Updated on 2025/11/10

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写真a

 
Toshinari Odawara
 
Organization
Health Service Center Director
Title
Director
External link

Degree

  • 医学博士 ( 横浜市立大学 )

Research Interests

  • クロイツフェルトヤコブ病

  • Frontotemporal Lobar Degeneration

  • メンタルヘルス

  • Geriatric Psychiatry

  • Emergency Psychiatry

  • Liaison psychiatry

  • Dementia with Lewy bodies

  • Alzheimer's disease

  • Neuropathology

Research Areas

  • Life Science / Medical management and medical sociology

  • Life Science / Psychiatry

Research History

  • Yokohama City University Medical Center   Psychiatric Center   Associate Professor

    2003.1 - 2015.3

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Papers

  • General and event-related psychological stress, and suicidal ideation among hospital workers during the coronavirus disease 2019 pandemic: Findings from the third wave of repeated cross-sectional studies. International journal

    Keiko Ide, Akira Suda, Asuka Yoshimi, Junichi Fujita, Munetaka Nomoto, Masatoshi Miyauchi, Tomohide Roppongi, Akitoyo Hishimoto, Toshinari Odawara, Takeshi Asami

    PCN reports : psychiatry and clinical neurosciences   4 ( 3 )   e70157   2025.9

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    Language：English   Publishing type：Research paper (scientific journal)  

    AIM: The psychological impact of the coronavirus disease 2019 (COVID-19) pandemic on hospital workers has been reported, but most previous studies focused on the first year of the pandemic, and long-term monitoring remains scarce. This study aimed to evaluate the psychological status of hospital workers as of March 2023, and identify associated factors. METHODS: A cross-sectional survey was conducted in March 2023 among all workers at two university hospitals in Yokohama, Japan. Similar surveys were conducted in March-April 2020 and March 2021. The prevalence of general psychological stress, event-related stress, and suicidal ideation was assessed using the 12-item General Health Questionnaire (GHQ-12), the Impact of Event Scale-Revised (IES-R), and Item 9 of the Patient Health Questionnaire (PHQ-9), respectively. Multivariable logistic regression analysis was performed to identify associated factors. RESULTS: A total of 4244 questionnaires were distributed and 2635 responses (62.1%) were analyzed. Severe general stress, event-related stress, and suicidal ideation were observed in 38.0%, 18.1%, and 10.0% of participants, respectively. Regression analysis identified isolation, exhaustion, and being office workers or support staff as significant factors for general stress; living with a partner and feeling protected were inversely associated. Event-related stress was associated with clerical work, isolation, and exhaustion. Suicidal ideation was associated with younger age, isolation, and coexisting general and event-related stress, while the anxiety factor showed a negative association. CONCLUSION: This study highlights the sustained psychological burden experienced by hospital workers in 2023. The findings underscore the importance of strategies to reduce isolation and enhance mental health support in healthcare settings.

    DOI： 10.1002/pcn5.70157

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  • Peripheral lymphocyte counts and regional cerebral blood flow on brain SPECT correlate in Alzheimer's disease: A retrospective cross-sectional study. International journal

    Hidehito Miyazaki, Keiko Ide, Hiroyuki Yamaguchi, Matsuyoshi Ogawa, Naoya Aoki, Omi Katsuse, Toshinari Odawara, Takeshi Asami

    Brain research   1859   149657 - 149657   2025.7

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    Language：English   Publishing type：Research paper (scientific journal)  

    BACKGROUND: Given emerging evidence of immune involvement in Alzheimer's disease (AD), we aimed to clarify whether peripheral lymphocyte counts are associated with regional cerebral blood flow (rCBF) as measured by brain single-photon emission computed tomography (SPECT). Identifying such a relationship may help to establish early, accessible biomarkers of disease progression. METHODS: Participants were 111 patients diagnosed with AD at the Yokohama City University Hospital Medical Center for Dementia Diseases between January 2021 and December 2023 and who underwent blood tests and brain SPECT. Sex, age, cognitive function tests, peripheral blood values, and rCBF on brain SPECT were investigated retrospectively. Neutrophil and lymphocyte counts were extracted from blood values. In addition, the rCBF in each region (frontal, parietal, temporal, occipital, and limbic system) was calculated from brain SPECT, and correlation analysis between lymphocytes and rCBF was performed. RESULTS: Significant positive correlations between lymphocyte counts in peripheral blood and rCBF were found in all regions except the left frontal lobe. In particular, the correlation coefficient between rCBF and lymphocyte count was highest in the right temporal lobe (ρ = 0.311, P = 0.001). CONCLUSIONS: Peripheral blood lymphocyte counts are positively related to rCBF on brain SPECT, and lymphocytes can be an early biomarker that can be tested inexpensively and easily. Limitations include the retrospective cross-sectional design and single-center setting, which preclude analysis of causality and changes over time.

    DOI： 10.1016/j.brainres.2025.149657

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  • Japan-multimodal intervention trial for the prevention of dementia in older people with lifestyle-related diseases: A community-based, 18-month, randomized controlled trial. International journal

    Keiko Ide, Shunsaku Mizushima, Kyoko Saito, Hiroko Suzuki, Yuhei Chiba, Kie Abe, Asuka Yoshimi, Akitoyo Hishimoto, Taro Yamanaka, Takashi Sakurai, Hidenori Arai, Masataka Taguri, Shoko Suzuki, Toshinari Odawara

    Journal of Alzheimer's disease : JAD   106 ( 2 )   574 - 588   2025.7

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    Language：English   Publishing type：Research paper (scientific journal)  

    BackgroundThe prevalence of Alzheimer's disease is increasing in Japan, highlighting the need to establish evidence-based strategies for its prevention.ObjectiveWe aimed to evaluate the effectiveness of a multimodal community-based intervention for Japanese older people with lifestyle-related diseases and to identify challenges in implementing such interventions to prevent dementia in local communities.MethodsAn 18-month randomized controlled trial was conducted among individuals aged 65-85 years with lifestyle-related diseases (hypertension, hyperlipidemia, diabetes, overweight/underweight, smoking), residing in a single apartment complex. Participants were randomly assigned to a multimodal intervention group (group-based physical exercise, nutritional guidance, management of lifestyle-related diseases, and cognitive training) or a control group. The primary outcome was the change in the composite score derived from seven neuropsychological tests. The trial was registered (UMIN000041887: September 24, 2020).ResultsOf 224 screened individuals, 198 were randomized (99 in each group), and 175 (88.4%) completed the 18-month assessment. There was no significant difference between the intervention and control groups in the primary outcome (change in composite test score: 0.25; 95% confidence interval 0.16 to 0.33 versus 0.29; 95% confidence interval 0.20 to 0.38, respectively; p = 0.463). However, a subgroup analysis of participants with mild cognitive impairment showed a significant intervention effect on changes in logical memory, for both immediate (p = 0.041) and delayed recall tasks (p = 0.043).ConclusionsThis multimodal intervention program demonstrated no effectiveness in mitigating cognitive decline. Further research is needed to develop more effective strategies and to better define target populations.

    DOI： 10.1177/13872877251344222

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  • アルツハイマー型認知症患者におけるIMP-SPECT脳血流量と末梢血炎症反応の関係

    宮崎 秀仁, 井出 恵子, 山口 博行, 青木 直哉, 勝瀬 大海, 小田原 俊成, 浅見 剛

    Dementia Japan   38 ( 4 )   675 - 675   2024.10

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    Language：Japanese   Publisher：(一社)日本認知症学会  

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  • 生活習慣病を有する高齢者の認知症進展予防を目指した多因子介入ランダム化比較試験 J-MINT Prime神奈川

    井出 恵子, 小田原 俊成, 水嶋 春朔, 齋藤 京子, 鈴木 裕子, 櫻井 孝, 田栗 正隆, 鈴木 翔子, 千葉 悠平, 阿部 紀絵, 吉見 明香, 菱本 明豊, 山中 太郎, 荒井 秀典

    精神神経学雑誌   ( 2024特別号 )   S561 - S561   2024.6

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    Language：Japanese   Publisher：(公社)日本精神神経学会  

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  • 大学生の自殺予防プログラム全国開発研究班活動報告

    太刀川 弘和, 高橋 あすみ, 布施 泰子, 石井 映美, 松原 敏郎, 丸谷 俊之, 小田原 俊成, 河西 千秋, 三井 信幸, 岡本 百合, 渡辺 慶一郎, 川島 義高, 白鳥 裕貴, 菅原 大地, 梶谷 康介, 太田 深秀, 安宅 勝弘

    大学のメンタルヘルス   6   61 - 61   2024.6

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    Language：Japanese   Publisher：(NPO)全国大学メンタルヘルス学会  

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  • MENTAL HEALTH SCREENING OF YOKOHAMA CITY UNIVERSITY STUDENTS BEFORE AND AFTER THE COVID-19 PANDEMIC

    土井原千穂, 岸本智美, 上村紀子, 伴野梨沙, 飯塚明雄, 栗原明日香, 圓谷弘美, 小田原俊成

    横浜医学(Web)   75 ( 4 )   2024

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  • 自殺予防プログラムの多施設共同研究の過程

    高橋 あすみ, 太刀川 弘和, 石井 映美, 布施 泰子, 松原 敏郎, 岡本 百合, 白鳥 裕貴, 太田 深秀, 丸谷 俊之, 三井 信幸, 渡辺 慶一郎, 川島 義高, 小田原 俊成, 菅原 大地, 河西 千秋, 安宅 勝弘

    大学のメンタルヘルス   7   56 - 56   2023.12

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    Language：Japanese   Publisher：(NPO)全国大学メンタルヘルス学会  

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  • 認知症予防のエビデンスと社会実装に向けた挑戦 J-MINT PRIME神奈川モデルから考える社会実装への課題

    小田原 俊成, 水嶋 春朔, 齋藤 京子, 鈴木 裕子, 櫻井 孝, 千葉 悠平, 阿部 紀絵, 井出 恵子, 吉見 明香, 菱本 明豊, 山中 太郎, 柾 晴美, 荒井 秀典

    老年精神医学雑誌   33 ( 増刊II )   184 - 184   2022.11

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    Language：Japanese   Publisher：(株)ワールドプランニング  

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  • 認知症予防のエビデンスと社会実装に向けた挑戦 J-MINT PRIME神奈川モデルから考える社会実装への課題

    小田原 俊成, 水嶋 春朔, 齋藤 京子, 鈴木 裕子, 櫻井 孝, 千葉 悠平, 阿部 紀絵, 井出 恵子, 吉見 明香, 菱本 明豊, 山中 太郎, 柾 晴美, 荒井 秀典

    老年精神医学雑誌   33 ( 増刊II )   184 - 184   2022.11

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    Language：Japanese   Publisher：(株)ワールドプランニング  

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  • 認知症予防のエビデンスと社会実装に向けた挑戦 J-MINT PRIME神奈川モデルから考える社会実装への課題

    小田原 俊成, 水嶋 春朔, 齋藤 京子, 鈴木 裕子, 櫻井 孝, 千葉 悠平, 阿部 紀絵, 井出 恵子, 吉見 明香, 菱本 明豊, 山中 太郎, 柾 晴美, 荒井 秀典

    Dementia Japan   36 ( 4 )   713 - 713   2022.10

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    Language：Japanese   Publisher：(一社)日本認知症学会  

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  • 認知症予防のエビデンスと社会実装に向けた挑戦 J-MINT PRIME神奈川モデルから考える社会実装への課題

    小田原 俊成, 水嶋 春朔, 齋藤 京子, 鈴木 裕子, 櫻井 孝, 千葉 悠平, 阿部 紀絵, 井出 恵子, 吉見 明香, 菱本 明豊, 山中 太郎, 柾 晴美, 荒井 秀典

