「慢性疼痛を有する地域住民における心拍変動で評価した自律神経機能と日常生活動作に関する症候の有無の関係：久山町研究」

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Journal of Affective Disorders  

We investigated the association between urinary neurotransmitter levels and the risk of the presence of depressive symptoms cross-sectionally, as well as the longitudinal risk of their development. A total of 2321 participants aged ≥40 years were enrolled in the cross-sectional analysis using the data from a baseline survey (2012–2013). Of these, 1654 participants without depressive symptoms at baseline were included in the longitudinal analysis using the data of both the baseline and follow-up surveys (2017–2018). Six urinary neurotransmitters—dopamine, homovanillic acid (HVA), vanillylmandelic acid (VMA), serotonin, 5-hydoroxyindoleacetic acid (5-HIAA], and gamma-aminobutyric acid (GABA)—were measured using liquid chromatography-mass spectrometry and corrected by urinary creatinine levels. Participants were categorized into sex-specific quartiles. Depressive symptoms were assessed by the Patient Health Questionnaire-9 (PHQ-9, ≥10 points). Odds ratios (ORs) for depressive symptoms were calculated using a logistic regression model. In the cross-sectional analysis, multivariable-adjusted ORs of the presence of depressive symptoms increased significantly with decreasing urinary levels of dopamine (Q1: 4.16 [95% confidence interval: 2.43–7.10] vs. Q4), serotonin (Q1: 2.60 [1.58–4.29] vs. Q4), and VMA (Q1: 2.75 [1.68–4.49] vs. Q4) (all P for trend <0.01). In the longitudinal analysis, 61 participants developed depressive symptoms. The multivariable-adjusted ORs of the development of depressive symptoms increased significantly with decreasing urinary dopamine levels (Q1: 2.57 [1.05–6.33] vs. Q4). Our findings suggest that lower urinary neurotransmitter levels are associated with an increased risk of both the presence and development of depressive symptoms in the general Japanese population.

DOI： 10.1016/j.jad.2026.121158

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PubMed

Language：English   Publisher：Journal of Clinical Monitoring and Computing  

Calculating the effect site concentration of remimazolam intraoperatively facilitates the prediction of the time from the end of remimazolam administration until the effect site concentration returns to the level at loss of consciousness (LOC). We hypothesised that the effect site concentration of remimazolam at LOC could be an indicator of arousal. This prospective, observational, single-centre study enrolled 107 patients who underwent laparoscopic surgery under remimazolam general anaesthesia. Sedative [bispectral index (BIS^®) and SedLine^®], non-invasive cardiac output (estimated continuous cardiac output^®), and effect site concentration of remimazolam monitoring were assessed simultaneously. The intraoperative remimazolam dose was adjusted to obtain the spectral edge frequency 95 (SEF) < 16 on SedLine^®. The primary endpoint was the relationship between the time for the effect site concentration of remimazolam to return to its level at LOC and recovery of consciousness (ROC). The median time from recovery of the effect site concentration of remimazolam to its level at LOC until ROC was 4.0 min. In the multivariate-adjusted general linear model, maintenance administration time and the effect site concentration of remimazolam ratio were significantly associated with the interval between effect site concentration of remimazolam recovery to LOC levels until ROC. This interval was significantly longer in patients whose effect site concentration of remimazolam ratio was lower. The effect site concentration of remimazolam at LOC could be useful for determining arousal time. The effect site concentration ratio and surgery duration could affect the time from recovery of effect site concentration of remimazolam to LOC levels until ROC.

DOI： 10.1007/s10877-025-01349-0

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PubMed

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Journal of Anesthesia  

Purpose: Kidneys are relatively resistant to ischemia. Few studies have examined the effects of short ischemic time in living-donor kidney transplantation. This retrospective study investigated the effects of ischemic time on renal function in living-donor kidney transplantation. Methods: Patients who have undergone kidney transplantation in Kyushu University Hospital between January 2017 and December 2021 were divided into two groups based on the median ischemic time (< 170 min and ≥ 170 min), after propensity score matching. A multivariate analysis was performed to determine the risk factors for renal dysfunction. Results: Each group contained 89 patients. Shorter ischemic time (< 170 min) was associated with higher postoperative glomerular filtration rates during the first–seventh postoperative days (POD7, 48.8 ± 18.9 vs. 42.8 ± 20.5; p = 0.04). Donor sex (female, odds ratio [OR]: 2.53, 95% confidence interval [CI] 1.11–5.82, p = 0.028), donor age (≥ 50 years, OR: 18.7, 95% CI 8.51–41.1, p < 0.001), diabetes (OR: 3.01, 95% CI 1.17–7.77, p = 0.023), and acute rejection within 1 year (OR: 17.3, 95% CI 2.02–148.2, p = 0.009) significantly increased renal dysfunction risk at 1 year. Ischemic time was not related to renal dysfunction 1 year after kidney transplantation (ischemic time ≥ 170 min, OR 1.06, 95% CI [0.52–2.14]; p = 0.88). The OR for an ischemic time ≥ 170 min was 0.69 (95% CI 0.27–1.75) in donors aged < 50 and 1.70 (95% CI: 0.63–4.60) in those aged ≥ 50 years (interaction p = 0.13). Conclusions: Longer ischemic time was correlated with early postoperative renal dysfunction, although the effect on renal function at 1 year was minimal with short ischemic times. Adverse effects of ischemic time on renal function after 1 year should be considered with older donors.

