patients, clinically diagnosed according to the consensus criteria, were included. RESULTS: Four factors were obtained. Factor 1 was closely akin to misidentifications, including Capgras syndrome, phantom boarder, and reduplication of people and places. Factor 2 consisted of reduplication of people, the belief that deceased relatives are still alive, and the belief that absent relatives are in the house, which was classified as a type of misidentification or paramnesia. Factor 3 was akin to visual hallucinations of nonhuman objects, and factor 4 mirrored the hallucination of people and feeling of presence. Delusions were independent of these factors. Following the results of factor analysis, the rates of each symptom group were identified. Hallucinations were the most frequent psychotic symptom in DLB (78%), followed by misidentifications (56%) and delusions (25%). CONCLUSION: This study suggested that hallucinations, misidentifications, and delusions should be separately considered in understanding of underlying pathophysiology or psychopathology of DLB.

[Epilepsy and psychic seizures].

Various psychic symptoms as ictal manifestation have been found in epileptic patients. They are classified as psychic seizures within simple partial seizures, and subclassified into affective, cognitive, dysmnesic seizures and so on, although the subclassification is not yet satisfactory and almost nothing is known about their relationships with normal brain functions. In this presentation, the speaker picked ictal fear, déjà vu and out-of-body experience (OBE) from them and suggested that studies on these symptoms could uniquely contribute to the progress of cognitive neuroscience, presenting some results from the research and case study that he had been engaged in. Psychic seizures are prone to be missed or misdiagnosed unless psychiatrists with sufficient knowledge and experience on epilepsy care would not treat them, because they are subjective symptoms that are diverse and subtle, while they have some characteristics as ictal symptoms.

Paramnesic multiplication of autobiographical memory as a manifestation of interictal psychosis.

This report describes a male patient with temporal lobe epilepsy who developed a persistent paranoid-hallucinatory state at the age of 23. The essential feature of his delusion was that he had repeatedly lived part of his life, namely between the ages of 21 and 25 years. The patient repeatedly attempted suicide to escape the endless repetition. His paramnesia has some similarity with a déjà vu phenomenon, which is a common ictal manifestation of temporal lobe epilepsy. However, while only a sense of vague familiarity is evoked in a déjà vu phenomenon, conscious recollection is experienced during his paramnesia. We attempted to explain the pathophysiological mechanism of the patient's paramnesia in the framework of the current neurobiological theory of human memory.