    Dementia Japan   36 ( 4 )   713 - 713   2022.10

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    Language：Japanese   Publisher：(一社)日本認知症学会  

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  • Validity and reliability of the Japanese versions of cognitive and behavioral scales for irritable bowel syndrome. Reviewed International journal

    Nagisa Sugaya, Yoshitoshi Tomita, Misako Funaba, Hiroshi Iida, Kentaro Shirotsuki, Fumiyuki Chin Gardner, Toshinari Odawara, Tetsuya Ando, Masahiko Inamori

    BioPsychoSocial medicine   16 ( 1 )   15 - 15   2022.7

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    BACKGROUND: The Cognitive Scale for Functional Bowel Disorders (CS-FBD) and Irritable Bowel Syndrome-Behavioral Responses Questionnaire (IBS-BRQ) are a useful measures to assess cognitive-behavioral aspects in individuals with IBS. This study aimed to confirm the reliability and validity of the Japanese versions of the CS-FBD (CS-FBD-J) and IBS-BRQ (IBS-BRQ-J). METHODS: Participants comprised 192 students and 22 outpatients diagnosed with irritable bowel syndrome (IBS). There were 76 students who met the diagnostic criteria for IBS and two students who received treatment for IBS. Participants completed questionnaires containing the CS-FBD-J, IBS Severity Index (IBS-SI), Visceral Sensitivity Index (VSI), 24-item Dysfunctional Attitudes Scale (DAS-24), Hospital Anxiety and Depression Scale (HADS), and Social Adaptation Self-evaluation Scale (SASS). RESULTS: Our exploratory factor analysis revealed that the CS-FBD-J had a unidimensional factor structure and that the factor loadings for two of the 25 items were less than 0.4. The IBS-BRQ-J had a two-factor structure, and the factor loadings for eight of the 26 items were less than 0.4. The confirmatory factor analysis for the 18-item version of IBS-BRQ-J showed that the model fit indices were not sufficient. The CS-FBD-J and IBS-BRQ-J had significant, moderate correlations with the IBS-SI and VSI in the IBS and control groups. Correlation between the DAS-24 and the CS-FBD-J was not significant. The CS-FBD-J and IBS-BRQ-J were significantly correlated to the HADS and SASS (IBS-BRQ-J) only in the IBS group. The scores of CS-FBD-J and IBS-BRQ-J showed significant group differences between the IBS patient group, non-patient IBS group, and control group. The internal consistencies of the CS-FBD-J and IBS-BRQ-J were high. The item-total correlation analysis for the CS-FBD-J and IBS-BRQ-J showed that the correlations between each item and the total score were significant. CONCLUSION: This study confirmed the reliability and validity of the 23-item version of the CS-FBS-J and the 18-item version of the IBS-BRQ-J with the deletion of items with low factor loadings. Regarding the IBS-BRQ-J, two factor structures were confirmed (factor 1: behavior obsessed with abdominal symptoms, factor 2: avoidance of abdominal symptoms and associated difficulties) although the model fit of the structure needs further study.

    DOI： 10.1186/s13030-022-00244-3

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  • 認知症予防の社会実装を考える J-MINT PRIME神奈川研究から社会実装を考える

    小田原 俊成, 水嶋 春朔, 齋藤 京子, 千葉 悠平, 阿部 紀絵, 吉見 明香, 井出 恵子, 山中 太郎, 柾 晴美, 菱本 明豊

    日本老年医学会雑誌   59 ( Suppl. )   72 - 72   2022.5

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    Language：Japanese   Publisher：(一社)日本老年医学会  

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  • 認知症予防の社会実装を考える J-MINT PRIME神奈川研究から社会実装を考える

    小田原 俊成, 水嶋 春朔, 齋藤 京子, 千葉 悠平, 阿部 紀絵, 吉見 明香, 井出 恵子, 山中 太郎, 柾 晴美, 菱本 明豊

    日本老年医学会雑誌   59 ( Suppl. )   72 - 72   2022.5

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    Language：Japanese   Publisher：(一社)日本老年医学会  

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  • Long-Term Efficacy and Safety of Zonisamide for Treatment of Parkinsonism in Patients With Dementia With Lewy Bodies: An Open-Label Extension of a Phase three Randomized Controlled Trial Reviewed

    Toshinari Odawara, Kazuko Hasegawa, Ritsuko Kajiwara, Hisao Takeuchi, Masaaki Tagawa, Kenji Kosaka, Miho Murata

    The American Journal of Geriatric Psychiatry   30 ( 3 )   314 - 328   2022.3

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    Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

    DOI： 10.1016/j.jagp.2021.07.002

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  • Plasma MMP-9 Levels as the Future Risk of Conversion to Dementia in ApoE4-Positive MCI Patients: Investigation Based on the Alzheimer's Disease Neuroimaging Initiative Database. International journal

    K Abe, Y Chiba, K Ide, A Yoshimi, T Asami, A Suda, T Odawara, A Hishimoto

    The journal of prevention of Alzheimer's disease   9 ( 2 )   331 - 337   2022

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    BACKGROUND: Matrix metalloproteinase 9 (MMP-9) has been reported to be correlated with declines in hippocampal volume and cognitive function in ApoE4-positive MCI patients. OBJECTIVES: The present study was aimed to investigate the effects of plasma matrix MMP-9 on the conversion risk between mild cognitive impairment (MCI) patients with and without ApoE4. DESIGN AND SETTING: Retrospective observational study using the data extracted from the Alzheimer's Disease Neuroimaging Initiative database. PARTICIPANTS: We included 211 ApoE4-positive MCI subjects (ApoE4+ MCI) and 184 ApoE4-negative MCI subjects (ApoE4- MCI). MEASUREMENTS: We obtained demographic and data including plasma MMP-9 levels at baseline and longitudinal changes in Clinical Dementia Rating (CDR) up to 15 years. We compared conversion rates between ApoE4+ MCI and ApoE4- MCI by the Log-rank test and calculated the hazard ratio (HR) for covariates including age, sex, educational attainment, drinking and smoking histories, medications, and plasma MMP-9 levels using a multiple Cox regression analysis of ApoE4+ MCI and ApoE4- MCI. RESULTS: No significant differences were observed in baseline plasma MMP-9 levels between ApoE4+ MCI and ApoE4- MCI. High plasma MMP-9 levels increased the conversion risk significantly more than low plasma MMP-9 levels (HR, 2.46 [95% CI, 1.31-4.48]) and middle plasma MMP-9 levels (HR, 1.67 [95% CI, 1.04-2.65]) in ApoE4+ MCI, but not in ApoE4- MCI. CONCLUSION: Plasma MMP-9 would be the risk of the future conversion to dementia in ApoE4+ MCI.

    DOI： 10.14283/jpad.2022.19

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  • The psychological distress and suicide-related ideation in hospital workers during the COVID-19 pandemic: Second results from repeated cross-sectional surveys. Reviewed International journal

    Keiko Ide, Takeshi Asami, Akira Suda, Asuka Yoshimi, Junichi Fujita, Yohko Shiraishi, Munetaka Nomoto, Masatoshi Miyauchi, Tomohide Roppongi, Taku Furuno, Kaori Watanabe, Tomoko Shimada, Tomoko Kaneko, Yusuke Saigusa, Kazumi Kubota, Hideaki Kato, Toshinari Odawara, Akitoyo Hishimoto

    PloS one   17 ( 11 )   e0277174   2022

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    The COVID-19 pandemic has been affecting the mental health of hospital workers. During the prolonged pandemic, hospital workers may experience much more severe psychological distress, leading to an increased risk of suicide. This study aimed to investigate changes in psychological effects on hospital workers over 12 months from the beginning of the pandemic and clarify factors associated with psychological distress and suicide-related ideation 1-year after the pandemic's beginning. These repeated, cross-sectional surveys collected demographic, mental health, and stress-related data from workers in 2 hospitals in Yokohama, Japan. The first survey, conducted in March-April 2020, contained the 12-item General Health Questionnaire (GHQ-12) assessing general distress and the Impact of Event Scale-Revised (IES-R) assessing event-related distress. In the second survey in March 2021, hospital workers at the same two hospitals were reassessed using the same questionnaire, and Item 9 of the Patient Health Questionnaire (PHQ-9) was added to assess their suicide-related ideation. The findings of the first and second surveys revealed that the average score of GHQ-12 (3.08 and 3.73, respectively), the IES-R total score (6.8 and 12.12, respectively), and the prevalence rates of severe general distress (35.0% and 44.0%, respectively) and severe event-related distress (7.0% and 17.1%, respectively) deteriorated. The second survey showed that 8.6% of the hospital workers were experiencing suicide-related ideation. Both the general and event-related distress were associated with suicide-related ideation. In these surveys, mental health outcomes among the hospital workers deteriorated over one year from the pandemic's beginning, and their severe psychological distress was the risk factor for the suicide-related ideation. Further studies are needed to compare the psychological effects on hospital workers during and after the prolonged pandemic and to explore appropriate measures to support hospital workers' mental health.

    DOI： 10.1371/journal.pone.0277174

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  • 多因子生活習慣介入による認知症予防 地域在住高齢者に対する多因子介入による認知症予防の取り組み

    小田原 俊成, 水嶋 春朔, 齋藤 京子, 鈴木 裕子, 櫻井 孝, 千葉 悠平, 阿部 紀恵, 吉見 明香, 井出 恵子, 菱本 明豊, 山中 太郎, 柾 晴美, 荒井 秀典

    Dementia Japan   35 ( 4 )   571 - 571   2021.10

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    Language：Japanese   Publisher：(一社)日本認知症学会  

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  • A Japanese multicenter study on PET and other biomarkers for subjects with potential preclinical and prodromal Alzheimer’s disease. Reviewed

    Senda M, Ishii K, Ito K, Ikeuchi T, Matsuda H, Iwatsubo T, Iwata A, Ihara R, Suzuki K, Kasuga K, Ikari Y, Niimi Y, AraiH, Tamaoka A, Arahata Y, Itoh Y, Tachibana H, Ichimiya Y, Washizuka S, Odawara T, Ishii K, Ono K, Yokota T, Nakanishi A, Matsubara E, Mori H, Shimada H

    J Prev Alz Dis   4 ( 8 )   495 - 502   2021.6

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    Language：English   Publishing type：Research paper (scientific journal)   Publisher：SERDI  

    BACKGROUND: PET (positron emission tomography) and CSF (cerebrospinal fluid) provide the “ATN” (Amyloid, Tau, Neurodegeneration) classification and play an essential role in early and differential diagnosis of Alzheimer’s disease (AD). OBJECTIVE: Biomarkers were evaluated in a Japanese multicenter study on cognitively unimpaired subjects (CU) and early (E) and late (L) mild cognitive impairment (MCI) patients. MEASUREMENTS: A total of 38 (26 CU, 7 EMCI, 5 LMCI) subjects with the age of 65-84 were enrolled. Amyloid-PET and FDG-PET as well as structural MRI were acquired on all of them, with an additional tau-PET with 18F-flortaucipir on 15 and CSF measurement of Aβ1-42, P-tau, and T-tau on 18 subjects. Positivity of amyloid and tau was determined based on the positive result of either PET or CSF. RESULTS: The amyloid positivity was 13/38, with discordance between PET and CSF in 6/18. Cortical tau deposition quantified with PET was significantly correlated with CSF P-tau, in spite of discordance in the binary positivity between visual PET interpretation and CSF P-tau in 5/8 (PET-/CSF+). Tau was positive in 7/9 amyloid positive and 8/16 amyloid negative subjects who underwent tau measurement, respectively. Overall, a large number of subjects presented quantitative measures and/or visual read that are close to the borderline of binary positivity, which caused, at least partly, the discordance between PET and CSF in amyloid and/or tau. Nine subjects presented either tau or FDG-PET positive while amyloid was negative, suggesting the possibility of non-AD disorders. CONCLUSION: Positivity rate of amyloid and tau, together with their relationship, was consistent with previous reports. Multicenter study on subjects with very mild or no cognitive impairment may need refining the positivity criteria and cutoff level as well as strict quality control of the measurements.

