Biomedical subjects

E Mori

Publications and source records attributed to E Mori.

At least 109 records · Page 6Linked to original sources

PubMed1998

Regional metabolism: associations with dyscalculia in Alzheimer's disease.

OBJECTIVES: The ability to calculate, which is an important aspect of social daily living, is commonly impaired in patients with Alzheimer's disease even early in the course of the disease. Dyscalculia is often accompanied by focal brain damage, and has been argued to be an independent sign localised around the left temporoparietal region. However, the region most responsible for dyscalculia in Alzheimer's disease has not been determined. The relation between calculation ability and regional cerebral glucose metabolism in Alzheimer's disease was therefore examined. METHODS: The calculation ability, In 91 patients with probable Alzheimer's disease of minimal to moderate severity, was assessed using the arithmetic subtest of the Wechsler adult intelligence scale-revised and the performance correlated with regional cerebral glucose metabolism determined by "F-fluorodeoxyglucose and PET. RESULTS: Regional glucose metabolism in the left inferior parietal lobule and in the left inferior temporal gyrus was significantly correlated with the calculation performance irrespective of age, sex, education, and severity of disease. CONCLUSIONS: The results suggest that dysfunction of the left inferior parietal lobule and the left inferior temporal gyrus plays an important part in producing dyscalculia in patients with Alzheimer's disease.

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PubMed1998

Frontotemporal dementia and Alzheimer disease: evaluation of cortical atrophy with automated hemispheric surface display generated with MR images.

PURPOSE: To determine the features of cortical atrophy in frontotemporal dementia (FTD) and Alzheimer disease by using a hemispheric surface display generated with magnetic resonance (MR) images. MATERIALS AND METHODS: The extent of cortical atrophy was evaluated with automated MR hemispheric surface display and volumetry in 18 patients with FTD and in 18 matched patients with Alzheimer disease. Results were compared with those in 18 healthy, matched control subjects. RESULTS: Most cortical regions were significantly atrophic in FTD and Alzheimer disease. The frontal and anterior temporal lobes were significantly more atrophic in FTD than in Alzheimer disease. The mean hemispheric-to-intracranial volume ratio in patients with FTD (56.2%) and those with Alzheimer disease (58.4%) was significantly smaller than the ratio in the control subjects (66.0%). Asymmetry of hemispheric volume was significantly larger in the FTD group than in the Alzheimer disease and control groups. CONCLUSION: Cortical atrophy in FTD is more widespread than was previously thought. Asymmetric frontal and anterior temporal atrophy is a distinctive feature of FTD and distinguishes it from Alzheimer disease. Hemispheric surface display is a useful complement to tomographic images and is useful for the evaluation of focal cortical atrophy in degenerative dementias, especially FTD.

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PubMed1998

Apolipoprotein E epsilon 4 allele and whole brain atrophy in late-onset Alzheimer's disease.

OBJECTIVE: Diffuse brain atrophy is one of the gross pathological features of Alzheimer's disease and is a result of degenerative changes. The epsilon 4 allele of apolipoprotein E (APOE) is a risk factor or susceptibility gene in late-onset sporadic Alzheimer's disease and may influence the pathological changes associated with the disease. The aim of this study was to examine the relationship between the APOE epsilon 4 allele and whole brain atrophy. METHOD: Whole brain volume was quantified by using high-resolution magnetic resonance imaging and the computerized brain segmentation technique in 178 patients with late-onset sporadic Alzheimer's disease who carried no APOE epsilon 4 alleles (N = 62), one epsilon 4 allele (N = 93), or two (N = 23) and had comparable clinical severity of dementia. RESULTS: An apparent positive correlation was found between normalized whole brain volume (relative to total intracranial volume) and number of APOE epsilon 4 alleles; i.e., patients carrying two APOE epsilon 4 alleles had the least brain atrophy. This association between the APOE epsilon 4 allele and brain volume was similar in women and men and was independent of age, level of education, duration of illness since symptom onset, and severity of dementia. CONCLUSIONS: The results indicate that cognitive dysfunction progresses before severe brain atrophy develops in patients carrying the APOE epsilon 4 allele and suggest that an APOE epsilon 4-allele-related mechanism that affects neuronal function before a decrement in brain matter is involved in the development of dementia.

