Uchida, Hiroyuki

写真a

Affiliation

School of Medicine, Department of Neuropsychiatry ( Shinanomachi )

Position

Professor
 

Books 【 Display / hide 】

  • Medications for Psychosis: Dopamine Blockers and Dopamine Partial Agonists (Antipsychotics)

    Kim E., Jarskog L.F., Fleischhacker W.W., Remington G., Lieberman J.A., Uchida H., Tasmans Psychiatry Fifth Edition, 2024.01

    　View Summary

    Since the era of antipsychotic pharmacotherapy began with the discovery of the antipsychotic properties of chlorpromazine in 1952, many new medications for psychosis (antipsychotics) have become available. All currently approved medications for psychosis, except pimavanserin, remain dopaminergic agents. Medications for psychosis alleviate psychotic symptoms and prevent relapse into psychosis in the treatment of schizophrenia. Moreover, they are also indicated for a variety of other conditions, including bipolar disorder and treatment-resistant depression. Medications for psychosis sometimes cause various side effects while their side effect profiles greatly differ among individual drugs. Much effort has recently been devoted to developing drugs that exert their effects by modulating neural systems other than the dopaminergic system, and several drugs have demonstrated promising results in Phase II and III trials. In addition, individualized treatment for a specific patient based on their biological characteristics is one of the future goals of psychopharmacological treatment of schizophrenia. These goals will be achieved with precise biological characterization of this illness.

  • Encyclopedia of Psychopharmacology

    Uchida Hiroyuki, 2010

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Papers 【 Display / hide 】

  • Relapse in Schizophrenia: A Systematic Review of Criteria for Clinical Studies and International Consensus Guidelines to Improve Them.

    Howes OD, Bukala BR, Chen EYH, Correll CU, Hasan A, Honer WG, Kane JM, Leucht S, Siafis S, Agid O, Akena D, Arango C, Atwoli L, Barnes TRE, Birnbaum ML, Bitter I, Breier A, Buchanan RW, Citrome L, Cotter DR, Crossley N, Davidson M, de Bartolomeis A, DeLisi LE, Dollfus S, Dursun SM, Ebdrup BH, Elkis H, Emsley R, Falkai P, Fernández-Egea E, Fleischhacker W, Freudenreich O, Gadelha A, Gaebel W, Graff-Guerrero A, Gridley A, Hallak JEC, Homan P, Kahn RS, Kaiser S, Kapi M, Kennedy JL, Kim E, Kinon BJ, Soo Kwon J, Lawrie SM, Lee J, Leweke FM, Li T, Libiger J, Marder SR, Melle I, Meltzer H, Mucci A, Naber D, Nakajima S, Nielsen J, O'Brien O, Ojagbemi A, Omlor W, Pantelis C, Peuskens J, Raedler TJ, Ran MS, Marques TR, Remington G, Rossell S, Rubio JM, Sachs G, Scott J, Si T, Siskind D, Siu CO, Sommer IE, Suzuki T, Takeuchi H, Tandon R, Taylor D, Teferra S, Thomas N, Tiihonen J, Uchida H, Ucok A, Umbricht D, Venkatasubramanian G, Wagner E, Walters JTR, Wang C, Weiser M, Wright C, Yu X, McCutcheon RA

    The American journal of psychiatry 182 ( 11 ) 969 - 983 2025.11

    ISSN  0002-953X

  • Long-interval intracortical inhibition in individuals with autism spectrum disorders: A TMS-EEG study with source estimation analyses

    Mimura Y., Nakajima S., Takano M., Wada M., Taniguchi K., Honda S., Uchida H., Mimura M., Noda Y.