    DOI： 10.14283/jpad.2021.37

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  • The psychological effects of COVID-19 on hospital workers at the beginning of the outbreak with a large disease cluster on the Diamond Princess cruise ship. Reviewed International journal

    Keiko Ide, Takeshi Asami, Akira Suda, Asuka Yoshimi, Junichi Fujita, Munetaka Nomoto, Tomohide Roppongi, Kousuke Hino, Yuichi Takahashi, Kaori Watanabe, Tomoko Shimada, Toyoko Hamasaki, Emi Endo, Tomoko Kaneko, Michiko Suzuki, Kazumi Kubota, Yusuke Saigusa, Hideaki Kato, Toshinari Odawara, Hideaki Nakajima, Ichiro Takeuchi, Takahisa Goto, Michiko Aihara, Akitoyo Hishimoto

    PloS one   16 ( 1 )   e0245294   2021

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    The aim of the present study was to investigate the psychological effects of the COVID-19 outbreak and associated factors on hospital workers at the beginning of the outbreak with a large disease cluster on the Diamond Princess cruise ship. This cross-sectional, survey-based study collected demographic data, mental health measurements, and stress-related questionnaires from workers in 2 hospitals in Yokohama, Japan, from March 23, 2020, to April 6, 2020. The prevalence rates of general psychological distress and event-related distress were assessed using the 12-item General Health Questionnaire (GHQ-12) and the 22-item Impact of Event Scale-Revised (IES-R), respectively. Exploratory factor analysis was conducted on the 26-item stress-related questionnaires. Multivariable logistic regression analysis was performed to identify factors associated with mental health outcomes for workers both at high- and low-risk for infection of COVID-19. A questionnaire was distributed to 4133 hospital workers, and 2697 (65.3%) valid questionnaires were used for analyses. Overall, 536 (20.0%) were high-risk workers, 944 (35.0%) of all hospital workers showed general distress, and 189 (7.0%) demonstrated event-related distress. Multivariable logistic regression analyses revealed that 'Feeling of being isolated and discriminated' was associated with both the general and event-related distress for both the high- and low-risk workers. In this survey, not only high-risk workers but also low-risk workers in the hospitals admitting COVID-19 patients reported experiencing psychological distress at the beginning of the outbreak.

    DOI： 10.1371/journal.pone.0245294

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  • Efficacy and Safety of Zonisamide in Dementia with Lewy Bodies Patients with Parkinsonism: A Post Hoc Analysis of Two Randomized, Double-Blind, Placebo-Controlled Trials. Reviewed International journal

    Kazuko Hasegawa, Kenji Kochi, Hidenori Maruyama, Osamu Konishi, Shunji Toya, Toshinari Odawara

    Journal of Alzheimer's disease : JAD   79 ( 2 )   627 - 637   2021

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    BACKGROUND: Although previous phase II and III clinical trials conducted in Japan showed that zonisamide improved parkinsonism in patients with dementia with Lewy bodies (DLB), some differences in efficacy outcomes were observed between the trials. OBJECTIVE: We aimed to further examine the efficacy and safety of zonisamide in DLB patients with parkinsonism in a post hoc analysis of pooled data from the previous phase II and III trials. METHODS: Both trials featured a 4-week run-in period followed by a 12-week treatment period with a double-blind, placebo-controlled, parallel-group, randomized, multicenter trial design. In our pooled analysis, the primary outcome was the change in Unified Parkinson's Disease Rating Scale (UPDRS) part III total score. Other outcomes included the changes in Mini-Mental State Examination (MMSE) and Neuropsychiatric Inventory-10 (NPI-10) scores, and the incidence of adverse events. RESULTS: Zonisamide significantly decreased the UPDRS part III total and individual motor symptom scores but did not affect the MMSE or NPI-10 scores at week 12. There was no difference in the incidence of adverse events between the zonisamide and placebo groups except for decreased appetite, which had an increased frequency in the zonisamide 50 mg group compared with placebo. CONCLUSION: Our findings indicate that zonisamide improved parkinsonism with DLB without deterioration of cognitive function and or worsening behavioral and psychological symptoms of dementia.

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  • Effect of zonisamide on parkinsonism in patients with dementia with Lewy bodies: A phase 3 randomized clinical trial. Reviewed International journal

    Miho Murata, Toshinari Odawara, Kazuko Hasegawa, Ritsuko Kajiwara, Hisao Takeuchi, Masaaki Tagawa, Kenji Kosaka

    Parkinsonism & related disorders   76   91 - 97   2020.7

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    INTRODUCTION: Zonisamide is approved in Japan for treating motor dysfunction in Parkinson's disease, and might also be effective for parkinsonism in patients with dementia with Lewy bodies (DLB). Our study evaluated the safety and efficacy of zonisamide for treating parkinsonism in patients with DLB. METHODS: This multicenter, randomized, double-blind, phase 3 trial was conducted in Japan between April 2015 and November 2017. Following a 4-week run-in period, outpatients diagnosed with probable DLB who had developed parkinsonism were randomized to receive oral zonisamide (25 or 50 mg/day) or placebo for 12 weeks, followed by a 40-week open-label extension. The primary endpoint was the change in Unified Parkinson's Disease Rating Scale (UPDRS) part III total score at Week 12. RESULTS: Of 351 patients randomized, 346 (mean age, 77.2 years; 188 males) were included in the modified intention-to-treat population. At Week 12, the group difference (least squares mean ± SEM) for changes from baseline (vs placebo) in UPDRS part III total score was -2.7 ± 0.9 (95% confidence interval [CI]: -4.4, -0.9, P = 0.005) in the zonisamide 25-mg group and -2.6 ± 0.9 (95% CI: -4.4, -0.8, P = 0.005) in the zonisamide 50-mg group. Adverse events were reported in 47.1%, 48.7%, and 54.5% of patients in the placebo and zonisamide 25- and 50-mg groups, and led to treatment discontinuation in 5.0%, 4.3%, and 9.8% of patients, respectively. CONCLUSION: Daily administration of 25- or 50-mg zonisamide significantly improved motor function compared with placebo; both doses were safe and well tolerated in patients with DLB.

    DOI： 10.1016/j.parkreldis.2019.12.005

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  • Fact-finding survey on diagnostic procedures and therapeutic interventions for parkinsonism accompanying dementia with Lewy bodies. Reviewed International journal

    Yuta Manabe, Toshinari Odawara, Osamu Konishi

    Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society   19 ( 4 )   345 - 354   2019.7

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    BACKGROUND: We performed a questionnaire survey of medical doctors engaged in the management of dementia to identify the actual status of treatment for dementia with Lewy bodies (DLB) in Japan. METHODS: Among participating medical doctors, we selected neurologists (Group N) and psychiatrists (Group P) because these physicians are usually involved in the management of DLB patients. The two groups were compared based on their diagnosis and treatment of DLB and in particular, parkinsonism. RESULTS: Neurological examinations and biomarker tests were less frequently performed by Group P than Group N. Antipsychotics and other psychotropics excluding anti-dementia drugs were significantly more frequently administered by Group P than Group N. The proportion of physicians who selected L-dopa as a first-line therapy for parkinsonism was significantly higher in Group N than in Group P. Despite these between-group differences, the following findings were common to the two groups: there was a discrepancy between the symptom that patients expressed the greatest desire to treat, and the awareness of physicians regarding the treatment of these symptoms; the initial agent was L-dopa; and physicians exercised caution against the occurrence of hallucinations, delusions, and other adverse drug reactions. CONCLUSIONS: The results of the present survey offer valuable insight for the formulation of future DLB therapeutic strategies.

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  • A survey of doctors on diagnosis and treatment of dementia with Lewy bodies: examination and treatment of behavioural and psychological symptoms. Reviewed International journal

    Toshinari Odawara, Yuta Manabe, Osamu Konishi

    Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society   19 ( 4 )   310 - 319   2019.7

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    BACKGROUND: Dementia with Lewy bodies (DLB) is a progressive form of dementia, accompanied by a range of behavioural and psychological symptoms. The aim of this study was to identify current clinical practice for the treatment of DLB in Japan. METHODS: We conducted a survey of medical doctors engaged in the management of dementia in Japan. Participants were divided into two groups: psychiatrists (Group P) and neurologists or neurosurgeons (Group NS). Doctors completed a questionnaire and we analysed their responses to compare the two groups with regard to diagnosis and treatment of DLB, and in particular the treatment of behavioural and psychological symptoms of dementia (BPSD). RESULTS: Responses suggested that Group P conducted biomarker examinations less frequently and decided on their own therapeutic strategies more frequently than did Group NS. Both groups most frequently selected hallucinations/delusions as the symptoms given highest treatment priority. More than 70% of respondents in both groups reported having difficulties in treating BPSD. Atypical antipsychotics were more frequently prescribed by Group P, but were also prescribed in 70% of patients in Group NS. A third of patients received atypical antipsychotics for more than 1 year. CONCLUSIONS: The responses to this survey highlighted the difficulties faced by clinicians managing patients with DLB and identified the need to effectively treat BPSD in such patients.

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  • Developmental disorder, Diagnosis and care Invited Reviewed

    FUJITA Junichi, ODAWARA Toshinari

    CAMPUS HEALTH   56 ( 2 )   11 - 16   2019.5

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  • Adjunct zonisamide to levodopa for DLB parkinsonism: A randomized double-blind phase 2 study. Reviewed International journal

    Miho Murata, Toshinari Odawara, Kazuko Hasegawa, Sayaka Iiyama, Masatoshi Nakamura, Masaaki Tagawa, Kenji Kosaka

    Neurology   90 ( 8 )   e664-e672 - e672   2018.2

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    OBJECTIVE: To investigate the efficacy and safety of zonisamide as an adjunct to levodopa therapy for parkinsonism in patients with dementia with Lewy bodies (DLB). METHODS: This phase 2, placebo-controlled, randomized, double-blind study consisted of run-in (placebo, 4 weeks) and treatment (placebo or zonisamide 25 or 50 mg once daily, 12 weeks) periods. Outpatients diagnosed with probable DLB were eligible for inclusion. The primary endpoint was the change from baseline in Unified Parkinson's Disease Rating Scale (UPDRS) part 3 total score at week 12. Cognitive function, behavioral and psychological symptoms of dementia (BPSD), caregiver burden, other UPDRS parts as secondary endpoints, and safety were also assessed. RESULTS: Overall, 158 patients with DLB received the study drug; 21 discontinued during treatment and 137 completed treatment. Improvement in UPDRS part 3 total score at week 12 was significantly greater in the zonisamide 50 mg group compared with placebo (between-group difference -4.1; 95% confidence interval -6.8 to -1.4; p = 0.003). Zonisamide did not worsen cognitive function, BPSD, or caregiver burden. The overall incidence of adverse events was higher in the zonisamide 50 mg than the 25 mg and placebo groups (65.3%, 43.1%, and 50.0%, respectively); similar rates of serious adverse events were observed among all groups. CONCLUSION: Zonisamide (adjunctive to levodopa) improved parkinsonism accompanying DLB without worsening cognitive function or psychiatric symptoms. CLINICAL TRIAL REGISTRATION: JapicCTI-122040. CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that zonisamide (adjunctive to levodopa) improves parkinsonism and is well-tolerated in patients with DLB.

