Uchida, Hiroyuki

写真a

Affiliation

School of Medicine, Department of Neuropsychiatry (Shinanomachi)

Position

Professor
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Books 【 Display / hide 】

  • Encyclopedia of Psychopharmacology

    Uchida Hiroyuki, 2010

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Papers 【 Display / hide 】

  • Alterations in subcortical magnetic susceptibility and disease-specific relationship with brain volume in major depressive disorder and schizophrenia

    Shibukawa S., Kan H., Honda S., Wada M., Tarumi R., Tsugawa S., Tobari Y., Maikusa N., Mimura M., Uchida H., Nakamura Y., Nakajima S., Noda Y., Koike S.

    Translational Psychiatry (Translational Psychiatry)  14 ( 1 ) 164 2024.12

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    Quantitative susceptibility mapping is a magnetic resonance imaging technique that measures brain tissues’ magnetic susceptibility, including iron deposition and myelination. This study examines the relationship between subcortical volume and magnetic susceptibility and determines specific differences in these measures among patients with major depressive disorder (MDD), patients with schizophrenia, and healthy controls (HCs). This was a cross-sectional study. Sex- and age- matched patients with MDD (n = 49), patients with schizophrenia (n = 24), and HCs (n = 50) were included. Magnetic resonance imaging was conducted using quantitative susceptibility mapping and T1-weighted imaging to measure subcortical susceptibility and volume. The acquired brain measurements were compared among groups using analyses of variance and post hoc comparisons. Finally, a general linear model examined the susceptibility–volume relationship. Significant group-level differences were found in the magnetic susceptibility of the nucleus accumbens and amygdala (p = 0.045). Post-hoc analyses indicated that the magnetic susceptibility of the nucleus accumbens and amygdala for the MDD group was significantly higher than that for the HC group (p = 0.0054, p = 0.0065, respectively). However, no significant differences in subcortical volume were found between the groups. The general linear model indicated a significant interaction between group and volume for the nucleus accumbens in MDD group but not schizophrenia or HC groups. This study showed susceptibility alterations in the nucleus accumbens and amygdala in MDD patients. A significant relationship was observed between subcortical susceptibility and volume in the MDD group’s nucleus accumbens, which indicated abnormalities in myelination and the dopaminergic system related to iron deposition.

  • Caution for psychiatrists: malignant hyperthermia risks with the anesthetic agent succinylcholine (Suxamethonium) during electroconvulsive therapy

    Nakano M., Funayama M., Takata T., Wakisaka R., Koyama G., Koreki A., Ishida T., Uchida H., Mimura M.

    BMC Psychiatry (BMC Psychiatry)  24 ( 1 ) 411 2024.12

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    Background: Malignant hyperthermia is a potentially lethal condition triggered by specific anesthetic drugs, especially a depolarizing muscle relaxant of succinylcholine (Suxamethonium). Despite the frequent use of succinylcholine with electroconvulsive therapy (ECT), there has been no reported case of potentially lethal malignant hyperthermia following ECT. In addition, the time interval between the administration of succinylcholine and the onset of malignant hyperthermia has not been outlined in the context of ECT. Case presentation: We present the case of a 79-year-old woman suffering from severe depression, who experienced severe malignant hyperthermia due to succinylcholine administration during an ECT session. She presented with a high fever of 40.2 °C, tachycardia of 140/min, hypertension with a blood pressure exceeding 200 mmHg, significant muscle rigidity, and impaired consciousness. These symptoms emerged two hours after ECT, which occurred in a psychiatric ward rather than an operating room, and reached their peak in less than 24 h. She was given 60 mg of dantrolene, which quickly reduced the muscular rigidity. Subsequently, she received two additional doses of 20 mg and 60 mg of dantrolene, which brought her fever down to 36.2 °C and completely eased her muscle rigidity within two days after ECT. Conclusions: This is the first reported case of potentially lethal malignant hyperthermia after ECT. In addition, it highlights the delayed onset of malignant hyperthermia following an ECT procedure, emphasizing the necessity for psychiatrists to recognize its onset even after the treatment. In the light of potentially lethal consequences of malignant hyperthermia, it is critically important for psychiatrists to closely monitor both intraoperative and postoperative patient’s vital signs and characteristic physical presentations, promptly identify any symptomatic emergence, and treat it immediately with dantrolene.

  • A case of painful legs and moving toes syndrome mimicking somatic symptom disorder

    Mimura Y., Komatsu K., Yasushi Y., Seki M., Nakajima S., Uchida H., Mimura M.