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PubMed1998

Alteration of regional cerebral glucose utilization with delusions in Alzheimer's disease.

The authors examined 65 patients with Alzheimer's disease for delusions and explored the relationship of delusions with regional cerebral glucose metabolism determined by [18F]fluorodeoxyglucose PET. In patients with delusions (n = 26), normalized glucose metabolism was significantly increased in the left inferior temporal gyrus and significantly decreased in the left medial occipital region as compared with those without delusions (n = 39). The two groups were similar in age, sex, and dementia severity. These results suggest that delusions in Alzheimer's disease are attributable to a dysfunction in specific brain areas rather than a simple reaction to intellectual deficits.

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PubMed1998

Amnestic people with Alzheimer's disease who remembered the Kobe earthquake.

BACKGROUND: Emotional memory is a special category of memory for events arousing strong emotions. To investigate the effects of emotional involvement on memory retention in individuals with Alzheimer's disease we studied peoples' memories of distressing experiences during a devastating earthquake. METHODS: Fifty-one subjects with probable Alzheimer's disease who experienced the Kobe earthquake at home in the greater Kobe area were studied. Memories of the earthquake were assessed 6 and 10 weeks after the disaster in semi-structured interviews, and were compared with memories of a magnetic resonance imaging (MRI) examination given after the earthquake. RESULTS: Forty-four (86.3%) of the subjects remembered the earthquake and 16 (31.4%) of subjects remembered the MRI experience. Factual content of the earthquake was lost in most of the subjects. CONCLUSIONS: Fear reinforces memory retention of an episode in subjects with Alzheimer's disease but does not enhance retention of its context, despite repeated exposure to the information.

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PubMed1998

Frontal lobe hypometabolism and depression in Alzheimer's disease.

Depression is common in Alzheimer's disease (AD). Clinicoanatomic studies in focal brain injuries and functional imaging studies both in primary depression and in depression secondary to neurologic diseases have demonstrated involvement of the frontal lobe. Frontal involvement has not been established in the depression of AD. We studied the correlation between focal brain metabolic abnormalities and depression in AD. In 53 patients with probable AD of minimal to moderate disability, we assessed the severity of depression using the Neuropsychiatric Inventory and correlated the depression score with regional cerebral glucose metabolism determined by 18F-fluorodeoxyglucose and PET. Depression was present in 19 patients (36%). The depression score correlated significantly with normalized glucose metabolic rates in the bilateral superior frontal and left anterior cingulate cortices. These results indicated an association between depression and decreased activity in the frontal lobe in AD and support frontal involvement, especially in the left side, in depression, irrespective of disease etiology.

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PubMed1998

Spontaneous dural carotid cavernous sinus fistula presenting isolated ophthalmoplegia: evaluation with MR angiography.

We describe three patients with spontaneous dural carotid cavernous sinus fistula presenting an isolated ophthalmoplegia where magnetic resonance angiography demonstrated abnormal flow-related enhancements in the cavernous sinus with extension into the inferior petrosal sinus. Magnetic resonance angiography is of value in evaluation of patients with isolated ophthalmoplegia.

Arteriovenous Fistula↗

PubMed1998

Regional cerebral glucose metabolism in dementia with Lewy bodies and Alzheimer's disease.

OBJECTIVE: To delineate the features of regional cerebral metabolic rate of glucose (CMRglc) in dementia with Lewy bodies (DLB). METHODS: We compared absolute CMRglc in 12 patients with a clinical diagnosis of DLB, 12 patients with a clinical diagnosis of Alzheimer's disease (AD), and 12 normal volunteers (NC), using 18F-fluorodeoxyglucose (FDG) and PET. The three groups were matched for age and sex, and there were no differences in disease duration or severity of cognitive disturbances between the DLB and AD groups. RESULTS: CMRglc was significantly lower in patients with DLB than in that of NC in most parts of the brain, except the sensorimotor cortices, basal ganglia, thalamus, and pons. Between the DLB and AD groups, there were significant regional CMRglc differences in the medial and lateral occipital lobes. In DLB and AD, the CMRglc reduction patterns were similar, though the global metabolic reduction was larger in DLB, and the occipital CMRglc reduction in DLB could differentiate DLB from AD. The relative occipital CMRglc (normalized to the sensorimotor CMRglc) was a useful measure for the differential diagnosis of DLB from AD. The sensitivity and the specificity were 92% when using the minimal value of the normalized occipital CMRglc in the NC group as the cut-off point. CONCLUSION: These different regional CMRglc reductions substantiate the pathologic, neurochemical, and clinical differences between DLB and AD.