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  • 【日常診療における病識・病感・負担感の取り扱い-治療効果を高めるための工夫-】レビー小体型認知症

    小田原 俊成

    臨床精神医学   46 ( 12 )   1521 - 1525   2017.12

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  • Head-to-Head Visual Comparison between Brain Perfusion SPECT and Arterial Spin-Labeling MRI with Different Postlabeling Delays in Alzheimer Disease Reviewed

    T. Kaneta, O. Katsuse, T. Hirano, M. Ogawa, K. Yoshida, T. Odawara, Y. Hirayasu, T. Inoue

    AMERICAN JOURNAL OF NEURORADIOLOGY   38 ( 8 )   1562 - 1568   2017.8

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    DOI： 10.3174/ajnr.A5238

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  • 【"失敗"から学んだこと;認知症診療実践の振り返り】数年の経過を経てレビー小体型認知症の診断に至った若年性認知症の1例 Reviewed

    小田原 俊成

    老年精神医学雑誌   28 ( 6 )   593 - 596   2017.6

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  • Voxel-wise correlations between cognition and cerebral blood flow using arterial spin-labeled perfusion MRI in patients with Alzheimer's disease: a cross-sectional study. Reviewed International journal

    Tomohiro Kaneta, Omi Katsuse, Takamasa Hirano, Matsuyoshi Ogawa, Ayako Shihikura-Hino, Keisuke Yoshida, Toshinari Odawara, Yoshio Hirayasu, Tomio Inoue

    BMC neurology   17 ( 1 )   91 - 91   2017.5

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    DOI： 10.1186/s12883-017-0870-x

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  • 大学生を対象とした日本の自殺予防研究に関する系統的レビュー Reviewed

    太刀川 弘和, 川島 義高, 小田原 俊成, 衛藤 暢明, 河西 千秋, 山田 光彦

    CAMPUS HEALTH   54 ( 2 )   186 - 191   2017.5

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  • 多職種による自殺企図者ケア 自殺未遂者ケアにおける、救命救急センターと精神科病棟の連携

    日野 耕介, 松森 響子, 伊藤 翼, 土井 智喜, 中村 京太, 小田原 俊成, 平安 良雄, 森村 尚登

    日本臨床救急医学会雑誌   18 ( 2 )   281 - 281   2015.4

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  • 【これからの総合病院精神科における認知症高齢者支援を考える】コンサルテーション・リエゾン活動における認知症高齢者対応

    日野 耕介, 小田原 俊成, 平安 良雄

    総合病院精神医学   27 ( 2 )   107 - 114   2015.4

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  • 【リエゾン精神医学の現状と今後の展望(I)】救急医療とリエゾン精神医学

    日野 耕介, 小田原 俊成

    精神医学   57 ( 3 )   185 - 193   2015.3

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  • Estimation of prevalence of dementia among aged inpatients in general hospital Reviewed

    ODAWARA Toshinari

    Japanese journal of general hospital psychiatry   27 ( 2 )   100 - 106   2015

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  • 横浜市立大学附属市民総合医療センターにおける摂食障害家族教室の実践 児童・思春期を対象に

    森川 美奈, 高橋 雄一, 大塚 達以, 中川 牧子, 西尾 友子, 小田原 俊成, 平安 良雄

    神奈川医学会雑誌   41 ( 2 )   290 - 291   2014.7

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  • Preventive effects of ramelteon on delirium: a randomized placebo-controlled trial. Reviewed International journal

    Kotaro Hatta, Yasuhiro Kishi, Ken Wada, Takashi Takeuchi, Toshinari Odawara, Chie Usui, Hiroyuki Nakamura

    JAMA psychiatry   71 ( 4 )   397 - 403   2014.4

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    DOI： 10.1001/jamapsychiatry.2013.3320

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  • 横浜市立大学附属市民総合医療センターにおける摂食障害家族教室の実践 児童・思春期を対象に

    森川 美奈, 高橋 雄一, 大塚 達以, 中川 牧子, 西尾 友子, 小田原 俊成, 平安 良雄

    神奈川県精神医学会誌   ( 63 )   58 - 58   2014.3

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  • Antipsychotics for delirium in the general hospital setting in consecutive 2453 inpatients: a prospective observational study. Reviewed International journal

    Kotaro Hatta, Yasuhiro Kishi, Ken Wada, Toshinari Odawara, Takashi Takeuchi, Takafumi Shiganami, Kazuo Tsuchida, Yoshio Oshima, Naohisa Uchimura, Rie Akaho, Akira Watanabe, Toshihiro Taira, Katsuji Nishimura, Naoko Hashimoto, Chie Usui, Hiroyuki Nakamura

    International journal of geriatric psychiatry   29 ( 3 )   253 - 62   2014.3

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    DOI： 10.1002/gps.3999

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  • 横浜市大学附属市民総合医療センターにおける摂食障害家族教室の実践 児童・思春期を対象に

    森川 美奈, 高橋 雄一, 大塚 達以, 中川 牧子, 西尾 友子, 小田原 俊成, 平安 良雄

    神奈川県精神医学会誌   ( 63 )   43 - 48   2014.3

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  • The predictive value of a change in natural killer cell activity for delirium. Reviewed International journal

    Kotaro Hatta, Yasuhiro Kishi, Takashi Takeuchi, Ken Wada, Toshinari Odawara, Chie Usui, Yutaka Machida, Hiroyuki Nakamura

    Progress in neuro-psychopharmacology & biological psychiatry   48   26 - 31   2014.1

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    DOI： 10.1016/j.pnpbp.2013.09.008

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  • 認知症の幻覚妄想．夕暮れ症候群とせん妄

    小田原 俊成

    日本認知症学会誌   28   259 - 264   2014

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  • 総合病院における高齢者支援 Reviewed

    小田原 俊成

    臨床精神医学   43   821 - 826   2014

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  • 【入院患者のうつ病・認知症 こんなときどうする?】【入院患者のうつ病】抑うつ状態の患者さんへの接し方を教えてください

    日野 耕介, 小田原 俊成

    レジデントノート   15 ( 13 )   2390 - 2395   2013.12

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  • 当センターにおける、自殺関連症例、精神科医の介入を要した症例の最近の動向と今後の展望

    岡村 泰, 日野 耕介, 伊藤 翼, 山田 朋樹, 岩下 眞之, 中村 京太, 春成 伸之, 小田原 俊成, 平安 良雄, 森村 尚登

    日本救急医学会雑誌   23 ( 10 )   599 - 599   2012.10

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  • 【総合病院における児童・思春期診療の現状と課題(2)】総合病院における児童精神科診療の課題 横浜市立大学附属市民総合医療センターにおける児童精神科専門診療について

    高橋 雄一, 中川 牧子, 大塚 達以, 小田原 俊成, 竹内 直樹, 平安 良雄

    総合病院精神医学   24 ( 4 )   342 - 348   2012.10

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  • Trait impulsivity in suicide attempters: preliminary study. Reviewed International journal

    Chiho Doihara, Chiaki Kawanishi, Nene Ohyama, Tomoki Yamada, Makiko Nakagawa, Yohko Iwamoto, Toshinari Odawara, Yoshio Hirayasu

    Psychiatry and clinical neurosciences   66 ( 6 )   529 - 32   2012.10

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    DOI： 10.1111/j.1440-1819.2012.02379.x

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  • Cautious notification and continual monitoring of patients with mild cognitive impairment. Invited International journal

    Toshinari Odawara

    Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society   12 ( 2 )   131 - 2   2012.6

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    DOI： 10.1111/j.1479-8301.2012.00417.x

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  • [Diagnostic criteria for dementia with Lewy bodies].

    Toshinari Odawara

    Nihon rinsho. Japanese journal of clinical medicine   69 Suppl 10 Pt 2   346 - 9   2011.12

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  • Comparison of characteristics of suicide attempters with schizophrenia spectrum disorders and those with mood disorders in Japan. Reviewed International journal

    Makiko Nakagawa, Chiaki Kawanishi, Tomoki Yamada, Kanna Sugiura, Yoko Iwamoto, Ryoko Sato, Satoshi Morita, Toshinari Odawara, Yoshio Hirayasu

    Psychiatry research   188 ( 1 )   78 - 82   2011.6

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    DOI： 10.1016/j.psychres.2010.09.008

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  • Administration of zonisamide in three cases of dementia with Lewy bodies. Reviewed International journal

    Toshinari Odawara, Kazumasa Shiozaki, Takashi Togo, Yoshio Hirayasu

    Psychiatry and clinical neurosciences   64 ( 3 )   327 - 9   2010.6

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    DOI： 10.1111/j.1440-1819.2010.02075.x

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  • 救命救急センターに入院した自殺未遂患者の在院期間の調査 精神科医のセンター常勤化前後での比較 Reviewed

    岩本洋子, 山田朋樹, 河西千秋, 中川牧子, 鈴木範行, 小田原俊成, 平安良雄

    精神医学   52 ( 1 )   87 - 90   2010

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  • Characteristics of suicide attempters with family history of suicide attempt: a retrospective chart review. Reviewed International journal

    Makiko Nakagawa, Chiaki Kawanishi, Tomoki Yamada, Yoko Iwamoto, Ryoko Sato, Hana Hasegawa, Satoshi Morita, Toshinari Odawara, Yoshio Hirayasu

    BMC psychiatry   9   32 - 32   2009.6

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    BACKGROUND: Family history of suicide attempt is one of the risks of suicide. We aimed at exploring the characteristics of Japanese suicide attempters with and without a family history of suicide attempt. METHODS: Suicide attempters admitted to an urban emergency department from 2003 to 2008 were interviewed by two attending psychiatrists on items concerning family history of suicide attempt and other sociodemographic and clinical information. Subjects were divided into two groups based on the presence or absence of a family history of suicide attempt, and differences between the two groups were subsequently analyzed. RESULTS: Out of the 469 suicide attempters, 70 (14.9%) had a family history of suicide attempt. A significantly higher rate of suicide motive connected with family relations (odds ratio 2.21, confidence interval 1.18-4.17, p < .05) as well as a significantly higher rate of deliberate self-harm (odds ratio 2.51, confidence interval 1.38-4.57, p < .05) were observed in patients with a family history of suicide compared to those without such history. No significant differences were observed in other items investigated. CONCLUSION: The present study has revealed the characteristics of suicide attempters with a family history of suicide attempt. Further understanding of the situation of such individuals is expected to lead to better treatment provision and outcomes, and family function might be a suitable focus in their treatment.

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  • 総合病院精神科病棟における高齢入院患者の在院日数に影響を及ぼす要因の検討

    野本 宗孝, 小田原 俊成, 大槻 正樹, 藤田 純一, 日野 耕介, 岩本 洋子, 石ヶ坪 潤, 山口 和己, 杉山 直也, 平安 良雄

    老年精神医学雑誌   20 ( 増刊II )   100 - 100   2009.6

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  • A randomized cross-over study of a traditional Japanese medicine (kampo), yokukansan, in the treatment of the behavioural and psychological symptoms of dementia. International journal

    Katsuyoshi Mizukami, Takashi Asada, Toru Kinoshita, Katsuaki Tanaka, Kazuki Sonohara, Ryuhei Nakai, Kiyoshi Yamaguchi, Haruo Hanyu, Kiyoshi Kanaya, Tetsuya Takao, Masakatsu Okada, Sumio Kudo, Hayato Kotoku, Masahiko Iwakiri, Hirofumi Kurita, Toshihiro Miyamura, Yosuke Kawasaki, Koji Omori, Kazumasa Shiozaki, Toshinari Odawara, Tatsuya Suzuki, Shizuru Yamada, Youichi Nakamura, Kenji Toba

    The international journal of neuropsychopharmacology   12 ( 2 )   191 - 9   2009.3

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    The effectiveness and safety of yokukansan (TJ-54), a traditional Japanese medicine (kampo) for the treatment of the behavioural and psychological symptoms of dementia (BPSD), were evaluated in 106 patients diagnosed as having Alzheimer's disease (AD) (including mixed-type dementia) or dementia with Lewy bodies. Patients were randomly assigned to group A (TJ-54 treatment in period I and no treatment in period II; each period lasting 4 wk) or group B (no treatment in period I and TJ-54 treatment in period II). BPSD and cognitive functions were evaluated using the Neuropsychiatric Inventory (NPI) and the Mini-Mental State Examination (MMSE), respectively. Activities of daily living (ADL) were evaluated using Instrumental Activities of Daily Living (IADL) in outpatients and the Barthel Index in in-patients. For the safety evaluation, adverse events were investigated. Significant improvements in mean total NPI score associated with TJ-54 treatment were observed in both periods (Wilcoxon test, p=0.040 in period I and p=0.048 in period II). The mean NPI scores significantly improved during TJ-54 treatment in groups A and B (p=0.002 and p=0.007, respectively) but not during periods of no treatment. Among the NPI subscales, significant improvements were observed in delusions, hallucinations, agitation/aggression, depression, anxiety, and irritability/lability. The effects of TJ-54 persisted for 1 month without any psychological withdrawal symptoms in group A. TJ-54 did not show any effect on either cognitive function or ADL. No serious adverse reactions were observed. The present study suggests that TJ-54 is an effective and well-tolerated treatment for patients with BPSD.

