論文

This study aimed to develop and validate the Japanese version of the Pediatric Eating Assessment Tool (PediEAT-J). The original PediEAT underwent forward–backward translation and cultural adaptation. Caregivers of 697 children aged 6 months–7 years completed the PediEAT-J. A subset of 70 caregivers repeated the questionnaire after two weeks to assess test–retest reliability. Internal consistency was evaluated with Cronbach’s alpha; reliability with the intraclass correlation coefficient (ICC). Construct validity was examined via confirmatory factor analysis (CFA) of the original four-factor model; discriminant validity was examined by comparing scores of children with caregiver-reported feeding concerns to those without. Internal consistency was high across subscales and the total score (α = 0.806–0.913). Test–retest reliability was excellent (ICC = 0.902). Model-fit indices were acceptable: comparative fit index = 0.889; Tucker–Lewis index = 0.867; root mean square error of approximation = 0.039 (90% CI: 0.036–0.041); standardized root mean square residual = 0.071. Children whose caregivers expressed feeding concerns scored significantly higher than those without concerns on total and subscale scores (all p < 0.01), confirming discriminant validity. The PediEAT-J is a reliable and valid Patient-Reported Outcome Measure (PROM) that enables comprehensive assessment of feeding difficulties in Japanese children aged 6 months–7 years. It supports clinical assessment and intervention by providing structured caregiver-reported data on a child's feeding skills.

片側巨脳症は、出生後早期から早期乳児てんかん性脳症などの難治性てんかんを認め、最重度の精神運動発達遅滞を呈することが多い発達予後不良の疾患である。薬物療法が無効のため生後早期に大脳半球離断術が行われることが多い。術後の経過中に、てんかん発作が消失しても非罹患側に脳波異常の出現を認めることがある。半球離断術によりてんかん発作が消失した症例を対象に、非罹患側の経時的脳波変化と発達月齢、発達指数との関係について後方視的に検討した。片側巨脳症の半球切除術後でてんかん発作の消失した症例では、術後の発達指数は全例で低下傾向だったが、発達月齢は運動・言語発達とも全例で緩徐ながら伸びていた。術後の発達は、発達指数よりも発達月齢で評価した方が、術後臨床的に発達を認める実態を把握しやすい。また経過中に非罹患側の突発活動が出現することがあり、その増加率が高いと表出性言語発達が遅滞する可能性が示唆された。(著者抄録)

神経発達症児の血清亜鉛値について健常児の参照値と比較検討した。血清亜鉛値を測定した学齢期の神経発達症児63名(男児49名、女児14名)を患者群とし、先行研究において年齢分布が一致する380名の健常児のデータを用いて解析を行った。その結果、患者群のうち19名(30%)が亜鉛欠乏症、また39名(62%)が潜在性亜鉛欠乏、亜鉛値正常は5名(8%)であり、血清亜鉛値は健常児の参照値と比較して有意に低値であった(p<0.001)。患者群の診断内訳では、ADHD(36名、54%)と自閉スペクトラム症(22名、39%)の2疾患が大部分を占めたものの、血清亜鉛値は疾患間で有意な差はなく(p=0.32)、性差も認められなかった(p=0.95)。神経発達症児は亜鉛欠乏傾向にあると考えられ、疾患や性別による血清亜鉛値の明らかな違いはなかった。(著者抄録)

BACKGROUND: During face identification in humans, facial information is sampled (seeing) and handled (processing) in ways that are influenced by the kind of facial image type, such as a self-image or an image of another face. However, the relationship between seeing and information processing is seldom considered. In this study, we aimed to reveal this relationship using simultaneous eye-tracking measurements and near-infrared spectroscopy (NIRS) in face identification tasks. METHODOLOGY/PRINCIPAL FINDINGS: 22 healthy adult subjects (8 males and 14 females) were shown facial morphing movies in which an initial facial image gradually changed into another facial image (that is, the subject's own face was changed to a familiar face). The fixation patterns on facial features were recorded, along with changes in oxyhemoglobin (oxyHb) levels in the frontal lobe, while the subjects identified several faces. In the self-face condition (self-face as the initial image), hemodynamic activity around the right inferior frontal gyrus (IFG) was significantly greater than in the familiar-face condition. On the other hand, the scanning strategy was similar in almost all conditions with more fixations on the eyes and nose than on other areas. Fixation time on the eye area did not correlate with changes in oxyHb levels, and none of the scanning strategy indices could estimate the hemodynamic changes. CONCLUSIONS/SIGNIFICANCE: We conclude that hemodynamic activity, i.e., the means of processing facial information, is not always modulated by the face-scanning strategy, i.e., the way of seeing, and that the right IFG plays important roles in both self-other facial discrimination and self-evaluation.

