Hisanobu Kaiya

Presenile dementia combined with amyotrophy: a review of 34 Japanese cases

Thirty-four Japanese cases exhibiting presenile dementia combined with amyotrophy were reviewed with four case reports. The clinical feature of dementia was generally unspecific and could not be clearly diagnosed as Picks disease or Alzheimers disease. But most of these patients did not exhibit manifest visual agnosia or apraxia suggesting posterior dementia. Brain CTs showed mild diffuse atrophy with non-circumscribed fronto-temporal accentuation. PSD (periodic synchronous discharge on EEG) as seen in Creutzfeldt-Jakob disease (CJD) was not noted in any of these cases. Although individual neurological findings were not contradictory to amyotrophy lateral sclerosis (ALS), the clinicopathologic findings, on the whole, could be regarded as indicative of an atypical spinal progressive muscular atrophy. The brain pathology lacked specific changes. A mild to moderate degree of glial proliferation, subcortical gliosis and a moderate spongy state of the upper cortical layers were seen mainly in the fronto-temporal area. Nigral degeneration was observed in half of the cases. No Picks cells, Picks balls, Alzheimers neurofibrillary changes or senile plaques were observed except in two cases, in whom it could be regarded as physiological. Brain weight was lighter than that of normal Japanese but heavier than that of Picks disease, Alzheimers disease or CJD. The brain pathology was similar to that of progressive subcortical gliosis. We have concluded that the disease under discussion might be a new disease entity.

Elevated plasma prostaglandin E2 levels in schizophrenia

Plasma levels of prostaglandin E2 (PGE2) were determined with radioimmunoassay in 40 DSM-III schizophrenics, 15 patients with other mental disorders, and 23 normal controls. The mean value of plasma immunoreactivity of PGE2 was significantly higher in the schizophrenic patients than in the normal controls. Schizophrenic patients with high plasma PGE2 levels had more guilt feelings and hallucinatory behavior on BPRS, relatively successful heterosexual relations, and a higher incidence of birth complications.

Decreased level of β-endorphin-like immunoreactivity in cerebrospinal fluid of patients with senile dementia of Alzheimer type

β-Endorphin-like immunoreactivity in cerebrospinal fluid (CSF) was observed to decrease in patients with Huntingtons disease and dementia due to brain vascular disease. The greatest decrease was seen in patients with presenile and senile dementia of Alzheimer type (SDAT). The immunoreactivity significantly correlated with psychological functions when examined using a dementia rating scale (r = 0.51, p < 0.01, for all dementia, r = 0.65, p < 0.02, for only SDAT). These results suggest that a B-endorphin-like substance may be related in the pathophysiology of dementia.

Essential and other fatty acids in plasma in schizophrenics and normal individuals from Japan

Plasma phospholipid and cholesterol ester fatty acid levels were measured in samples from normal individuals, schizophrenics, and patients with affective and paranoid disorders in Japan. The schizophrenics were divided into groups with normal and reduced platelet sensitivity to the aggregation-inhibiting effects of prostaglandin (PG) E1. As in samples from schizophrenics in several other countries, linoleic acid levels were significantly below normal, as was the ratio of linoleic acid to its metabolites. Phospholipid fatty acid levels were normal in patients with paranoid or affective disorders. When the schizophrenics were divided into those with and without an abnormal response to PGE1, oleic acid was higher and eicosapentaenoic acid lower in those patients with an abnormal response. This study lends further support to the idea that schizophrenics may differ from controls in their essential fatty acid and eicosanoid metabolism.

