中原 仁 (ナカハラ ジン)

NAKAHARA Jin

写真a

所属(所属キャンパス)

医学部 内科学教室(神経) Department of Neurology, Keio University School of Medicine (信濃町)

職名

教授

HP

外部リンク

プロフィール 【 表示 / 非表示

  • ・日本神経学会 関東甲信越支部代表、代議員ほか
    ・日本内科学会 評議員ほか
    ・日本神経免疫学会 理事ほか
    ・日本神経治療学会 評議員
    ・日本神経感染症学会 評議員
    ・日本多発性硬化症ネットワーク 理事
    ・環アジア多発性硬化症治療研究会議(PACTRIMS)中央委員会委員
    ・米国神経学会(AAN)・欧州神経学会(EAN)会員

教員からのメッセージ 【 表示 / 非表示

  • 神経内科領域のあらゆる疾患を対象に、先進的なトランスレーショナル・リサーチから在宅医療まで、手段を問わず患者の生命の質(quality of life)を改善させる治療の具現化に向けた研究を行っている。

その他の所属・職名 【 表示 / 非表示

  • 慶應義塾大学病院パーキンソン病センター, センター長

  • 慶應義塾大学パーキンソン病研究センター, センター長

  • 慶應義塾大学病院脳卒中センター, センター長

経歴 【 表示 / 非表示

  • 2003年04月
    -
    2004年03月

    慶應義塾大学, COEプログラム(生命科学), 研究員

  • 2004年04月
    -
    2007年03月

    独立行政法人日本学術振興会, 特別研究員(DC1)

  • 2007年04月
    -
    2008年11月

    独立行政法人日本学術振興会, 特別研究員(PD)

  • 2008年12月
    -
    2013年03月

    慶應義塾大学, 医学部総合医科学研究センター, 特任講師

  • 2013年04月
    -
    2018年03月

    慶應義塾大学, 医学部内科学教室(神経), 助教

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学歴 【 表示 / 非表示

  • 2003年03月

    慶應義塾大学, 医学部

    大学, 卒業

  • 2007年03月

    慶應義塾大学, 医学研究科, 生理系専攻

    大学院, 修了, 博士

学位 【 表示 / 非表示

  • 博士(医学), 慶應義塾大学, 課程, 2007年03月

免許・資格 【 表示 / 非表示

  • 医師免許証, 2003年05月

  • 日本医師会認定産業医, 2011年09月

  • 日本内科学会認定内科医, 2013年09月

  • 日本神経学会認定神経内科専門医, 2014年07月

  • 日本内科学会認定総合内科専門医, 2019年12月

 

研究分野 【 表示 / 非表示

  • ライフサイエンス / 神経内科学

研究キーワード 【 表示 / 非表示

  • オリゴデンドロサイト

  • 多発性硬化症

  • 神経免疫学

  • 神経内科学

  • 視神経脊髄炎関連疾患

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研究テーマ 【 表示 / 非表示

  • 神経治療学の拠点形成, 

    2018年
    -
    継続中

  • 多発性硬化症の臨床研究, 

    2011年
    -
    継続中

  • 中枢神経系髄鞘再生療法の開発, 

    1999年
    -
    継続中

 

著書 【 表示 / 非表示

  • Visualization of Myelin for the Diagnosis and Treatment Monitoring of Multiple Sclerosis

    Nakahara J., Advances in Experimental Medicine and Biology, 2019年

     概要を見る

    Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS) affecting more than two million people worldwide. As the exact etiology of MS remains elusive, the diagnosis of MS is made by referring to the McDonald diagnostic criteria, which utilizes MRI as a tool to identify “demyelinated” MS lesions. In particular, hyperintense lesions on T2-weighted images (T2WI) or so-called “T2-lesions” are considered to represent demyelinated MS lesions. T2WI, however, lacks myelin specificity, and moreover, remyelination could not be depicted by the use of such modality. For the accurate diagnosis and treatment decision-making, or for the future development of remyelination therapeutics, imaging tools to visualize myelin-specific signals are mandatory. In this chapter, the current use and the limitation of imaging modalities in MS diagnosis and treatment will be reviewed, with the introduction of new imaging method, namely q-space Myelin Map (qMM), to be used for visualization of demyelination and remyelination in MS.