It is assumed that children with autism spectrum disorders (ASD) have specificities for self-face recognition, which is known to be a basic cognitive ability for social development. In the present study, we investigated neurological substrates and potentially influential factors for self-face recognition of ASD patients using near-infrared spectroscopy (NIRS). The subjects were 11 healthy adult men, 13 normally developing boys, and 10 boys with ASD. Their hemodynamic activities in the frontal area and their scanning strategies (eye-movement) were examined during self-face recognition. Other factors such as ASD severities and self-consciousness were also evaluated by parents and patients, respectively. Oxygenated hemoglobin levels were higher in the regions corresponding to the right inferior frontal gyrus than in those corresponding to the left inferior frontal gyrus. In two groups of children these activities reflected ASD severities, such that the more serious ASD characteristics corresponded with lower activity levels. Moreover, higher levels of public self-consciousness intensified the activities, which were not influenced by the scanning strategies. These findings suggest that dysfunction in the right inferior frontal gyrus areas responsible for self-face recognition is one of the crucial neural substrates underlying ASD characteristics, which could potentially be used to evaluate psychological aspects such as public self-consciousness. (C) 2010 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

The study aimed to compare serum zinc levels between children with neurodevelopmental disorders and healthy children. A total of 63 school-aged children（49 boys and 14 girls）with neurodevelopmental disorders were included in the patients group, and in the previous study, 380 healthy age-matched children constituted the control group. Zinc deficiency was found in 19 children（30%）, latent zinc deficiency in 39（62%）, and five patients（8%）had normal zinc levels. Serum zinc level in children with neurodevelopmental disorders was significantly lower than the control data for the healthy group（p＜0.001）. Most children with neurodevelopmental disorders had either attention-deficit/hyperactivity disorder（36 patients, 54%）and autism spectrum disorder（22 patients, 39%）. There was no significant difference seen in the diseases（p＝0.32）and sex（p＝0.95）. Children with neurodevelopmental disorders tend to have a zinc deficiency. No significant serum zinc level differences were notes based on disease or sex.

Spatial working memory (SWM) involves both simultaneous and sequential encoding, but the differences in their neural correlates are unclear. We investigated the differences in prefrontal cortex activity related to these SWM encoding types. We also examined the patterns of brain activity influencing individual visuospatial abilities (VSA). We conducted SWM tasks with two different conditions, sequential and simultaneous encoding, and examined hemodynamic activity in 39 healthy adults using nearinfrared spectroscopy. The bilateral dorsolateral prefrontal cortex was activated more strongly in the sequential condition compared with the simultaneous condition. This suggests that prefrontal cortex activity underlying SWM is modulated by the type of encoding. We also found that individuals with high VSA showed weaker activation in the right-dorsolateral prefrontal cortex compared with those with lower VSA during the simultaneous condition. This hypoactivation is thought to reflect neural efficiency in the individuals with high ability. These findings are expected to lead to a better understanding of neural substrates for SWM. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

The purpose of this study was to elucidate the association between children's behavior (i.e., prosocial and problematic behavior) and the parenting style (i.e., laxness and overreactivity) of their caregivers by using longitudinal data in the Japanese population. These data were collected when the children were 7.5 and 9 years. We proposed three hypotheses: children's behavior at 7.5 years will predict their behavior at 9 years; children's behavior at 7.5 years will predict the parenting of their caregivers; and the parenting style of caregivers will affect their children's behavior at 9 years. We evaluated children's behavior and parenting behavior using a strength and difficulties questionnaire and a parenting scale. The hypotheses were tested using structural equation modeling (SEM). The results of the SEM showed that children's behavior at 7.5 years predicted their behavior at 9 years. Children's problematic behavior at 7.5 years triggered over-reactive parenting in their caregivers at 9 years, which increased problematic behavior and decreased prosocial behavior in the children at 9 years. These findings indicate the association between children's behavior and the parenting style of caregivers in Japan.

The present study aimed to reveal the influences of attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms on self-esteem and self-perception during early adolescence and to clarify the spillover effect of self-esteem on depressive symptoms. ADHD symptoms in 564 early adolescents were evaluated via teacher-rating scales. Self-esteem and depressive symptoms were assessed via self-reported scales. We analyzed the relationships among these symptoms using structural equation modeling. Severe inattentive symptoms decreased self-esteem and hyperactive-impulsive symptoms affected self-perception for non-academic domains. Although these ADHD symptoms did not directly affect depressive symptoms, low self-esteem led to severe depression. ODD symptoms had a direct impact on depression without the mediating effects of self-esteem. These results indicated that inattentive symptoms had a negative impact on self-esteem and an indirect negative effect on depressive symptoms in adolescents, even if ADHD symptoms were subthreshold. Severe ODD symptoms can be directly associated with depressive symptoms during early adolescence.

Activity in the alpha band of the electroencephalogram (EEG) reflects functional inhibition of the cerebral cortex. The superior frontal cortex (SFC) is known to control alpha activity. Based on this relationship between SFC and alpha, we hypothesized that SFC controlled alpha mediates proactive control over interference. In this study, we examined the relationship between SFC and alpha in the flanker task by simultaneously recording EEG and near infrared spectroscopy (NIRS). Forty participants performed a flanker task with occasional (compatible 75%, incompatible 25%) and successive (incompatible 100%) conditions. In the occasional condition, larger SFC activity was related to pre-stimulus alpha enhancement under occipital electrodes. This is consistent with a model in which SFC enhances pre-stimulus alpha activity, leading to proactive control over interference. However, we could not detect a correlation between SFC activity and alpha activity in the successive condition. Active inhibition may have been reduced by a need to continuously inhibit brain regions associated with the irrelevant information. This may have reduced the role of the SFC in controlling alpha activity. Based on these findings, we postulate that there are two cerebral mechanisms of proactive control over interference.