Kazuhiro Sasaki

Reduced size of right hippocampus in 39- to 80-year-old normal subjects carrying the apolipoprotein E ϵ4 allele

Abstract Hippocampal size on magnetic resonance imaging was compared between normal subjects with the apolipoprotein E (apo E) ϵ4 allele (ϵ4/4, ϵ4/3, and ϵ4/2) and those without the ϵ4 allele (ϵ3/3, ϵ3/2, and ϵ2/2) in the age range of 39–80 years. The Mini-Mental State Examination (MMSE) scores did not differ between the two groups. The right hippocampal area and its ratio to hemisphere area and intracranial cavity area were significantly smaller in ϵ4 carriers than non-carriers, whereas hemisphere area did not differ between the two groups. These results suggest that as early as their forties, apo E ϵ4 allele carriers have a markedly smaller right hippocampus with no apparent cognitive impairment, which may have some significance in the high prevalence of the ϵ4 allele in Alzheimers disease as well as other conditions that cause dementia.

Concentrations of α-tocopherol and its quinone derivative in cerebrospinal fluid from patients with vascular dementia of the Binswanger type and Alzheimer type dementia

We determined the concentrations of α-tocopherol (α-TOH) and α-tocopherol quinone(α-TQ), an oxidized derivative of α-TOH, in cerebrospinal fluid from patients with Alzheimer type dementia (ATD) and those with vascular dementia of the Binswanger type (VDBT). Compared with results for the controls, the VDBT patients had unaltered concentrations of α-TOH, but a statistically significant, 3.6-fold increase of α-TQ (P < 0.01) which was significantly correlated with decreases in the Mini-Mental State Examination scores (P < 0.05). In contrast, ATD patients had significantly decreased concentrations of α-TOH (P < 0.01), but had unaltered concentrations of α-TQ. These results suggest that there is greater oxidation of α-TOH to α-TQ in VDBT brain, but are inconclusive about the occurrence of peroxidation in ATD brains.

Reduced and oxidized forms of glutathione and α-tocopherol in the cerebrospinal fluid of parkinsonian patients: comparison between before and after l-dopa treatment

In the cerebrospinal fluid of untreated patients with Parkinsons disease (PD) the concentrations of reduced glutathione (GSH) and alpha-tocopherol (alpha-TOH) were unaltered but the concentration of oxidized glutathione (glutathione disulfide, GSSG) (P < 0.001), the GSSG/GSH ratio (P < 0.06), alpha-tocopherol quinone (alpha-TQ) (P < 0.001), and the alpha-TQ/alpha-TOH ratio (P < 0.01) were reduced significantly. In L-dopa-treated patients, the concentrations of GSH, GSSG, and the alpha-TQ concentration and the alpha-TQ/alpha-TOH ratio (P < 0.05) increased compared with untreated PD patients. These results suggest that oxidation of GSH and alpha-TOH is decreased in untreated PD patients, but is activated to a control level or more after L-dopa treatment.

Cerebral perfusion patterns in vascular dementia of Binswanger type compared with senile dementia of Alzheimer type: a SPECT study.

SummaryCerebral perfusion patterns in 18 cases with vascular dementia of Binswanger type (VDBT) (8 moderate and 10 severe cases) were compared with 25 cases with senile dementia of Alzheimer type (SDAT) (16 moderate and 9 severe cases) and 14 controls by single photon emission computed tomography usingN-isopropyl-p-123I iodoamphetamine (IMP) as a tracer. The cerebral: cerebellar IMP uptake ratio (%) (CCR) was used as a measure of relative cerebral perfusion. The CCRs were about 85–90% in all areas in controls. Moderate VDBT patients showed a remarkable decrease of CCRs in the basal grey region (thalamus and basal ganglia) (right 79%, left 77%) and in the frontal area (right 79%, left 80%) (P<0.01). In severe VDBT patients a significant decrease of the CCR was noted in all regions (P<0.01). The decrease of mean CCRs in the hemispheres was significantly correlated with the severity of disease determined by psychometric testing. Patients with SDAT showed a significant decrease of the CCR in the parietal (right 71%, left 74%) and right temporal (78%) areas in the moderate stage (P<0.01), and further progression of dementia was associated with low perfusion areas extending to the frontal areas (78%,P<0.01). These differences in the perfusion patterns and their changes with progression of the illnesses may be reflected in characteristic clinical features.

Comparison of symptomatic and asymptomatic reinfarctions after small subcortical stroke

We compared possible factors leading to symptomatic and asymptomatic reinfarcts in 207 patients an average of 2.1 years after their index atherothrombotic stroke presenting with small subcortical infarcts. Symptomatic reinfarcts were mostly small infarcts in the perforating artery regions associated with angiographic evidence of atherosclerosis of parent arteries (large-artery disease), a high hematocrit, elevated fibrinogen and Lp(a) levels. They occurred with insufficient inhibition of platelet aggregability in patients receiving antiplatelet medication. In contrast, many asymptomatic reinfarcts were small perforator infarcts not associated with large-artery disease or cortical infarcts, and occurred in the absence of hematologic risk markers, and in spite of sufficient inhibition of platelet aggregability.

The utility of on‐site ultrasound screening in population at high risk for deep venous thrombosis in temporary housing after the great East Japan Earthquake

To evaluate the diagnostic performance of ultrasonography for screening of a population at risk for deep vein thrombosis (DVT) in a post‐disaster setting.