DOI： 10.1007/s00540-025-03607-6

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PubMed

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Brain Communications  

Longitudinal analyses of the influence of chronic pain on pain-related regional brain volumes in general populations are warranted. This prospective cohort study investigated the association between the presence of chronic pain at baseline and the subsequent changes in pain-related regional brain volumes among Japanese community-dwelling older residents. Participants aged 65 years or older who underwent brain magnetic resonance imaging (MRI) scans in both 2012 and 2017 were included. According to the presence or absence of chronic pain (defined as pain lasting for longer than 3 months) in 2012, participants were categorized into a 'chronic pain' group and 'no chronic pain' group. Region-of-interest analyses for the ventrolateral prefrontal cortex, dorsolateral prefrontal cortex, orbitofrontal cortex, postcentral gyrus, insular cortex, thalamus, anterior cingulate cortex, posterior cingulate cortex, amygdala and hippocampus were performed using FreeSurfer software. Whole-brain analysis was conducted by voxel-based morphometry. Rates of change in regional brain volume at 5 years after baseline were estimated using analysis of covariance. Among the 766 participants included in the FreeSurfer analysis, 444 (58%) were female and 287 (37%) were categorized into the chronic pain group. The results of FreeSurfer analysis showed that the chronic pain group had significantly greater decreases in regional volume in the postcentral gyrus (-2.187% in the chronic pain group versus -1.681% in the no chronic pain group, P = 0.01), thalamus (-4.400% versus -3.897%, P = 0.006), anterior cingulate cortex (-2.507% versus -1.941%, P = 0.004) and amygdala (-4.739% versus -4.022%, P = 0.03) compared to the no chronic pain group after adjusting for age, sex, education attainment, marital status, hypertension, diabetes, serum total cholesterol level, body mass index, current smoking, current drinking, regular exercise, cerebrovascular lesions on MRI, activities in daily living disability and depressive symptoms. Among the 730 participants included in the voxel-based morphometry analysis, 433 (59%) were female and 272 (37%) were categorized into the chronic pain group. The voxel-based morphometry analysis showed that the chronic pain group had a significantly greater regional volume decrease in the right anterior insula than the no chronic pain group. Our findings suggest that the presence of chronic pain at baseline is associated with a significantly greater decrease in the volume of pain-related brain regions at 5 years after baseline in community-dwelling older Japanese.

DOI： 10.1093/braincomms/fcaf149

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PubMed

Language：English   Publishing type：Research paper (scientific journal)   Publisher：European Journal of Pain United Kingdom  

Background: Autonomic nervous system dysfunction has been reported to be associated with impaired activities of daily living (ADL) among patients with chronic pain, but the association has not been fully addressed in general populations. This study cross-sectionally investigated the association between autonomic nervous system function and the presence of subjective symptoms affecting ADL in community-dwelling residents with chronic pain. Methods: A total of 888 residents with chronic pain, aged 40–79 years, who underwent a health examination in 2017–2018 were included. Based on heart rate variability measured by fingertip pulse wave, the standard deviation of normal-to-normal intervals (SDNN), root mean square of successive RR interval differences (RMSSD), low frequency (LF) power, and high frequency (HF) power were calculated. Symptoms affecting ADL were defined as those scoring ≥1 on the modified Rankin Scale. Odds ratios (ORs) and their 95% confidence intervals (CIs) for symptoms affecting ADL were estimated using a logistic regression analysis. Results: The overall prevalence of symptoms affecting ADL was 39.4%. The ORs for symptoms affecting ADL increased significantly per 1-standard-deviation decrement in log-transformed SDNN (OR 1.23 [95% CI 1.06–1.44]), RMSSD (1.25 [1.08–1.45]), LF power (1.29 [1.11–1.52]), and HF power (1.29 [1.11–1.51]) after adjusting for age, sex, education, hypertension, diabetes, serum total cholesterol level, body mass index, past medical history, current smoking, current drinking, exercise, depressive symptoms, and pain intensity. Conclusions: Decreased heart rate variability was associated with the presence of symptoms affecting ADL among individuals with chronic pain in a Japanese community. Significance: Decrease in heart rate variability was associated with the presence of symptoms affecting ADL among individuals with chronic pain in a Japanese community. This article could help scientists understand the significance of autonomic nervous system dysfunction in the pathology of chronic pain. Approaches that target autonomic nervous system dysfunction may be an option to relieve or prevent symptoms affecting ADL for chronic pain sufferers.

DOI： 10.1002/ejp.2224

Web of Science

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PubMed

Language：Japanese  

Language：Japanese  

Language：Japanese