1.White Matter Hyperintensities and Neuropsychiatric Symptoms in Neurodegenerative Diseases
Shigeki KATAKAMI ; Hideki KANEMOTO ; Daiki TAOMOTO ; Yuto SATAKE ; Takashi SUEHIRO ; Shunsuke SATO ; Kenji YOSHIYAMA ; Tetsuo KASHIBAYASHI ; Ryuichi TAKAHASHI ; Kenji TAGAI ; Shunichiro SHINAGAWA ; Kazunari ISHII ; Hiroaki KAZUI ; Manabu IKEDA
Journal of Clinical Neurology 2026;22(2):183-192
Background:
and Purpose Neuropsychiatric symptoms (NPS) are frequent in dementia and mild cognitive impairment (MCI), yet their reported associations with white matter hyperintensities (WMHs) remain inconsistent. We examined item-level associations between WMHs and NPS across Alzheimer’s disease dementia (ADD), dementia with Lewy bodies (DLB), and amnestic MCI (aMCI).
Methods:
This multicenter retrospective study involved 523 patients: 276 with ADD, 67 with DLB, and 180 with aMCI. Three-dimensional T1-weighted and T2–fluid-attenuated inversion recovery magnetic resonance images were processed with BAAD (Brain Anatomical Analysis using Diffeomorphic Deformation) software to quantify WMH volume (WMHV) and gray matter volume (GMV), normalized to total intracranial volume (TIV). NPS were assessed using the Neuropsychiatric Inventory. Multiple regression analyses were performed within each group, adjusting for GMV/TIV, age, sex, years of education, Clinical Dementia Rating–Sum of Boxes score, and institution.
Results:
In the aMCI group, higher WMHV/TIV was positively associated with depression, apathy, and disinhibition, and negatively with delusions. Subregional analyses revealed NPSspecific topographic patterns. No significant associations were detected in the ADD or DLB group. GMV/TIV was positively associated with delusions in the ADD group, but negatively associated with hallucinations in the DLB group.
Conclusions
Associations between WMHs and NPS were evident in the aMCI group but absent in the ADD and DLB groups, suggesting a stage-dependent effect. WMHs may contribute to NPS primarily in prodromal stages, whereas their influence may be overshadowed by neurodegenerative pathology in dementia. Clarifying the mechanisms underlying WMHs is critical for evaluating their potential as intervention targets.
2.Characteristics and treatment outcomes of tuberculosis cases by risk groups, Japan, 2007-2010
Uchimura Kazuhiro ; Ngamvithayapong-Yanai Jintana ; Kawatsu Lisa ; Ohkado Akihiro ; Yoshiyama Takashi ; Shimouchi Akira ; Ito Kunihiko
Western Pacific Surveillance and Response 2013;4(1):11-18
Introduction: We studied the characteristics and treatment outcomes of the following risk groups for tuberculosis (TB): those with HIV and diabetes mellitus (DM), contact cases, the homeless, foreigners, health care workers (HCW) and the elderly.
Method: A descriptive cross-sectional study was conducted by analysing the Japanese TB surveillance data of all cases registered between 2007 and 2010 (N = 96 689).
Results: The annual proportion of TB cases by risk group was stable over the study period, although there was a slight but significant increase observed for foreigner and elderly cases. Homeless and elderly TB cases had the highest DM co-morbidity (16.6% and 15.3%), respectively. HIV co-infection was low in all TB cases (0.2%) yet highest in foreigners (1.3%). HIV status of 45% of TB cases was unknown. The proportion of multidrug-resistant TB (MDR-TB) was similar among all risk groups (0.0%–0.9%) except foreigner, at 3.4%. Males in most risk groups had higher mortality than females; the mortality of all TB cases in all age groups for both males and females was 3.6–24 times higher than the general population.
Discussion: Reasons for the high proportion of “HIV status unknown” should be investigated and improved. Contact tracing among foreign cases with MDR-TB should be a priority. Homeless persons should be screened for DM together with TB. Programmes to enhance health and nutrition status may benefit TB prevention among the elderly. Tuberculosis screening and TB education are important for HCW.


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