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PubMed1998

Medial temporal and whole-brain atrophy in dementia with Lewy bodies: a volumetric MRI study.

OBJECTIVE: Dementia with Lewy bodies (DLB) is emerging as a common cause of degenerative dementia. A recent pathologic study has indicated that the medial temporal lobe in patients with DLB was less atrophic than that in patients with AD. The purpose of this study was to examine whether medial temporal MRI volumetry was useful to differentiate DLB from AD clinically. METHODS: We compared the volumes of the hippocampal formation, amygdaloid complex, and whole brain in 27 patients with probable DLB (based on the criteria of the Consortium on DLB International Workshop), 27 patients with probable AD (based on criteria of the National Institute of Neurological Disease and Stroke/Alzheimer's Disease and Related Disorders Association), and 27 normal elderly subjects using an MRI-based volumetric technique. The three groups were matched for age and sex. Severity of cognitive disturbances represented by their Mini-Mental State Examination score was comparable between the DLB and AD groups. RESULTS: Hippocampal volume (normalized to intracranial volume) in the DLB group was significantly larger than that in the AD group, but significantly smaller than that in the normal control group. There were no significant differences in the amygdala and whole-brain volume between the DLB group and the AD group, but the atrophies of the amygdala and whole brain were more severe in the DLB group than those in the control group. CONCLUSIONS: These findings indicate the usefulness of MRI hippocampal volumetry in clinically discriminating patients with DLB from patients with AD.

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PubMed1998

Paradoxical hippocampus perfusion in mild-to-moderate Alzheimer's disease.

UNLABELLED: The purpose of this study was to clarify the changes in hippocampal perfusion in mild-to-moderate Alzheimer's disease using PET and (15)O-labeled water. METHODS: Sixteen patients with probable mild-to-moderate Alzheimer's disease (age: 68.1+/-11.3 yr; MMSE: 21.1+/-4.5) and 10 normal volunteers (age: 65.1+/-8.2 yr) were studied. Regional cerebral blood flow (CBF) and cerebral blood volume (CBV) were measured using (15)O-labeled water autoradiographic method, C(15)O-gas inhalation technique and PET. RESULTS: Although the mean CBF in the parietotemporal region was significantly lower in the patient group than in the control group, the mean CBF in the hippocampus did not show significant reduction between the two groups, both in absolute and relative values. There was no significant regional CBV difference between the two groups. Parietotemporal perfusion correlated well with cognitive scores, both in absolute and relative values, in Alzheimer's disease, but hippocampal perfusion did not correlate well. CONCLUSION: Hippocampal perfusion was preserved in mild-to-moderate Alzheimer's disease.

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PubMed1998

[Neuropsychiatric features in Dementia with Lewy bodies and Alzheimer's disease].