The morphology of the corpus callosum in schizophrenia: An MRI study

40 schizophrenic patients and 17 normal controls underwent magnetic resonance imaging (MRI) of the brain. All subjects were consenting males. The size and form of the corpus callosum in the mid-sagittal cut of MRI were evaluated. This study revealed that the mean size of the anterior region of the corpus callosum was significantly greater in schizophrenics than in controls. The elongated anterior corpus callosum, which did not correlate with age, duration of illness, birth complications or any measures of brain areas in the midsagittal cut, was regarded as a primary change. Schizophrenics with the elongated corpus callosum seemed to have an unfavorable prognosis, because the large corpus callosum suggested poor heterosexual relations, reduced number of hospitalizations, low academic grades and mild anxiety-depression syndrome. A smooth and even corpus callosum seen in schizophrenics was likely a change dependent on duration of illness.

Accumulation of diacylgylcerol in platelet phosphoinositide turnover in Schizophrenia: A biological marker of good prognosis?

Phosphoinositide (PI) turnover was examined by measuring phosphatidic acid (PA) and diacylglycerol (DG) production following thrombin stimulation in platelet membranes from 20 schizophrenic patients, 10 patients with other mental disorders, and 9 normal controls. In 6 of 13 acute schizophrenic patients, DG was not transformed into phosphatidic acid (PA), but accumulated in the platelets instead. The abnormal findings persisted for at least 2 months, but then reversed over a long period. Three years later, the patients with abnormal PI turnover had a significantly better outcome than other acute schizophrenic patients.

Coping styles to basic disorders among schizophrenics

Coping efforts to subjectively experienced basic disorders were investigated by self‐report in 60 chronic schizophrenics in Japan, and the relationships to clinical and demographic variables, intelligence, personality, and attitude toward their illness were analyzed. Self‐reports on coping efforts were obtained for more than half of all subjectively experienced basic disorders, and the predominant technique was reported to be the approach oriented towards problem‐solving. Within each coping style, the behavioral change, divertive problem‐solving approach correlated negatively with hospitalization and symptoms, and the struggle, problem‐solving efforts without any effective results correlated positively with symptoms. Suggestions regarding integration of these self‐efforts into psychosocial treatment of schizophrenia are discussed.

Plasma glutamate decarboxylase activity in neuropsychiatry

Plasma glutamate decarboxylase (GAD) activity was measured in patients with endogenous psychoses and neurologic diseases. Unmedicated schizophrenic patients showed no difference in plasma GAD levels compared to controls. Administration of neuroleptics together with anticholinergic agents increased plasma GAD activity in schizophrenic patients. Compared to controls, patients with major depression and bipolar illness showed significantly lower GAD activity. No effect of antidepressants and minor tranquilizers on plasma GAD activity was found. Relatively lower GAD activity was shown in neurotic patients. The enzyme activity in plasma of patients with Huntingtons chorea (HC) was lower than control levels. The plasma GAD concentrations correlated with cerebrospinal fluid concentrations in five HC patients.

Ultrastructure of acetylcholinesterase synthesizing neurons in the neostriatum

Acetylcholinesterase (AChE) ultracytochemistry with thiocholine method was studied in the rat neostriatum. AChE synthesizing neurons were identified by observing reappearance of the enzyme after application of an AChE inhibitor, DFP. Neurons in the neostriatum were classified into 6 types. All such types were demonstrated to synthesize AChE. Two types of efferent neuron (types III and IV) have shown a relatively large amount of AChE and resynthesized the enzyme in the earlier stage after DFP. A tentative model of the neuronal network in the neostriatum was schematically shown.

Two types of dopaminergic nerve terminals in the rat neostriatum. An ultrastructural study

In the neostriatum 7.7% of all boutons absorbed alpha-methylnoradrenaline, thus staining their synaptic vesicles profiles granular. These presumably monoaminergic synapses were divided into two types according to ultrastructural features. Type A was composed of a relatively large axon terminal and a dendritic spine with postsynaptic membrane thickening. The axon terminal of type B, that is a bouton en passant, was smaller than the postsynaptic profile, while the synaptic contact was symmetrical. Following nigral coagulation, both types of synapse degenerated. It is concluded that both types of synapse are dopaminergic.