慶應義塾大学 · 医学
Akihiro Takamiya教授の研究室は、うつ病や若年性アルツハイマー病に代表される神経精神疾患における電気けいれん療法(ECT)の効果とその神経生物学的メカニズムを、画像診断(MRI、PET)と行動評価を統合して解明しています。特に、ECTが脳の構造的・機能的ネットワークに与える影響、とりわけ海馬や前頭側頭連合領域、デフォルトモードネットワークの変化と臨床改善の関連を解明しています。また、無意識状態の患者におけるECTの受容性や、高齢期のうつ病とアルツハイマー病の病態的重複についても探求しています。
Figures are computed from collected data and may differ slightly.
ECT increased brain volume in the limbic structures. The clinical relevance of volume increase needs further investigation. Declaration of interest None.
The current meta-analysis suggests the potential benefit of ECT on motor and non-motor symptoms in presumably complicated and difficult-to-treat subgroups. © 2020 International Parkinson and Movement Disorder Society.
Approximately 80% of the patients showed overall satisfaction with ECT irrespective of consent status. Relatives were more satisfied with ECT than patients. Electroconvulsive therapy can be a lifesaving treatment for severely depressed patients, and the subjective experience of involuntary patients should be taken into consideration when discussing involuntary ECT treatment.
ECT-induced change in the right frontotemporal connectivity and thalamocortical connectivity, and changes in the nodes of the default mode network were associated with clinical improvement. Modulation of these networks may explain the underlying mechanisms by which ECT exert its potent and rapid antidepressant effect.
Right unilateral ECT induces widespread, bilateral regional volume expansion and contraction, with the largest change in the right MTL. This dynamic volume change cannot be explained by the effect of electrical stimulation alone and is related to the cumulative effect of ECT-induced seizures.
Late-life depression (LLD) is associated with a risk of developing Alzheimer's disease (AD). However, the role of AD-pathophysiology in LLD, and its association with clinical symptoms and cognitive function are elusive. In this study, one hundred subjects underwent amyloid positron emission tomography (PET) imaging with [<sup>18</sup>F]-flutemetamol and structural MRI: 48 severely depressed elderly subjects (age 74.1 ± 7.5 years, 33 female) and 52 age-/gender-matched healthy controls (72.4 ± 6.4
status: Published
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