BACKGROUND AND PURPOSE: Dementia with Lewy bodies (DLB) is commonly accompanied by neuropsychiatric symptoms. Among them, visual hallucinations are reportedly distinguishing DLB from Alzheimer's disease (AD). However, studies that compared frequency of delusions or depression between in DLB and in AD demonstrated conflicting results. Other neuropsychiatric symptoms including aggression, anxiety, and disinhibition have been rarely explored in DLB. In the present study, in order to elucidate the distinctive neuropsychiatric features in DLB, we analyzed neuropsychiatric symptoms in patients with DLB and with AD using data-based materials. SUBJECTS AND METHODS: Subjects were 15 DLB patients extracted from the Dementia Data Bank in the Hyogo Institute for Aging Brain and Cognitive Disorders, where clinical information of patients with dementia were prospectively assembled with planed, standardized assessments. Both patients groups did not differ in age, education, and duration of illness. The male proportion was significantly greater in the DLB group compared with the AD group (DLB: Male 8, Female 7; AD: Male 27, Female 124, p = 0.008). Patients' neuropsychiatric symptoms were assessed with the Neuropsychiatric Inventory during an interview with a caregiver familiar to the patient's everyday behavior. The Mini-Mental State Examination (MMSE) was used for assessing severity of cognitive impairment. RESULTS: The DLB group had significantly lower MMSE scores compared with AD group (DLB: 16.2 +/- 5.6, AD: 19.3 +/- 4.4, p = 0.013). None of neuropsychiatric symptoms, however, showed a significant relationship with MMSE scores in the DLB group. Hallucination were present in eight (53.3%) of the DLB group. Visual hallucinations were present in seven patients, and both visual and auditory hallucinations in one patient. The frequency of hallucinations (p < 0.0001) and that of visual hallucinations (p < 0.0001) were significantly greater in the DLB group than in the AD group. There was no significant difference in the frequency of auditory hallucinations. Delusions were present in 11 (73.3%) of the DLB group. Misidentification delusions were present in 11 patients, and persecutory delusions were coexisted in 8 patients. The frequency of delusions and that of persecutory delusions in the DLB group did not significantly differ from the AD group. However, the frequency of misidentification delusions was significantly greater in the DLB group than in the AD group (p < 0.0001). No significant difference was noted in the frequency of other neuropsychiatric symptoms. CONCLUSIONS: Hallucinations, especially visual hallucinations, and misidentification delusions are helpful diagnostic features of DLB in differentiating from AD.

Alzheimer Disease↗

PubMed1998

[Caregiver burden in dementia: evaluation with a Japanese version of the Zarit caregiver burden interview].

BACKGROUND AND PURPOSE: Dementia patients need assistance or supervision in their daily activities. This often places a major burden on their caregivers. The caregiver burden is reportedly a critical determinant for negative caregiving outcomes. However, in Japan, no study evaluating the burden experienced by caregivers for patients with established dementia diagnosis with a standardized instrument has been carried out. The Zarit Caregiver Burden Interview (ZBI) is a standardized, validated, reliable tool for assessment of the burden of caregivers for dementia patients, and has been used in many studies in North America. In this study, we arranged a Japanese version of the ZBI and applied it to caregivers who were caring dementia patients. After examining the reliability and validity of this version, we then studied a relationship between patients' impairments and caregivers' burden. SUBJECTS AND METHODS: Subjects were 117 dementia patients. Diagnosis of dementia was made through extensive examinations including MRI and PET/SPECT of the brain and based on appropriate clinical diagnostic criteria of each disorder, which included Alzheimer's disease (n = 76), frontotemporal dementia (n = 10), vascular dementia (n = 11), progressive supranuclear palsy (n = 3), corticobasal degeneration (n = 5), dementia with Lewy bodies (n = 11), and normal pressure hydrocephalus (n = 1). The patients included 80 women and 37 men; the mean age was 72.3 +/- 7.7 (SD) years. Trained nurses interviewed a principal caregiver of each patient by using the ZBI. The caregivers included the patients' spouses (n = 62), offsprings (n = 17), offspring's spouses (n = 37), and sibling (n = 1). Cognitive, functional, and neuropsychiatric impairments and severity of dementia were assessed with standardized instruments of the Mini-Mental State Examination (MMSE), Hyogo Activities of Daily Living Scale (HADLS), Neuropsychiatric Inventory (NPI), and Clinical Dementia Rating (CDR), respectively. RESULTS: The mean total ZBI score was 28.6 +/- 15.3 (SD), the Personal strain (PS) score was 17.4 +/- 8.9, and Role strain (RS) score was 6.5 +/- 5.7. All three scores had high Cronbach's alpha coefficients (Total: 0.88, PS: 0.78, RS: 0.80) and had high Pearson's correlation coefficients with a single global rating of burden (Total: 0.69, PS: 0.65, RS: 0.60). All ZBI scores were significantly correlated with MMSE, CDR, HADLS, and NPI scores. A stepwise regression analysis revealed only the HADLS score and NPI score as significant predictors of ZBI scores. CONCLUSIONS: This Japanese version of the ZBI has a sufficient reliability and validity comparable to those reported for the original version. Our results suggested that the patients' functional and neuropsychiatric impairments were main patient's factors to increase the caregiver's burden.