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  • [Are there many patients with dementia with Lewy bodies in Japan?].

    Toshinari Odawara

    Seishin shinkeigaku zasshi = Psychiatria et neurologia Japonica   111 ( 1 )   37 - 42   2009

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  • Total Mini-Mental State Examination score and regional cerebral blood flow using Z score imaging and automated ROI analysis software in subjects with memory impairment. Reviewed

    Eiji Ikeda, Kazumasa Shiozaki, Nobukazu Takahashi, Takashi Togo, Toshinari Odawara, Takashi Oka, Tomio Inoue, Yoshio Hirayasu

    Annals of nuclear medicine   22 ( 6 )   539 - 42   2008.7

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  • 首都圏の高度救命救急センターで入院治療を受けた重症自殺未遂者の特徴

    中川 牧子, 山田 朋樹, 岩本 洋子, 河西 千秋, 小田原 俊成, 佐藤 玲子, 長谷川 花, 須田 顕, 平安 良雄

    精神神経学雑誌   ( 2008特別 )   S - 374   2008.5

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  • Evaluation of subjective treatment satisfaction with antipsychotics in schizophrenia patients. Reviewed International journal

    Midori Fujikawa, Takashi Togo, Asuka Yoshimi, Junichi Fujita, Munetaka Nomoto, Atsushi Kamijo, Toru Amagai, Hirotake Uchikado, Omi Katsuse, Hideki Hosojima, Yoshihisa Sakura, Ryo Furusho, Akira Suda, Takayuki Yamaguchi, Taketo Hori, Ayuko Kamada, Taizo Kondo, Michitomo Ito, Toshinari Odawara, Yoshio Hirayasu

    Progress in neuro-psychopharmacology & biological psychiatry   32 ( 3 )   755 - 60   2008.4

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    Adherence to antipsychotic treatment is particularly important in the long-term management of schizophrenia and other related psychotic disorders since poor adherence to medication is associated with poor health outcomes. Although the patients' subjective satisfaction with the medication is crucial for adherence to medication, few studies have examined the relationship between subjective satisfaction with antipsychotics and adherence. In this study, we investigated subjective satisfaction with antipsychotics in patients with schizophrenia by using the Treatment Satisfaction Questionnaire for Medication (TSQM), a self-reporting instrument to assess the major dimensions of patients' satisfaction with their medication. The subjects included 121 clinically stabilized outpatients who met the following criteria: 1) patients between 20 and 65 years of age, diagnosed with schizophrenia or other psychotic disorders as defined by DSM-IV, 2) patients undergoing oral antipsychotic monotherapy or taking only an antiparkinsonian agent as an adjuvant remedy, and 3) patients who had received a stable dose of an antipsychotic for more than four weeks. Patients were asked to answer the TSQM questions, and their clinical symptoms were also evaluated by the Brief Psychiatric Rating Scale (BPRS). Satisfaction with regard to side-effects (p=0.015) and global satisfaction (p=0.035) were significantly higher in patients taking second-generation antipsychotics (SGAs, n=111) than those taking first-generation antipsychotics (FGAs, n=10), whereas no significant difference was found between the two groups in clinical symptoms according to BPRS (p=0.637) or the Drug-induced Extrapyramidal Symptoms Scale (DIEPSS, p=0.209). In addition, correlations were not significant between the subjective satisfactions and clinician-rated objective measures of the symptoms. These findings suggest that SGAs have more favorable subjective satisfaction profiles than FGAs in the treatment of schizophrenia. Since it is often difficult to detect the difference by a traditional objective assessment of the patients, it is desirable that physicians pay attention to the patients' subjective satisfaction in conjunction with their own objective clinical assessment.

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  • Risperidoneからolanzapineへの切り替えにより精神病後抑うつの改善が得られた初発統合失調症の4例

    大塚 達以, 小田原 俊成, 細島 英樹, 加藤 由以子, 齋藤 聖, 平安 良雄

    精神科治療学   23 ( 3 )   353 - 359   2008.3

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  • 下垂体機能不全により老年期幻覚妄想状態をきたした一例

    近藤 大三, 鎌田 鮎子, 須田 顕, 古荘 竜, 藤代 潤, 小田原 俊成

    神奈川医学会雑誌   35 ( 1 )   86 - 86   2008.1

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  • Psychiatric assessment of suicide attempters in Japan: a pilot study at a critical emergency unit in an urban area. Reviewed International journal

    Tomoki Yamada, Chiaki Kawanishi, Hana Hasegawa, Ryoko Sato, Akiko Konishi, Daiji Kato, Taku Furuno, Ikuko Kishida, Toshinari Odawara, Mitsugi Sugiyama, Yoshio Hirayasu

    BMC psychiatry   7   64 - 64   2007.11

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    DOI： 10.1186/1471-244X-7-64

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  • オランザピンの剤型による服薬満足度の違いについて Reviewed

    藤川美登里, 都甲崇, 吉見明香, 藤田純一, 野本宗孝, 上条敦史, 天貝徹, 内門大丈, 勝瀬大海, 細島英樹, 佐倉義久, 古荘竜, 須田顕, 山口孝之, 伊藤導智, 小田原俊成, 平安良雄

    精神医学   49 ( 5 )   543 - 546   2007

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  • [Current status of health services rendered by the Department of Neurology, Yokohama City University-affiliated Hospital--from the viewpoint of a psychiatric emergency core hospital].

    Toshinari Odawara, Naoya Sugiyama, Yoshio Heian

    Seishin shinkeigaku zasshi = Psychiatria et neurologia Japonica   109 ( 10 )   968 - 75   2007

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  • Features of elderly patients admitted to a general hospital psychiatric unit Reviewed

    Yoshiko Furukawa, Toshinari Odawara, Yasuhiro Yamada, Jyunichi Fujita, Yoshio Hirayasu

    Psychogeriatrics   6 ( 2 )   55 - 59   2006.6

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    DOI： 10.1111/j.1479-8301.2006.00147.x

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  • 精神科救急にて入院した統合失調症患者の治療導入時の処方実態について

    大塚 達以, 小田原 俊成, 細島 英樹, 加藤 由以子, 山田 朋樹, 平安 良雄

    臨床精神薬理   9 ( 6 )   1199 - 1209   2006.6

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  • Early effects of olanzapine on serum levels of ghrelin, adiponectin and leptin in patients with schizophrenia. International journal

    Hideki Hosojima, Takashi Togo, Toshinari Odawara, Koichi Hasegawa, Satoshi Miura, Yuiko Kato, Akiko Kanai, Akihiko Kase, Hirotake Uchikado, Yoshio Hirayasu

    Journal of psychopharmacology (Oxford, England)   20 ( 1 )   75 - 9   2006.1

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    Although treatment with antipsychotics, particularly olanzapine and clozapine, has been implicated in weight gain and higher incidence of diabetes, the mechanism of these adverse reactions remains unclear. The purposes of this study were to explore the early effects of olanzapine on serum levels of ghrelin, adiponectin and leptin, three recently identified hormones that play crucial roles in the regulation of energy balance and glucose metabolism. Thirteen patients with schizophrenia who had not received any medication in the 4 weeks prior to this study were included. The patients received olanzapine at an average dose of 14.5mg/day. Serum levels of ghrelin, adiponectin, leptin and insulin, as well as weight and fasting glucose, were investigated at the baseline and at 4 weeks. Serum ghrelin levels had decreased (p 0.03) and leptin had increased (p 0.02), while adiponectin and insulin levels had not significantly changed at Week 4 (p 0.29 and p 0.25, respectively). Weight had increased (p 0.01), while fasting glucose had not significantly changed (p 0.46). These findings suggest that ghrelin levels decrease and leptin levels increase after initiation of olanzapine therapy. Weight gain is also considered to be an early change, while change in insulin sensitivity is not an early change of treatment with olanzapine. Further large-scale and longitudinal studies are warranted to elucidate metabolic changes involving ghrelin, adiponectin, leptin and insulin and their impact on weight and glucose metabolism during treatment with olanzapine and other antipsychotics.

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  • Use of restraint in a general hospital psychiatric unit in Japan. Reviewed International journal

    Toshinari Odawara, Hiroyuki Narita, Yasuhiro Yamada, Jyunichi Fujita, Tomoki Yamada, Yoshio Hirayasu

    Psychiatry and clinical neurosciences   59 ( 5 )   605 - 9   2005.10

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    DOI： 10.1111/j.1440-1819.2005.01422.x

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  • 統合失調症急性期治療導入後のRisperidoneからOlanzapineへの切り替えの有用性について 初発5症例での検討

    齋藤 聖, 加藤 由以子, 細島 英樹, 大塚 達以, 青木 芳子, 小田原 俊成, 平安 良雄

    神奈川医学会雑誌   32 ( 2 )   249 - 250   2005.7

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  • 抑うつ気分が先行した前頭側頭型痴呆が疑われた一例

    長谷川 花, 須田 顕, 佐藤 玲子, 鈴木 東洋, 加藤 由以子, 山田 康弘, 小田原 俊成

    神奈川医学会雑誌   32 ( 1 )   77 - 77   2005.1

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  • [Mandatory postgraduate training in psychiatry in Yokohama City University and the affiliated medical facilities under the new system of postgraduate clinical education in Japan].

