Oral Session

Oral Session 14 一般口演14

O14-1 Cortical surface architecture endophenotype and correlates of clinical diagnosis of autism spectrum disorder 自閉症スペクトラム障害のエンドフェノタイプと臨床診断に関与する皮質構造異常 Yamagata Bun（山縣文）¹，青木悠太²，板橋貴史²，橋本龍一郎²，三村將¹，加藤進昌² ¹Department of Neuropsychiatry, Keio University School of Medicine, Tokyo ²Medical Institute of Developmental Disabilities Research, Showa University, Tokyo Identifying endophenotype and neural correlates for a diagnosis of autism spectrum disorder (ASD) is particularly important because of its complex genetic influence. However, the prior studies have some potential drawbacks. First, because they regarded the shared atypical brain feature between individuals with ASD and their unaffected siblings as the ASD endophenotype, they might have underestimated similarity between siblings. Second, given people with ASD endophenotype (i.e., individuals with ASD and their unaffected siblings) do not always develop a clinical ASD diagnosis, the prior studies had not accounted for the presence of ASD endophenotype among individuals with ASD. Focusing on the cortical volume and three surface-based parameters, cortical thickness, fractal dimension, and sulcal depth (SD), we aimed to identify a pattern of ASD endophenotype and neural correlates for the clinical diagnosis. Enrolling 30 people with ASD endophenotype (15 people with ASD and 15 of their unaffected siblings) and 30 people without (15 pairs of TD siblings), sparse logistic regression with a leave-one-pair-out cross-validation showed high accuracy for identification of the ASD endophenotype (73.3%), which is more evident in SD compared with other parameters. A bootstrapping analysis accounting for a difference in SD between typical siblings showed substantially large difference between individuals with ASD and their unaffected siblings in seven out of 68 regions-of-interest. Intriguingly, both endophenotype and clinical diagnosis emphasize the social brain but they did not completely match. These findings suggest that both ASD endophenotype and clinical diagnosis emerge as SD and the neural correlates for the clinical diagnosis can be dissociated from the endophenotype.		O14-2 A case study of 60 years old male of alcoholism and dissocial personality disorder with criminal records of thinner abuseand bodily injury resulting in death シンナー乱用歴・傷害致死など犯罪歴があるアルコール依存、非社会性パーソナリティ障害の60歳男性 Suzuki Mitsuo（鈴木三夫）¹，石川雅枝¹，石川経子¹，石川玄子¹，中村正明¹，原田元²，石川文之進¹ ¹Hotokukai-Utsunomiya Hospital ²Research Institute for EEG Analysis [Object]He has auditory hallucination and delusion of persecution. He was frequently hospitalized for schizophrenia. We diagnosed his illness as a dissocial personality disorder. We report his course of treatment and his EEG analysis.[Medical history]He abused thinner when he was in junior high school. After he graduated the school, he frequently changed his job. When he was 20 years old or around, he suffered from hallucination and delusion, and violated other person. He intended to suicide. He was hospitalized 6 times for schizophrenia. When he was 7 years old, he drunk and fought with and killed other person. He was in prison for 4 years and 6 months. When he was 59 years old, he had convulsive attacks for 2 times. He was diagnosed as schizophrenia and alcoholism.[When he was hospitalized in our hospital]Diagnosis (1) He is alcoholism, withdrawal syndrome and suffered from visual and auditory hallucination. Non-flushing type. (2) He may suffer from epilepsy (3) Dissocial personality disorder.[Hospitalization process]We continued intramuscular injection of Levomepromazine 25mg, then changed to Levomepromazine 50mg, Valproic acid 400mg, Clonazepam 2mg (per 1 day).[Examination findings]When he was hospitalized, his EEG had 8-10Hz alpha wave mixed with delta and theta waves. His MRI showed slight brain atrophy, and slight abnormal findings of enlarged ventricles and brain groove at frontal and temporal brain.[Conclusion]He repeatedly used abusive language, injured other person, frequently intended to suicide. He showed epileptic seizured but kept self consciousness. He is not core schizophrenia.(In the presentation, we respected privacy confidentiality obligations and made sufficient consideration for maintaining anonymity. The patient agreed to this presentation.)

O14-3 The relative perfusion decrease of the posterior cingulate gyri is useful for judging the possibility of the onset of the behavioral and psychological symptoms of Alzheimer's disease 帯状回島兆候に基づく認知症患者の精神行動障害の予測可能性について Yasuno Fumihiko（安野史彦）¹，松岡究²，宮坂俊輝³，高橋誠人²，北村聡一郎²，吉川裕昌²，服部英幸¹，吉川公彦³，岸本年史² ¹Department of Psychiatry, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan ²Department of Psychiatry, Nara Medical University, Kashihara, Japan ³Department of Radiology, Nara Medical University, Kashihara, Japan Background：The cingulate island sign (CIS) ratio of the perfusion of the posterior cingulate gyri (PCG) to the medial occipital lobe was shown to be useful for differentiating Dementia with Lewy bodies (DLB) from Alzheimer’s disease (AD). Our objective was to investigate the associations of clinical symptoms and the CIS ratio as an index of the relative perfusion decrease of PCG at the early stage of AD. Methods： Eleven patients with AD at the early stage and 8 subjects with amnesic mild cognitive impairment (MCI) were examined. Z score maps of the obtained [99mTc]ECD-SPECT images of patients were converted and CIS ratio was determined using the easy Z score imaging system (eZIS) analysis. Relationships between CIS ratio and clinical symptom scores were examined using Spearman's rank correlation tests. Results：Significant correlation was identified between CIS ratio and Neuropsychiatry Inventory-questionnaire (NPI-Q) score. No significant correlations were identified between CIS ratio and other scale scores of cognitive functions including episodic memory. With a CIS ratio of 0.49, we correctly discriminated patients with and without BPSD with a sensitivity of 83.3% and specificity of 85.7%. Discussion：The decrease of PCG perfusion on ECD-SPECT relative to the medial occipital area in prodromal/early AD was closely associated with behavioral and psychological symptoms of dementia (BPSD). CIS ratio is not only useful for the differentiation of DLB from AD but also can be clinically used as a specific indicator to predict the onset of BPSD at the early stage of AD.