    Clinical Neurophysiology 178   2110936 2025.10

    ISSN  13882457

    　View Summary

    Objective: This study aimed to evaluate Long-interval Intracortical Inhibition (LICI) in the Dorsolateral Prefrontal Cortex (DLPFC) of individuals with Autism Spectrum Disorder (ASD) using transcranial magnetic stimulation combined with electroencephalography (TMS-EEG) with source-based estimation analyses. Methods: We applied the LICI paradigm to the left DLPFC of 32 individuals with ASD and 34 healthy controls. First, sensor-level Local Mean Field Power (LMFP) was calculated from TMS-evoked potentials for all participants to detect the LICI effect. Subsequently, source-based analyses were performed using dynamic statistical parametric mapping to minimize the influence of volume conduction. Finally, time–frequency (TF) analyses at the source level were conducted to further characterize the LICI effects. Results: LMFP analysis revealed that cortical activity in the interval of 165–234 ms post-stimulation was suppressed by LICI (p = 0.024). Source-based analyses confirmed inhibitory effects within the same time range. Additionally, TF analyses indicated suppressive effects within 30–300 ms in the theta to alpha bands. However, no significant group differences in the LICI effects were detected. Conclusions: TMS-EEG combined with LICI alone may be insufficient to detect GABA(B) receptor dysfunction in ASD. Significance: This is the first TMS-EEG study to elucidate the LICI effect by applying source-estimation methods in ASD.

  • 【うつ病123のQ&A】(第VI部)うつ病の生物学的基盤と最新治療　Ketamineはなぜ,うつ病に効果があるのでしょうか?

    内田 裕之

    精神科治療学 ((株)星和書店)  40 ( 増刊 ) 214 - 215 2025.10

    ISSN  0912-1862

  • The association between amygdalar volume changes and depressive symptom improvements after repeated ketamine infusion in treatment-resistant depression: a double-blind, randomized, placebo-controlled trial with the following open-label study

    Yonezawa K., Nakajima S., Hondo N., Ohtani Y., Nomoto-Takahashi K., Yatomi T., Tomiyama S., Nagai N., Kusudo K., Takahashi K., Honda S., Moriyama S., Yamada T., Koike S., Uchida H., Tani H.

    Journal of Psychiatric Research 190   400 - 408 2025.10

    ISSN  00223956

    　View Summary

    Background: Ketamine is effective for treatment-resistant depression (TRD), where its mechanism remains unclear. Though the amygdala plays an important role in emotional processing and mood state, no study has explored the relationship between amygdalar subfield volumes and ketamine's effect in patients with TRD. We hypothesized that amygdalar subfield volume changes would correlate with clinical response to ketamine in patients with TRD. Methods: We used data from a double-blind, randomized, placebo-controlled trial (jRCTs031210124). Among 31 completers, 11 (35.5 %) participants in the ketamine group and 15 (48.4 %) participants in the placebo group underwent 0.8 mm-isotropic T1-and T2-weighted multimodal magnetic resonance imaging scans before and after the interventions. Depressive symptoms were assessed with the Montgomery Åsberg Depression Rating Scale (MADRS). We focused on the three amygdalar subfields: laterobasal (LB), centromedial, and superficial nuclei. Multivariable and post-hoc univariate regression analyses were conducted to explore the factors associated with the change in the MADRS total and subdomain scores. Results: There was a significant interaction between the volume changes in the right LB and group for the MADRS dysphoria score changes (F (3, 22) = 3.63, p = 0.029, R<sup>2</sup> = 0.24, treatment by volume change interaction: β = 0.61, p = 0.028). Post-hoc analyses found that changes in MADRS dysphoria scores related to volume changes in the right LB in the ketamine group (β = 0.65, p = 0.028), but not in the placebo group. Conclusions: The reductions in right LB volumes correlate with better clinical responses to ketamine in patients with TRD, suggesting ketamine may exert its effect by attenuating amygdalar overactivity in this population.

  • Glutamate plus glutamine to GABA ratio as a predictor of ketamine response in treatment-resistant depression: A double-blind, randomized, open-label extension study

    Ohtani Y., Tani H., Honda S., Nomoto-Takahashi K., Yatomi T., Yonezawa K., Tomiyama S., Nagai N., Kusudo K., Moriyama S., Noda Y., Koike S., Edden R.A.E., Uchida H., Nakajima S.

