Keiji Yamaguchi

Camptocormia in Japanese patients with Parkinson's disease: a multicenter study.

The aim of this work was to investigate the prevalence of camptocormia and the clinical characteristics of patients with camptocormia in a large population of PD patients.

Screening for Impaired Cognitive Domains in a Large Parkinson's Disease Population and Its Application to the Diagnostic Procedure for Parkinson's Disease Dementia

Background: Dementia is a new focus of research on improved treatment for Parkinsons disease (PD). In 2007, a screening tool for PD dementia (PD-D) was developed by the Movement Disorder Society (Level I testing), which still requires verification by a large population study. Methods: We conducted a cross-sectional and multicenter study including 13 institutions administering the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) to 304 PD patients (mean age: 70.6 ± 8.3 years; mean Hoehn and Yahr stage: 2.7 ± 0.7). Results: In all, 34.5% of the patients had MMSE scores <26; 94.3% of these patients had impairments in ≥2 cognitive domains and met the criteria for probable PD-D by Level I testing. Executive dysfunction combined with attention and memory impairment was most common (51.4%). In the Level I subtests of executive function, the score for phonemic fluency declined by <50% in patients with high MoCA scores (24-30 points) and lacked specificity for PD-D. No patient had visuospatial impairment (measured by the pentagon copying subtest) alone, and the score for pentagon copying stayed at ≥70% even in patients with low MMSE scores (12-25 points), therefore lacking sensitivity for PD-D. Conclusions: Level I testing with administration of the MMSE and MoCA is a practical and efficient screening tool for PD-D. However, the phonemic fluency and pentagon copying tests should be replaced by more specific/sensitive ones when screening for PD-D.

Comparison between MMSE and Montreal Cognitive Assessment (MoCA) for detecting cognitive impairments in patients with Parkinson's disease: A multicenter study of Keio PD database

posterior DMN connectivity normalized in the middle and posterior cingulate gyri but remained in the precuneus and retrosplenial cortex after adjusting for global cortical PiB retention in DLB. Conclusions: Patients with DLB are characterized by increases in the anterior DMN and decreases in the posterior DMN and PVN. This reciprocal change in the anterior and posterior DMN identified in patients with DLB closely resemble the DMN changes observed in AD. Although As load modifies the decreases in the middle and posterior cingulate regions in the posterior DMN, connectivity abnormalities in DLB persist even after controlling for As load. The pattern of posterior DMN and PVN connectivity decreases sparing the middle and posterior cingulate gyri after adjusting for As load is consistent with the pattern of regional hypometabolism typically observed in DLB.

Comparing the Montreal Cognitive Assessment with Mini‐Mental State Examination in Japanese Parkinson's disease patients

The Montreal Cognitive Assessment (MoCA) is the most suitable measure for screening cognitive impairment in Parkinsons disease (PD). However, the utility of the MoCA has not been documented sufficiently, especially in Asian populations. The present multicenter study included a large number of Japanese patients, and compared Mini‐Mental State Examination (MMSE) and MoCA scores in PD patients.

In Vivo Measurement of Superoxide in the Cerebral Cortex Utilizing Cypridina luciferin analog (MCLA) Chemiluminescence

Temproal profile of superoxide (O2 −) generation following cerebral hypoxia and ischemia has been obscure, although it has been implicated in the progression of reperfusion injury. We have examined the time course of O 2 − generation in the cat cortex following reversible hypoxia and forebrain incomplete ischomia. We used 20 cats anesthetized with halothane inhalation. A closed cranial window was placed over the exposed temporoparietal cortex, and Cypridina luciferin analog (MCLA), a chemiluminescence probe for the measurement of O 2 − , was dissolved in the artificial cerebrospinal fluid (ACSF) and superfused continuously throughout the experiments. We simultaneously monitored a reflectance (398 nm) from the cortex by means of an in vivo fluoromicroscope with two photomultiplier tubes. We subtracted a hemodynamic artifact from the MCLA chemiluminescence. Hypoxia was induced by pure N2 inhalation for 1 min, and forebrain incomplete ischemia was induced by 30-min ligation of both common carotid arteries combined with hypotension (= 50 mmHg). As a result, the MCLA chemiluminescence increased following reoxygenation and reperfusion, indicating an enhanced O 2 − generation. It was significantly reduced during hypoxia and severe ischemia, but fluctuated during mild ischemia. We speculate a breakdown of arachidonic acid and a biochemical interaction between endothelial cells and polymorphonuclear leukocytes as a source of O 2 − generation.