Cochlear implants introduced during the 1990’s improved hearing for children experiencing sensory deprivation from congenital deafness, and for adults with acquired deafness.　Children with congenital deafness undergoing this procedure has becomes younger （<12 months）, although most children have it before 12y, with 5-6y the norm.　Postoperative speech and hearing is acquired very well and most children go into mainstream education.　Outcomes for cochlear implantation in adults with acquired deafness are also very good for reacquiring hearing.　Mid-1990’s data shows most patients under 70y undergo the procedure for implantation in the middle ear, although there are positive effects for patients 80-90y.　This is especially beneficial for patients additionally burdened with sight deprivation.

View full abstract

1.　It is accepted as dogma that all action comes from the central nervous system.　Symptomology can be predicted from lesions, known as “focal lesions”.
2.　However, even with highly localized speech apraxia, 1） There is still debate concerning legions surrounding the definition and findings of symptomology, 2） There is graceful degradation centered on the lesions.　3） It is doubtful that pathegenesis can be explained only by researching lesions and activation.
3.　It is understood that symptom definition compares to a corresponding lesion, and that there is functional localization with legions.　However, as an example of a function whose distributed or structure is not understood, in speech function 1） involves many complex processes, 2） shows graceful degradation, and 3） is a group of transitional processes.
4.　Taking apraxia as an example of a distributed but unified network, there is left hemispheric dominance, but the extent of “central system” white matter pathology is unclear, indicating it result from a “localized” network.
5.　As a highly localized example not well understood, intelligence encompasses a possible aggregate of a wide network of position and functions.
6.　Even in highly localized legions, reduction in function from injury can manifest in graceful degradation.　It is insufficient to elucidate psychoneurological function by solely pursuing researching on the localized character of legions and activations.　Future contributions can be made from other research fields.

View full abstract

　Visualization of anatomical and functional neural network changes associated with aging are important in order to develop reliable imaging biomarkers for very early diagnosis and breakthrough treatment of neurodegenerative dementia.　We have investigated the changes of the brain network in healthy subjects using resting-state functional MRI, diffusion tensor MRI, 3D MPRAGE, and magnetoencephalography.　Based on preliminary analysis with 200 healthy aging subjects, brain atrophy is observed mainly in limbic and premotor areas.　Diffusion tract imaging showed anatomical network disruption surrounding the lateral cerebral ventricle.　However, resting state functional MRI showed a decrease in resting connectivity in the fundamental resting state networks such as default mode network.　However, increases in resting connectivity across multiple functional ROIs were more frequently observed than decreases.　These results may be a compensatory phenomenon of functional brain networks against the progression of brain atrophy and disruption of anatomical brain networks with aging brain.　Dynamic remodeling of anatomical and functional networks appear to be occurring more widely in the aging brain than previously supposed.

View full abstract

With the demographic shift in age, dementia will become one of the most important health problems worldwide.　Vascular cognitive impairment （VCI） is the second most common type of dementia after Alzheimer’s disease and is frequently responsible for the cognitive decline of the elderly.　In order to investigate the underlying mechanisms involved in VCI, a mouse model of chronic cerebral hypoperfusion has been developed, which involves the narrowing of the bilateral common carotid arteries with newly designed microcoils.　This model is equivalent and complementary to the classical rat model of chronic cerebral hypoperfusion generated by bilateral common carotid artery occlusion.　As alternative models, an application of device called ameroid constrictors on the bilateral common carotid arteries in mice or rats offers reliable models of continuous reduction of cerebral blood flow, which may more closely mimic cognitive impairment subsequent to chronic cerebral hypoperfusion.　These models show good reproducibility of the white matter changes characterized by blood-brain barrier disruption, glial activation, oxidative stress, and oligodendrocyte loss following chronic cerebral hypoperfusion.　Detailed characterization of these models may help to decipher the substrates associated with impaired memory and move toward a more integrated therapy of VCI.

View full abstract

This article focused on the effect of exercise and physical activity for prevention of dementia and cognitive decline from the viewpoint of physical activity epidemiology.　First of all, we summarized evidence for the effect of exercise and physical activity from a prospective cohort study in community-dwelling older adults.　Next, we summarized the relationship among physical frailty, dementia and cognitive decline.　Finally, we discussed the effect of exercise intervention on the improvement of cognitive function in a non-dementia population, and patients with dementia and mild cognitive impairment.

