₂₆₁255 精神医学のフロンティア 統合失調症患者における認知機能障害の推定 : 多施設共同研究 藤野陽生 1,2, 住吉チカ 3, 安田由華 4, 山森英長 4, 藤本美智子 4, 福永雅喜 5, 三浦健一郎 6, 竹林佑人 7, 岡田直大 8, 磯村周一 9, 河

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120 4 2018 255 ₂₆₁255 精神医学のフロンティア 統合失調症患者における認知機能障害の推定 : 多施設共同研究 藤野陽生 12 住吉チカ 3 安田由華 4 山森英長 4 藤本美智子 4 福永雅喜 5 三浦健一郎 6 竹林佑人 7 岡田直大 8 磯村周一 9 河野直子 1011 豊巻敦人 12 久我弘典 1314 磯部昌憲 815 大矢一登 16 岡久祐子 17 髙木学 17 橋本直樹 12 加藤正樹 18 鬼塚俊明 9 上野雄文 914 大沼徹 7 笠井清登 8 尾崎紀夫 11 住吉太幹 19 井村修 1 橋本亮太 420 COCORO Haruo Fujino Chika Sumiyoshi Yuka Yasuda Hidenaga Yamamori Michiko Fujimoto Masaki Fukunaga Kenichiro Miura Yuto Takebayashi Naohiro Okada Shuichi Isomura Naoko Kawano Atsuhito Toyomaki Hironori Kuga Masanori Isobe Kazuto Oya Yuko Okahisa Manabu Takaki Naoki Hashimoto Masaki Kato Toshiaki Onitsuka Takefumi Ueno Tohru Ohnuma Kiyoto Kasai Norio Ozaki Tomiki Sumiyoshi Osamu Imura Ryota Hashimoto COCORO(Cognitive Genetics Collaborative Research Organization) 11 446 686 WAIS JART 25 16.3 84.2 100.5 20 39.7 81.6 索引用語

256 2018 120 4 はじめに 1 1 2 SD 2328 4711 1 162129 IQ IQ 332 IQ 332 JART 1920 3 WAIS 23 12 JART IQ 25810131825 2731 Ⅰ. 研究の方法および結果 1 11 446 686 1 1 23 4 5 6 7 8 9 1011 1213 14 15 16 17 18 19 20 PCN 9 1

257 1 N 446 N 686 2 F P 228 218 340 346 0.26 0.61 35.8 12.0 35.5 13.7 0.12 0.73 13.7 2.4 14.5 1.9 35.6 3.2 10 9 IQ JART 100.5 10.7 108.2 7.6 196.5 2.8 10 41 IQ FSIQ 84.2 17.7 111.6 12.2 947.1 1.5 10 151 16.3 13.2 3.4 10.2 805.2 3.6 10 134 FSIQ full scale intelligence quotient FSIQ IQ 9 SCID NP WAIS IQ FSIQ IQ JART 25 1924 WAIS FSIQ IQ 1222 10 3151732 WAIS 30 2 IQ EIQ FSIQ 2 P 0.73 0.61 P 3.2 10 9 度数(%0-60 -50-40 -30-20 -10 0 10 20 30 40 30 20 )10 推定認知機能障害スコア 1 9 F 805.2 P 3.6 10 134 FSIQ IQ F 196.5 P 2.8 10 41 F 947.1 P 1.5 10 151 16.3 10 10 69.3 20 39.7 1 FSIQ EIQ Kruskal Wallis test 2 0.9 P 0.35 WAIS

258 2018 120 4 感度0.6 0.8 1.0 1.0 0.8 0.6 0.4 0.2 AUC=0.88 (95% Cl:0.86~0.90) 0.0 0.0 0.2 0.4 1- 特異度 2 ROC 9 EIQ FSIQ receiver operating characteristic ROC 81.6 0.79 0.83 AUC 0.88 2 Ⅱ. 考察 本論文の意義 苦労 工夫したことなどを含めて 1 16.3 IQ 10 3151732 70 30 40 20 14 30 1 30 13.5 20 30 26.315 20 15.910 15 13.710 30.7 FSIQ WAIS EIQ EIQ 30 14 3151732 JART JART IQ 10 EIQ FSIQ 0.9 1

259 2 3 1 3 9 WAIS 90 120 10 おわりに 今後の課題および方向性 6 JSPS JP25293250 JP16H05375 JP26860924 16H01689 16H06395 16H06399 16K21720 利益相反 MSD