論文 【 表示 / 非表示

  • Validation study of the Japanese version of the King's Parkinson's Disease Pain Scale and the King's Parkinson's Disease Pain Questionnaire

    Kurihara K., Fujioka S., Mizutani Y., Watanabe H., Iwaoka K., Maeda T., Seki M., Tezuka T., Nakahara J., Konno T., Ishiguro T., Onodera O., Asano Y., Takahashi K., Rizos A., Chaudhuri K.R., Tsuboi Y.

    Parkinsonism and Related Disorders (Parkinsonism and Related Disorders)  120 2024年03月

    ISSN  13538020

     概要を見る

    Introduction: The King's Parkinson's Disease Pain Scale (KPPS)/King's Parkinson's Disease Pain Questionnaire (KPPQ) was developed as a tool to quantitatively assess pain in patients with Parkinson's disease (PwPD). Here, we conducted a Japanese multicenter validation study to verify the reliability of KPPS/KPPQ in Japanese PwPD. Methods: PwPD, ≥20 years, with unexplained pain were included; those with a definitive primary cause of pain other than PD were excluded. A total of 151 patients who fulfilled the criteria were analyzed, and test-retest reliability was investigated in 25 individuals. Results: The 151 patients included 101 women (66.9 %); mean age 68.3 ± 9.9 years, mean disease duration 9.2 ± 5.2 years. The most frequent pain type in the KPPS classification was musculoskeletal pain (82.8 %). There was a positive correlation between KPPS total score and the Non-Motor Symptoms Scale (NMSS) total score, NMSS item 27, the Parkinson's disease sleep scale-version 2 (PDSS-2) total score, PDSS-2 item 10, the Parkinson's Disease Questionnaire-8 (PDQ-8) summary index and PDQ-8 item 7. Cronbach's alpha of KPPS was 0.626 (0.562–0.658) and the intraclass correlation coefficient of test-retest reliability was 0.740. Cronbach's alpha of KPPQ was 0.660 (0.617–0.705) and a test-retest reliability of kappa coefficient was 0.593 (0.0–1.0). Conclusions: KPPS correlated well with other scales for assessing pain. KPPS correlated well with patients' quality of life, non-motor symptoms, and sleep disturbances. The reproducibility of KPPS/KPPQ makes it suitable for continuous evaluation of the same patient. On the other hand, the internal consistency of KPPS/KPPQ is rather low.

  • Non-lesional white matter changes depicted by q-space diffusional MRI correlate with clinical disabilities in multiple sclerosis

    Motegi H., Kufukihara K., Kitagawa S., Sekiguchi K., Hata J., Fujiwara H., Jinzaki M., Okano H., Nakamura M., Iguchi Y., Nakahara J.

    Journal of the Neurological Sciences (Journal of the Neurological Sciences)  456 2024年01月

    ISSN  0022510X

     概要を見る

    Background: We previously developed an optimized q-space diffusional MRI technique (normalized leptokurtic diffusion [NLD] map) to delineate the demyelinated lesions of multiple sclerosis (MS) patients. Herein, we evaluated the utility of NLD maps to discern the white matter abnormalities in normal-appearing white matter (NAWM) and the abnormalities' possible associations with physical and cognitive disabilities in MS. Methods: We conducted a retrospective observational study of MS patients treated at our hospital (Jan. 2012 to Dec. 2022). Clinical and MRI data were collected; Processing Speed Test (PST) data were obtained when possible. For a quantitative analysis of the NLD maps, we calculated the NLD index as GVROI/GVREF, where GV is a mean grayscale value in the regions of interest (ROIs) and the reference area (REF; cerebrospinal fluid). Results: One hundred-one individuals with MS were included. The lower corpus callosum and non-lesional WM NLD index were associated with worse Expanded Disability Status Scale (EDSS) and PST scores. The NLD indexes in the corpus callosum (p < 0.0001) and non-lesional white matter (p < 0.0001) were significantly reduced in progressive MS compared to relapsing-remitting MS. We categorized MS severity as moderate/severe (EDSS score ≥ 4 points) and mild (EDSS score < 4 points). The NLD indexes in the corpus callosum (p < 0.0001) and non-lesional white matter (p < 0.0001) were significantly lower in the moderate/severe MS group compared to the mild MS group. Conclusion: The NLD map revealed abnormalities in the non-lesional white matter, providing valuable insights for evaluating manifestations in MS patients.