    Psychogeriatrics (Psychogeriatrics)  24 ( 4 ) 1023 - 1029 2024.07

    ISSN  13463500

  • Aberrant heartbeat-evoked potential in schizophrenia

    Koreki A., Ogyu K., Miyazaki T., Takenouchi K., Matsushita K., Honda S., Koizumi T., Onaya M., Uchida H., Mimura M., Nakajima S., Noda Y.

    Progress in Neuro-Psychopharmacology and Biological Psychiatry (Progress in Neuro-Psychopharmacology and Biological Psychiatry)  132   110969 2024.06

    ISSN  02785846

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    Self-disturbance is considered a core feature underlying the psychopathology of schizophrenia. Interoception has an important role in the development of a sense of self, leading to increased interest in the potential contribution of abnormal interoception to self-disturbances in schizophrenia. Several neuropsychological studies have demonstrated aberrant interoception in schizophrenia. However, cortical interoceptive processing has not yet been thoroughly investigated. Thus, we sought to examine resting-state heartbeat-evoked potential (HEP) in this population. We hypothesized that patients with schizophrenia would exhibit significant alterations in HEP compared to healthy controls (HCs). In this cross-sectional electroencephalogram (EEG) study, we compared the HEPs between age- and sex-matched groups of patients with schizophrenia and HCs. A 10-min resting-state EEG with eyes closed and an electrocardiogram (ECG) were recorded and analyzed for the time window of 450 ms to 500 ms after an ECG R peak. A positive HEP shift was observed in the frontal-central regions (F [1, 82] = 7.402, p = 0.008, partial η2 = 0.009) in patients with schizophrenia (n = 61) when compared with HCs (n = 31) after adjusting for confounders such as age, sex, and heart rate. A cluster-based correction analysis revealed that the HEP around the right frontal area (Fp2, F4, and F8) showed the most significant group differences (F [1, 82] = 10.079, p = 0.002, partial η2 = 0.021), with a peak at the F4 electrode site (F [1, 82] = 12.646, p < 0.001, partial η2 = 0.069). We observed no correlation between HEP and symptoms in patients with schizophrenia. A positive shift of HEP during the late component could reflect a trait abnormality in schizophrenia. Further research is required to determine the association between the altered cortical interoceptive processing indexed with HEP and self-disturbances in schizophrenia.

  • Decreased short-latency afferent inhibition in individuals with mild cognitive impairment: A TMS-EEG study

    Mimura Y., Tobari Y., Nakajima S., Takano M., Wada M., Honda S., Bun S., Tabuchi H., Ito D., Matsui M., Uchida H., Mimura M., Noda Y.

    Progress in Neuro-Psychopharmacology and Biological Psychiatry (Progress in Neuro-Psychopharmacology and Biological Psychiatry)  132   110967 2024.06

    ISSN  02785846

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    TMS combined with EEG (TMS-EEG) is a tool to characterize the neurophysiological dynamics of the cortex. Among the TMS paradigms, short-latency afferent inhibition (SAI) allows the investigation of inhibitory effects mediated by the cholinergic system. The aim of this study was to compare cholinergic function in the DLPFC between individuals with mild cognitive impairment (MCI) and healthy controls (HC) using TMS-EEG with the SAI paradigm. In this study, 30 MCI and 30 HC subjects were included. The SAI paradigm consisted of 80 single pulse TMS and 80 SAI stimulations applied to the left DLPFC. N100 components, global mean field power (GMFP) and total power were calculated. As a result, individuals with MCI showed reduced inhibitory effects on N100 components and GMFP at approximately 100 ms post-stimulation and on β-band activity at 200 ms post-stimulation compared to HC. Individuals with MCI showed reduced SAI, suggesting impaired cholinergic function in the DLPFC compared to the HC group. We conclude that these findings underscore the clinical applicability of the TMS-EEG method as a powerful tool for assessing cholinergic function in individuals with MCI.

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Papers, etc., Registered in KOARA 【 Display / hide 】

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Reviews, Commentaries, etc. 【 Display / hide 】

  • Cumulative remission rate after sequential treatments in depression: reappraisal of the STAR*D trial data

    Sakurai H., Noma H., Watanabe K., Uchida H., Furukawa T.A.