    Reiko Sato, Chiaki Kawanishi, Kazumasa Shiosaki, Naoya Sugiyama, Shuichiro Fujiwara, Atsushi Ozawa, Toshinari Odawara, Yoshio Hirayasu

    Seishin shinkeigaku zasshi = Psychiatria et neurologia Japonica   107 ( 8 )   841 - 5   2005

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  • Ubiquitin and ubiquitin-related proteins in the brains of patients with atypical Pick's disease without Pick bodies and dementia with motor neuron disease. International journal

    Yoshiko Furukawa, Eizo Iseki, Hiroaki Hino, Toshinari Odawara, Kenji Ikeda, Kuniaki Tsuchiya, Kenji Kosaka

    Neuropathology : official journal of the Japanese Society of Neuropathology   24 ( 4 )   306 - 14   2004.12

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    Nine cases of atypical Pick's disease without Pick bodies (aPiD) and seven cases of dementia with motor neuron diseases (D-MND) were compared using immunohistochemistry of ubiquitin (ub) and ub-related proteins. All cases showed rostral-dominant atrophy in the temporal and frontal lobes, although the degree of atrophy with neuronal loss was much more severe in the aPiD cases. In both aPiD and D-MND cases, ub-positive and tau-negative structures were found mainly in the hippocampal dentate gyrus and cerebral cortex. Granular cells of the dentate gyrus showed similar ub-positive intraneuronal inclusions in both cases. In the aPiD cases, most of the ub-positive cortical structures were ub-positive dendrites in layers II-IIIab and layers V-VI, although some neurons also showed diffuse ub-positive staining in the cytoplasm. In the D-MND cases, some neurons showed ub-positive inclusions in layers II-IIIab, and ub-positive dendrites were unremarkable. The number of ub-positive neurons and dendrites in relation to the degree of neuronal loss in the cerebral cortex were then evaluated. The number of ub-positive neurons in the regions showing very mild to mild neuronal loss was significantly greater in the D-MND cases than in the aPiD cases. However, in the aPiD cases, the number of ub-positive neurons was significantly greater in the regions showing moderate neuronal loss. When double-immunostained, almost all ub-positive structures were positive for ub-binding protein p62. Some ub-positive or negative neurons in the cerebral cortex were immunostained with anti-ub ligase (Parkin) and anti-ub C-terminal hydrolase (UCH-L1) antibodies. Granular cells of the dentate gyrus were weakly positive for UCH-L1. There could be some differences in the mechanism by which neurons in the cerebral cortex accumulate ub between aPiD and D-MND.

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  • 抑うつ気分が先行した前頭側頭型痴呆が疑われた一例

    長谷川 花, 須田 顕, 佐藤 玲子, 鈴木 東洋, 加藤 由以子, 山田 康弘, 小田原 俊成

    神奈川県精神医学会誌   ( 54 )   69 - 69   2004.12

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  • 統合失調症治療における多施設での抗精神病薬の多剤併用・大量療法からolanzapineへの切り替え研究

    山田 朋樹, 上原 久美, 古野 拓, 小島 克夫, 都甲 崇, 庄司 美香, 小田原 俊成, 小阪 憲司, 平安 良雄

    臨床精神薬理   7 ( 11 )   1769 - 1784   2004.11

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  • Psychomotor retardation correlates with frontal hypoperfusion and the Modified Stroop Test in patients under 60-years-old with major depression. Reviewed International journal

    Hiroyuki Narita, Toshinari Odawara, Eizo Iseki, Kenji Kosaka, Yoshio Hirayasu

    Psychiatry and clinical neurosciences   58 ( 4 )   389 - 95   2004.8

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  • [A case with late-onset MELAS with hallucination and delusion]. Reviewed

    Hiroyuki Narita, Toshinari Odawara, Toshihiko Matsumoto, Shigeru Kimura, Tomoki Yamada, Eizo Iseki, Kazuya Miyakawa, Hiroaki Hino, Daiji Kato, Kenji Kosaka, Yoshio Hirayasu

    No to shinkei = Brain and nerve   56 ( 4 )   345 - 9   2004.4

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    We report a 53-year-old male patient with late onset mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes(MELAS) with hallucination and delusion. The patient manifested various neurological symptoms including perceptive deafness, muscle weakness of limbs with loss of consciousness, sensory abnormalities in hands, feet and a face, abnormal sense of taste, tremor, palsy of upward eye movement and weak deep tendon reflexes prior to the psychotic episode. He was diagnosed as MELAS, because of high serum lactic acid and pyruvic acid, and the point mutation in the mitochondrial DNA 3243. SPECT imaging showed decreased perfusion in occipital cortex and thalamus. These SPECT changes improved after disappearing visual hallucination. Hallucination might be caused by delirium due to stroke-like episode. Dysfunction in the occipital cortex and thalamus might be involved with this perfusion change.

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  • Ubiquitin and ubiquitin-related proteins in neurons and dendrites of brains of atypical Pick's disease without Pick bodies. Reviewed International journal

    Yoshiko Furukawa, Eizo Iseki, Hiroaki Hino, Akiko Kanai, Toshinari Odawara, Kenji Kosaka

    Neuropathology : official journal of the Japanese Society of Neuropathology   24 ( 1 )   38 - 45   2004.3

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    Nine cases of atypical Pick's disease without Pick bodies were investigated immunohistochemically. Ubiquitin (ub)-positive and tau-negative structures were mainly found in the cerebral cortex and hippocampal dentate gyrus. In the cerebral cortex, most of the ub-positive structures had ub-positive dendrites in the neuropil, although some also showed diffuse ub-positive staining in the neuronal cytoplasm. These ub-positive structures were distributed throughout layers II-IIIab and layers V-VI. Granular cells of the dentate gyrus had ub-positive intraneuronal inclusions. When the numbers of ub-positive neurons and dendrites were evaluated in relation to the degree of neuronal loss in the cerebral cortex, the number of ub-positive neurons was significantly lower in regions showing very mild neuronal loss and higher in regions showing moderate neuronal loss. In contrast, ub-positive dendrites were detected even in cortical regions showing very mild neuronal loss. Immunoelectron-microscopically, ub-positive structures contained ub-positive ribosome-like granular components in the neuronal cytoplasm and dendrites, which were occasionally related to the rough endoplasmic reticulum and accompanied by a few filamentous components. Almost all ub-positive structures were positive for ub-binding protein p62 in double-immunostaining method. Some ub-positive or negative neurons in the cerebral cortex were positively immunolabeled with anti-ub ligase (Parkin) and anti-ub C-terminal hydrolase antibodies, whereas dendrites were not labeled by these antibodies. From the present study, it is suggested that in the cerebral cortex, these ubiquitinated proteins may firstly accumulate in the dendrites at the onset of neuronal degeneration, then appear in the neuronal cytoplasm before finally disappearing with neuronal loss.

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  • Transient lesion in the splenium of the corpus callosum, possibly due to carbamazepine. Reviewed International journal

    Hiroyuki Narita, Toshinari Odawara, Chiaki Kawanishi, Ikuko Kishida, Eizo Iseki, Kenji Kosaka

    Psychiatry and clinical neurosciences   57 ( 5 )   550 - 1   2003.10

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  • Different immunoreactivities of the microtubule-binding region of tau and its molecular basis in brains from patients with Alzheimer's disease, Pick's disease, progressive supranuclear palsy and corticobasal degeneration. Reviewed International journal

    Tetsuaki Arai, Kenji Ikeda, Haruhiko Akiyama, Kuniaki Tsuchiya, Shuji Iritani, Koichi Ishiguro, Saburo Yagishita, Tatsuro Oda, Toshinari Odawara, Eizo Iseki

    Acta neuropathologica   105 ( 5 )   489 - 98   2003.5

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    The microtubule-associated protein tau accumulates as cytoplasmic inclusions in Alzheimer's disease (AD), Pick's disease (PiD), progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). We investigated the immunoreactivity of tau-positive structures using a panel of antibodies to epitopes spanning the entire length of the tau molecule. In ethanol-fixed brain tissues, most antibodies to the microtubule-binding domain (MBD) required formic acid (FA) treatment to stain tau inclusions in PSP and CBD. This is in contrast with the intense labeling of neurofibrillary tangles in AD without FA treatment. Pick bodies (PiB) in PiD showed an intermediate pattern with respect to the immunoreactivity of the MBD because accumulated tau in PiB mostly lacks the insertion of exon 10, and the proportion of tau phosphorylated at Ser262 is smaller than in other abnormal tau structures. Such immunohistochemical profiles appeared to correlate with the occurrence of the smeared tau on immunoblot analysis of brain homogenate. The smeared tau was more abundant in AD and PiD than in PSP and CBD. Since the smeared tau was N-terminally truncated and was characteristic of advanced forms of modified tau, these findings suggest that tau accumulated in AD and PiD was processed more markedly than that in PSP and CBD. The MBD of tau may be masked in the presence of the intact N terminus and require FA treatment for antibody recognition in tissue sections. Advanced modification may expose the MBD in brain tissues of AD and PiD. It is suggested that the processing of abnormally accumulated tau characterizes the pathophysiology of each tauopathy.

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  • [A Japanese family with familial Alzheimer's disease associated with presenilin 1 mutation: relationship between younger age of onset and ApoE gene polymorphism].

    Wami Marui, Eizo Iseki, Naoya Sugiyama, Takehiko Matsumura, Kyoko Suzuki, Toshinari Odawara, Hiroaki Hino, Kenji Kosaka

    No to shinkei = Brain and nerve   55 ( 4 )   349 - 53   2003.4

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    We previously reported a Japanese family with early-onset familial Alzheimer's disease associated with G 209 R presenilin 1(PS 1) mutation. There have been six patients across three generations in this family. In the present report, we described the clinical course, findings with neuroimaging and results of genetic examination of PS 1 and apolipoprotein E(ApoE) in three of six patients(II-1, III-1 and 2). The clinical course was common to all three patients. Memory disturbance, disorientation, amnestic aphasia, personality changes and perseveration appeared at early stages, whereas Gerstmann's syndrome, myoclonus and general convulsion were recognized at advanced stages. CT disclosed mild brain atrophy in the temporal lobes at early stages and diffuse brain atrophy predominantly in the fronto--temporal lobes at advanced stages. SPECT exhibited hypoperfusion in the fronto-temporal areas at early stages and hypoperfusion in the fronto-temporal and parieto-occipital areas at advanced stages. The age of onset in six patients demonstrated two clusters at age 53-55(I-1, II-1, 2 and 5) and age 46-48(III-1 and 2). PS 1 genotyping demonstrated that the heterozygous exonic missense mutation G 209 R was confirmed in all three patients. Regarding the ApoE genotyping, II-1(mother) was epsilon 3/epsilon 3, whereas III-1 and 2(children) were epsilon 3/epsilon 4. These findings suggest the possibility that there might be a gene dose effect, since the age of onset ranged from 5 to 7 years younger in patients who received epsilon 4 alleles from the father.

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  • [Organic catatonic disorder].

    Toshinari Odawara

    Ryoikibetsu shokogun shirizu   ( 40 )   164 - 7   2003

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  • 治療経過中に痴呆様症状を呈したACTH単独欠損症の1例 Reviewed

    藤田純一, 金井晶子, 細島英樹, 佐藤玲子, 坂本誠, 小田原俊成

    神奈川県精神医学会雑誌   53   45 - 50   2003

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  • Clinicopathological study of two subtypes of Pick's disease in Japan. Reviewed International journal

    Toshinari Odawara, Eizo Iseki, Akiko Kanai, Tetsuaki Arai, Toshio Katsuragi, Hiroaki Hino, Yoshiko Furukawa, Masanori Kato, Takayuki Yamamoto, Kenji Kosaka

    Dementia and geriatric cognitive disorders   15 ( 1 )   19 - 25   2003

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    We examined the clinical and neuropathological findings in 3 cases of Pick's disease with Pick bodies (PiD) and 7 cases of atypical Pick's disease without Pick bodies (aPiD). PiD and aPiD cases corresponded clinically to frontotemporal dementia and semantic dementia, respectively, based on the clinical diagnostic criteria of frontotemporal lobar degeneration. Brain CT showed that cerebral atrophy was accentuated at an early stage of the illness in the anterior portion of the frontal lobes in PiD cases and in the anterior portion of the temporal lobes in aPiD cases. Neuropathologically, PiD cases showed more circumscribed lobar atrophy than aPiD cases. Both PiD and aPiD cases revealed moderate to severe degeneration with neuronal loss and gliosis in the affected cerebral cortex and subcortical nuclei, but only aPiD cases had pyramidal tract degeneration. Immunohistochemical analyses demonstrated that tauopathy with phosphorylated tau accumulation in the Pick bodies in PiD cases, while aPiD cases showed ubiquitinopathy with ubiquitin accumulation in the intraneuronal and dendritic inclusions. These findings suggested that two subtypes of Pick's disease in Japan can be distinguished not only neuropathologically but also clinically based on differences in pathogenesis.

