ACE-R J proved to be an accurate cognitive instrument for detecting MCI and mild dementia. Further neuropsychological evaluation is required for the differential diagnosis of dementia subtypes.

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Intracranial meningeal melanocytoma is an uncommon tumor that is considered benign. We formerly reported an intracranial meningeal melanocytoma. Here we report a extremely rare case of malignant transformation of this tumor. A 49-year-old man complained of a headache. Magnetic resonance scanning revealed a mass in the left frontal region. The patient underwent gross total removal of the tomor in 1994. The histological findings showed a meningeal melanocytoma. In 1998, he underwent gamma-knife surgery for local recurrence. An additional operation was performed in 1999 became tumor growth was not stopped. The tumor was partially excised by left frontal craniotomy. Histopathological examination revealed a malignant melanoma originating from a melanocytoma. The tumor was composed of a proliferation of severely atypical melanocytoid cells with slightly irregular nuclei and prominent nucleoli, associated with necrosis and hemorrhage. Mitotic figures were encountered occasionally. After six months, he died from cerebrospinal fluid dissemination of this tumor. To our knowledge, this is the first report of malignant transformation of an intracranial meningeal melanocytoma.

We report an autopsy case of Creutzfeldt-Jakob disease with a codon 180 point mutation of the prion protein gene (PRNP). A 77-year-old woman developed gait instability, followed by dementia and limb/truncal ataxia. She became akinetic and mute 18 months and died of pneumonia 26 months after the disease onset. Analysis of the PRNP gene revealed a codon 180 point mutation. Post-mortem examination revealed marked spongiosis, neuronal loss, and astrocytic gliosis in the cerebral cortex. Mild to moderate spongiosis and neuronal loss were observed in the limbic cortex and basal ganglia. There was no spongiform change in the hippocampus, brain stem or cerebellum. Many senile plaques and neurofibrillary tangles were found, and the Braak stages were stage C and stage IV, respectively. Immunostaining for prion protein (PrP) revealed granular (synaptic-type) and patchy PrP deposition in the cerebral cortex and especially in the hippocampus. Most patchy PrP deposits were colocalized with amyloid beta plaques, but some of them were isolated. The relatively strong PrP deposition and coexistence of Alzheimer-type pathology of this case are remarkable. We suppose that amyloid beta plaques might act as a facilitating factor for PrP deposition.

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Background Early detection of mild cognitive impairment (MCI) and dementia is very important to begin appropriate treatment promptly and to prevent disease exacerbation. We investigated the screening accuracy of the Japanese version of Addenbrooke’s Cognitive Examination III (ACE-III) to diagnose MCI and dementia. Methods The original ACE-III was translated and adapted to Japanese. It was then administered to a Japanese population. The Hasegawa Dementia Scale-revised (HDS-R) and Mini-mental State Examination (MMSE) were also applied to evaluate cognitive dysfunction. In total, 389 subjects (dementia = 178, MCI = 137, controls = 73) took part in our study. Results The optimal ACE-III cut-off scores to detect MCI and dementia were 88/89 (sensitivity 0.77, specificity 0.92) and 75/76 (sensitivity 0.82, specificity 0.90), respectively. ACE-III was superior to HDS-R and MMSE in the detection of MCI or dementia. The internal consistency, test-retest reliability, and inter-rater reliability of ACE-III were excellent. Conclusions ACE-III is a useful cognitive test to detect MCI and dementia. ACE-III may be widely useful in clinical practice.

Skin temperature is an effective indicator for objectively evaluating human sensations, because it is controlled by sympathetic nerve activity which reflects the course of information processing in the brain. In this paper, we show a method to evaluate stress from skin temperature and an equipment which continuously measures skin temperature of an subject working in front of a computer terminal.An experiment is performed to investigate a relationship between stressfull task and the skin temperature. The experiment shows that there is a high correlation among stress, skin temperatures on nose and forehead. From this experiment, a regression equation is derived which computes the intensity of stress from skin temperatures on nose and forehead.A non-contact skin temperature measuring system is developed based on knowledge obtained in the experiment. The system comprised of an infrared camera, color camera, image processing unit and work station. The features are the abilities to track nose and forehead positions of an subject doing computer operation automatically and to evaluate the stress continuously.

Background/Aims: The frontal assessment battery (FAB) is reported to be a useful tool for screening frontal function. However, the neural substrates involved remain to be elucidated. The aim of the present study was to identify the brain regions responsible for FAB performance in patients with early dementia. We sought a correlation between FAB scores and brain perfusion. Methods: A total of 117 subjects participated in this study (Alzheimer’s disease = 51, frontotemporal dementia = 14, vascular dementia = 13, dementia with Lewy bodies = 7, psychiatric disease = 7, mild cognitive impairment = 11, controls = 14). They underwent brain single photon emission computed tomography with ^99mTc-ethylcisteinate dimer, and we analyzed the data, using a regional cerebral blood flow (rCBF) quantification software program, 3DSRT (3-dimensional stereotaxic region of interest template). Results: FAB scores had a moderately positive correlation with left callosomarginal and precentral rCBF. Comparison of rCBF between high- and low-scoring FAB groups revealed that the latter showed significantly lower rCBF in the bilateral callosomarginal and left precentral regions. Conclusion: The results in this study suggest that the FAB mainly reflects the function of the callosomarginal and precentral segments, especially the left side, and that it might be a valid frontal lobe function test.