    Journal of Affective Disorders 383   354 - 362 2025.08

    ISSN  01650327

    　View Summary

    Background: Approximately 30 % of patients with treatment-resistant depression (TRD) respond to ketamine; however, no replicable predictors of response have been reported. The imbalance between excitatory and inhibitory neurotransmissions may be implicated in the mechanism of action of ketamine. This study aimed to evaluate whether the ratio of glutamate and glutamine (Glx) to GABA levels at baseline in the dorsal anterior cingulate cortex (dACC) could predict ketamine response in patients with TRD. Method: This exploratory study analyzed data from a double-blind randomized clinical trial with an open-label extension study (jRCTs031210124). Fifteen participants in the ketamine group and 15 of 16 participants in the placebo group received repeated intravenous ketamine during the double-blind and open-label extension periods, respectively. We measured Glx and GABA levels in the dACC before and after treatment during the double-blind period using proton magnetic resonance spectroscopy. The 17-item Hamilton Depression Rating Scale (HDRS-17) was measured for depressive symptomatology. General linear models were used to examine the relationship between baseline Glx/GABA ratio and HDRS-17 score changes. Result: Changes in HDRS-17 scores (mean (±SD)) following ketamine treatment were −4.9 (6.5) and −4.9 (5.2) in the double-blind and open-label periods, respectively. A higher baseline dACC Glx/GABA ratio was correlated with greater improvement in HDRS-17 (β = −0.42, p = 0.040). In the ketamine group, a reduction in the dACC Glx/GABA ratio was correlated with greater HDRS-17 improvement (β = 0.74, p = 0.009) with no such association in the placebo group. Conclusion: These results suggest that excitatory-inhibitory imbalance in the dACC may predict the efficacy of ketamine in TRD.

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

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Reviews, Commentaries, etc. 【 Display / hide 】

  • Reversible dementia due to hyperthyroidism: Cognitive impairment, delusions, and agitation resolved with antithyroid treatment

    Koyama G., Nakano M., Takata T., Kuramochi S., Koreki A., Ishida T., Uchida H., Funayama M.

    Journal of the Neurological Sciences 472   123474 2025.05

    ISSN  0022510X

  • 精神展開剤シロシビンによるうつ病治療

    内田 裕之

    精神科治療学 ((株)星和書店)  40 ( 2 ) 221 - 224 2025.02

    ISSN  0912-1862

  • Pisa Syndrome after Discontinuation of Low-Dose Sulpiride: A Case Report

    Koyama G., Nakano M., Takata T., Mimura Y., Uchida H., Funayama M.

    Journal of Clinical Psychopharmacology  2025

    ISSN  02710749

  • 自閉症スペクトラムとの鑑別に難渋した初回エピソード統合失調症の1例

    小野 瑛之介, 谷 英明, 木村 真奈美, 前田 貴記, 内田 裕之

    精神神経学雑誌 ((公社)日本精神神経学会)  126 ( 12 ) 830 - 830 2024.12

    ISSN  0033-2658

  • うつ病の背景に存在した捉えづらい右側頭葉前方の損傷による高次脳機能障害の1例

    橋本 卓哉, 須藤 亜紗実, 谷 英明, 船山 道隆, 前田 貴記, 内田 裕之

    精神神経学雑誌 ((公社)日本精神神経学会)  126 ( 12 ) 829 - 829 2024.12

    ISSN  0033-2658

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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

    [Domestic presentation]  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

    [International presentation]  American Association for Geriatric Psychiatry (Savannah) , 

    2010
    , 

    Poster presentation

  • Clozapine and global cognition in schizophrenia.

    Tarek RajjiUchida Hiroyuki

    [International presentation]  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

    [International presentation]  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

    [Domestic presentation]  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 】

  • Creation of music that brings flexibility to our thinking like psychedelics

    2025.06
    -
    2029.03

    挑戦的研究（開拓）, Principal investigator

  • 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

    　View Summary

    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

    　View Summary

    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

    　View Summary

    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。

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Awards 【 Display / hide 】

  • Journal of Clinical Psychopharmacology, Top Reviewers of 2024

    2025.04

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

  • 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.

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Courses Taught 【 Display / hide 】

  • PSYCHIATRY: SEMINAR

    2025

  • PSYCHIATRY: PRACTICE

    2025

  • PSYCHIATRY

    2025

  • PSYCHIATRIC PALLIATIVE CARE MEDICINE: SEMINAR

    2025

  • PSYCHIATRIC PALLIATIVE CARE MEDICINE: PRACTICE

    2025

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