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  • Degeneration of Pick bodies visualized by methenamine-silver staining and immunohistochemistry. Reviewed International journal

    Toshinari Odawara, Eizo Iseki, Yoshiko Furukawa, Kyoko Suzuki, Hiroaki Hino, Kenji Kosaka

    Neuropathology : official journal of the Japanese Society of Neuropathology   22 ( 3 )   180 - 5   2002.9

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    The degeneration process of Pick's bodies (PB) was investigated using methenamine-silver (MS) staining and immunohistochemistry. Methenamine-silver staining sensitively detected extracellular PB as well as intracellular PB in the granular cell layer of the dentate gyrus. Extracellular PB appeared as granular masses with ill-defined boundaries in the neuropil. For MS electron microscopy, the extracellular PB were composed of randomly oriented fibrillary components measuring 9-12 nm in diameter with astroglial processes and degenerated organelles. Tau immunoreactivity of extracellular PB was reduced or abolished. These findings indicate that MS staining is a convenient method for detecting extracellular PB. In addition, it was shown that microglial involvement was associated with PB-bearing neurons at the late stage of the degeneration process and that extracellular PB remained in the neuropil with astroglial reaction.

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  • Familial frontotemporal dementia and parkinsonism with a novel N296H mutation in exon 10 of the tau gene and a widespread tau accumulation in the glial cells

    Eizo Iseki, Takehiko Matsumura, Wami Marui, Hiroaki Hino, Toshinari Odawara, Naoya Sugiyama, Kyoko Suzuki, Hajime Sawada, Tetsuaki Arai, Kenji Kosaka

    Acta Neuropathologica   102 ( 3 )   285 - 292   2001

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    DOI： 10.1007/s004010000333

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  • Ubiquitin-immunohistochemical investigation of atypical Pick's disease without Pick bodies

    Eizo Iseki, Feng Li, Toshinari Odawara, Hiroaki Hino, Kyoko Suzuki, Kenji Kosaka, Haruhiko Akiyama, Kenji Ikeda, Masanori Kato

    Journal of the Neurological Sciences   159 ( 2 )   194 - 201   1998.8

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    DOI： 10.1016/S0022-510X(98)00168-3

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  • Heparan sulfate proteoglycans recognize ghost Pick bodies

    Toshinari Odawara, Eizo Iseki, Feng Li, Kenji Kosaka, Kenji Ikeda

    Neuroscience Letters   242 ( 2 )   120 - 122   1998.2

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    DOI： 10.1016/S0304-3940(98)00027-5

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  • Age-related ubiquitin-positive granular structures in non-demented subjects and neurodegenerative disorders

    Eizo Iseki, Toshinari Odawara, Feng Li, Kenji Kosaka, Tohru Nishimura, Haruhiko Akiyama, Kenji Ikeda

    Journal of the Neurological Sciences   142 ( 1-2 )   25 - 29   1996

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    DOI： 10.1016/0022-510X(96)00024-X

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  • Neuropathological evaluation and apolipoprotein E gene polymorphism analysis in diffuse Lewy body disease

    Chiaki Kawanishi, Kyoko Suzuki, Toshinari Odawara, Eizo Iseki, Hideki Onishi, Tomohiro Miyakawa, Yoshiteru Yamada, Kenji Kosaka, Naoki Kondo, Takayuki Yamamoto

    Journal of the Neurological Sciences   136 ( 1-2 )   140 - 142   1996

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    DOI： 10.1016/0022-510X(95)00312-P

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  • Investigation of tau-2 positive microglia-like cells in the subcortical nuclei of human neurodegenerative disorders

    Toshinari Odawara, Eizo Iseki, Kenji Kosaka, Haruhiko Akiyama, Kenji Ikeda, Takayuki Yamamoto

    Neuroscience Letters   192 ( 3 )   145 - 148   1995.6

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  • A pathological study of Lewy bodies and senile changes in the amygdala in diffuse Lewy body disease

    Eizo Iseki, Toshinari Odawara, Kyoko Suzuki, Kenji Kosaka, Haruhiko Akiyama, Kenji Ikeda

    Neuropathology   15 ( 3-4 )   112 - 116   1995

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    Language：English   Publishing type：Research paper (scientific journal)  

    DOI： 10.1111/j.1440-1789.1995.tb00252.x

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  • Incidence and Distribution of Senile Plaques and Neurofibrillary Tangles in Late‐onset Diffuse Lewy Body Disease

    Toshinari Odawara, Eizo Iseki, Kenji Kosaka, Chie Haga, Kenji Ikeda

    Neuropathology   14 ( 1 )   7 - 11   1994

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    Language：English   Publishing type：Research paper (scientific journal)  

    DOI： 10.1111/j.1440-1789.1994.tb00237.x

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  • Evaluation of Neuropathological Stages Based on Quantification of Senile Changes in Non‐Demented Elderly Individuals and Alzheimer‐Type Dementia

    Eizo Iseki, Toshinari Odawara, Kenji Kosaka, Chie Haga, Kenji Ikeda

    Neuropathology   13 ( 2 )   147 - 152   1993

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    Language：English   Publishing type：Research paper (scientific journal)  

    DOI： 10.1111/j.1440-1789.1993.tb00225.x

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Books

  • かかりつけ医のための「攻める」認知症ガイド．BPSDの治療-総論、易怒性、暴力行為の治療、家族のメンタルケア．

    小田原 俊成（ Role： Joint author）

    日本医事新報社  2018 

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  • 認知症診療連携マニュアル．

    小田原 俊成（ Role： Edit）

    星和書店  2018 

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  • 精神科レジデントハンドブック第３版

    小田原 俊成（ Role： Joint author）

    中外医学社  2017 

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  • Clinician．レビー小体型認知症のＢＰＳＤに対する治療とケア

    小田原 俊成（ Role： Contributor648;79-85）

    エーザイ株式会社  2016 

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  • レジデントノート．入院患者のうつ病・認知症

    小田原 俊成（ Role： Edit2382－2447）

    羊土社  2013 

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  • 病棟・ICUで出会うせん妄の診かた．認知症に伴うせん妄

    小田原 俊成（ Role： Contributor122－131）

    中外医学社  2012 

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  • 物忘れ、不安感とともに「貴重品を盗まれる」と訴える症例

    小田原 俊成（ Role： Contributor47－55）

    新興医学出版社  2011 

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  • 精神科研修ノート,精神科専門医取得に向けて

    小田原 俊成（15-17）

    診断と治療社  2011 

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  • 総合診療マニュアル，心療内科と精神神経系－オーバービュー、成年期の疾患、老年期の疾患－

    小田原 俊成（ Role： Contributor687‐690,697‐706）

    金芳堂  2010 

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  • 統合失調症の異種性について，Ⅰ．統合失調症の概念，統合失調症の治療－臨床と基礎－，佐藤光源、丹羽真一、井上新平編集

    小田原俊成, 平安良雄（ Role： Contributor98－101）

    朝倉書店  2007 

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  • 鑑別診断．Ｓ9巻アルツハイマー病．臨床精神医学講座．

    小田原 俊成, 小阪憲司（ Role： Contributor276-287）

    中山書店  2000 

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MISC

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Research Projects

  • 高齢者の認知機能と生活習慣に関する観察研究

    Grant number：25K10819  2025.4 - 2027.3

    日本学術振興会 科学研究費助成事業  基盤研究(C)

    小田原俊成

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  • 認知症未病改善に向けた、評価・介入の総括的準備研究．

    2024.10 - 2025.3

    令和6年度科学技術イノベーション共創拠点推進事業 

    小田原俊成

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    Authorship：Principal investigator 

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  • 認知機能障害に対する評価技術の開発

    2024.4 - 2025.3

    COI-NEXT 

    小田原俊成

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    Authorship：Coinvestigator(s) 

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  • 神奈川県みらい未病コホート研究を活用した生活習慣と認知機能に関する観察研究

    2023.12 - 2024.11

    ファイザーヘルスリサーチ振興財団  第３２回ファイザーヘルスリサーチ研究助成金 

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  • 認知症対策官民イノベーション実証基盤整備事業．認知症予防を目指した多因子介入によるランダム化比較研究．

    2019 - 2022

    国立研究開発法人日本医療研究開発機構 

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    Authorship：Coinvestigator(s) 

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  • Prediction, prevention, and treatment of delirium from the perspective of neuroinflammation

    Grant number：26461773  2014.4 - 2017.3

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

    Hatta Kotaro

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    Grant amount：\4940000 （ Direct Cost: \3800000 、 Indirect Cost：\1140000 ）

    We examined whether suvorexant, a potent and selective orexin receptor antagonist, is effective for the prevention of delirium.Method: We conducted a multi-center, rater-blinded, randomized placebo-controlled clinical trial in intensive care units and regular acute wards between April 2015 and March 2016. Eligible patients were 65-89 years old and newly admitted due to emergency. Seventy-two patients were randomly assigned to receive suvorexant (15 mg/day; 36 patients) and placebo (36 patients) every night for three days. The primary outcome measure was incidence of delirium as determined by the DSM-5. Trained psychiatrists assessed for delirium. We found that development of delirium occurred significantly less often among patients taking suvorexant than those taking placebo (0% [n/N=0/36] vs. 17% [6/36], P=.025). Suvorexant administered nightly to elderly patients admitted for acute care may provide protection against delirium.

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  • 病・診・介護の連携による認知症ネットワーク構築に関する研究事業

    2012 - 2014

    平成24~26年厚生労働科学研究補助金 

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    Authorship：Coinvestigator(s) 

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  • A study on treatment, prevention, and medical safty of delirium

    Grant number：23591728  2011.4 - 2015.3

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

    HATTA Kotaro, KISHI Yasuhiro, ODAWARA Toshinari, TAKEUCHI Takashi, SUGITA Manabu, USUI Chie, KAMIJO Yoshito, MACHIDA Yutaka, NAKAMURA Hiroyuki

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    Grant amount：\5070000 （ Direct Cost: \3900000 、 Indirect Cost：\1170000 ）

    First, we have demonstrated preventive effects of ramelteon, a melatonin agonist, on delirium through a randomized placebo-controlled trial. This finding supports a possible pathogenic role of melatonin neurotransmission in delirium. This accomplishment may provide a paradigm shift from treatment to prevention in clinical practice of delirium. Second, we have demonstrated the predictive value of a change in natural killer cell activity for delirium. The importance of delirium prediction may increase as we have developed an effective prevention method. Third, we have demonstrated that in the general hospital setting under management including fine dosage adjustment in individual patients and the early detection of side-effects, antipsychotics have a low risk in the treatment of patients with delirium, and have high efficacy.
    These findings such as prevention, prediction, and treatment will provide clinical guidelines for delirium.

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  • The strategies for optimizing the use of restraint in medical practice

    Grant number：18590497  2006 - 2008

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

    SUGIYAMA Naoya

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    Grant amount：\4160000 （ Direct Cost: \3500000 、 Indirect Cost：\660000 ）

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  • The Study concerning the pathogenesis of non-Alzheimer neurodegenerative dementias from the perspective of abnormal cytoskeletons

    Grant number：12670952  2000 - 2003

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

    ISEKI Eizo, ODAWARA Toshinori

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    Grant amount：\3300000 （ Direct Cost: \3300000 ）

    The study concerning the pathogenesis of non-Alzheimer neurodegenerative dementias has been performed from the perspective of abnormal cytoskeletons. Cytopathological and clinicopathological studies of dementia with Lewy bodies (DLB) have been focused. In the cytopathological studies, formation process or degeneration process of Lewy bodies was investigated using α-synuclein immunohistochemistry. Lewy bodies were formed by the accumulation of α-synuclein in the abnormal cytoskeletons with axonal transport blockage, and degenerated with glial and immunological reaction. In the clinicopathological studies, Lewy pathology was graded from stage I to stage IV, and autopsied cases of DLB were classified into some subtypes according to the degree of Lewy pathology or Alzheimer pathology. In frontotemporal dementia (FTD), Pick's disease (PiD) was divided into two types of tauopathy and ubiquitinopathy.