    World Psychiatry (World Psychiatry)  23 ( 1 ) 156 - 157 2024.02

    ISSN  17238617

  • パーキンソン病に対する脳深部刺激療法後に4-condition testが病態の把握に有用であった1例

    大草 翔平, 大河内 遼太郎, 坂井 悠人, 忽滑谷 智紀, 小杉 健三, 工藤 駿, 手塚 俊樹, 二瓶 義廣, 秋山 武紀, 内田 裕之, 三村 將, 戸田 正博, 小林 正人, 中原 仁, 関 守信

    日本定位・機能神経外科学会プログラム・抄録集 ((一社)日本定位・機能神経外科学会)  63回   121 - 121 2024.01

  • 精神展開剤の過去・現在・これから

    内田 裕之

    BRAIN and NERVE: 神経研究の進歩 ((株)医学書院)  75 ( 12 ) 1355 - 1359 2023.12

    ISSN  1881-6096

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    ＜文献概要＞近年,精神展開剤をうつ病など複数の精神科疾患の治療に応用する動きが活発になっている。精神展開剤は1960年代に治療効果が検証されていたが,市井での乱用により1970年に麻薬に指定され,いったん臨床研究は中断した。しかし,1994年の臨床試験を皮切りに,多数の臨床試験が実施され,大きな盛り上がりを見せている。本総説では,強力な治療効果を有する精神展開剤の歴史を概観し,本分野の今後の展望を概観する。

  • うつ病患者における抑うつ的反芻思考と気質・性格に関する検討

    野田 祥子, 片山 奈理子, 野上 和香, 天野 瑞紀, 伊原 栄, 小林 由季, 満田 大, 倉田 知佳, 佐々木 洋平, 内田 裕之, 中川 敦夫

    日本認知療法・認知行動療法学会プログラム・抄録集 (日本認知療法・認知行動療法学会)  23回   259 - 259 2023.11

  • 大動脈弁狭窄症に対する系統的スクリーニングと意思決定支援体制　その導入による変化

    河野 佐代子, 江口 洋子, 大角 梓, 竹内 啓善, 田久保 美千代, 木村 範子, 内田 裕之, 三村 將, 藤澤 大介

    総合病院精神医学 ((一社)日本総合病院精神医学会)  35 ( Suppl. ) S - 230 2023.11

    ISSN  0915-5872

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Presentations 【 Display / hide 】

  • 処方変更後のリスペリドン血中濃度を予測する試み: Population Pharmacokineticsを用いて

    Uchida Hiroyuki

    第20回日本臨床精神薬理学会 (仙台) , 

    2010
    , 

    Poster presentation

  • Effects of discontinuing benzodiazepine-derivative hypnotics on cognitive and motor functions in the elderly.

    Uchida Hiroyuki

    American Association for Geriatric Psychiatry (Savannah) , 

    2010
    , 

    Poster presentation

  • Clozapine and global cognition in schizophrenia.

    Tarek RajjiUchida Hiroyuki

    American Association for Geriatric Psychiatry (Savannah) , 

    2010
    , 

    Poster presentation

  • Low dose versus standard dose of antipsychotics for relapse prevention in schizophrenia: a meta-analysis

    Uchida Hiroyuki

    2nd International Schizophrenia Research Society (Florence) , 

    2010
    , 

    Poster presentation

  • 抗うつ薬の変更はどのタイミングで行うべきか？ 無作為割り付け前向き試験

    Uchida Hiroyuki

    第20回日本臨床精神薬理学会 (仙台) , 

    2010
    , 

    Poster presentation

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Research Projects of Competitive Funds, etc. 【 Display / hide 】

  • Elucidating mechanisms of antidepressant effects of ketamine for treatment-resistant depression: an AMPA PET study

    2022.04
    -
    2025.03

    MEXT,JSPS, Grant-in-Aid for Scientific Research, 基盤研究(B), Principal investigator

  • Analysis of inappropriate use of psychotropics, and cohort study of suicide attempts including overdose and transition of the elderly psychiatric diagnoses

