Hirano, Jinichi

写真a

Affiliation

School of Medicine, Department of Neuropsychiatry （Shinanomachi）

Position

Assistant Professor/Senior Assistant Professor
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Papers 【 Display / hide 】

  • Individual Prediction of Remission Based on Clinical Features Following Electroconvulsive Therapy: A Machine Learning Approach.

    Nakajima K, Takamiya A, Uchida T, Kudo S, Nishida H, Minami F, Yamamoto Y, Yamagata B, Mimura M, Hirano J

    The Journal of clinical psychiatry 83 （ 5 ）  2022.08

    ISSN  0160-6689

  • Impact of Sevoflurane and Thiopental Used Over the Course of Electroconvulsive Therapy: Propensity Score Matching Analysis

    Yatomi T., Uchida T., Takamiya A., Wada M., Kudo S., Nakajima K., Nishida H., Yamagata B., Mimura M., Hirano J.

    Frontiers in Human Neuroscience （Frontiers in Human Neuroscience)  16 2022.07

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    Objective: Although anesthetics play an important role in electroconvulsive therapy (ECT), the clinical efficacy and seizure adequacy of sevoflurane in the course of ECT remain unclear. The purpose of this study was to examine the clinical efficacy and seizure adequacy of sevoflurane, compared with those of thiopental, in the course of ECT in patients with mood disorders. Methods: We conducted a retrospective chart review. Patients who underwent a course of ECT and received sevoflurane (n = 26) or thiopental (n = 26) were included. Factors associated with ECT and treatment outcomes were compared between the two groups using propensity score (PS) matching. Between-group differences were examined using an independent t-test for continuous variables and a χ2-test for categorical variables. Results: Patients who received sevoflurane needed more stimulations (sevoflurane: 13.2 ± 4 times, thiopental: 10.0 ± 2.5 times, df = 51, p = 0.001) and sessions (sevoflurane: 10.0 ± 2.1 times, thiopental: 8.4 ± 2.1 times, df = 51, p = 0.01) and had more inadequate seizures (sevoflurane: 5 ± 3.9 times, thiopental: 2.7 ± 2.7 times, df = 51, p = 0.015). Remission and response rates were similar in both groups. Conclusion: The present findings indicate that sevoflurane should be used with caution in ECT and only when the clinical rationale is clear.

  • Similar Hemodynamic Signal Patterns Between Compact NIRS and 52-Channel NIRS During a Verbal Fluency Task

    Hirano J., Takamiya A., Yamamoto Y., Minami F., Mimura M., Yamagata B.

    Frontiers in Psychiatry （Frontiers in Psychiatry)  12 2021.12

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    Multichannel near-infrared spectroscopy (NIRS), including 52-channel NIRS (52ch-NIRS), has been used increasingly to capture hemodynamic changes in the brain because of its safety, low cost, portability, and high temporal resolution. However, optode caps might cause pain and motion artifacts if worn for extended periods of time because of the weight of the cables and the pressure of the optodes on the scalp. Recently, a small NIRS apparatus called compact NIRS (cNIRS) has been developed, and uses only a few flexible sensors. Because this device is expected to be more suitable than 52ch-NIRS in the clinical practice for patients with children or psychiatric conditions, we tested whether the two systems were clinically comparable. Specifically, we evaluated the correlation between patterns of hemodynamic changes generated by 52ch-NIRS and cNIRS in the frontopolar region. We scanned 14 healthy adults with 52ch-NIRS and cNIRS, and measured activation patterns of oxygenated-hemoglobin [oxy-Hb] and deoxygenated-hemoglobin [deoxy-Hb] in the frontal pole while they performed a verbal fluency task. We performed detailed temporal domain comparisons of time-course patterns between the two NIRS-based signals. We found that 52ch-NIRS and cNIRS showed significant correlations in [oxy-Hb] and [deoxy-Hb] time-course changes in numerous channels. Our findings indicate that cNIRS and 52ch-NIRS capture similar task-dependent hemodynamic changes due to metabolic demand, which supports the validity of cNIRS measurement techniques. Therefore, this small device has a strong potential for clinical application with infants and children, as well as for use in the rehabilitation or treatment of patients with psychiatric disorders using biofeedback.

  • Neuronal network mechanisms associated with depressive symptom improvement following electroconvulsive therapy

    Takamiya A., Kishimoto T., Hirano J., Nishikata S., Sawada K., Kurokawa S., Yamagata B., Kikuchi T., Mimura M.

    Psychological Medicine （Psychological Medicine)  51 （ 16 ） 2856 - 2863 2021.12

    ISSN  00332917

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    Background Electroconvulsive therapy (ECT) is the most effective antidepressant treatment for severe depression. Although recent structural magnetic resonance imaging (MRI) studies have consistently reported ECT-induced hippocampal volume increases, most studies did not find the association of the hippocampal volume changes with clinical improvement. To understand the underlying mechanisms of ECT action, we aimed to identify the longitudinal effects of ECT on hippocampal functional connectivity (FC) and their associations with clinical improvement. Methods Resting-state functional MRI was acquired before and after bilateral ECT in 27 depressed individuals. A priori hippocampal seed-based FC analysis and a data-driven multivoxel pattern analysis (MVPA) were conducted to investigate FC changes associated with clinical improvement. The statistical threshold was set at cluster-level false discovery rate-corrected p < 0.05. Results Depressive symptom improvement after ECT was positively associated with the change in the right hippocampus-ventromedial prefrontal cortex FC, and negatively associated with the right hippocampus-superior frontal gyrus FC. MVPA confirmed the results of hippocampal seed-based analyses and identified the following additional clusters associated with clinical improvement following ECT: the thalamus, the sensorimotor cortex, and the precuneus. Conclusions ECT-induced change in the right frontotemporal connectivity and thalamocortical connectivity, and changes in the nodes of the default mode network were associated with clinical improvement. Modulation of these networks may explain the underlying mechanisms by which ECT exert its potent and rapid antidepressant effect.