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  • ピック嗜銀球および関連構造物の消長過程の神経病理学的検討

    Grant number：12770540  2000 - 2001

    日本学術振興会  科学研究費助成事業  奨励研究(A)

    小田原 俊成

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    Grant amount：\1900000 （ Direct Cost: \1900000 ）

    今年度はピック病(PD)に出現するピック嗜銀球(PB)の変性過程について検討を行った。
    (方法)PBを有するPD4症例の剖検脳を用い、4%PFA固定後の海馬を含む側頭葉のパラフィン切片およびビブラトーム切片を作製し、メセナミン銀(MS)染色のほか各種抗体による免疫染色を施し、光顕所見および電子顕微鏡学的所見を検討した。
    (結果)PBの好発する海馬歯状回では、MS染色は細胞内PBの他、その近傍に核をもたない粗顆粒状の不整な球状構造物を明瞭に認識した。これらは抗tau抗体では染まらないか弱陽性で、免疫電顕ではtau免疫原性を失った線維成分が細胞外に集族したもので、細胞外PBと考えられた。細胞外PBにはastroglial fibrilsが混在していた。次に細胞内PBのtau免疫原性の違いに基づき、PBの変性過程におけるミクログリアの関与を検討した。tau弱陽性PBを含有する境界不明瞭な神経細胞は半数以上がその周囲にHLA-DR陽性のミクログリアの反応が認められたのに対し、tau強陽性PBを含有する境界明瞭な神経細胞にはミクログリアの反応は乏しかった。
    (考察)MS染色は細胞外PBを認識する簡便な染色法であることが示された。PB含有神経細胞の変性・消失にはミクログリアが関与する可能性が示唆された。アストログリアは主として神経細胞の死後、細胞外PBの処理過程に関与していると考えられた。

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  • 神経原線維変化生成過程におけるプロテオグリカンの役割について

    Grant number：09770753  1997

    日本学術振興会  科学研究費助成事業  奨励研究(A)

    小田原 俊成

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    Grant amount：\1100000 （ Direct Cost: \1100000 ）

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  • A study on the pathophysiology of diffuse Lewy body disease

    Grant number：07457212  1995 - 1997

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (B)

    KOSAKA Kenji, GOTOU Kenichi, ONISHI Hideki, ISEKI Eizo

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    Grant amount：\5400000 （ Direct Cost: \5400000 ）

    The results of our 3-year research on diffuse Lewy body disease (DLBD) are as follows :
    1.Our investigation of 100 autopsied demented cases revealed that DLBD was the third frequent (15.4%) dementing illness, following Alzheimer-type dementia (43.6%) and vasculor dementia (23.1%).
    2.Our immuno-electron microscopic examination disclosed that both spongy state in the entorhinal cortex and ubiquitin-positive neurites in the CA_<2-3> area, which are specific to DLBD,derive from degeneration of presynaptic terminals of large pyramidal neurons in the entorhinal cortex. It suggests that both the changes are closely related through the perforant pathway, and that they play an important role in memory disturbance of DLBD.
    3.Ubiquitin-positive neurites were found not only in the hippocampal CA_<2-3> areas, but also in the parahippocampal cortex, amygdala (especially, central nucleus) and nucleus basalis of Meynert.
    4.In the amygdala Lewy bodies were most frequently fpound in the medial parts of the accessory basal and basal nuclei.
    5.A new cerebral type of Lewy body disease was found, in which numerous Lewy bodies were present in the cerebral cortex, but only rare in the brain stem nuclei.
    6.The frequency of apolipoprotein E_4 was as high in the common form as in Alzheimer-typr dementia, but low in the pure form of DLBD.
    7.The possibility of selective decrease of acetylcholine M_2 receptor in DLBD was suggested.
    The second International Workshop on DLBD will be held in Amsterdam in July 1988. Then, Kosaka will give an invited lecture on DLBD research in Japan.

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  • 富士川流域に発生したクロイツフェルドヤコブ病の家系および分子遺伝学的解析

    Grant number：07770790  1995

    日本学術振興会  科学研究費助成事業  奨励研究(A)

    小田原 俊成

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    Grant amount：\1000000 （ Direct Cost: \1000000 ）

    学会、研究会などを通じ当教室でのプリオン遺伝子解析について各方面へ周知された結果、本年、6例のCJD患者の遺伝子解析をおこなうことが出来た。この6例はいずれも痴呆や視覚障害、片麻痺などの大脳巣症状などで初発し、精査中に急速に痴呆が進行し、ミオクローヌスや脳波上PSDも出現するなど、典型的なCJDが疑われた時点で、患者家族の同意のもとに患者末梢血を採取したものである。各々即刻当教室に送付され、白血球から迅速法を用いてDNAを抽出した。このDNAを、プリオンタンパク遺伝子(PRNP)領域をはさんだプライマーを用いてPCR法で増幅し、増幅したDNAフラグメントに制限酵素BsmAlを作用させた。その結果、山梨県出身で関東在住の2症例(内1例は河内、小田原ら;日本神経学会関東地方会)と、静岡県富士市在住の1例、計3症例はDNAフラグメントが2つに切断されず、コドン200にグルタミン酸がリジンとなる変異をもつとみられた。さらに診断を確実にするために、増幅されたDNAフラグメントがコドン200に変異がある場合のみ、制限酵素Bxtlで切断されるように設計したミスマッチプライマーを用いてPCRをおこない、やはり同様の変異を確認した(宮川、小田原ら;行動遺伝研究会)。この内の1例は兄がCJDで死亡している家族例であった。この地域と無縁の3例ではコドン200異常を認めなかった。なお、いずれの症例も解析中にも病状は進行し早期に失外套状態に至っている。今回関東在住のCJD症例でコドン200異常を有する2例はいずれも山梨県出身者であった。こんことはコドン200異常と富士川流域との強い相関を予想させるが、コドン200異常は同一家系内でもCJDの発症年齢に開きがあり、その日本における浸透率などさらに症例を蓄積し検討する必要があると考える。パラフィン包埋標本については現在解析中である。

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  • Epidemiologic and clinicopathologic study of presenile demented disorders

    Grant number：05670820  1993 - 1995

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for General Scientific Research (C)

    ISEKI Eizo, KOSAKA Kenji, ODAWARA Toshinari

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    Grant amount：\2100000 （ Direct Cost: \2100000 ）

    In order to examine the demographic data of the patients with presenile dementia, the informations were obtained through questionnaires sent to 99 medical facilities, composed of 15 mental hospitals, and 96 hospitals and 88 clinics having Departments of psychiatry, neurology and neurosurgery. The objects were all the demented patients with the disease onset in the age of 30-64 years regardless of the cause. They had been the outpatients or inpatients during a month of Oct, 1995. The items of questionnaires were composed of sex, adress, age, duration, diagnosis, complications, severity and inheritance of dementia. As the result, the disorder of the highest incidence was Alzheimer's disease (AD), and the second was vascular dementia (VD). Other disorders included Pick's disease, progressive supranuclear palsy, alcholic dementia and brain injury, et al. Inheritance of dementia was found in 12% of the patients with AD.The patients with AD were usually severer than those with VD.The patients with alcohlic dementia had the high proportion of inpatients, although their severity of dementia was relatively mild. The epidemiologic study of presenile dementia is more difficult than that of senile dementia, because it includes various disorders, and has long duration of disease.

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  • 痴呆性変性疾患にみられる神経原線維変化とニューロピル・スレッドの出現様式一免疫組織学的手法を用いて

    Grant number：05770739  1993

    日本学術振興会  科学研究費助成事業  奨励研究(A)

    小田原 俊成

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    Grant amount：\900000 （ Direct Cost: \900000 ）

    びまん性レビー小体病(DLBD)7例、進行性核上性麻痺(PSP)3例、ピック病(PD)2例に出現する神経原線維変化(NFT)およびニューロピル・スレッド(NT)の出現状況について免疫組織化学的に検討し、アルツハイマー型老年痴呆(SDAT)4例と比較した。方法は各症例の海馬を通る大脳半球前額断の10mu厚パラフィン切片に抗Tau-2免疫染色(Sigma-T5530,1:8000)を施し、大脳皮質におけるNFT・NTの出現量、分布を半定量的に調べた。また、他のTau-2陽性構造物についてもその分析を検討した。DLBD例では、NFTは全例の海馬傍回(Transentorhinal pre-alpha)に出現し、次いで海馬から内側後頭側頭回にかけて好発していた。また、下側頭回、帯状回、島回の錐体細胞層にも散在していた。NTの分布は、下側頭回、帯状回、島回でNFTの局在に一致し、出現量もほぼ比例していたが、上前頭回から下頭頂小葉においては、NFTが散見されるのみでNTは認められなかった。PSP例では2例でTransentorhinal pre-alphaにNFT・NTが少数みられたが、その他の大脳皮質には認められなかった。全例の前中心回を主として、前頭葉、下頭頂小葉にかけてTau-2陽性グリア内構造物が多数分布していた。PDではNFT・NTは出現していなかったが、1例でTau-2陽性のピック小体が中・下側頭回、帯状回、前頭葉の主に顆粒細胞層に多発していた。SDAT4例では、DLBD例と同様、NFTは海馬・海馬傍回に好発し、全大脳皮質にわたって出現していた。NTはNFTの出現量と平行し、NFT同様、大脳皮質全体に認められた。今回検索した痴呆性変性疾患のうち、DLBDは全例にNFTが出現していたが、NETが新皮質に散見される例においても、NTの出現によって示される神経細胞突起の障害は、大脳皮質全体には及んでいないことが明らかとなった。PSPでは生理的加齢による範囲内と考えられた。

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  • A comparative study of diffuse Lewy body disease and Alzheimer type dementia

    Grant number：04454306  1992 - 1994

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research  Grant-in-Aid for General Scientific Research (B)

    KOSAKA Kenji, ODAWARA Toshinari, ISEKI Eizo

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    Grant amount：\5800000 （ Direct Cost: \5800000 ）

    The differences of diffuse Lewy body disease (DLBD) with Alzheimer-type dementia (ATD) were examined from clinical, pathological, immuno-histochemical and biochemical view-points.
    1) Most of Japanese elderly DLBD patients had the common form, and most of cases with the pure from suffered from DLBD at the younger age than 40 years. On the other hand, most Euro-American DLBD cases were the elderly.
    2) DLBD can be clinically as well as pathologically differentiated from ATD.Therefore, we can not agree with the opinoin of Hansen et al that DLBD is a subtype of ATD.
    3) Ubiquitin-positive thread-like structures (UPT) and intraglial tau2-positive structures (ITS) are specific to DLBD.
    4) UPT are differentiated from neuropil threads in that they are tau-, NFT-, and beta protein-immunonegative. They are found not only in the CA2-3 of the hippocampus, but also in the amygdala, parahippocampal cortex, nucleus basalis of Meynert and hypothalamus. There are two kinds of UPT : (1) fibrillar or fusiform, and (2) lod-like ones. The former are associated with distal axons, and the latter with proxismal axons.
    5) It was suggested that ITS-containing cells are microglia.
    6) Our biochemical study revealed that 5-HT and noradrenaline activities in the cerebral cortex were much lower in DLBD than in ATD.
    7) In the amygdala, which is one of the preferential sites of Lewy bodies, they were more frequently found in the medical parts of the accessory basal and basal nuclei.

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