著者

永山 寛

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.12, no.3, pp.78-85, 2016-06-15 (Released:2016-07-13)

参考文献数

48

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Depression is found in about 40% of patients with Parkinson's disease (PD). The main characteristics of depression in PD is inability to experience pleasure, however, the symptoms such as severe anxiety, suicidal idea, daily fluctuation of mood, depression associated hallucination and delusion are relatively rare. In more than half of these patients, the cause of depression is closely linked the pathophysiology of PD itself. The feature of depression in PD is limited and is equivalent for the words of anhedonia/apathy, although the feature of "depression" is also occasionally found in PD. Indeed, recent studies suggested the features of depression, apathy (anhedonia) and dementia were independent in PD. As the mechanism of anhedonia/apathy in PD, the disturbance of acetylcholine and other monoamine system such as noradrenaline as well as dopaminergic system is indicated. The dopamine system that concerns with anhedonia/apathy is considered to be originated from ventral tegmental area in the midbrain project to nucleus accumbens, amygdala and mesolimbic system. Malfunction of these neurons cause the inactivation of emotion and motivation as the disruption of frontostriatal circuits, and this is related to the anhedonia/apathy in PD. Moreover, recent studies have shown that the dysfunction of amygdala and the disruption of its connectivity in the brain is suggested to the etiology of depression in PD. In the treatment of depression, at first, the sufficient medication for motor symptoms is needed, because depression in PD is linked the pathophysiology of PD. In the next step, anti-depressants are used. Some dopamine agonist such as pramipexole is also effective.

著者

永山 寛 片山 泰朗

出版者

一般社団法人 日本内科学会

雑誌

日本内科学会雑誌 (ISSN:00215384)

巻号頁・発行日

vol.101, no.8, pp.2212-2218, 2012 (Released:2013-08-10)

参考文献数

10

被引用文献数

1 1

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神経疾患と関連する肝胆膵・消化管疾患として,ここでは肝性脳症に関連した2疾患,Wilson病,IgG4関連神経疾患を取り上げた.前三者は古くから認識されている疾患であるが様々な面で進歩もみられるので,病態や分類,臨床的特徴,治療を最近の知見を含めて改めて把握したい.IgG4関連神経疾患はこれから症例の蓄積や知見の整理が期待されるが,病理学的概念も合わせてその特徴を知っておくべき疾患である.

著者

恒吉 玲代 永山 寛 涌井 佐和子 浜岡 隆文 齋藤 和人 前田 明 図子 浩二 井上 尚武 和田 智仁 隅野 美砂輝 荻田 太 吉武 裕

出版者

日本体力医学会

雑誌

体力科學 (ISSN:0039906X)

巻号頁・発行日

vol.57, no.4, pp.433-442, 2008-08-01

被引用文献数

4 6

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There have so far been no studies examining the physical fitness and physical activity (PA), measured using objective measures, in homebound elderly people. The purpose of this study was to examine physical fitness levels and PA patterns and evaluate their relationships in homebound elderly people. In 2004, a total of 3964 community-dwelling elderly aged 65 years and over participated in a base line survey. The subject data were directly collected by in-home interviewer. Subjects were defined as being homebound if they went outdoors less than once a week. However, the subjects who could not go out without assistance due to sickness and/or disability were excluded from the analysis. In 2005, 38 homebound (22 men, 16 women) and 70 non-homebound (33 men, 37 women) older adults who participated in the base line survey were selected. Measurements of physical fitness levels and PA patterns measured using an accelerometer, were taken in 2005. The total steps per day did not significantly differ between homebound and non-homebound men and women. The time spent in 1.8 METs activity (corresponding to activity level 1 of the accelerometer) was significantly higher in women than in men for non-homebound and homebound, respectively. The time spent in lower-, moderate-, and high-intensity PA did not significantly differ between homebound and non-homebound men and women, respectively. Handgrip strength, knee extensor strength, leg extensor power, stepping and maximum walking speed were significantly higher in non-homebound than in homebound men and women. These results suggest that the physical fitness levels of homebound were lower than those of non-homebound, but no difference was observed in the PA levels between homebound and non-homebound.