View full abstract

Accumulating evidence from human and animal studies shows that physical activity and exercise improve cognitive function and reduce a risk of dementia.　The mechanisms underlying the positive effect of physical activity and exercise on cognition might be proposed as follows:1） physical activity and exercise induce structural changes in the brain including hippocampus, such as neurogenesis, angiogenesis and synaptogenesis, which may be linked to functional changes in the brain, and 2） physical activity and exercise centrally and peripherally increase the levels of growth factors, which partly mediate the structural and functional plastic changes in the brain, such as brain-derived neurotrophic factor, insulin-like growth factor 1 and vascular endothelial growth factor.　The preventive effect of physical activity and exercise on β-amyloid accumulation in the brain may be associated with reducing a risk of dementia.　Aerobic exercise is primarily effective on improving cognitive function and reducing a risk of dementia.　Resistance training also improves cognitive function in elderly people.　Although the most beneficial intensity of exercise for improving cognitive function are not well-known, physical activity and exercise at light-moderate intensities （below the lactate threshold） may be expected to improve cognition.

View full abstract

A number of epidemiological evidence suggests that moderate- to relatively high-intensity exercise or physical activity benefits cognitive function among sedentary middle-aged and older adults.　The past exercise or physical activity intervention focused on walking, dual-task walking, tai chi, dance exercise, square stepping, stationary cycling training, high-intensity resistance training, and so on.　In particular, the effectiveness of social dance on cognitive function has been emphasized in Western countries, while in Japan so-called “synapsology” （may be stated as “synapse exercise” or “synapcise”） has been getting popular as an useful tool of cognitive enhancement.　Randomized clinical trials assessing the benefits of exercise are equivocal, however.　Some researchers recently reported that exercise programs compared with health education programs did not result in improvements in overall or domain-specific cognitive function.　Such current work needs to be extended more comprehensively to Japanese adults.

View full abstract

Renaissance Corporation was established to support the development of regional support systems, companies involved in providing health care support, and nursing services.　In November, 2011, the Synapsology^Ⓡ method to stimulate brain activity was developed for all populations from youth to the elderly.　It has been applied in particular to the elderly, sports clubs, instruction in preventative care and other regional care facilities, including homes and cognitive support programs.　The Synapsology^Ⓡ approach is multidisciplinary and includes games to include cognitive performance as well as physical exercise to stimulate brain activity.

View full abstract

Expanding our knowledge of the historical backgrounds of dementia may benefit a holistic understanding of the concept of dementia and its causative diseases.　This article aims to review the trajectory of the concepts of dementia and how dementia has come to be considered as a medicosocial problem in Japan.　The first reference to cognitive decline associated with aging appeared in the era of mythology, being described as a supernatural phenomenon that should be accepted with awe.　In the 8th Century, those who had lost resilient mental function were described as crazy and ugly.　In the 11th and 12th Centuries, “absent-minded” was often used to describe cognitively impaired elderly, and various anti-social behaviors were ascribed to this “senile insanity”.　In the 17th Century, a new term “rômô” or dotage came into use in the similar context that cognitive decline was an unavoidable physiological changes associated with aging.　In contrast, ancient and medieval medical books underlined the importance of “exogenous malignant vapors” seeping through the skin into the body, or loss of “energized blood” as the major causes of cognitive impairment and dementia.　Since the 17the century, there was a burgeoning concept that dementia is a consequence of age-related brain diseases.　In the early 20th Century, dementia came to be recognized as a result of senility （senile dementia）, atherosclerotic psychosis （vascular dementia） or Alzheimer’s disease, closing in on the current understanding of pathophysiology of dementia.

View full abstract

The number of older drivers is increasing in Japan.　Car driving is an important personal mobility factor for living independently, interacting socially, and improving quality of life.　However, older drivers are at high risk regarding traffic safety because of visual, physical, and cognitive impairments.　These impairments are caused by neurological and psychiatric disorders as well as normative age-related changes.　One of the problems to be solved in an aged society is the development of a method to evaluate medical fitness to drive in older drivers.
Several methods to evaluate medical fitness to drive were reviewed on theoretical models of car driving:brain activity during simulated driving using functional brain imaging, the effects of cognitive load and a sedative anti-histamine drug during actual driving, and the detection of risky driving behavior through neuropsychological tests.　Practical problems associated with acquiring valid and reliable data during naturalistic driving were pointed out.
Evaluation of medical fitness to drive requires further interdisciplinary research between basic and clinical studies.

View full abstract

Magicians actually perform no miracles, but make audience believe in them with many psychological techniques.　To perform magic tricks, magicians need to inhibit optical information about their secrets to prevent audiences from producing information to recognize impossible phenomenon.　With the theory of gestalt perception, audiences may understand parts of a trick but not the whole.　Usually the sum of each part almost equals the whole, but magicians make gaps between each part.　The magician’s emotion will influence the audience’s emotion, which they use to deflect audience attention.　The audience cannot look at everything all the time.　Presented with questions people will search for an answer.　When they think they have got the answer, they stop thinking about possible questions.　This economizes cognitive resources.　Therefore, magicians give audiences false “secrets” in the form of tasks – checking objects or remembering a card – so they will not spend cognitive resources noticing the “real” secrets of a trick.　Audiences focus on the moving objects or objects the magician looks at, and magicians use these to attract people’s attention and to avoid them understanding the secret behind the “miracles”.

View full abstract