  • Improvement of Functional Outcomes in Patients with Stroke who Received Alteplase for Over 15 Years: Japan Stroke Data Bank

    Ishigami A., Toyoda K., Nakai M., Yoshimura S., Wada S., Sasahara Y., Sonoda K., Miwa K., Koge J., Shiozawa M., Iwanaga Y., Miyamoto Y., Nakahara J., Suzuki N., Kobayashi S., Minematsu K., Koga M.

    Journal of Atherosclerosis and Thrombosis (Journal of Atherosclerosis and Thrombosis)  31 ( 1 ) 90 - 99 2024年

    ISSN  13403478

     概要を見る

    Aim: The nationwide verification of intravenous thrombolysis (IVT) was rarely performed after the extension of the therapeutic time window of alteplase or after the expansion of mechanical thrombectomy (MT). We aimed to examine the long-term change in accurate real-world outcomes of IVT in patients with acute ischemic stroke (AIS) using the Japan Stroke Databank, a representative Japan-wide stroke database. Methods: We extracted all patients with AIS who received IVT with alteplase between October 11, 2005, the approval date for alteplase use for AIS in Japan, and December 31, 2020. Patients were categorized into three groups using two critical dates in Japan as cutoffs: the official extension date of the therapeutic time window for IVT to within 4.5 h of symptom onset and the publication date of the revised guideline, where the evidence level of MT was heightened. We assessed the yearly trend of IVT implementation rates and the secular changes and three-group changes in clinical outcomes at discharge. Results: Of 124,382 patients with AIS, 9,569 (7.7%) received IVT (females, 41%; median age, 75 years). The IVT implementation rate has generally increased over time and plateaued in recent years. The proportion of favorable outcomes (modified Rankin Scale score of 0–2) increased yearly over 15 years. The results of the changes in the outcomes of the three groups were similar to those of the annual changes. Conclusions: We revealed that IVT implementation rates in patients with AIS increased, and the functional outcome in these patients improved over 15 years. Therefore, the Japanese IVT dissemination strategy is considered appropriate and effective.

  • Systemic lupus erythematosus mimicking retinal migraine: a case report

    Tezuka T., Shibata M., Hanaoka H., Izawa Y., Kikuchi T., Akino K., Ozawa Y., Saito M., Kaneko Y., Nakahara J., Takizawa T.

    Cephalalgia : an international journal of headache (Cephalalgia : an international journal of headache)  43 ( 12 )  2023年12月

    ISSN  03331024

     概要を見る

    BACKGROUND: Retinal migraine is a diagnosis of exclusion and is characterized by repeated episodes of transient monocular blindness associated with migraine. We report a case of systemic lupus erythematosus with acute episodes mimicking retinal migraines. CASE REPORT: A 46-year-old woman with a history of migraine with aura since her 20s and Evans syndrome presented with episodic transient monocular blindness. Retinal migraine was considered as the cause, and migraine prophylaxis initially reduced its frequency. After 5 months, the frequency increased, with chilblain-like lupus lesions on her extremities. Laboratory testing revealed lymphopenia and hypocomplementemia, fulfilling the diagnostic criteria for systemic lupus erythematosus, which may have caused Evans syndrome and transient monocular blindness, mimicking retinal migraines. After intravenous methylprednisolone and rituximab therapy, the transient monocular blindness episodes did not recur. CONCLUSION: Given the clinical presentation, systemic lupus erythematosus should be considered as a cause of transient monocular blindness and should be distinguished from retinal migraine.

  • Predicting response to CGRP-monoclonal antibodies in patients with migraine in Japan: a single-centre retrospective observational study

    Ihara K., Ohtani S., Watanabe N., Takahashi N., Miyazaki N., Ishizuchi K., Hori S., Takemura R., Nakahara J., Takizawa T.