Activities of Daily Living↗

PubMed1998

CSF spaces in idiopathic normal pressure hydrocephalus: morphology and volumetry.

PURPOSE: Idiopathic normal pressure hydrocephalus (NPH) is an important cause of dementia in the elderly; however, idiopathic NPH is often difficult to differentiate from normal aging and vascular dementias in which brain atrophy with ventricular dilatation (hydrocephalus ex vacuo or central atrophy) is present. To elucidate the distinctive features of the distribution of CSF in idiopathic NPH, we used MR imaging to investigate the morphologic features and volume of the CSF space in patients with idiopathic NPH compared with those with other dementias. METHODS: We assessed the size of four CSF compartments (the ventricle, basal cistern, sylvian space, and suprasylvian subarachnoid space) in 11 shunt-responsive patients with idiopathic NPH by semiquantitative and volumetric analyses of coronal T1-weighted MR images. The results were compared with those in 11 age- and sex-matched patients with Alzheimer disease and in 11 patients with vascular dementia. RESULTS: In patients with idiopathic NPH, the CSF volume was significantly increased in the ventricles and decreased in the superior convexity and medial subarachnoid spaces as compared with patients with other dementias. The sylvian CSF volume in patients with idiopathic NPH was significantly greater than in patients with Alzheimer disease. The volume of the basal cistern was comparable among the three groups. In several patients with idiopathic NPH, focally dilated sulci were observed over the convexity or medial surface of the hemisphere. CONCLUSION: Our results indicate that findings of enlarged basal cisterns and sylvian fissures and of focally dilated sulci support, rather than exclude, the diagnosis of shunt-responsive idiopathic NPH and suggest that this condition is caused by a suprasylvian subarachnoid block.

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PubMed1998

Cerebral glucose metabolism in patients with frontotemporal dementia.

UNLABELLED: Frontotemporal dementia (FTD) is a dementia syndrome characterized by peculiar behavioral changes arising from frontotemporal involvement and distinct from Alzheimer's disease (AD). The purpose of this study was to elucidate the specific patterns in cerebral glucose metabolism in patients with FTD and to compare them with the patterns in patients with AD and normal elderly subjects using fluorodeoxyglucose (FDG) and PET. METHODS: Twenty-one patients with a clinical diagnosis of FTD [mean age 67.0 +/- 7.0 yr, Mini Mental State Examination (MMSE) score 18.7 +/- 5.7], 21 age-, sex- and dementia-severity-matched patients with probable AD (mean age 66.9 +/- 7.1 yr, MMSE score 20.2 +/- 5.5) and 21 age- and sex-matched normal control subjects (mean age 66.8 +/- 5.7 yr) were studied. The cerebral metabolic rate for glucose (CMRglc) was measured with FDG and PET. Absolute measures of regional CMRglc were compared among the three groups. One-way ANOVA and the posthoc Tukey HSD test were used for statistical analyses. RESULTS: In the FTD group, CMRglc was preserved only in the left cerebellum, right sensorimotor area and occipital lobes. The CMRglc was significantly lower in the FTD group as opposed to the AD group in the hippocampi, orbital gyri, anterior temporal lobes, anterior cingulate gyri, basal ganglia, thalami, middle and superior frontal gyri and left inferior frontal gyrus. CONCLUSION: Although metabolic abnormality in FTD is predominant in the frontal and anterior temporal lobes and the subcortical structures, it is more widespread than has been previously stressed. These findings document an FTD-specific cerebral involvement and facilitate differential diagnosis of degenerative dementias.

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PubMed1997

Regional cerebral glucose metabolism in dementia with Lewy bodies and Alzheimer's disease: a comparative study using positron emission tomography.