260 2018 120 4 Meiji Seika MSD Meiji Seika Meiji Seika MSD CogState Meiji Seika 謝辞 文献 1 Allen D. N. Goldstein G. Warnick E. A consideration of neuropsychologically normal schizophrenia. J Int Neuropsychol Soc 9 56 63 2003 2 Azechi M. Iwase M. Ikezawa K. et al. Discriminant analysis in schizophrenia and healthy subjects using prefrontal activation during frontal lobe tasks a near infrared spectroscopy. Schizophr Res 117 52 60 2010 3 Badcock J. C. Dragović M. Waters F. A. et al. Dimensions of intelligence in schizophrenia evidence from patients with preserved deteriorated and compromised intellect. J Psychiatr Res 39 11 19 2005 4 Bowie C. R. Harvey P. D. Cognitive deficits and functional outcome in schizophrenia. Neuropsychiatr Dis Treat 2 531 536 2006 5 Chou P. H. Koike S. Nishimura Y. et al. Similar age related decline in cortical activity over frontotemporal regions in schizophrenia a multichannel near infrared spectroscopy study. Schizophr Bull 41 268 279 2015 6 COCORO http://www.sp web.sakura.ne.jp/ lab/method_cognitive impairment.html 2018 02 21 7 Fujino H. Sumiyoshi C. Sumiyoshi T. et al. Performance on the Wechsler Adult Intelligence Scale in Japanese patients with schizophrenia. Psychiatry Clin Neurosci 68 534 541 2014 8 Fujino H. Sumiyoshi C. Sumiyoshi T. et al. Predicting employment status and subjective quality of life in patients with schizophrenia. Schizophr Res Cogn 3 20 25 2016 9 Fujino H. Sumiyoshi C. Yasuda Y. et al. Estimated cognitive decline in patients with schizophrenia a multicenter study. Psychiatry Clin Neurosci 71 294 300 2017 10 Fukumoto M. Hashimoto R. Ohi K. et al. Relation between remission status and attention in patients with schizophrenia. Psychiatry Clin Neurosci 68 234 241 2014 11 Hagiya K. Sumiyoshi T. Kanie A. et al. Facial expression perception correlates with verbal working memory function in schizophrenia. Psychiatry Clin Neurosci 69 773 781 2015 12 Hashimoto R. Ikeda M. Ohi K. et al. Genome wide association study of cognitive decline in schizophrenia. Am J Psychiatry 170 683 684 2013 13 Hashimoto R. Ikeda M. Yamashita F. et al. Common variants at 1p36 are associated with superior frontal gyrus volume. Transl Psychiatry 4 e472 2014 14 John J. P. Arunachalam V. Ratnam B. et al. Expanding the schizophrenia phenotype a composite evaluation of neurodevelopmental markers. Compr Psychiatry 49 78 86 2008 15 Kremen W. S. Seidman L. J. Faraone S. V. et al. IQ decline in cross sectional studies of schizophrenia methodology and interpretation. Psychiatry Res 158 181 194 2008 16 Kremen W. S. Vinogradov S. Poole J. H. et al.

Powered by TCPDF (www.tcpdf.org) 261 Cognitive decline in schizophrenia from childhood to midlife a 33 year longitudinal birth cohort study. Schizophr Res 118 1 5 2010 17 Leeson V. C. Sharma P. Harrison M. et al. IQ trajectory cognitive reserve and clinical outcome following a first episode of psychosis a 3 year longitudinal study. Schizophr Bull 37 768 777 2011 18 Marumo K. Takizawa R. Kinou M. et al. Functional abnormalities in the left ventrolateral prefrontal cortex during a semantic fluency task and their association with thought disorder in patients with schizophrenia. Neuroimage 85 518 526 2014 19Japanese Adult Reading Test JART 2006 20 Matsuoka K. Uno M. Kasai K. et al. Estimation of premorbid IQ in individuals with Alzheimer s disease using Japanese ideographic script Kanji compound words Japanese version of National Adult Reading Test. Psychiatry Clin Neurosci 60 332 339 2006 21 Meier M. H. Caspi A. Reichenberg A. et al. Neuropsychological decline in schizophrenia from the premorbid to the postonset period evidence from a population representative longitudinal study. Am J Psychiatry 171 91 101 2014 22 Miura K. Hashimoto R. Fujimoto M. et al. An integrated eye movement score as a neurophysiological marker of schizophrenia. Schizophr Res 160 228 229 2014 23 Mohamed S. Paulsen J. S. O Leary D. et al. Generalized cognitive deficits in schizophrenia a study of first episode patients. Arch Gen Psychiatry 56 749 754 1999 24 WAIS WAIS Wechsler Adult Intelligence Scale 3rd ed 2006 25 Nishimura Y. Takizawa R. Koike S. et al. Association of decreased prefrontal hemodynamic response during a verbal fluency task with EGR3 gene polymorphism in patients with schizophrenia and in healthy individuals. Neuroimage 85 527 534 2014 26 Ohi K. Hashimoto R. Ikeda M. et al. Glutamate networks implicate cognitive impairments in schizophrenia genome wide association studies of 52 cognitive phenotypes. Schizophr Bull 41 909 918 2015 27 Ohi K. Hashimoto R. Yasuda Y. et al. The SIGMAR1 gene is associated with a risk of schizophrenia and activation of the prefrontal cortex. Prog Neuropsychopharmacol Biol Psychiatry 35 1309 1315 2011 28 Palmer B. W. Dawes S. E. Heaton R. K. What do we know about neuropsychological aspects of schizophrenia? Neuropsychol Rev 19 365 384 2009 29 Sheitman B. B. Murray M. G. Snyder J. A. et al. IQ scores of treatment resistant schizophrenia patients before and after the onset of the illness. Schizophr Res 46 203 207 2000 30 Sumiyoshi C. Fujino H. Sumiyoshi T. et al. Usefulness of the Wechsler Intelligence Scale short form for assessing functional outcomes in patients with schizophrenia. Psychiatry Res 245 371 378 2016 31 Watanabe Y. Tanaka H. Tsukabe A. et al. Neuromelanin magnetic resonance imaging reveals increased dopaminergic neuron activity in the substantia nigra of patients with schizophrenia. PLoS One 9 e104619 2014 32 Weickert T. W. Goldberg T. E. Gold J. M. et al. Cognitive impairments in patients with schizophrenia displaying preserved and compromised intellect. Arch Gen Psychiatry 57 907 913 2000