    Journal of Headache and Pain (Journal of Headache and Pain)  24 ( 1 )  2023年12月

    ISSN  11292369

     概要を見る

    Background: Anti-calcitonin gene-related peptide monoclonal antibodies (CGRPmAbs) are a favourable option for patients with migraine who experience distressful headache disability and fail to respond to traditional preventive treatment options. However, since CGRPmAb has been available for only 2 years in Japan, the difference between good and poor responders remains unknown. We aimed to investigate the clinical characteristics of patients with migraine in Japan who responded well to CGRPmAb based on real-world data. Methods: We analysed patients who visited Keio University Hospital, Tokyo, Japan, between the 12th of August 2021 and 31st of August 2022, and were prescribed one of three CGRPmAbs (erenumab, galcanezumab, and fremanezumab) for more than 3 months. We recorded the patients’ basic migraine characteristics, such as pain quality, monthly migraine days (MMD)/monthly headache days (MHD), and the number of prior treatment failures. We defined good responders as patients whose MMDs decreased by more than 50% after 3 months of treatment and other patients as poor responders. We compared the baseline migraine characteristics between the two groups and performed logistic regression analysis based on the items that showed statistically significant differences. Results: In total, 101 patients were considered eligible for the responder analysis (galcanezumab: 57 (56%), fremanezumab: 31 (31%), and erenumab: 13 (13%)). After 3 months of treatment, 55 (54%) patients achieved ≥ 50% reduction in MMDs. Comparisons between ≥ 50% responders and non-responders revealed that age was significantly higher (p = 0.003), and MHD and total prior treatment failures were significantly lower (p = 0.027, 0.040, respectively), in responders than in non-responders. Age was a positive predictive factor, and the total number of prior treatment failures and past medical history of immuno-rheumatologic diseases were negative predictive factors of CGRPmAb responsiveness in Japanese patients with migraine. Conclusions: Patients with migraine who are older, with fewer prior treatment failures and no past history of immuno-rheumatologic disease, may respond well to CGRPmAbs.

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総説・解説等 【 表示 / 非表示

競争的研究費の研究課題 【 表示 / 非表示

  • 視神経脊髄炎スペクトラム障害のプレシジョンメディシン基盤確立

    2023年04月
    -
    2028年03月

    中原 仁, 基盤研究(B), 補助金,  研究代表者

  • ミエリンマップ法を用いた多発性硬化症における髄鞘病理の画像解析

    2018年04月
    -
    2023年03月

    文部科学省・日本学術振興会, 科学研究費助成事業, 中原 仁, 基盤研究(C), 補助金,  研究代表者

  • 髄鞘の可視化技術による多発性硬化症の病型分類に関する研究

    2013年04月
    -
    2016年03月

    文部科学省, 科学研究費補助金(文部科学省・日本学術振興会), 中原仁, 補助金,  研究代表者

  • 髄鞘を標的とした神経変性疾患・脊髄損傷に対する新規治療戦略に関する研究

    2013年04月
    -
    2016年03月

    文部科学省, 科学研究費補助金(文部科学省・日本学術振興会), 中原仁, 補助金,  研究代表者

  • アストロサイトによるin vivoケトン体生合成機構の解明

    2010年04月
    -
    2013年03月

    文部科学省, 科学研究費補助金(文部科学省・日本学術振興会), 中原仁, 補助金,  研究代表者

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知的財産権等 【 表示 / 非表示

  • Drug delivery system toward demyelinating lesion and biochemical marker of demyelinating lesions

    出願日: 8252540  2012年08月 

    発行日: 8252540  2012年08月

    特許権, 共同

  • Medicinal compositions containing Fc receptor γ chain activator

    出願日: 7901678  2011年03月 

    発行日: 7901678  2011年03月

    特許権, 共同

  • Fc受容体γ鎖活性化物質を含有する医薬組成物

    出願日: 4214249  2008年11月 

    発行日: 4214249  2008年11月

    特許権, 共同

受賞 【 表示 / 非表示

  • Best Presentation賞

    2017年, Sendai Conference

  • MSJ-PACTRIMS investigator award

    2014年, Pan-Asian Committee for Treatment and Research in Multiple Sclerosis (PACTRIMS)

  • 優秀指導教官賞

    2014年, 日本内科学会

  • MSJ-PACTRIMS Investigator賞

    2014年, 環アジア多発性硬化症治療研究会議

  • 優秀指導教官賞

    2014年, 内科学サミット2014

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担当授業科目 【 表示 / 非表示

  • 内科学(神経)講義

    2023年度

  • 内科学講義

    2023年度

  • 内科学演習

    2023年度

  • 内科学実習

    2023年度

  • 内科学

    2023年度

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所属学協会 【 表示 / 非表示

  • 日本内科学会

     
  • 日本神経学会

     
  • 日本神経免疫学会

     
  • 日本神経治療学会

     
  • 日本脳卒中学会

     

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