    2021.04
    -
    2022.03

    Grants-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (C), No Setting

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    第一に、向精神薬の不適切使用に関する実態を、本邦において厚生労働省から提供されるレセプト情報・特定健診等情報データベース（NDB）の解析により明らかにする。第二に、過量服薬や自殺の転帰と向精神薬の使用に関する関連を、NDBや海外のデータベースから経時的なデータを抽出し、経時的変化を追う解析及び横断面の解析を行い明らかにする。第三に、NDBや海外のデータベースから抗てんかん薬の使用と認知症発症の関連を、向精神薬の処方と診断名等の変遷を縦断的に解析することにより明らかにし、てんかんを有することによる認知症発症のリスクの一端を解明する。
    向精神薬と身体疾患薬の併用に関する実態把握は十分に行われていなかった。今回、我々は厚生労働省から得たレセプト情報・特定健診等情報データベース（NDB）から得た2015年1月における58万1990人のデータにつき、炭酸リチウム服用患者、選択的セロトニン再取り込み阻害薬（SSRI）/　セロトニン-ノルアドレナリン再取り込み阻害薬（SNRI）服用患者、ミルタザピン服用患者、について各々非服用者を対象に身体疾患薬の処方率の比較をFisher's exact testを用いて行う、等の解析を施行した。その結果、NSAIDs、利尿薬、ACE阻害薬、ARBの処方率は、炭酸リチウム服用患者が非服用患者に比して、有意に低く(18.3%(235人/1284人) VS 31.9%(409人/1284人)、p=7.6×10^(-10))、NSAIDs、抗血栓薬の処方率はSSRI/SNRI服用患者と非服用患者において同等であり（23.1%(3078人/13330人) VS 24.1%（3219人/13330人)、p=0.044)、ワーファリン処方率はミルタザピン服用患者が非服用者に比して有意に低かった（0.78%(18人/2300人) VS 1.65%（38人/2300人)、p=0.01)こと等がわかり、各々の向精神薬服用中患者の相当数が注意喚起を要する身体疾患の薬剤併用を受けている事を明らかにした（上記の解析では、全てBonferroniの補正を行い、p＜0.05/3を統計的に有意な差があるものとした。）。精神科医、身体科の医師への服薬併用注意を強く喚起し、薬物治療の安全性を高める上で極めて重要な成果であり、今後もビッグデータから現場の処方実態を捉え直すことが望まれる。なお本研究成果は、7th Congress of AsCNP2021にて口頭発表予定であり、研究期間中に論文投稿を開始している。

  • Development of pre-morbid diagnostic marker of schizophrenia: AMPA PET study

    2020.07
    -
    2024.03

    MEXT,JSPS, Grant-in-Aid for Scientific Research, Grant-in-Aid for Challenging Research (Pioneering), Principal investigator

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    統合失調症は早期発見・早期治療により、より良い予後が達成できる。精神病発症危険状態（At Risk Mental State [ARMS]）という、発病前ではあるものの今後の発病リスクの高い一群がある。ARMSのうち約30％が精神病（主に統合失調症）に移行するが、“移行者”を早期診断する方法はないため治療の遅れにつながっている。本研究では、統合失調症と関連の深いAMPA受容体をPET検査により測定し、統合失調症に移行するARMS症例、移行しないARMS症例の両者を比較し、今後の診断に役立てる。

  • AMPA受容体に注目した統合失調症の病態解明：世界初AMPA受容体PET研究

    2019.04
    -
    2022.03

    MEXT,JSPS, Grant-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (B), Principal investigator

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    統合失調症の原因解明は停滞しており、斬新な視点による研究が緊急課題である。グルタミン神経系のAMPA受容体は、動物研究により統合失調症の発病への関与が明らかになっているが、ヒトのデータはなかった。そこで本研究では、統合失調症患者の脳内のAMPA受容体密度を、陽電子放射断層撮影（PET)検査により測定し、AMPA受容体が統合失調症の発病にいかに関連しているか解明する。

  • 唾液メタボロームマッピング解析を用いた精神疾患の病態解明および臨床応用法の開発

    2019.04
    -
    2022.03

    Kanagawa Dental College, Grant-in-Aid for Scientific Research (C), No Setting

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    近年、複雑な社会環境により精神疾患に罹患した歯科受診患者が急増している。しかしながら、精神疾患の病態は複雑で、未だ原因が解明されていないのが現状である。また精神疾患の診断法は、問診や臨床症状を基にした主観的な診断が主体であるが、病態が複雑であることから診断の客観的評価法の確立が必須である。さらに再発が多いことから、予防、早期発見および予後管理を行うことが喫緊の課題である。本研究は、唾液の代謝産物から精神疾患の病態を解明し、さらに精神疾患の予防、早期発見、診断として利用できるように簡易検出系の開発を行い、ヒトで臨床応用することを最終目標とする。

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Awards 【 Display / hide 】

  • 日本臨床精神神経薬理学会　ポールヤンセン賞

    2024.05

    Type of Award： Award from Japanese society, conference, symposium, etc.

  • Journal of Clinical Psychopharmacology, Top Reviewers of 2023

    2024.04

    Type of Award： Honored in official journal of a scientific society, scientific journal

  • Journal of Clinical Psychopharmacology, Top Reviewers of 2022

    2023.04

  • 日本臨床精神神経薬理学会　ポールヤンセン賞

    2022.11

    Type of Award： Award from Japanese society, conference, symposium, etc.

  • Neuropsychopharmacology Reports NPPR Review Award 2021

    2021.07

    Type of Award： Award from Japanese society, conference, symposium, etc.

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Courses Taught 【 Display / hide 】

  • PSYCHIATRY: SEMINAR

    2024

  • PSYCHIATRY: PRACTICE

    2024

  • PSYCHIATRY 2

    2024

  • PSYCHIATRY

    2024

  • PSYCHIATRIC PALLIATIVE CARE MEDICINE: SEMINAR

    2024

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