Regional cerebral metabolic rate of glucose (rCMRglc) was studied in 19 patients with a clinical diagnosis of dementia with Lewy bodies (DLB) and 19 patients with a clinical diagnosis of Alzheimer's disease (AD), using [18F]fluorodeoxyglucose ([18F]FDG) and positron emission tomography (PET). The two groups were matched with age, gender, disease duration and severity of cognitive disturbances. In 'dementia with Lewy bodies' (DLB) patients, when compared with AD patients, significant rCMRglc decreases were distributed in the temporo-parieto-occipital association cortices and the cerebellar hemispheres. In contrast, the medial temporal and cingulate rCMRglc were significantly lower in AD patients than those in DLB patients. These different regional emphases of glucose hypometabolism are consistent with the pathological and neurochemical differences between DLB and AD and explain the different clinical features of the two diseases.

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PubMed1997

Paralogous histidine biosynthetic genes: evolutionary analysis of the Saccharomyces cerevisiae HIS6 and HIS7 genes.

The HIS6 gene from Saccharomyces cerevisiae strain YNN282 is able to complement both the S. cerevisiae his6 and the Escherichia coli hisA mutations. The cloning and the nucleotide sequence indicated that this gene encodes a putative phosphoribosyl-5-amino-1-phosphoribosyl-4-imidazolecarboxiamide isomerase (5' Pro-FAR isomerase, EC 5.3.1.16) of 261 amino acids, with a molecular weight of 29,554. The HIS6 gene product shares a significant degree of sequence similarity with the prokaryotic HisA proteins and HisF proteins, and with the C-terminal domain of the S. cerevisiae HIS7 protein (homologous to HisF), indicating that the yeast HIS6 and HIS7 genes are paralogous. Moreover, the HIS6 gene is organized into two homologous modules half the size of the entire gene, typical of all the known prokaryotic hisA and hisF genes. The structure of the yeast HIS6 gene supports the two-step evolutionary model suggested by Fani et al. (J. Mol. Evol. 1994; 38: 489-495) to explain the present-day hisA and hisF genes. According to this idea, the hisF gene originated from the duplication of an ancestral hisA gene which, in turn, was the result of an earlier gene elongation event involving an ancestral module half the size of the extant gene. Results reported in this paper also suggest that these two successive paralogous gene duplications took probably place in the early steps of molecular evolution of the histidine pathway, well before the diversification of the three domains, and that this pathway was one of the metabolic activities of the last common ancestor. The molecular evolution of the yeast HIS6 and HIS7 genes is also discussed.

Aldose-Ketose Isomerases↗

PubMed1997

Binding of mouse sperm to beta-galactose residues on egg zona pellucida and asialofetuin-coupled beads.

Mouse eggs fixed with paraformaldehyde were incubated with various exoglycosidases and their sperm-binding activities were examined. The number of sperm bound per egg was increased by sialidase treatment and decreased by beta-galactosidase treatment. No prominent reduction of sperm-binding was observed after alpha-galactosidase treatment. Mouse sperm also bound to asialofetuin-coupled agarose beads but not to fetuin-coupled beads. The sperm-binding was abolished when asialofetuin-gel was treated with beta-galactosidase specific to the beta 1-->4 linkage or N-Glycanase. Furthermore asialofetuin, but not beta-galactosidase-treated asialofetuin, competitively inhibited the binding of sperm to the zona pellucida of live eggs. These results suggest that mouse sperm recognize beta-galactose residues of the zona pellucida at the initial stage of the binding.

Animals↗

PubMed1997

Vasospastic angina induced by nonsteroidal anti-inflammatory drugs.

We report two cases of vasospastic angina associated with anaphylactic reaction caused by nonsteroidal anti-inflammatory drugs (NSAIDs). Both patients exhibited anaphylactic manifestations, such as general rash and urticaria, along with angina pectoris with electrocardiographic ST-segment elevations after suppository administration of diclofenac sodium or indomethacin, the most commonly used NSAIDs. Although these patients had normal coronary arteriograms, intracoronary administration of ergonovine or acetylcholine provoked diffuse coronary artery spasms accompanied by chest pain and ischemic ST-segment changes. It is therefore suggested that an allergic mechanism may be involved as a causative factor of the coronary artery spasm induced by NSAIDs.

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