  • Electroconvulsive Therapy for Patients with Depression Who Lack Capacity for Consent: Doing Good and Doing No Harm

    Takamiya A., Bouckaert F., Sienaert P., Uchida T., Kudo S., Yamagata B., Kishimoto T., Mimura M., Hirano J.

    Journal of ECT （Journal of ECT)  37 （ 3 ） 171 - 175 2021.09

    ISSN  10950680

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    Objective Electroconvulsive therapy (ECT) is provided in real-world clinical settings for patients lacking capacity for consent. The aim of this study was to investigate the clinical characteristics and clinical effectiveness of ECT in this population. Methods A retrospective chart review was conducted to collect data from patients who received ECT to treat their depressive episodes between April 2012 and March 2019. Differences in clinical characteristics and short-/long-term clinical outcomes between patients who received ECT with their relatives' consent and patients who received ECT by their own consent were examined. The short-/long-term clinical outcomes were determined by clinical global impression scores and readmission rate, respectively. Results Of 168 patients with depressive episodes, 34 (20.2%) received ECT with their relatives' consent. Those patients were older, had lower body mass index, and had shorter episode duration. They also exhibited more frequent psychotic, melancholic, and catatonic features. The main indication for ECT in this population was the need for rapid recovery. Patients lacking capacity for consent showed similar remission (61.8%) and response (82.4%) rates to those with capacity for consent. Readmission rate was not significantly different between groups. Conclusions There were no significant differences in short-/long-term ECT effectiveness between patients with/without capacity for consent. Electroconvulsive therapy is the only established and effective treatment in clinical settings for the most severe cases, wherein patients are incapable of giving consent but need rapid recovery. A general rejection of this practice due to concerns surrounding consent may be unethical under the ethical principles of medical care.

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

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Reviews, Commentaries, etc. 【 Display / hide 】

  • Prolonged Post-Electroconvulsive Therapy Delirium Controlled with Donepezil

    Takamiya A., Sawada K., Hirano J., Mimura M., Kishimoto T.

    Journal of ECT (Journal of ECT)  35 ( 3 ) E29 - E30 2019.09

    ISSN  10950680

  • 【ニューロモデュレーション治療の可能性】精神疾患に対するニューロモデュレーション

    高宮 彰紘, 岸本 泰士郎, 平野 仁一, 山縣 文, 三村 將

    精神科 ((有)科学評論社)  34 ( 6 ) 551 - 556 2019.06

    ISSN  1347-4790

  • 【免疫と精神神経疾患】うつ病

    平野 仁一

    精神科 ((有)科学評論社)  27 ( 4 ) 234 - 240 2015.10

    ISSN  1347-4790

  • 【一般内科診療で役立つうつ病の知識-こころの問題にどう対処するか】光トポグラフィー(NIRS)

    平野 仁一

    内科 ((株)南江堂)  115 ( 2 ) 275 - 279 2015.02

    ISSN  0022-1961

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    精神疾患の臨床診断は通常,本人や家族からの問診結果に基づいてなされるが,問診から得られる情報が十分でなかったり,情報を十分に得てもなお診断の確定が困難である場合が少なくない.とくに,うつ病,双極性障害および統合失調症等は,いずれも初期にうつ状態を呈することが多いため,正確な鑑別診断はしばしば困難である.これまでは精神疾患の診断に関する生物学的な指標が確立されていなかった.光トポグラフィー検査は人体に安全な近赤外線を用いて,脳表の血流変化を捉えるものである.言語流暢性課題下での光トポグラフィー検査は,抑うつ状態の鑑別診断の補助として2014年から保険採用されており,精神科臨床において臨床診断の補助となるものである.(著者抄録)

  • 【炎症の観点からみた精神疾患とストレス】うつ病と炎症

    平野 仁一

    精神科 ((有)科学評論社)  25 ( 2 ) 113 - 120 2014.08

    ISSN  1347-4790

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

  • 電気けいれん療法の治療効果発現におけるγ帯域神経活動が与える影響の解明

    2021.04
    -
    2024.03

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

  • 電気けいれん療法の急性期作用期機序解明に関するマルチモーダルでの縦断的観察研

    2017.04
    -
    2021.03

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

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Courses Taught 【 Display / hide 】

  • LECTURE SERIES, PSYCHIATRY

    2024

  • LECTURE SERIES, PSYCHIATRY

    2023

  • LECTURE SERIES, PSYCHIATRY

    2022

  • LECTURE SERIES, PSYCHIATRY

    2021

  • LECTURE SERIES, PSYCHIATRY

    2020

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