Brain and nerve = Shinkei kenkyū no shinpo
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Review
[Biomarkers for Alzheimer's disease: after Alzheimer's disease neuroimaging initiative studies].
Recent advances in biomarker studies compiled from the Alzheimer's Disease Neuroimaging Initiative (ADNI) are summarized here. CSF Aβ42, total tau, and phosphorylated tau181 are the most sensitive biomarkers for diagnosing Alzheimer's disease (AD) and predicting the onset of AD in cases with mild cognitive impairment (MCI) due to AD. ⋯ Basic and clinical studies have contributed considerably to the establishment of clinical evidence that supports the usefulness of these markers. Given the progress in the diagnosis of preclinical AD, discovery of therapy that is essential for the cure of AD is expected soon.
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Despite recent knowledge on the pathophysiology of Parkinson disease, the precise and early diagnosis of this condition remains difficult. Advances in imaging techniques have enabled the assessment of in vivo structural, neurometabolic, and neurochemical changes in Parkinson disease, and their role as biomarkers have assumed greater importance in recent years. We presently review the various approaches with these imaging techniques for the study of Parkinson disease. ⋯ Moreover, radiotracer imaging with dopaminergic markers facilitates the assessment of pre- and postsynaptic nigro-striatal integrity, and other radiotracers have been used in the studies of nondopaminergic neurotransmitter systems, such as the cholinergic, noradrenergic, and serotonergic systems. These imaging techniques can be used to detect presymptomatic disease and to monitor disease progression. Thus, imaging data provide meaningful insights into the pathological process in Parkinson disease.
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Amyotrophic lateral sclerosis (ALS) is an adult-onset neurodegenerative disorder characterized by the death of upper and lower motor neurons. Approximately 20% of familial ALS cases are caused by mutations in the superoxide dismutase 1 (SOD1) gene. We generated rats that express a human SOD1 transgene with two different ALS-associated mutations and found that these rats develop remarkable motor neuron degeneration and paralysis. ⋯ These projects have been supported by the "Super Special Consortium for Supporting the Development of Cutting-edge Medical Care" (tokku), a special program organized by the Cabinet Office of the Japanese government (research representative: Hideyuki Okano, M. D., Ph. D., Professor at Keio University).
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Spatial patterns of spontaneous fluctuations in blood oxygenation level-dependent (BOLD) signals reflect the underlying neural architecture. The study of the brain network based on these self-organized patterns is termed resting-state functional MRI (fMRI). This review article aims at briefly reviewing a basic concept of this technology and discussing its implications for neuropsychological studies. ⋯ Second, I have discussed the reservations and potential pitfalls of 2 major imaging methods: voxel-based lesion-symptom mapping and task fMRI. Problems encountered with voxel-based lesion-symptom mapping can be overcome by using resting-state fMRI and evaluating undamaged brain networks in patients. Regarding task fMRI in patients, I have also emphasized the importance of evaluating the baseline brain activity because the amplitude of activation in BOLD fMRI is hard to interpret as the same baseline cannot be assumed for both patient and normal groups.
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Collagen VI-related muscle disorders include severe Ullrich's disease (Ullrich congenital muscular dystrophy:UCMD) and milder Bethlem myopathy. Mutations in the 3 collagen VI genes, namely, COL6A1, COL6A2, and COL6A3, cause both diseases. UCMD is inherited in an autosomal recessive manner, and de novo dominant mutations are also reported. ⋯ We evaluated the role of nonsense-mediated mRNA decay (NMD) in UCMD associated with a premature termination codon in the COL6A2 gene, which caused the loss of collagen VI. A pharmacological block of NMD caused upregulation of the mutant collagen VI and partially functional extracellular matrix formation. Cyclosporin A has been reported to correct mitochondrial dysfunction and muscle apoptosis in patients with collagen VI myopathies, and a pilot trial of cyclosporin A was carried out.